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33 The side effects include myalgias, arthralgia, sinusitis, fever, and flu-like symptoms

When combined with alpha-lipoic acid, some early research has shown that benfotiamine may enhance effects in reducing pain and improving nerve conduction in people with diabetic neuropathy.8 The synergy likely stems from their complementary mechanisms: benfotiamine helps manage glucose-induced damage, while ALA reduces oxidative stress and improves blood flow

These effects are usually mild and disappear with dosage adjustment