{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:03:13Z","timestamp":1784167393502,"version":"3.55.0"},"reference-count":118,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Nutritional peripheral neuropathy is a clinically important condition associated with inadequate intake, malabsorption, bariatric surgery, aging, metabolic disease, and chronic medication exposure. B vitamins serve as essential coenzymes in mitochondrial energy metabolism, one-carbon metabolism, neurotransmitter synthesis, redox regulation, and myelin maintenance. This narrative review synthesizes mechanistic and clinical evidence linking B vitamin-dependent coenzyme systems to nutritional neuropathy and selected neuropsychiatric manifestations. Particular emphasis is placed on the tricarboxylic acid cycle, electron transport chain, urea cycle, folate\u2013methionine cycle, and MTHFR-dependent one-carbon metabolism. The proposed \u201cdynamic coenzyme network\u201d is intended as an integrative mechanistic framework rather than a stand-alone therapeutic recommendation. Although biochemical interdependence among B vitamins supports evaluation for combined or functional deficiencies in selected patients, mechanistic plausibility should not be equated with clinical efficacy. Clinical consideration of B vitamin repletion should be guided by documented deficiency, dietary and gastrointestinal risk factors, medication exposure, neurological phenotype, and functional biomarkers such as homocysteine and methylmalonic acid. Adjunctive nutrients, including alpha-lipoic acid and acetyl-L-carnitine, may have context-specific relevance, particularly in metabolic neuropathies, but evidence for fixed multi-nutrient combinations remains heterogeneous. Further well-designed clinical studies are needed to determine whether this mechanistic framework translates into meaningful neurological or neuropsychiatric benefit beyond established deficiency states.<\/jats:p>","DOI":"10.3390\/nu18142306","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T01:05:58Z","timestamp":1784077558000},"page":"2306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Dynamic Coenzyme Network of B Vitamins in Nutritional Neuropathy and Neuropsychiatric Vulnerability: A Mechanistic Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8746-3718","authenticated-orcid":false,"given":"Yonghyun","family":"Yoon","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea"},{"name":"Incheon Terminal Orthopedic Surgery Clinic, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"International Academy of Regenerative Medicine, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"The Board of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-9856","authenticated-orcid":false,"given":"Jihyo","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowook","family":"Park","sequence":"additional","affiliation":[{"name":"International Academy of Regenerative Medicine, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"Department of Rehabilitation Medicine, Sae Yonsei Rehabilitation Clinic, Seoul 03186, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehyun","family":"Shim","sequence":"additional","affiliation":[{"name":"International Academy of Regenerative Medicine, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"Department of Neurosurgery, Chungdammadi Neurosurgery Clinic, Seoul 03186, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1392-829X","authenticated-orcid":false,"given":"King Hei Stanley","family":"Lam","sequence":"additional","affiliation":[{"name":"The Board of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-1614","authenticated-orcid":false,"given":"Jeimylo C.","family":"de Castro","sequence":"additional","affiliation":[{"name":"SMARTMD Center for Non-Surgical Pain Interventions, Makati 1205, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6722-0268","authenticated-orcid":false,"given":"Teinny","family":"Suryadi","sequence":"additional","affiliation":[{"name":"The Board of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-0988","authenticated-orcid":false,"given":"Anwar","family":"Suhaimi","sequence":"additional","affiliation":[{"name":"The Board of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Kowloon, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan-Mo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, Wonkwang University, Iksan 54649, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s13668-025-00723-3","article-title":"B Vitamin Deficiencies and Associated Neuropathies","volume":"15","author":"Alvarez","year":"2026","journal-title":"Curr. 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