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@HectorConvector, Step off the gas. I'm in the U. S.  That was what I remember my doctor telling me thirty years ago.  Things may have changed since then.  If I've "misremembered," I apologize.  I'm human.  Things are different on the other side of the pond.  Here we go by mg/dl.  The smaller incremental changes are more noticeable using mg/dl.   Also, I adopted a Ketogenic diet.  Ketogenic diets don't spike blood glucose as much, and therefore return to fasting levels sooner.  My own experience is my postprandial blood glucose level returned to fasting levels an hour after the end of a meal on a Ketogenic diet.  I was asking if the thiamine you take is thiamine hydrochloride or Benfotiamine or Thiamine TTFD.  Thiamine Mononitrate is not well absorbed nor utilized by the body.  I learned that amounts larger than 100 mgs of thiamine hydrochloride needs to be taken in thiamine deficiency.   500mgs thiamine hydrochloride is recommended by the World Health Organization for several days and look for health improvement.  Thiamine is safe and nontoxic even in higher amounts. When thiamine is taken in high doses, there's a big change in energy availability, especially in the brain, where pain is registered.  A twenty percent increase in dietary thiamine results in an eighty percent increase in brain function.  Thiamine has analgesic properties.   I learned about high dose thiamine from Dr. Derek Lonsdale and Dr. Chandler Marrs through their website hormonesmatter.com.  I have taken high dose thiamine to correct my deficiency about fifteen years ago.  I could feel myself dying, I was so sick and in pain.  I was grasping at straws.  No harm, no foul, just to try it and see, right?  I tried it and that made all the difference.  High dose thiamine made astounding health improvements within a very short period of time for me.  I wonder if 500 mg of thiamine hydrochloride would have the same effect on you.

Evidence from normoglycaemic studies shows that healthy people peak at ~1 hour, and they then return to baseline in 2–3 hours, not 1. CGM shows normal post-meal rises even in metabolically healthy subjects. Clinical tests use the 2-hour value to judge normal glucose clearance. Therefore the 1-hour-back-to-fasting claim contradicts both physiology and clinical diagnostic standards.

I'm not sure what you're referring to as "normal" here - and is this something your doctor has mentioned (in bold)? As that isn't what any study or official information says. According to diabetes UK and the British Heart Foundation, normal fasting blood sugar is 4.9-5.4mmol/L. Normal by 2 hours from the start of a meal is anywhere below 7.8mmol/L. Random (more than 2 hours after a meal) should be below 5.6mmol/L.  Not in any study of normoglyceamic individuals does blood sugar go down to less than 5.4mmol/L one hour from the start of a meal, and I don't see such numbers being considered a limit for one hour post prandial in any official definition of normal blood sugar ranges anywhere. It is basically impossible even for the most metabolically healthy individual to have a blood sugar level anything like a fasting number 1 hour only after eating a high carb meal. This is also why medical standards use the 2-hour postprandial value, not 1 hour. Blood sugar normally spikes at about 1 hour after a high carb meal.  For example this study shows that young, healthy normoglycaemic people experience a 1hr peak blood sugar level of about 6.5-7mmol/L before which the 2hr number returns to about 4.7mmol/L, slightly higher than the fasting number of that morning. https://pmc.ncbi.nlm.nih.gov/articles/PMC2769652/?utm_source=chatgpt.com Even a normal person isn't going to be seeing essentially fasting blood sugar numbers after any meal except for one with 0 carbohdrates contents.

My skin biopsy and MRI scan shows no signs of any type of nerve damage. Nothing consistent with demylination or peripheral nerve damage. On the contrary, the nerve function from the skin biopsy proved better than normal. I don't get any pins and needles or have any loss of nerve function. It's pain only.  Thiamin I take is 100mg a day in tablet. I used to test blood sugar a lot in the past, and it never correlated directly with the nerve pain. It has only correlated with increased exercise and stress. The after eating getting worse thing happens when the blood flow is directed to the stomach for digestion away from the peripheral areas, which is normal, but central sensitization has caused normal sensations to be turned into pain by the brain, according to the latest doctors, hence whey I am being referred to the pain clinic.

@HectorConvector, My blood glucose level would spike after I ate.  It wouldn't return to "normal" fasting blood glucose level for longer and longer.  Blood glucose level should return to normal an hour after eating.  Mine would take two hours, then three hours, then longer.  So over night fasting blood tests wouldn't necessarily be very high until they got really bad.  But the peripheral neuropathy would feel the worst while my glucose was too high.  My blood glucose meter confirmed this.   On top of all that, my Celiac disease was still undiagnosed at the time, and I was suffering from malabsorption and nutritional deficiencies.  The deficiencies in B vitamins affected not just insulin production in the pancreas, but also the nerves in my extremities.  Nerves need B vitamins to maintain the myelin sheath protecting the nerves (like the plastic coating on electrical wires) when they fire.  When the myelin sheath is not maintained, that "pins and needles" feeling starts and increases as more of the sheath is damaged.  My parathesia progressed until the "pins and needles" went from my toes all the way up to my thighs.   Without sufficient vitamins, I started slowly losing weight.  Our bodies will start using not only stored fat, but also tear down our own muscles to provide fuel for the body to stay functional.   I hope you don't have pre-diabetes or diabetes.  Most diabetics have a thiamine deficiency.   How much thiamine are you taking?  What form of Thiamine are you taking?