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by Jeffrey Lubell | Apr 15, 2021 | Brain, Supplements | 190 comments. Please complete the survey whether your experience has been positive or negative. Philadelphia, PA: Elsevier Saunders; 2012. Longtime readers of the Health Rising blog may remember an article that Cort wrote in 2013 about the promising results of a small study that found marked reductions in fatigue among three individuals with Fibromyalgia who took high doses of thiamine (Vitamin B-1). Thiamine: Health Benefits, Side Effects, Uses, Dose Our science team must pass long technical science tests, difficult logical reasoning and reading comprehension tests. It is nothing to do with simple vitamin replacement. The enzymes that require thiamine have been deprived of it for so long that it can be expected that they have deteriorated physically in their metabolic responsibility. Most foods contain small amounts of thiamine. In cases of severe deficiency, thiamine can be administered intravenously. Rodriquez-Martin JL, Qizilbash N, Lopez-Arrieta JM. amzn_assoc_bg_color = "FFFFFF"; The information found on Health Rising is mostly put together by people with ME/CFS and/or FM. 2014;8(1):1-5. More than three-quarters of respondents report that high-dose thiamine has helped them either a great deal (48.1 percent) or somewhat (29.6 percent). You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition. In ramping up from 300 mg to 1,800 mg daily over time, she experienced an almost immediate improvement in post-exertional malaise, followed by what felt like dose-dependent improvements in visual and mental acuity as we increased the dose. J Am Coll Cardiol. For more discussion on the potential of high-dose thiamine to help people with ME-CFS and the neurological implications of EDS, including full citations, see my Medium post on this topic. Pacing pacing.. Thiamine Further research would be needed to determine if one form is more effective than others as a whole or for particular groups. Usual Adult Dose for Wernicke's Encephalopathy. In a review of 20 clinical studies, supplementation with thiamine improved cardiac function in people with heart failure [14]. The absence of apparent decrease in blood thiamine despite the presence of symptoms referable to a mild The theory of a dysfunction in thiamine transport from blood to mitochondria remains a plausible explanation. which enables users to obtain detailed information and reports based on their genome. And people with intracranial HYPOtension would likely feel worse from high-dose thiamine, even as people with intracranial HYPERtension potentially feel better. The recommended daily allowance of thiamine is 1.1-1.2 mg/day. Responses by Dr. Antonio Costantini. For this reason, you may want to take a B-complex vitamin, which includes all the B vitamins. Heating foods can reduce their thiamine content. Thiamine plays an important role in helping the body convert carbohydrates and fat into energy. It is essential for normal growth and development and helps to maintain proper functioning of the heart and the nervous and digestive systems. Thiamine cannot be stored in the body; however, once absorbed, the vitamin is concentrated in muscle tissue. but is for informational and educational purposes alone. Recent studies suggest that thiamin may lower the risk of developing cataracts. Taking vitamin B1 supplements along with an antidepressant is good for depression. Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study. Jeffery is a father of a daughter with ME/CFS and allied disorders. The study used 300 mg tablets of oral thiamine hydrochloride, assigning a daily dose by gender and body weight (BW) as follows: It is not clear whether the study participants took their pills all at once each day or spread out into divided doses, but they were advised not to take the pills in the evening due to the risk of temporary sleeplessness. They found the patients reported fatigue declined by an average of 4.5 points while taking high-dose thiamine as compared with an increase of an average of 0.75 points while taking the placebo, a statistically significant difference. A dose of vitamins B1 and B12 can help improve nerve pain in people with diabetes and may reduce the need for painkillers. J Am Coll Cardiol. To be included in the study, participants needed to have a fatigue score greater than 12, which is about 70 percent higher than the mean fatigue score of 7 in the general population. Hopefully, patients medical providers can provide guidance on these questions. Studies show that high blood sugar and insulin levels improve after taking vitamin B1 for 6 weeks. 19th ed. The participants in our study were exposed to high doses of thiamine which induces passive diffusion that will add thiamine to the cells and the mitochondria. They are continually monitored by our internal peer-review process and if we see anyone making material science errors, we don't let them write for us again. Thiamine helps in the 2) By contrast, the 2013 study on fibromyalgia used 600 to 1,800 mg of thiamine daily, more than 500 times this amount. amzn_assoc_default_search_category = ""; Much greater mental and mood stability. 45.4 percent of respondents report taking high-dose thiamine for 6 months or more, while 12.7 percent report taking high-dose thiamine for 3 to 6 months. The treatment of patients at risk of developing Wernicke's encephalopathy in the community. Antioxid Redox Signal. Costantini A, Pala MI. There are reasons to believe high-dose thiamine could potentially help people with ME/CFS, Fibromyalgia and the neurological complications of Ehlers-Danlos Syndrome. Although blood thiamine and thiamine pyrophosphate levels were within normal limit in all the patients, high-dose thiamine therapy administered orally or parenterally led to an appreciable improvement of the fatigue. 2009 Oct 27;54(18):1660-1673. Review. Thiamine Diabetics Benefits and Effects By Dr Faisal Rasheed, M.D. Respondents report benefits in each of the dosage ranges examined. Kidney damage in people with diabetes (diabetic nephropathy). 9 Benefits of Thiamine (Vitamin B1) + Sources, Dosage Thiamine These mechanisms are important both for predicting the potential conditions that high-dose thiamine could help treat and for clarifying the limitations and cautions that should be applied to its use. High-dose Cochrane Database Syst Rev. Get the most in-depth information available on the latest ME/CFS and FM treatment and research findings by registering for Health Rising's free ME/CFS and Fibromyalgia blog here. One individual reports drying of the skin, another reports jitteriness that went away, one notes diarrhea, and another notes significant mouth/tongue pain and irritation.. Alon with vitamin C, thiamine can reduce the effects of sepsis. Along with improvements in brain fog, one respondent, quoted toward the beginning of this post, reports improvements in mental abilities and mood and mental stability. Given the small sample size, non-representative sample, and my limited statistical skills, I did not do any sophisticated statistical analysis. Carbonic anhydrase inhibitors are powerful medications that have the potential to interact with a number of other medications and supplements. They also help the nervous system function properly and are needed for good brain function. Eat a balanced diet rich in thiamine, and try not to overcook or over-refrigerate food in order to keep as many nutrients as possible. Because of its positive effect on attitude and brain function, it is also known as a "morale Rev Med Liege. When I have acute symptoms of spinal CSF leaks and positional headache, I need to avoid large doses of B1. All of these categories are overlapping, with individual respondents able to be included in more than one category. Albumin in Thompson J. Vitamins, minerals and supplements: part two. The remaining 18.2 percent report using a wide range of thiamine forms including allithiamine, lipothiamine, sulbutiamine, TPP, thiamine tetrahydrofurfuryl disulfide, coenzymated thiamine, thiamax, and thiamine HCL IM. Caveats aside, the results are striking. Don't miss another one. People in developed countries do not usually get beriberi because staple foods such as cereals and bread are fortified with vitamin B1 [5]. In the January 2021 issue of Alimentary Pharmacology & Therapeutics, Palle Bager and colleagues published a randomized controlled trial examining whether oral Jacques PF, Chylack LT Jr, Hankinson SE, et al. (The passive transport theory articulated by Bager and Costantini might potentially be useful, however.) As Lonsdale acknowledged, this hypothesis still needs to be evaluated through research. Rigorous research is needed to assess whether this might be the case, and if so, who is most likely to benefit. Benefits. B1 helps me pacing, because it brings down the tachycardia and Im able to be upright for longer. is a clickable link to peer-reviewed scientific studies. Another 5.5 percent report that high-dose thiamine has improved certain symptoms a little (which I define as a small improvement). (As noted below, however, 73% of the people with MCAS that responded to the survey report large improvements from high-dose thiamine.) But I did examine a few cross-tabulations that I report on below. 5% of respondents report no improvement, 9.1% mixed results, and 5.5% report high-dose thiamine made them feel worse. These studies show that people who ingest plenty of protein along with vitamins A, B1, B2, and B3 (or niacin) in their diet are less likely to develop cataracts. Of the 55 respondents, 49 report having ME/CFS, 20 report having Fibromyalgia, and 12 report having EDS. I see three important next steps: 1. Prescribing thiamine to impatients with alcohol use disorders: how well are we doing? Vitamin B1 appears to help with the development of the myelin sheath, a coat that wraps around nerves to protect them from damage and death [9]. It might be useful to study different doses of high-dose thiamine to see whether there are better or different outcomes at each dose. USA. Other symptoms with more than 10 of the 55 respondents reporting improvements include: other pain, dizziness/lightheadedness, insomnia, neck pain, headaches, and vision issues. Current aspects of thiamine deficiency on heart function. It is impossible to say for sure why some people appear to have benefitted from high-dose thiamine, while others appear to not have benefitted. 2001;132(1):19-26. The four categories are: While the number of respondents within each category is small, and so differences could be due to chance, the results for the last category appear quite different from the results of all the other categories. So researchers have speculated that thiamine might help Alzheimer disease. Early Reports Spark Interest in Little Used Supplement. Comment * document.getElementById("comment").setAttribute( "id", "a57e3798e90bc876c1af13863a14a927" );document.getElementById("a6cbe26769").setAttribute( "id", "comment" ); Save my name, email, and website in this browser for the next time I comment. In addition to the symptomatic improvements captured by the survey, two respondents report benefits for dysautonomia / heart rate: One respondent reports improvement in light and noise sensitivity, while another reports improvement in edema. This is not because I have any reason to suspect that 200 mg daily is the minimum amount of thiamine needed to be effective to the contrary, a newly released study (in preprint) suggests that administration of 100 mg of thiamine daily was associated with a substantial reduction in mortality among critically ill COVID-19 patients. Philadelphia, PA: Elsevier Saunders; 2011:chap 46. I look forward to discussing the findings with anyone who wishes to comment on this post. High-Dose Thiamine A few people report taking the last dose of the supplement before 5 p.m. in order to avoid insomnia, which matches the advice given by Dr. Antonio Costantini, one of the pioneers of this treatment. Sica DA. Thiamine appears safe in these doses. One individual reports getting vertigo and being unable to walk straight, but the individual resolved the problem by lowering the dose. Ingested Vitamin B1 from food and dietary supplements is absorbed by the small intestine through active transport at nutritional doses and by passive diffusion at pharmacological doses [1]. Females: BW <60 kg: 600 mg (2 tablets), BW 60-70 kg: 900 mg (3 tablets), BW 71-80 kg: 1200 mg (4 tablets), and BW >80 kg: 1500 mg (5 tablets); Males: BW <60 kg: 900 mg (3 tablets), BW 60-70 kg: 1200 mg (4 tablets), BW 71-80 kg: 1500 mg (5 tablets) and BW >80 kg: 1800 mg (6 tablets).. Thiamine, or Vitamin B1, is an essential nutrient required by the body. It may also be labeled as thiamine hydrochloride or thiamine mononitrate. If you take a diuretic, ask your doctor if you need a thiamine supplement. Figure 3 shows respondents reports of worsening of these same symptoms. For example, many individuals with ME/CFS have reduced blood flow to the brain. amzn_assoc_theme = "light"; The other half got the placebo first, then the washout, and then high-dose thiamine. Functions & Benefits of Thiamine 1) Metabolism. Soukoulis V, Dihu JB, Sole M, Anker SD, Cleland J, Fonarow GC, Metra M, Pasini E, Strzelczyk T, Taegtmeyer H, Gheorghiade M. Micronutrient deficiencies an unmet need in heart failure. Required fields are marked *. Whereas before my BP and HR were all over the place (hyperPOTS low pressure, high pressure, bradycardia tachycardia), now Im only stuck with orthostatic hypertension and the tachycardia. The case for predicting the benefits for people with ME/CFS is more circumstantial. The hypothesized mechanisms I describe above are alternatives in the sense that one or more may be accurate while the others may be inaccurate. However, at gene-expression levels, more-pronounced effects were observed on lipid-droplet formation and lipidation of very-low-density lipoprotein, suggesting that thiamine affects lipid metabolism not only through its known classic Thiamine Uses, Side Effects & Warnings - Drugs.com Getting enough vitamins C, E, and B complex vitamins, particularly B1, B2, B9 (folic acid), and B12, may further protect the lens of your eyes from developing cataracts. Early research shows that taking high-dose thiamine (300 mg daily) decreases the amount of albumin in the urine in people with type 2 diabetes. Some of the most common places to find B1 include: A lack of vitamin B1 can lead to serious health consequences. Beriberi, a condition that causes a loss of appetite, muscle weakness, and a pricking feeling in the toes and burning in the feet, Fast heartbeat, low blood pressure (hypotension), and fluid retention. I hypothesize that the benefits accrue through one or more of four potential pathways: This is a lot to unpack, so let me offer this high-level overview, and refer readers interested in the technical details to a blog post I wrote on Medium that explains my theory in more detail, with full citations. Long-term treatment showed significant improvements [8]. Digoxin: Laboratory studies suggest that digoxin, a medication used to treat heart conditions, may reduce the ability of heart cells to absorb and use vitamin B1. and Marco Colangeli, his Research Assistant since 2011. In the process, by inhibiting carbonic anhydrase isoenzymes, high-dose thiamine produces carbon dioxide, which leads to increased blood flow to the brain and an increase in the availability of oxygen at the cellular and tissue levels for aerobic respiration, reducing reliance on anaerobic respiration and helping to clear lactate. However, evidence in terms of randomized controlled trials is lacking, and the recommendations are based on small studies and anecdotal reports. Outcomes were most consistently positive for those taking benfotiamine and the combined group of thiamine mononitrate and generic thiamine, but I would not read too much into this since the numbers within each of those groups are small and these results could easily be affected by other variables, such as the medical conditions and diagnoses of those who took different forms of thiamine. Four additional respondents (7.8 percent) report that they are now taking a daily dose below 200 mg. As shown in Figure 2, most study respondents report substantial benefits from high-dose thiamine. amzn_assoc_width = 265; amzn_assoc_marketplace = "amazon"; Alcohol consumption can damage the brain through numerous mechanisms; one of these mechanisms involves the reduced availability of Vitamin B1 to the brain as a consequence of continued alcohol consumption [10]. Neuritis of pregnancy: If vomiting severe to preclude oral therapy, give 5 to 10 mg IM daily. Since some of the respondents who say high-dose thiamine helped them somewhat report large improvements in fatigue or other symptoms while others report smaller or mixed benefits, I have integrated individuals responses on the overall effectiveness of high-dose thiamine with their responses on its effects on individual symptoms to produce Figure 1. Very high doses may cause stomach upset. It is possible that other diuretics may have the same effect. Wernicke-Korsakoff is actually two disorders. I will summarize and report out the results in a future column. Early research shows that taking high-dose thiamine (300 mg daily) decreases the amount of albumin in the urine in people with type 2 diabetes. The body needs Vitamin B1 to make ATP, the bodys main energy-carrying molecule. Thiamine helps in the conversion of carbohydrates into glucose, which is the preferred source of energy that the body runs off of to keep your metabolism running smoothly. It also helps break down proteins and fats [ 3 ]. Instead, I will focus on the key neurological and metabolic abnormalities to explain the potential mechanisms by which thiamine can The primary outcome consisted of a measurement based on Section I of the IBD-F fatigue scale. It is available in a variety of forms, including tablets, soft gels, and lozenges. Usual Adult Dose for Beriberi. Research has found high-dose folic acid was more effective at slowing down progression than thiamine (vitamin B1) and riboflavin (vitamin B2), which are often used to help treat macular degeneration. Perhaps a group of people within this sub-category needs a different treatment approach? amzn_assoc_search_type = "search_widget"; For women experiencing symptoms of premenstrual syndrome (PMS), 100 mg is probably the best dose to take to minimize these symptoms. One reports taking 600 mg of intramuscular thiamine, which far exceeds the dosage recommendations from Dr. Costantini for that form. The second individual reports having a CSF leak, which can lead to alternating periods of intracranial hypo- and hypertension. Thiamine The most common dosages are 600 mg (9 respondents) followed by 500 mg and 1,500 mg daily (7 respondents each). Could High-Dose Thiamine (B-1) Help with ME/CFS, Fibromyalgia, and the Neurological Complications of Ehlers-Danlos Syndrome? WebFurther research is needed to confirm the potential benefits and mechanisms of action. The short answer is we do not know for sure, but several hypotheses have been offered. Also, high-carb diets tend to provide more thiamine than low-carb diets. Potential benefits could include improvements in mental acuity / brain fog and certain kinds of headaches due to reductions in intracranial hypertension and reductions in post-exertional malaise due to increases in aerobic respiration and lactate clearance. Nearly half (49.1 percent) of respondents report using oral thiamine hydrochloride, the thiamine form used in most of the studies of high-dose thiamine to date, while 18.2 percent report using oral benfotiamine, 10.9 percent report using oral thiamine mononitrate, and another 5.5 percent report using generic oral thiamine, which is often thiamine mononitrate. Thiamine, also known as Vitamin B-1, is an essential nutrient that plays a critical role in aerobic cellular respiration. 2007;104(49):19637-42. A complete set of comments by survey respondents may be found here. Information is shared for educational purposes only. Preliminary evidence suggests that thiamine, along with other nutrients, may lower the risk of developing cataracts. Further research is needed to determine what benefits might accrue at different doses of thiamine above the formal FDA recommendation. Thiamine Also known as thiamine, B1 helps your body turn food into energy. More than 40 of the 55 respondents report improvements in fatigue and more than 35 report benefits from post-exertional malaise and brain fog (as adjusted). amzn_assoc_region = "US"; 8 to 9 people also report tachycardia and arrhythmia, mostly as a moderate problem that persists. It also may be the case that some individuals benefit through one mechanism while others benefit through another mechanism, which may help explain why people with a wide range of conditions report benefits from high-dose thiamine. One individual stopped using high-dose thiamine, despite experiencing large benefits, due to rectal bleeding; the individual notes experiencing this symptom from many different supplements. Section I of this validated scale consists of five questions to the patient asking about fatigue over the past two weeks. Long-term nutrient intake and early age-related nuclear lens opacities. FAQ HIGH-D0SE THIAMINE (HDT) THERAPY for Parkinson's In 2013, zdemir and colleagues found that high-dose thiamine inhibited three carbonic anhydrase isoenzymes nearly as well as acetazolamide (Diamox). Lack of vitamin B1 is one reason for uneven cardiac function.. 2005 Oct;78(10):366-8. Review. It is interesting to see strong results reported by people taking 200-499 mg daily as the protocol that has been researched to date focuses on a daily dose between 600 and 1,800 mg, varied by weight and gender. To help bolster the case for conducting a rigorous study of whether high-dose thiamine benefits individuals with ME/CFS, fibromyalgia, or the neurological complications of EDS, it would be helpful to learn more about whether individuals with these conditions have benefitted from high-dose thiamine. WebMD does not provide medical advice, diagnosis or treatment. people who identify as having fibromyalgia but not EDS; people who identify as having ME/CFS but not EDS, fibromyalgia or POTS; and. It also comes as slow-release tablets containing 100mg of thiamine and as a liquid amzn_assoc_ad_type = "responsive_search_widget"; Use of vitamin supplements and cataract: the Blue Mountains Eye Study. Below, I excerpt selected comments on high-dose thiamine from those reporting positive effects and then from those who report experiencing no effect, mixed results or feeling worse from high-dose thiamine. Consequently, the carbohydrate metabolism can normalize, and a reduction of fatigue is likely to follow.. All but 7 of the survey responses came between April 15 and May 9, 2021, with the balance coming in the prior year. In general, I would expect people with intracranial hypertension to benefit from a carbonic anhydrase inhibitor and people with intracranial hypotension to potentially feel worse from the same agent. In the April 2021 blog Could High-Dose Thiamine (B-1) Help with ME/CFS, Fibromyalgia, and the Neurological Complications of Ehlers-Danlos Syndrome? I reported on the findings of a randomized controlled trial of high-dose thiamine (for people with quiescent inflammatory bowel disease), offered several hypotheses for why high-dose thiamine might have positive effects, and speculated that it might be helpful for people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia and Ehlers-Danlos Syndrome (EDS). Alcohol. Building on a hypothesis first advanced by Costantini, Bager and colleagues suggest the possibility that high-dose thiamine may have helped compensate for a defect in the active transport mechanism through which thiamine is normally absorbed. However, this is not true of all people who take phenytoin. Nearly 2/3rds of Survey Respondents Report Large Objective: NA. However, absorption of thiamine is poor in elderly individuals. The body needs Vitamin B1 to make ATP, the bodys main energy-carrying molecule. Thiamin - Health Professional Fact Sheet - Office of DiNicolantonio JJ, Niazi AK, Lavie CJ, O'Keefe JH, Ventura HO. But you should talk to your doctor before taking a large amount. A larger sample and better controls for other variations among sample members would also be helpful. More research is needed before thiamine can be proposed as a treatment for Alzheimer disease. It is not intended as medical advice and should be used for informational purposes only. My healthy husband (who is normally spectacularly in observant about his own health) volunteered, without even knowing Id given it to him for a few days, that his memory had improved., After taking a supplement called Parasym Plus [whose first ingredient is thiamine] my life changed drastically for the better, I felt as if I was in a fog for 6 years and it was very scary, almost immediately after taking it I felt as if the fog had lifted, I could think more clearly, got my sense of direction back and was able to drive again, I had the energy sit up through an entire movie with I couldnt do for years, it also helped tremendously with chronic edema in my legs!, I used it because I had ME/CFS and had a lot of problems processing alcohol and formaldehyde (which made me really sick), I saw a massive improvement., My miracle is allithiamine- began 3/2020 and then in the month of August 2020 my high heart rate / POTS went down significantly I just never gave up searching and wow am I so happy. Isenberg-Grzeda E, Chabon B, Nicolson SE. As shown in the top panel of Figure 5, more than 70 percent of people who identify as having each of the following conditions report improvements from high-dose thiamine: ME/CFS, fibromyalgia, EDS, and MCAS. 2001;2:CD001498. Most dietary Vitamin B1 is in phosphorylated forms, and intestinal phosphatases hydrolyze them to free thiamine before the vitamin is absorbed. Am J Ophthalmol. 6th ed. High doses of thiamine can improve muscle coordination and confusion, but rarely improves memory loss. Life Sci. Arch Ophthalmol. Your email address will not be published. Phenytoin (Dilantin): Preliminary evidence suggests that some people taking phenytoin have lower levels of thiamine in their blood, which may contribute to the side effects of the drug. Thiamine is key to the production of acetylcholine. Vitamin B1 biosynthesis in plants requires the essential iron sulfur cluster protein, THIC. The fibromyalgia study was one of a series of case studies published by the Italian physician, Antonio Costantini, and colleagues in 2013-2018, finding reductions in fatigue from high-dose thiamine among individuals with a range or neurological and inflammatory conditions, including Inflammatory Bowel Disease (IBD), Multiple Sclerosis, Parkinsons Disease, and chronic cluster headaches. SelfDecode is a personalized health report service, I would recommend that individuals interested in trying high-dose thiamine discuss with their medical providers if this is a safe treatment option for them given their individual circumstances and other medications and supplements. There is reason to believe that some of the other pathways may also apply. A complete and balanced diet should follow. Bonucchi J, Hassan I, Policeni B, Kaboli P. Thyrotoxicosis associated with Wernicke's encephalopathy. triggers the pro-inflammatory Th-17 process, Craniocervical instability and Chiari malformation. Moreover, as we have learned the hard way over the years, some treatments that seem to be effective based on retrospective recollection do not end up being effective when subjected to rigorous evaluation. More research is needed. A 2020 study found signs of possible intracranial hypertension in 83% of 205 individuals with ME/CFS that had an MRI performed. But the survey did include several dimensions that can be analyzed for potential clues.

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