A Cochrane review of herbal and dietary therapies for primary and secondary dysmenorrhoea concluded that thiamine is an effective treatment when taken at 100 mg/day, although this conclusion is tempered slightly by its basis on only one large RCT (Wilson & Murphy 2001). That trial was a randomised, double-blind, placebo-controlled crossover design conducted over 5 months in 556 women and procured a positive improvement in >90% of the treatment cycle versus <1 % in the placebo phase. The improvements observed during treatment appeared to have lasting effects, even after cessation of supplementation, for up to 3 months (Gokhale 1996). Due to the dramatic 'success' of this study, it has attracted skepticism regarding its methodology; certainly a question is why, with such positive results, an attempt to replicate the findings has not been undertaken in over 9 years (Fugh-Berman & Kronenberg 2003).

Clinical note— No protection against insect bites

One claim that has been around for many years is that high oral doses of certain B vitamins could act as a deterrent to insects such as mosquitoes. Principally the myth has centred around thiamine. A recent review of prophylaxis against insect bites found that neither topical application nor oral dosing of thiamine is an effective preventative strategy (Rudin 2005).

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