Post-traumatic stress disorder, metabolic syndrome, diabetic distress, and vitamin B1/benfotiamine

A person with post-traumatic stress disorder (PTSD) is more likely to develop metabolic syndrome (MetS), depression, and diabetic distress. It also raises the risk of cardiometabolic and neurodegenerative diseases (NDD). At the same time, type 2 diabetes mellitus and MetS can also cause the development of core neurosis-like and psychiatric symptoms characteristic of PTSD. Chronic stress is associated with cardiovascular diseases, type 2 diabetes, and NDD. More and more people think that mitochondrial dysfunction, peripheral/central chronic low-grade inflammation (CLGI), and oxidative stress are the main causes of these diseases. Pathophysiological processes link them together. To make things better for these patients, interventions that aim to control CLGI and oxidative stress may be better, following the ideas of precision medicine. Deficiency of certain biofactors, in particular, vitamin B1, is associated with an increased risk of MetS, type 2 diabetes, cardiovascular diseases, and NDD. Targeted effects on CLGI, oxidative stress, and mitochondrial metabolism disorders suggest that the use of antioxidants, particularly vitamin B1/benfotiamine (BFT), may have a positive effect not only on the course of comorbid diseases but also on the main manifestations of PTSD. Exogenous vitamin B1, or BFT, corrects thiamine status disorders. BFT exhibits potent effects in animal models of NDD, stress-induced anxiety, aggression, and depression. Thus, BFT can be considered a potentially safe and cost-effective drug for the treatment of many central nervous system diseases. Despite its positive aspects, the therapeutic potential of BFT remains limited, as beneficial effects require high doses over a long period of time. Dibenzoylthiamine, a lipophilic form of BFT, has been shown to have anti-inflammatory and antioxidant effects at much lower doses than BFT, both in vitro and in vivo. However, more preclinical and clinical studies are needed to be sure of the clinical viability and therapeutic potential of BFT and dibenzoylthiamine. This review pays extra attention to the analysis of the features of the biological role of vitamin B1, the mechanism of BFT action, especially its impact on glucose metabolism and mitochondrial function, the state of neuroinflammation, and how dibenzoylthiamine can protect neurons. We conducted the search in Scopus, Science Direct (from Elsevier), PubMed, and the MEDLINE databases. The keywords used were “thiamine”, “benfotiamine”, “dibenzoylthiamine”, “post-traumatic stress disorder”, “metabolic syndrome”, “diabetic distress”, and “diabetes mellitus”. We conducted a manual search for the bibliography of publications to pinpoint research results that eluded online search.