Re: How To Use Thiamine For Chronic Disease.

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I do not exaggerate when I say that Thiamine is the most overlooked factor in modern chronic disease. The role of thiamine in mitochondrial health is so integral, that if you have a chronic condition (mental or physical,) you need to be supplementing with Thiamine. Heres why.

What is Thiamine?

Thiamine, also known as Vitamin B1, is one of the seven B-vitamins involved in energy production in the cells. Not only that, Thiamine is the most important of the 7, and acts as a gatekeeper to energy production processes. Thiamine is needed for the first step in the cycle of ATP production in our cells. If you don’t remember your chemistry classes, no worries. ATP is the molecule our cells burn to create our energy. Without it, we don’t have energy.

By extension, without Thiamine, your cells can’t even Start the process to create energy. You can have all the magnesium, folate, and other B-vitamins you need for energy production, but without Thiamine, it doesn’t matter.

So why don’t we hear about it?

Known as “Beriberi” in English, and “Kakke” in Japanese and Chinese, severe Thiamine deficiency is not a new discovery. Kakke ravaged late 19th century Japan and medical descriptions of the disease date as far back as 7th century Europe and other records as far as 1st century China. In Japan, unlike most diseases, severe Thiamine deficiency was a condition of the rich, not the poor. This is because the cause was nutritional. Factory polished “white” rice was predominantly available in the cities, whereas the countryside still subsisted on unprocessed brown rice. The process of polishing rice removes a crucial vitamin found in the rice husks. Can you guess which one?

It would not be discovered until much later what Exactly caused Beriberi, but Japanese and European researchers alike discovered the dietary link. Now we understand the condition quite well, and it is taught in western medical school that this once common disease has been eradicated via food fortification.

They’re wrong.

But I’m not conspiracy theorist or fear mongerer. As you’ll soon learn, there’s a perfect storm that has managed to hide what may be a rampant problem.

Why Don’t We Talk About Thiamine?

All in all, the answer to this question is as simple as good old-fashioned medical dogma. You see, thiamine is a question which modern medicine claims to have undeniably answered: “You can’t get thiamine deficiency in a first world country.” Based on food fortification, and low recommended daily values (RDVs) which were set over half a century ago, the medical consensus is that thiamine deficiency is nearly impossible to develop. While severe Beriberi certainly isn’t rampant, mild to moderate Thiamine deficiency abounds, and it may be getting worse.

Let’s take a look at why.

For one thing, the very mindset that beriberi has been eradicated is an issue. Thiamine testing, like so many important tests, is not part of standard medical physicals. Even when a patient does exhibit symptoms, Thiamine is rarely considered. What’s more, like magnesium, Thiamine blood tests can be highly inaccurate. Due to the importance of the vitamin, the body will keep blood levels stable in all but the most severe cases of deficiency. In essence, a serum test has no bearing on the thiamine status of the body at large.

Next we need to honestly assess the state of modern western nutrition. Thiamine plays a central role in glucose metabolism and your ability to process carbohydrates. With the excessive amount of sugar in western diets, there is an added burden on our Thiamine stores, and some of the most common symptoms of Thiamine deficiency are diabetes and heart diseases: the two most common maladies of the modern west.

According to Dr. Chandler Marrs, author of Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition: “Measurable thiamine deficiency has been observed across multiple patient populations with incidence rates ranging from 20% to over 90% depending upon the study. This suggests that the RDA requirement may be insufficient to meet the demands of modern living.”

https://www.amazon.com/Thiamine-Deficiency-Disease-Dysautonomia-Malnutrition-ebook/dp/B073NCFNLX

Though death (mortality) from Thiamine deficiency is rare, morbidity, the state of being severely limited by ones health or a disease, is not. Here we discover why Thiamine may be the most overlooked factor in modern day states of chronic disease.

Thiamine in Chronic Disease

Chronic disease is a decidedly broad category. From autoimmune conditions like lupus or hashimotos, to fatigue based illnesses like chronic fatigue syndrome and fibromyalgia, to Parkinson’s, POTS, Lyme disease, or diabetes, chronic diseases are a jumbled bag of titles with little to no systemic organization.

Some diseases describe symptoms: Post Orthostatic Tachycardia Syndrome, or POTS, describes symptoms, but on further investigation may be a case of chronic fatigue syndrome, both of which might be exacerbated by Epstein Barr or other hidden infections like Lyme.

I mention this simply to emphasize that we can get so caught up in specificity and labels that we often ignore root causes and solutions.

Here’s the thing. Thiamine deficiency can manifest as nearly every chronic disease, as well as be caused by them.

Notable symptoms of Thiamine deficiency could be but are not limited to:

Heart Palpitations, heart rhythms, and heart disease of all kinds
Insulin resistance diabetes
Digestion issues, IBS, and Crohns
Muscle weakness, trembling, and shakiness & peripheral neuropathy
Fatigue, often severe
Difficulty breathing, feelings of “air hunger”
Edema and swelling
Dysautonomia
Panic attacks & anxiety
Korsakoff psychosis

Symptom lists are great and all, but nothing quite hits home like successful treatment stories. Though generally overlooked, a few studies have been conducted on using high dose thiamine to treat different chronic diseases, as well as a number of specialists doing this work.

Fatigue From Inflammatory Bowel Diseases (Crohn’s, etc.)

One of the best examples is this study on fatigue from Inflammatory Bowel Disease. High dose thiamine (600mg/d to 1200mg/d oral thiamine) significantly improved fatigue in over 60% of patients compared to less than 15% in the placebo group.
Thiamine Supplementation in Heart Disease.

Another great one is this study on thiamine supplementation in patients with systolic heart failure, where in two separate trials, thiamine caused a significant improvement in left systolic ejection fraction. We have also seen that in rats with heart arrhythmia from thiamine deficiency, thiamine supplementation is able to reverse heart arrhythmia without permanent damage. Thiamine may be a critical component in treating heart failure. I myself have experienced a great reduction in heart palpitations since supplementing with thiamine, as have friends and colleagues.
Thiamine in Autoimmune Thyroid

This one is simply an anecdote by Dr. Isabella Wentz, but she found herself thiamine deficient in nutrient testing while healing autoimmune thyroid disease. She experienced significant improvement taking oral benthothiamine in dosage ranges above 600mg, as have many of her clients.
High dose Thiamine for Parkinson’s Disease

Now for my favorite research. Parkinson’s disease is a neurodegenerative condition by which nerves break down, causing neurological disorders and loss of strength and function in the limbs. That’s putting it lightly. This condition sucks and there’s no known cure. However, Dr. Antonio Costantiti had been treating Parkinson’s with high dose oral thiamine HCL until his own unfortunate death from Covid in 2020. The therapy resulted in improvements of 33 to 71% in motor sensory control symptoms in Parkinson’s patients. Unlike other conditions, Parkinson’s sufferers experienced a return of symptoms if they stopped taking Thiamine, which may indicate an inability to store Thiamine as a major component of Parkinson’s disease. You can learn more about his HDT method for Parkinsons at https://highdosethiamine.org/.

Who Should Take High Dose Thiamine and How To Take It.

Personally, I believe that everyone should do 3 months of high dose Thiamine supplementation, regardless of health status. However, I especially believe that you should try it if you have:

A mental health condition
A breathing condition
Diabetes or a metabolic condition
A gut or digestive health condition
An autoimmune condition
A neurologic condition
A chronic condition of any kind

Doesn’t leave much off the list does it? By now I hope you see where I’m coming from. Remember that Thiamine is involved with the first step in energy processes at the level of the cell, of the mitochondria. More and more evidence is appearing that mytochondrial health lies near the center of chronic disease and aging.

Even if Thiamine deficiency wasn’t present at the start of your condition, it has likely begun as a result. Demands on Thiamine increase in the presence of chronic disease states, even including high stress such as in the case of PTSD and trauma responses.
Testing for Thiamine Deficiency.

With all of that said, you can always test for Thiamine, but make sure to do it right. Serum Thiamine tests can show good Thiamine levels despite a deficiency. Fortunately, there is ONE test that is highly accurate: the erythrocyte transketolase test. This is the only accurate way to test for normal Thiamine function.

Transketolase is an enzyme that is strongly connected to Thiamine function. This test measures the activity of this enzyme after adding thiamine to the blood sample. The activity of the enzyme in reaction to the thiamine allows us to determine how deficient Thiamine already was. For a great article that goes deeper on the science, check out Thiamine Deficiency Testing: Understanding the Labs at hormonesmatter.com.

Be careful, as you will need to request this test directly. Doctors will typically perform a serum B1 test which will only show deficiency in the most severe cases.

And finally, I do not recommend waiting to get a test to try Thiamine. Deficiency is so likely in any disease condition that I personally suggest trying it. If getting a test is easy and you’d rather go that route, that’s fine, but don’t delay on trying thiamine if getting tested is holding you back. There are other clear indicators of Thiamine Deficiency once you start supplementing, such as paradox reactions, we’ll discuss soon.

What Kind of Thiamine to Use

Now that we know who should try thiamine and how to test for it, here’s how to do it. Firstly, choose a type of Thiamine. There are 3 kinds of oral thiamine supplements I recommend. TTFL is the best, crosses the blood brain barrier, and is highly bioavailable. Next is benfothiamine, which does not directly cross the blood brain barrier but I’d highly bioavailable. Finally is Thiamine HCL, which is low in bioavailability but can be better tolerated in sensitive individuals and those who experience paradox reactions.
Low and Slow. How Much to Take.

Thiamine supplementation has the best clinical outcomes in ultra high doses, between 1 and 3 grams (1000–3000mg) but I suggest starting with no more than 100mg. If you don’t experience any negative symptoms at 100mg, raise by 100mg per day until you reach 600mg for women and 1200mg for men. If at any point you start experiencing negative reactions, stay at that dose or lower it, until you have no negative reactions. Continue at this dose for 1 month and monitor for improvements.
What to take with Thiamine.

At a minimum, take a full spectrum b vitamin complex and magnesium (ideally an ionic magnesium supplement, magnesium malate or magnesium glycinate. I’ve written about magnesium supplementation extensively here.) Why? Because although thiamin itself is safe to take and dies not deplete other vitamins and minerals directly, in the case of a deficiency, new thiamine may result in greater use of your stores of other components of the ATP pathways. You may also be low in those vitamins already.
How To Manage Paradox Reactions To Thiamine.

A small number of individuals may experience paradox reactions to thiamine. A paradox reaction means a worsening of symptoms, or experiencing the symptoms of low thiamine in reaction to taking thiamine. Don’t be alarmed! This is actually a very good sign. Paradox Reactions are a direct indication of Thiamine deficiency. It may be that in cases of long standing thiamine deficiency, the body overreacts to new Thiamine stores and rapidly utilizes what’s given along with other potentially low vitamins and minerals. Think of it like putting a little gas in the engine then stomping the gas pedal to the floor.

Paradox Reactions appear to be the most common in chronic fatigue sufferers, and I myself an actively working through them at the time of this writing. Currently, 100mg if Thiamine HCL ellicits strong fatigue in me as well as feelings of air hunger. I have lowered to 50mg per day and will be upping my dose by 25mg weekly until I can take 600mg without negative reactions.

If you are having a paradox reaction, lower your dose or try a less potent form of Thiamine (HCL is the least potent.) Make sure you’re also taking a b-complex, and magnesium. From here, you can begin troubleshooting with other supplements to support Thiamine utilization.

Troubleshooting Other Vitamins and Minerals.

For many, it can be helpful to go beyond a B-complex and magnesium when taking Thiamin. As follows are the most common extra supporters needed, listed in order from what is most needed to least:

B-complex: a B-omplex is high priority with Thiamine supplementation. I recommend Thorne basic B-complex. If you have methylation issues, then pre-methylated forms are important. I’ll discuss methylation supporters later.

Potassium: People often need extra potassium support while taking thiamin. I recommend increasing food sources of potassium from bananas and avocados. Otherwise aim for 500mg potassium to 2000mg on a high dose Thiamine protocol. Do not take without magnesium. I recommend Thorne potassium citrate.

Glutathione: Especially when using TTFD thiamine, glutathione stores can be used up quickly. Many report benefit from supplementing with glutathione during the first week, and potentially longer. A common symptom of low glutathione from Thiamine is headache. I recommend bulletproof glutathione for the first week, and on occasion if it seems helpful later.

Calcium: calcium is the next oft-overlooked factor in thiamine supplementation. Especially if you’re still having negative reactions while taking magnesium and potassium. Thiamine Deficiency outs a burden on electrolyte conent. If Thiamine supplementation triggers negative cardiovascular reactions, such as palpitations, this may be a more precise indicator of calcium issues as well. I recommend a whole bone matrix form of calcium like heart and soil bone matrix or ancestral supplements living bone.

Other Nutrients: Other nutrients I’ve seen mentioned for thiamine support are Selenium, Zinc, Iron, Iodine, Copper, and Molybdenum. However, this gets a bit into the weeds and it can be difficult to pinpoint what’s exactly going on. My suggestion is to take Heart & Soil Beef Organs to supply a whole food source if the most bioavailable vitamins. Then look into nutrient testing for deeper tailoring.

Bonus: Oxalate Dumping, a Possible Cause of Thiamine Side Effects

Once while living in a moldy house, I started experiencing burning and frequent urination. Sometimes when I’d urinate, the stream would split as though something were clogged. I also experienced aching pain in my lower back near where I imagined my kidneys would be, and occasionally, cloudy urine. At the time, I had not had much sexual experience and had been with the same partner for over a year. Though I hadn’t gotten tested yet, I knew then it wasn’t likely to be an STD, but instead, Oxalates.

Oxalates are microscopic needle-like structures found in some plant foods that can accumulate in our bodies. If you eat high amounts of brassica vegetables (brussel sprouts, broccoli, kale, spinach, etc.) Tumeric, and even sweet potatoes, the high oxalate content can promote kidney stones, thyroid goiter, and renal disease. For a great read about oxalates and other plant toxins, check out my article Your Vegetables Want to Kill You.

Oxalates can accumulate in our tissues, and oxalate dumping refers to an emerging theory that the body has a process of excreting oxalates on a cyclical basis. Essentially, someone with high oxalates will offload them periodically, which may cause certain health symptoms to increase.

Another aspect of this theory is that certain health practices can instigate oxalate dumping. Collagen protein, for example, or ketogenic diets have been observed to cause some to experience a rash, passing kidney stones, burning and frequent urination, and cloudy urine: all symptoms of passing oxalate.

Oxalate dumping as a theory is not backed by any research at this time, however, these effects have been seen commonly in those who react negatively to Thiamine. Thiamine Deficiency has been observed in cases of hyperoxaluria (excess oxalate in urine,) so correcting Thiamine deficiency should lower oxalate, not increase it.

Again. A paradox reaction.

I personally have experienced this while taking Thiamine. If I dose too high, I get burning, cloudy urine, kidney pain, gout like symptoms in my joints, etc. Other reasons I suspect oxalate dumping have to do with my lifestyle before my health crashed in 2017. For years leading up to the development of health issues, I ate ridiculous amounts of broccoli, kale, and brussel sprouts. I put tablespoons of tumeric powder in my coffee daily, and to this day, even though I test normal on thyroid function labs, I have a noticable thyroid goiter I can feel with my hands.

At the end of the day, the protocols for Thiamine supplementation remain the same with oxalate dumping. Go low and slow, monitor other nutrients, and wait until you feel better before increasing the dose. This section is just to inform you of some reasons why you may or may not be experiencing strange symptoms while taking Thiamine.

If you experience a severe oxalate dump, one tactic I’ve heard is to actually eat some high oxalate food. The idea is that the body will register an intake of oxalate, and to prepare, stop dumping oxalate from your tissues. This can also be a way to confirm your symptoms are an oxalate dump. If you experience a reduction in Thiamine Side effects from eating brussel sprouts, it may be they were the result of oxalate dumping.

For deeper dives on the topic of oxalate dumping, Elliot Overton has some great material. His Facebook group is also a wonderful place for discussion regarding this and Thiamine supplementation at large.

How To Use Thiamine For Chronic Disease

So there you have it, an overview of the most overlooked and possibly most important nutrient for health. I hope by now you have a sufficient understanding to try thiamine, and also the tools to dial in your own protocol. If you do need more resources, I strongly recommend the work of Dr. Chandler Marrs, Dr. Derrick Lonsdale, and nutritionist Elliott Overton. All three contribute articles on Chandler’s website http://www.hormonesmatter.com. Dr. Marrs and Dr. Lonsdale coauthored a great book on the topic: Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, and Elliott has thiamine guides and other resources on his website: http://www.eonutrition.co.uk.

Lastly, I also highly recommend the Facebook groups:

Addressing thiamine deficiency & paradox reactions (by Elliott Overton)
Understanding Mitochondrial Nutrients (by Hormones Matter)

And as always, if you have questions, feel free to reach out to me directly at kerikssonconsulting@gmail.com or via my social medias. Keenan Eriksson on Facebook, and keenan_eriksson on Instagram.
Thiamine
Chronic Disease
Mental Illness
Mental Health
Health

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Written by Keenan Eriksson
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Biohacking-Based Life Coach & Author. I Help My Clients Overcome Disease & Optimize Their Lives Using Biology.
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