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Choosing Wisely Recommendations

Don’t routinely use B vitamin supplements for the treatment of polyneuropathy or neuropathic pain unless a deficiency exists.

Rationale and Comments

There is no indication for supplementing with B vitamins in patients with polyneuropathy unless a deficiency has been detected or is highly likely secondary to other medical factors (e.g., gastric bypass surgery). In addition to being an unnecessary expense, excessive vitamin B-6 can lead to toxicity and cause worsening neuropathy.

Sponsoring Organizations

  • American Association of Neuromuscular & Electrodiagnostic Medicine

Sources

  • Expert consensus

Disciplines

  • Neurologic

References

  • Bril V et al. Neurology. 2011 May 17;76(20):1758-65.
  • Kulkantrakorn K. Neurol Sci. 2014 Nov;35(11):1827-30.
  • Pluijims et al. Pain Pract. 2011 Mar-Apr;11(2):191-8.