Abstract
Evidence suggests that there may be an association between Parkinson’s disease (PD) and aberrations in thiamine (vitamin B1) utilization and processing. Low free thiamine levels have been found in the cerebrospinal fluid of patients with PD. Two independent research groups have reported improved symptomatology in patients with PD following high-dose parenteral thiamine therapy. Experimental models further support this connection. Benfotiamine, a lipid-soluble thiamine derivative with enhanced oral bioavailability, along with methylcobalamin, an active form of vitamin B12, have demonstrated neuroprotective properties. Here we describe two cases of patients with PD who experienced marked improvements in tremor, fatigue, cognition, and overall quality of life following oral treatment with benfotiamine and methylcobalamin.