As I have previously written, glycation may be the main driver behind the aging process, as high blood glucose levels lead to unused sugar getting tangled in proteins and fat, which causes a vicious cycle of oxidation, inflammation and tissue damage. To make things worse, one effect of aging is less control over blood sugar spikes! (Croat Med J.)
Fortunately, a unique form of vitamin B1, known as benfotiamine, has been found in multiple studies to protect against the effects of elevated blood sugar. "Regular" B1, known as thiamine, also prevents the formation of glycation molecules, but it is quickly used up and excreted partially because it is water soluble. Benfotiamine is fat soluble, which boosts absorption and makes it more difficult to excrete. In one study, benfotiamine increased thiamine uptake into the liver and heart by 10-40%; and in the muscles and brain, it was increased 5-25 times over! (Arzneimittelforschung). Supplementation has also been shown to reduce the formation of AGEs in blood cells by 40%. In a study on human subjects taking 1,050mg of benfotiamine for three days, it completely prevented endothelial blood flow impairment after a meal rich in AGEs (Diabetes Care).
Benfotiamine has several mechanisms of action that reduce damage from sugar. It can activate an enzyme known as transketolase, which converts dangerous glucose-induced metabolites into safe compounds. It inhibits nuclear factor-kappaB activation, which is a major inflammatory molecule. Additionally, a study from 2012 showed that benfotiamine increases glucose breakdown by 70% in hyperglycaemia, and up to 49% in normal glucose conditions (Genes Nutr). It is also superior to thiamine alone in reducing neurodegenerative diseases and cancer (Clin Lab), as well as kidney and nerve damage seen in diabetic patients (Biochem Soc Trans).
Conventional "wisdom" says that you cannot reverse the damage caused by sugar. However, when benfotiamine was given to mice with Alzheimer's disease for eight weeks, it reduced both amyloid plaque and phosphorylated tau proteins, alongside a dose-dependent memory improvement (Brain). It was then determined that a reduction in glycation end products was behind the reversals in Alzheimer's pathophysiology (Mol Cell Neurosci). In another animal study, benfotiamine was found to reverse the accumulation of AGEs in the retina, as well as increasing their excretion! (Diabetologia) So there is hope for the already-aged, but benfotiamine really should become more widely available! B vitamins are commonly thrown into magnesium and iron supplements, because they are often needed together, so maybe at least some of the thiamine should be replaced with benfotiamine.