Evaluating the efficacy and tolerability of the oral combination of alpha lipoic acid and vitamin B complex preparation in carpal tunnel syndrome - a single center, randomized, double-blind, placebo-controlled trial

Sep 29, 2026

Carpal Tunnel Syndrome (CTS) is a common nerve entrapment causing disability through impaired hand function. This single-center, randomized, double-blind, placebo-controlled trial evaluated whether an oral combination of alpha-lipoic acid (ALA) and vitamin B complex improves CTS symptoms and quality of life in patients with mild to moderate CTS. Seventy participants received active treatment or placebo for 6 months and were assessed across baseline, 3 months, and 6 months using questionnaires and nerve conduction testing.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Current treatment options for CTS

Rationale for ALA and vitamin B complex

Method

Study design and participants

Interventions and outcomes

Results

Pain outcomes

Other clinical measures and tolerability

Conclusion

Zainal et al. BMC Neurology (2026) 26:7 [https://doi.org/10.1186/s12883-025-04430-y](https://doi.org/10.1186/s12883-025-04430-y) BMC Neurology RESEARCH Open Access Evaluating the efficacy and tolerability of the oral combination of alpha lipoic acid and vitamin B complex preparation in carpal tunnel syndrome: a single center, randomized, double-blind, placebo-controlled trial Nur Alya Zainal 1, Anna Misya’il Abdul Rashid2*, Adnan Lutfi A Rauf3, Abdul Hanif Khan Yusof Khan2, Wan AliaaWan Sulaiman2 and Hamidon Basri2 Abstract Background Carpal Tunnel Syndrome (CTS) is the most common type of nerve entrapment and can cause significant disability by impairing hand functionality. This study aims to evaluate the efficacy and tolerability of an oral combination of alpha-lipoic acid (ALA) and vitamin B complex in alleviating CTS symptoms and improving the quality of life in patients with mild to moderate CTS. Method A total of 70 patients with mild to moderate CTS were enrolled in this study at Hospital Sultan Abdul Aziz Shah, Selangor, Malaysia. Using a double-blind Randomized Controlled Trial (RCT) design, participants were randomly assigned to either the treatment group (n = 37) or the placebo group (n = 33) . The treatment group received two tablets once daily containing alpha-lipoic acid (300 mg), methylcobalamin (500 mcg), vitamin B1 (39 mg), and vitamin B6 (8 mg) i. e. Bionerv while placebo group received combination of maltodextrin, microcrystalline cellulose, tricalcium phosphate, silicon gioxide, magnesium stearate; two tablets once daily for 6 months. Patients were evaluated across three visits: baseline (Visit 1), 3 months (Visit 2), and 6 months (Visit 3) . During each visit, patients were evaluated using three assessments. The three assessments included three standardized questionnaires: SF-36, VAS, and BCTQ, Nerve Conduction Study (NCS) and Patient-Reported Questionnaire to monitor any side effects. Results A significant improvement in VAS scores was observed in the treatment group, indicating better pain control. However, no statistically significant differences were found between the treatment and placebo groups in other outcome measures, including SF-36, BCTQ, and NCS parameters. While improvements in SF-36 and BCTQ scores were noted in the treatment group, these changes did not reach statistical significance and should be interpreted as a positive trend rather than definitive evidence of efficacy. The combination of alpha-lipoic acid and vitamin B complex was well tolerated, with most participants reporting minimal and self-limiting adverse effects. The most common *Correspondence: Anna Misya’il Abdul Rashid [annamisyail@yahoo.com](annamisyail@yahoo.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. Zainal et al. BMC Neurology (2026) 26:7 Page 2 of 11 side effects were mild gastrointestinal symptoms, such as abdominal discomfort and diarrhea, which resolved upon discontinuation of drugs. Conclusion The oral combination of alpha-lipoic acid and vitamin B complex (Bionerv) dem

FAQs

What was the main objective of this trial?

To evaluate the efficacy and tolerability of an oral combination of alpha-lipoic acid and vitamin B complex for relieving CTS symptoms and improving quality of life in mild to moderate cases.

How were participants assigned and treated?

Seventy patients were enrolled and randomized in a double-blind RCT to receive either alpha-lipoic acid plus vitamin B complex tablets or a placebo for 6 months.

What outcomes improved, and what did not reach statistical significance?

VAS pain scores improved significantly in the treatment group. SF-36, BCTQ, and nerve conduction study parameters showed improvements in the treatment group but did not reach statistical significance.

Sep 29, 2026

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