Why we must understand thiamine

Thiamine (vitamin B1) is used by the body to cope with stress. Unfortunately, as thiamine is used up, our autonomic nervous system, which relies on thiamine, begins to fail, leading to various chronic illnesses. Therefore, thiamine supplementation is one of our best tools for treating chronic illness.


We are living with increasing levels of stress:
  • The cost of living is increasing
  • House affordability is decreasing
  • Job security is decreasing
  • Mothers have to be in paid employment in addition to being mothers
  • We are generally less connected with our community compared with previous generations


Our insufficient consumption of thiamine: 
  • There is less thiamine in the diet today due to soil depletion, food processing, longer storage and the increased use of preservatives. The fortification of food with thiamine only partially addresses this decline in naturally available thiamine.
  • An even greater issue is that we struggle to consume enough thiamine to cope with increasing levels of stress, on top of increasing levels of poisons and toxins in our food, water, air and homes.
  • Insufficient thiamine results in failure of the autonomic nervous system. Such failure of the autonomic nervous system manifests as multiple functional disorders with an array of symptoms.
  • We are seeing severe symptoms of thiamine deficiency mostly in women after prolonged periods of stress.


Neurological symptoms include:
  • Headaches and migraines
  • Brain fog and poor concentration
  • Dizziness and lightheadedness
  • Tingling or numbness in hands and feet (peripheral neuropathy)
  • Loss of muscle function
  • Poor coordination
  • Mental confusion
  • Difficulty speaking (stammering/stuttering)
  • Ticking
  • Vision problems
  • Memory loss
  • Hallucinations


Cardiovascular & respiratory symptoms include:
  • Shortness of breath
  • Shallow or irregular breathing
  • Air hunger (dyspnea) and apnea
  • Rapid heart rate (tachycardia )
  • Slow heart rate (bradycardia)
  • Blood pressure fluctuations
  • Swelling (edema) in the legs and feet
  • Fatigue
  • Poor temperature control
  • Hyperhidrosis (uncontrolled sweating)


Gut symptoms include:
  • Delayed stomach emptying (gastroparesis)
  • Poor bowel function, such as constipation
  • Diarrhea
  • Nausea
  • Bloating
  • Acid reflux
  • Pain around the belly button
  • Gas
  • Swallowing difficulties
  • Loss of appetite


Bladder symptoms include:
  • Bladder pain
  • Frequent urination
  • Urgency even when the bladder is not full


How thiamine is being overlooked:
  • Doctors are taught that severe thiamine deficiency (beriberi) is rare in the modern world, particularly because many foods are fortified with thiamine.
  • Patients who present with symptoms of severe thiamine deficiency are therefore not tested for their thiamine levels.
  • Rather, we diagnose patients with diseases that have the same symptoms. These diseases include chronic fatigue; POTS (postural orthostatic tachycardia syndrome); neurological disorders such as Parkinson’s disease, Alzheimer’s disease, Wernicke–Korsakoff syndrome and fibromyalgia; autoimmune diseases such as Lupus, Sjögren’s syndrome, rheumatoid arthritis and multiple sclerosis; chronic infections such as Lyme disease and long COVID; conversion disorder (functional neurological symptom disorder); dementia; ADHD; autism; OCD; learning disorders; interstitial cystitis; Crohn’s disease; chronic intestinal bowel obstruction (CIBO); small intestinal bacterial overgrowth (SIBO); irritable bowel syndrome; and inflammatory bowel diseases such as ulcerated colitis.
  • Thiamine, despite being inexpensive and safe and having the deficiency symptoms described above – none of which are disputed – is rarely given to patients.
  • We are not saying that all illnesses are due solely to a thiamine deficiency or can be cured with thiamine, but rather that thiamine is likely an effective tool in treating most chronic illnesses.


How thiamine is used up in handling stress:
  • Under stress, there is an increase in glucose metabolism, meaning the body uses more sugar as fuel to respond to stressors, and thiamine is necessary to process that glucose. Specifically, thiamine converts carbohydrates into ATP.
  • Thiamine is necessary for proper adrenal gland function and synthesising stress hormones such as cortisol, adrenaline and norepinephrine.
  • Thiamine is then needed for metabolising and clearing excess cortisol, which is harmful to the nervous system when elevated for long periods.


How thiamine is important in treating neurological issues
  • Too much of the stress hormone cortisol for too long can be toxic to nerve cells, leading to reduced myelin production (slowing down nerve signals), neuronal shrinkage (especially in memory-related areas like the hippocampus) and increased excitotoxicity (where neurons become overstimulated and die).
  • Thiamine protects against stress-induced nerve damage by clearing excess cortisol. 
  • In addition, thiamine (together with omega 3, choline, magnesium and vitamins B6, B9 (methylfolate), B12 (especially) and D) helps maintain myelin sheaths (the protective coverings of nerve fibers), which are critical for nerve signal transmission.
  • Thiamine is required for the production of neurotransmitters like acetylcholine, which is a neurotransmitter crucial for muscle control and memory. Neurotransmitters are chemicals that help transmit signals in the brain.
  • Nerve damage is a major cause of bladder control issues.


How thiamine is important in treating cardiovascular & respiratory issues
  • Thiamine is needed by the body to metabolise glucose into ATP for energy. The heart requires a continuous supply of energy to pump blood. Insufficient thiamine can ultimately lead to heart failure.
  • Thiamine deficiency weakens the heart (dilated cardiomyopathy) through the disruption of energy production, increased lactic acid, increased fluid retention and damage to heart cells.
  • Thiamine regulates blood pressure and ensures proper circulation of the vascular system by keeping the heart strong (preventing low blood pressure), regulating blood vessel tone (preventing excessive vasodilation),
    preventing fluid overload (as seen for edema and high blood pressure) and supporting the nervous system’s control of blood pressure. 
  • Thiamine supports energy metabolism in the diaphragm for breathing.
  • Thiamine deficiency can lead to respiratory muscle weakness and thus difficulty breathing, especially during physical exertion or illness.
  • Thiamine is required for regulating the autonomic control of breathing. Its deficiency can result in hypoventilation (shallow breathing) or irregular breathing patterns, as the nervous system's ability to regulate breathing becomes compromised.
  • In thiamine deficiency, there may be an accumulation of lactic acid in the bloodstream (lactic acidosis), which can worsen respiratory distress as the body attempts to compensate for the acidosis by increasing the breathing rate.


How thiamine is important in treating gut issues:
  • Gut health is not solely about the bacteria that live in the digestive tract but also about how well the body is moving food through the digestive tract. 
  • Proper movement of food through the digestive tract requires good nerve transmission, which relies on thiamine. 
  • When this movement slows down or becomes impaired (slow gut motility), food can sit too long in the digestive system, which can lead to excessive fermentation and various digestive issues, such as small intestinal bacterial overgrowth (SIBO).
  • Additionally, thiamine is needed to provide the energy for cells in the digestive tract to function properly and for cell turnover in the digestive tract.
  • There are severe downstream effects of a poorly working digestive tract, such as poor nutrient absorption and a lack of appetite, which might be worsening your chronic illness.


Forms of vitamin B1:
  • The regular forms of vitamin B1 are thiamine hydrochloride for supplements, thiamine mononitrate for fortified food, and free thiamine naturally occurring in food.
  • Benfotiamine is a version of vitamin B1 that is fat soluble and thus better absorbed and used by the body, especially in tissues like the nerves and blood vessels. Moreover, because it is fat soluble, benfotiamine can be stored by the body in fat tissue and the liver for long-term use. Finally, benfotiamine passes through the blood–barrier more readily than regular thiamine, which requires a specific transport system. Since regular thiamine relies on this specific transport system, it is possible for the brain to be deficient in thiamine even if there is a sufficient level of regular thiamine in the blood. We recommend taking benfotiamine over regular thiamine.
  • Thiamine tetrahydrofurfuryl disulfide (TTFD) is a fat-soluble form of vitamin B1 that enters the brain efficiently and is used in Japan for neurological diseases. TTFD is harder to source than benfotiamine.
  • The optimal treatment may well be a combination of regular thiamine, benfotiamine and TTFD, as the three forms have different uses.


Therapeutic doses for chronic illness:
  • Therapeutic doses for treating chronic illness start around 250–1500 mg of benfotiamine per day and can be as high as 5 g per day.


Co-factors:
  • Anyone high dosing on a single B vitamin, such as thiamine/benfotiamine, should also be taking a B-complex, as B vitamins work together. 
  • Other co-factors to take when high dosing on thiamine/benfotiamine are magnesium and vitamin K. 


Further research:

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