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Whether from injury, surgery, genetics, diabetes, or another disease, nerve pain or neuropathy causes unrelenting and often severe pain and discomfort—and certain B vitamins might be able to help.
A trio of vitamins in the B complex family—B1, B6, and B12—are considered “neurotropic B vitamins” due to their involvement with the nervous system.
Increasing your intake of vitamin-B-rich foods and/or supplementing with these B vitamins has the potential to improve nerve function and repair, leading to pain relief, reduced inflammation, and nerve tissue regeneration.
However, there are some precautions to take when it comes to dosages, as more is not always better—let’s take a closer look at how vitamins B1, B6, and B12 can promote healthy nerve function.
B Vitamins for Neuropathy and Healthy Nerve Cells
Three of the eight B vitamins are known for their role in restoring nerve function.
Thiamin (vitamin B1), pyridoxine (vitamin B6), and cobalamin (vitamin B12) protect nerves against oxidative stress and damage, maintain myelin health, promote nerve cell survival, provide essential energy to nerve cells, and more.
Conversely, a deficiency in vitamins B1, B6, or B12 is linked to nerve degeneration, pain, and peripheral neuropathy. Therefore, supplementing with these B vitamins supports nerve repair, reduces neuropathy and its associated pain, and promotes nerve regeneration.
Also known as thiamin, vitamin B1 is involved with membrane and nerve conduction and the synthesis of myelin (the protective coating surrounding nerve fibers) and several neurotransmitters, including acetylcholine and serotonin.
Thiamin is thought to be involved in nerve impulse transmission, as it regulates sodium channels and acetylcholine receptors, which are key “ingredients” in activating and transmitting signals from nerve cells. It also plays a significant role in cellular energy metabolism, providing much-needed energy to nerve cells.
Research also suggests that thiamin acts as an antioxidant, protecting nerves from oxidative damage that can lead to cell death and degeneration.
The connections between vitamin B1 and the nervous system have been recognized for almost one hundred years, as a deficiency in the vitamin leads to beriberi—a potentially fatal set of symptoms that include, among other things, severe neurological damage.
Thiamin deficiency affects both the CNS (central nervous system) and PNS (peripheral nervous system), causing symptoms like confusion, impaired memory and cognition, loss of psychomotor skills, and ataxia (loss of balance).
Therefore, replenishing or maintaining adequate thiamin stores is thought to benefit nerve health.
In a small study from 2008, people with diabetic neuropathy who took 600mg per day of benfotiamine (a more bioavailable thiamin precursor) had reduced neuropathic pain and improvements in their condition.
Another clinical trial is currently in the works on this topic, which is testing the effects of benfotiamine on diabetic neuropathy in people with type 2 diabetes.
Plus, animal research has seen some benefits of thiamin for nerve health. In a systematic review from 2021, two animal studies analyzed the effects of thiamin on nerve regeneration.
One study found that vitamin B1 protected diabetic rats’ peripheral nerves against damage from high blood sugar, especially when the vitamin was in the form of benfotiamine and given immediately after the diabetes was induced (rather than two months later).
The rats given vitamin B1 had increased nerve conduction velocity and reduced formation of advanced glycation end products—proteins or fats exposed to high amounts of sugar that become inflammatory.
Other research shows that vitamin B1 suppressed thermal hyperalgesia—a marker of neuropathic pain—in rats with injured brains.
While we don’t have much research on how thiamin affects neuropathy or nerve pain in humans, the evidence so far is promising.
Plus, thiamin does not have a tolerable upper intake level (UL)—therefore, supplementing with thiamin is not likely to cause adverse effects if taken in excess.
Overall, thiamin plays a critical role in nerve health, as it protects nerve cells from oxidative stress, normalizes pain sensations, reduces neuron hyperexcitability, and facilitates the metabolism of carbohydrates for energy production.
Vitamin B6, or pyridoxine, is necessary for amino acid metabolism, including serotonin and GABA—two neurotransmitters essential for nerve signal transmission.
By increasing GABA synthesis, vitamin B6 can inhibit glutamate release and reduce the hyperexcitability of neurons—a state linked to neuropathy and cognitive impairment.
Vitamin B6 is also required for sphingolipid synthesis—a class of fats located in nerve cell membranes and the myelin sheath, the insulating layer protecting axons and allowing for rapid and efficient electrical impulse transmission.
Research on people with carpal tunnel syndrome (a nerve compression injury) found that B6 treatment (120mg per day for three months) reduced clinical symptoms and increased the conduction velocity of sensory nerves—how fast an electrical impulse moves through the nerve.
In a study with rats, vitamin B6 exhibited neuroprotective effects, counteracting the nerve damage from excessive glutamate release.
As high glutamate is thought to cause neuronal damage in several neurological diseases, B6 may be able to help protect nerves in such cases.
While vitamin B6’s benefits to neuropathy and nerve protection have been seen in some studies, it’s imperative to know that taking too much B6 can also cause the same problems they’re trying to treat.
In this paradox, chronic and excessive doses of vitamin B6 have been shown to cause neuropathy in the hands and feet, unsteady gait, light sensitivity, skin rashes and lesions, nausea, heartburn, ataxia (loss of control of body movements), and impaired reflexes.
There is a tolerable upper intake level for vitamin B6—100 milligrams per day for adults—as chronic and excessive consumption can lead to these severe neurological symptoms.
Interestingly, the previously mentioned study on carpal tunnel patients used doses of 120mg with no adverse effects. Other reports state that amounts over 200mg can lead to nerve damage and neuropathy.
Overall, moderate amounts of B6 are vital for protecting nerve cells and the myelin sheath from damage, synthesizing neurotransmitters, inhibiting excess glutamate release, and restoring sensory nerve function.
Vitamin B12 (cobalamin) has exhibited promising evidence of nerve-regenerating functions, including 15 animal studies showing its benefits.
It’s thought that vitamin B12 supports healthy nerve function by protecting nerve cells from damage, promoting myelin formation, and reducing Wallerian degeneration responses—nerve degeneration after a nerve fiber is injured or crushed.
In a study with mice with sciatic nerve injuries, vitamin B12 promoted functional nerve recovery, including increasing the number and diameter of myelinated fibers and axons.
B12 has also been shown to increase the activity of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which promote nerve survival and regeneration.
For these reasons, supplemental vitamin B12 is proposed for treating neuropathy, as it may alleviate pain by increasing nerve regeneration and decreasing ectopic nerve firing (which causes neuropathic pain), as seen in a systematic review of 24 studies.
It also helps with diabetic neuropathy, as seen in this randomized controlled trial from 2021.
In this study, people with type 2 diabetes and both peripheral and autonomic diabetic neuropathy who took 1,000mcg of oral B12 for one year had significant improvements in all neurophysiological parameters, sudomotor function, pain score, and quality of life.
Like thiamin, no upper limit has been set for vitamin B12, as no established toxic intake level exists.
Considering this evidence, vitamin B12 is a strong contender for nerve health and reducing nerve pain, as it promotes nerve cell survival, remyelination, and protection from nerve damage.
Should You Take All Three B Vitamins Together?
Although these three B vitamins have valuable effects on nerves individually, they may exhibit more significant benefits when combined.
Research with animals has supported their synergistic activity. In a study of rats with diabetes, the combination of vitamins B1, B6, and B12 restored sensory nerve function more effectively than the individual B vitamins. One exception was with sensory nerve conduction velocity, which only vitamin B6 improved.
These three B vitamins are often seen together in “B complex” supplements, which typically contain all eight B vitamins. However, you’ll want to take precautions with the amount of vitamin B6 included—especially if you take multiple supplements—so you don’t exceed the upper limit of B6.
B Vitamins for Nerve Health FAQs
Which B Vitamin Is Best for Nerve Repair?
Three vitamins have been shown to be beneficial for healthy nerve cells: vitamin B1 (thiamin), vitamin B6 (pyridoxine), and vitamin B12 (cobalamin), which are considered the neurotropic B vitamins.
These B vitamins improve nerve function by protecting against nerve damage, maintaining myelin sheath function, promoting nerve cell survival, providing essential energy to nerve cells, helping nerve cells regenerate, and more.
Is B6 or B12 Better for Nerves?
Both B6 and B12 are helpful for nerve health, but vitamin B12 may have more benefits. B12 supports healthy nerve function by protecting nerve cells from damage, promoting myelin formation, and reducing nerve degeneration responses. Research with humans shows that vitamin B12 reduces pain, improves markers of diabetic neuropathy, increases nerve regeneration, and acts as a treatment for peripheral neuropathic pain. Plus, you don’t have to worry about taking too much B12; conversely, vitamin B6 has an upper limit above which neurological symptoms can occur.
How Much Vitamin B Should I Take for Nerve Damage?
Vitamin B doses for nerve damage are typically recommended as follows:
• 50-100 milligrams of vitamin B1 (thiamin)
• <100 milligrams of vitamin B6
• 1000-5000 micrograms of vitamin B12 or more
Can Too Much B12 Make Peripheral Neuropathy Worse?
No, too much vitamin B12 is not known to make neuropathy worse. However, too much vitamin B6 is well-known to cause peripheral neuropathy and other neurological symptoms. Keep in mind that in the case of diabetic peripheral neuropathy, the influence of B vitamins and other dietary factors (harmful or helpful) also competes with the underlying pathology encouraging the nerve dysfunction.
Is It Okay To Take B1, B6, and B12 Every Day?
Yes, you can take B1, B6, and B12 every day; B vitamins are water-soluble and do not accumulate in the body in toxic amounts. Although the body can store B12 for years, it’s still recommended to consume it daily. Vitamins B1 and B6 are not stored in the body and must be replenished daily with food or supplements.
Why Does Neuropathy Occur?
Peripheral neuropathy causes weakness, numbness, and pain from nerve damage, usually in the hands and feet. This nerve damage can come from many potential causes, with one of the most common being diabetes. Diabetic neuropathy is a complication that comes from uncontrolled high blood sugar levels. Over time, high blood glucose damages the small blood vessels that supply nerves, so nutrients and oxygen cannot reach the nerves. This causes nerve damage, leading to pain, tingling, and numbness.
Other causes of peripheral neuropathy include:
• Trauma or peripheral nerve injury
• Diabetes (known as diabetic neuropathy, diabetic peripheral neuropathy, or diabetic polyneuropathy when it affects many nerves)
• Other diseases, including multiple sclerosis, Lyme disease, and other autoimmune and inflammatory conditions
• Ischemia (reduced blood flow)
• Deficiencies in vitamins B1, B6, or B12
• Taking excessive amounts of B6