Mechanisms of action of vitamin B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin) in pain: a narrative review

ABSTRACT

Pain is a complex sensory and emotional experience with nociceptive, nociplastic, and neuropathic components. An involvement of neurotropic B vitamins (B1 – thiamine, B6 – pyridoxine, and B12 – cyanocobalamin) as modulators of inflammation and pain has been long discussed. New evidence suggests their therapeutic potential in different pain conditions. In this review, we discuss the main role of neurotropic B vitamins on different nociceptive pathways in the nervous system and to describe their analgesic action mechanisms. The performed literature review showed that, through different mechanisms, these vitamins regulate several inflammatory and neural mediators in nociceptive and neuropathic pain. Some of these processes include aiming the activation of the descending pain modulatory system and in specific intracellular pathways, anti-inflammatory, antioxidative and nerve regenerative effects. Moreover, recent data shows the antinociceptive, antiallodynic, and anti-hyperalgesic effects of the combination of these vitamins, as well as their synergistic effects with known analgesics. Understanding how vitamins B1, B6, and B12 affect several nociceptive mechanisms can therefore be of significance in the treatment of various pain conditions.

KEYWORDS:

• Inflammation
• nociception
• neuropathic pain
• vitamin B1
• vitamin B6
• vitamin B12

Acknowledgements

Medical writing and editing were supported by Kerstin Eckart (Munich, Germany) and sponsored by P&G Health Germany GmbH. .

Disclosure statement

Carlos Calderon-Ospina has carried out consulting activities for P&G Health International.

Data availability statement

Data sharing is not applicable to this article as no new data were created or analyzed in this review article.