Vitamin B1
Place in Therapy
Place in Therapy
A review of the current evidence suggests that Vitamin B1 may reduce pain compared with placebo in young Indian women with moderate to very severe primary dysmenorrhea when used at a dose of 100 mg for 90 days. The primary literature is limited to one large RCT, but systematic reviews and clinical guidelines agree that this trial was of moderate quality. This therapy is likely beneficial, though it is unclear how the results can be generalized to other populations. The results need to be further assessed by other large RCTs, preferably with different study populations.
At this time, there is limited evidence to recommend this therapy to all women with dysmenorrhea. Given that the treatment is free from side effects, inexpensive, easy to administer, and does not cause any harm if missed for a day or two, the potential benefits likely outweigh the potential harms. Vitamin B1’s main place in therapy is reserved for patients who have contraindications to NSAIDs, received ineffective therapy from NSAIDs or if the patient wishes to try a natural health product. Although Vitamin B1 has stronger evidence with respect to other herbal or dietary therapies, there is no head-to-head trial showing Vitamin B1as the best option. Since the onset of action is slow, with optimal results in 3 months, Vitamin B1 alone is not recommended for women who require fast relief of menstrual pain. It may, however, be used in combination with heat therapy or NSAIDs until relief is achieved.
References:
1. Gokhale LB. Curative treatment of primary (spasmodic) dysmenorrhoea. Indian J Med Res. 1996;103:227-31.
2. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2009;(3):CD002124.
3. Latthe PM, Champaneria R, Khan KS. Dysmenorrhoea. Clin Evid (Online). 2010.
4. Lefebvre G, Pinsonneault O, Antao V, et al. Primary Dysmenorrhea Consensus Guidelines. JOGC. 2005;1117-1130.
5. Thiamine (Vitamin B1). In: Natural Standard: the authority on integrative medicine. Cambridge (MA): Natural Standard; 2013. Available at: http://www.naturalstandard.com.proxy.lib.uwaterloo.ca/databases/herbssupplements/thiamin.asp?#evidencereviewdiscussion. Accessed May 13, 2013.
6. Smith RP, Kaunitz AM. Primary dysmenorrhea in adult women. In: UptoDate. Barbieri RL, Falk SJ, eds. UpToDate. Waltham, Mass: UpToDate; 2013. Available at: http://www.uptodate.com/contents/treatment-of-primary-dysmenorrhea-in-adult-women. Accessed May 13, 2013.
A review of the current evidence suggests that Vitamin B1 may reduce pain compared with placebo in young Indian women with moderate to very severe primary dysmenorrhea when used at a dose of 100 mg for 90 days. The primary literature is limited to one large RCT, but systematic reviews and clinical guidelines agree that this trial was of moderate quality. This therapy is likely beneficial, though it is unclear how the results can be generalized to other populations. The results need to be further assessed by other large RCTs, preferably with different study populations.
At this time, there is limited evidence to recommend this therapy to all women with dysmenorrhea. Given that the treatment is free from side effects, inexpensive, easy to administer, and does not cause any harm if missed for a day or two, the potential benefits likely outweigh the potential harms. Vitamin B1’s main place in therapy is reserved for patients who have contraindications to NSAIDs, received ineffective therapy from NSAIDs or if the patient wishes to try a natural health product. Although Vitamin B1 has stronger evidence with respect to other herbal or dietary therapies, there is no head-to-head trial showing Vitamin B1as the best option. Since the onset of action is slow, with optimal results in 3 months, Vitamin B1 alone is not recommended for women who require fast relief of menstrual pain. It may, however, be used in combination with heat therapy or NSAIDs until relief is achieved.
References:
1. Gokhale LB. Curative treatment of primary (spasmodic) dysmenorrhoea. Indian J Med Res. 1996;103:227-31.
2. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and secondary dysmenorrhoea. Cochrane Database Syst Rev. 2009;(3):CD002124.
3. Latthe PM, Champaneria R, Khan KS. Dysmenorrhoea. Clin Evid (Online). 2010.
4. Lefebvre G, Pinsonneault O, Antao V, et al. Primary Dysmenorrhea Consensus Guidelines. JOGC. 2005;1117-1130.
5. Thiamine (Vitamin B1). In: Natural Standard: the authority on integrative medicine. Cambridge (MA): Natural Standard; 2013. Available at: http://www.naturalstandard.com.proxy.lib.uwaterloo.ca/databases/herbssupplements/thiamin.asp?#evidencereviewdiscussion. Accessed May 13, 2013.
6. Smith RP, Kaunitz AM. Primary dysmenorrhea in adult women. In: UptoDate. Barbieri RL, Falk SJ, eds. UpToDate. Waltham, Mass: UpToDate; 2013. Available at: http://www.uptodate.com/contents/treatment-of-primary-dysmenorrhea-in-adult-women. Accessed May 13, 2013.