Postherpetic neuralgia

Overview

Vitamin B12 (WA 64; medium effect size, medium evidence, high trust) has medium-strength evidence for postherpetic neuralgia across three studies. Subcutaneous B12 injections about six times weekly for one month reduced shingles-related nerve pain better than oral B12 or lidocaine alone; combined with lidocaine, injections reduced pain by more than half when started early and improved rash, itching, and numbness.

Oral B12 alone was less effective than injections. See the heatmap and evidence reviews below.

Effect graph

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Relevant supplements

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Vitamin B12	★★★★★	Medium

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Studies

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1 supplement for rated at least stars. All purchase bands. No minimum star filter.

Vitamin B12View supplement →

Consider purchase★★★★★

How we scored this

Effect SizeMediumEvidenceMediumTrustHigh

Evidence Review

Injections of vitamin B12 under the skin (1000 mcg) given about six times a week for a month help reduce pain from shingles-related nerve pain better than oral vitamin B12 or lidocaine injections alone.
When combined with lidocaine shots, vitamin B12 injections reduce pain by over half if started soon after symptoms appear.
These injections also help improve the rash, itching, and numbness that come with the condition.

Browse 3 studies

RCTLocal Administration of Methylcobalamin and Lidocaine for Acute Ophthalmic Herpetic Neuralgia: A Single-Center Randomized Controlled Trial2016n=98

A randomized trial of 98 found that the mean pain scores in A1 (2.6 ± 0.7) and B1 (1.2 ± 0.8) decreased significantly compared with those in A0 (7.0 ± 1.7) and B0 (5.6 ± 1.9), and the difference between the two therapeutic strategies significantly increased over time.

Effect: Benefit
Duration: 14 days
Population: Patients with acute ophthalmic herpetic neuralgia
Participants: 98

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RCTThiamine, cobalamin, locally injected alone or combination for herpetic itching: a single-center randomized controlled trial2014n=16

A randomized trial of 16 patients with herpetic itching found that however, lidocaine did not provide significant itch or pain relief than the other groups.

Effect: No Benefit
Duration: 4 weeks
Dose: 1 g/day
Population: Patients With Herpetic Itching
Participants: 16

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RCTA single-center randomized controlled trial of local methylcobalamin injection for subacute herpetic neuralgia2013n=33

A randomized trial of 33 patients with subacute herpetic neuralgia found that subjects were randomized to receive local methylcobalamin injection (N = 33), oral methylcobalamin (N = 33), or subcutaneous 1.0% lidocaine injection (N = 32) for 4 weeks.

Effect: Benefit
Duration: 28 days
Population: Patients With Subacute Herpetic Neuralgia
Participants: 33
Ages: ≥50

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Evidence visualised

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Effect-size distribution

How large the reported benefits tend to be

Study distribution across 1 supplements for postherpetic neuralgia (3 studies total).
Supplement	DEX	Studies	Meta-analyses	Share
Vitamin B12	★★★★★64%	3	0	100%

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Overview

Effect graph

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Studies

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