Back pain and B vitamins

Back Pain and B Vitamins: Notes from Personal Experience

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Throughout the history of medicine, performing research on oneself has been time-honored. Before I describe the experiment on myself, I must digress. As many readers on this website know, I have written a great deal about thiamine and its use in therapy. In particular, I have long been interested in a derivative of this vitamin that is to be found naturally occurring in garlic. It has been synthesized and sold under various trade names. Its chemical name is complex, so I use the initials TTFD. Without going into details, its action is superior to that of the thiamine from which it is derived. I have used TTFD for the treatment of hundreds, if not thousands, of patients. Over the years, I became certain that there was no bad side to its use, whatever the dose. My experiment proved me wrong but in a way that I should have anticipated.

Vitamins Work Together

Vitamins work as a team and thiamine is a member of a group of vitamins known as the B complex that is vital to energy metabolism. We are however beginning to learn that vitamins, either singly or given in a group, can be used as drugs and it requires a great deal of research in order to understand completely these relationships if they are used therapeutically. As I have a particular condition that is precancerous, I have been attempting to find ways and means of preventing the possible onset of cancer by the daily use of a variety of nutrient supplements. We now know that thiamine is implicated in many conditions, including cancer.

For some time I had been taking 100 mg of TTFD a day and one tablet of B complex. I raised the dose of TTFD to 200 mg a day without raising the dose of B complex to see if I could perceive any difference in what I experienced. After about a month with this dose, I was getting into bed one evening and was suddenly afflicted with the worst pain in my left leg that I had ever experienced. It appeared to be muscular pain because any movement would sharply increase the pain and often cause me to cry out involuntarily. Sleep was of course impossible and at about 3 AM, one night last week, I remembered a manuscript that I had come across that purported to relieve pain by an injection of vitamins B1, B6, and B12, administered separately or in combination. I took three tablets of B complex (three times the previous daily dose) and about 15 minutes later I noticed some diminution in the pain. I waited a while before repeating the dose of B complex twice more and within about 45 minutes I was pretty well pain free. It was a shattering experience that demanded some form of explanation, if possible.

The Mechanics and Biochemistry of B Vitamins

My personal explanation is as follows. Each member of the B group of vitamins has a vital part to play in energy metabolism and I had produced an artificial balance between them that severely decreased the efficiency of their combined action. An analogy may help to explain what I am talking about. Imagine a machine that relies on cogwheels, such as a clock. The motor, whether it be clock-work or electric, passes the energy via the cog-wheels to the hands of the clock. The very first cogwheel in the series is the master, because without it nothing happens. The rest of the cogwheels are just as important but only function because of the first one.

The energy that our cells require is passed through a series of enzymes that are the equivalent of the cogwheels. Each enzyme requires one or more cofactors that can be thought of as a special lubricant that differs for each cogwheel. Imagine now that the first cogwheel is an enzyme that requires thiamine and you have added so much lubricant that it causes the meshing with the next cogwheel to slip. The motor keeps running but the transmission breaks down. Like all analogies, this is imperfect. Thiamine is known as the rate limiting factor in the enzyme complex that demands the presence of all the B vitamins. You can think of thiamine as being the dominant member but no less essential than the others.

Vitamins as Drugs

A drug is  “a substance that, when ingested, alters physiological actions in the body”. That definition automatically excludes each vitamin and essential mineral, such as magnesium, as a drug under normal healthy circumstances because each is essential to normal human and animal physiology. However, we are completely dependent on appropriate nutrition in order to acquire the vitamins and essential minerals. Because we no longer obey the life rules of Mother Nature, it has become exceedingly easy to develop (non-caloric) nutrient deficiency. It particularly applies to the B complex because of its essential role in liberating energy from glucose. We know from studies of thiamine deficient diets in human subjects that the earliest symptoms are “emotional” in character and may be classified as “psychosomatic”. If the symptoms are not recognized and go on for years, we can assume that the structure of the enzymes deteriorates. If and when clinical and biochemical recognition occurs, it would seem logical to assume that the vitamin cofactor would have to be increased drastically in order to reconstitute the enzyme. The vitamin is therefore used under those circumstances as a drug until reconstitution is complete. When the normal activity of the enzyme is restored, the vitamin returns to its state as a nutrient and its therapeutic dose needs to be reduced.

Prevention Versus Recovery

In my case, the explanation may be different. I was taking a colossal dose of TTFD with insufficient concentrations of the B complex, perhaps causing an imbalance in the selective activities of each. If that is the mechanism, I can only guess that it interfered with oxidative metabolism. Also, I can no longer state that there is no “toxicity” from taking large doses of TTFD. It does seem to imply that the remainder of the B complex should always be used with TTFD. We know that beriberi patients required 100 mg of thiamine three times a day for months. If blood sugar was normal they always responded. If there was hyperglycemia the response was slower. If there was hypoglycemia, some did not respond at all. We can be sure that the thiamine dependent enzymes were sick and that they were being reconstituted by thiamine being used as a drug. Thus, my situation is quite different than treating a thiamine deficient patient. High doses are required only for sick thiamine dependent enzymes that have long been lacking sufficient concentrations of their cofactor(s). Preventive therapy is different than long-term deficiency.


Derrick Lonsdale M.D., is a Fellow of the American College of Nutrition (FACN), Fellow of the American College for Advancement in Medicine (FACAM). Though now retired, Dr. Lonsdale was a practitioner in pediatrics at the Cleveland Clinic for 20 years and was Head of the Section of Biochemical Genetics at the Clinic. In 1982, Lonsdale joined the Preventive Medicine Group to specialize in nutrient-based therapy. Dr. Lonsdale has written over 100 published papers and the conclusions support the idea that healing comes from the body itself rather than from external medical interventions.


  1. This may be of interest regarding garlic, and TTFD
    Hope for Dementia With a Novel Aged-Garlic Formula
    Nexus magazine April-May 2015

  2. Dear Dr Lonsdale,
    In an interview I heard you say Potassium Magnesium Aspartate is a favorite form of supplement to use with TTFD. And then in other comments you say only Magnesium. Can you clarify for me? Thank you, again for your most important work with TD!

    • Magnesium potassium aspartate is but one salt of magnesium. You can ‘t take MAGNESIUM– it exists as a metal.

  3. I suffered horrible neck pain for about 15 years and had X-rays and MRI’s conforming only mild degeneration. I was begging for surgery or something to let me function. I was tested by my family doctor for MTHFR and then put on methylfolate and methyl b12. This changed my life and has allowed me to move and exercise and live like a normal person. It did not help my lower back pain but I will take it!!

  4. I have been struggling with POTS for a while now and around 2 weeks ago started applying 50mg Allithiamine transdermally + magnesium + potassium and noticed a significant improvement. 1.5 weeks in my heart racing got worse as did sleep and I just felt worse (not detox worse, something going wrong worse). I stopped the allithiamine and felt better.

    I have since read that other B vits are needed. I have taken a b-complex yesterday along with 25mg allithiamine + mag + potas and noticed my POTS was slightly worse. I have trouble with folate, I believe it’s what caused my sudden worsening of POTS last year.

    Should I just keep playing around with the dosages? How come otthers can take big doses of thiamine without support nutrients and do fine?

  5. “If there was hypoglycemia, some did not respond at all. ”
    Can you please explain this to me? I have hypoglycemia and beri beri.

    • Beriberi, the disease caused by thiamin deficiency, may be associated with a normal blood glucose. If so it responds quickly to thiamin. At a later stage of the disease, blood sugar is found to be unusually high like diabetes and does not respond as well to thiamin. At an even later stage of the disease, the blood sugar is found to be low. The patients are much less likely to respond to thiamin.

    • Hi Dr Lonsdale

      I have just come accross this and am very impressed by your knowledge and answers.

      My husband has been suffering really bad low back pain which radiates to his neck and has been told it is all due to IBS. It does appear to be related to food which in turn affects his diaphram and then he gets pain in his back. He is diabetic but controls with diet. He is not fat. In fact he is losing weight at the moment and struggling to eat. All the docs would offer is Paracetamol which an acupuncturist said should not be given on empty stomach or if dehydrated. They advised 8 a day for a month! He is trying FODMAP diet but does not really want to eat much anyway.

      Having read your info on B supplements we have ordered some thiamine but there are not many supplements with more than 100mcg in UK. Also read your comment about diabetic and the fact you think diabetic patients may not get any relief from taking thiamine. I sont believe he is diabetic but in the UK they moved the goal posts. He is also on Warfarin due to ateial fib which was eventually cured by op. We have also ordered Mega Mag as he is probably low in this. He has never wanted to take supplements before but just wants rid of the debilitating pain and to improve his quality of life! Uk docs do not treat chronic pain unfortunately. I would welcome any advice about the Bs!

      Thank you.

  6. Dr.Lonsdale

    This paper relates to Alzheimer’s and thiamine but with a surprising result.

    “Surprisingly, our results suggest that only benfotiamine, but not fursultiamine, is beneficial and the increase in brain thiamine levels does not appear to be sufficient for the beneficial effects.”

    what’s your opinion?

    • I am very surprised at this result. The early research in Japan on the disulfide derivatives was overwhelmingly in favor of them. Furthermore Bettendorff’s group in Belgium published the fact that benfotiamine did not cross the blood brain barrier whereas the disulfide does. There is certainly something wrong somewhere.

    • Well, there is currently a research program being carried out in Cornell, using Benfotiamin to treat Alzheimer disease. I have to admit that I was surprised by the inferiority of the disulfide derivative reported in this manuscript. Bettendorff, a researcher in Belgium who has a long record of thiamin study, many years ago produced evidence that the disulfide crossed the blood brain barrier, whereas the non-disulfide derivative did not. I am personally convinced that Alzheimer’s disease is incurable no matter what you do. I have offered the possible explanation that if the symptoms are detected very early, that it can be prevented. There is much evidence that Alzheimer’s disease is the result of long-term thiamin deficiency and that prevention is the only way that we can get rid of the disease. Is sugar ingestion and the use of alcohol the ultimate cause of this disease and many others?

  7. Excellent analogy about b1 is part of a team, I picture b1 as the larger super hero ?

    Your wisdom and experience is so appreciated I have been having huge success on my wife with thiamine and because of you optimising it.

    Thanks you so much for being so honest and sharif the continuaed passion for Thiamine you discovered gold so many years ago, I wish I knew you when I was younger, metabolic syndrome won’t have impacted me as much as it did.

  8. Interesting! A long time ago there was a practitioner in England who was very popular. He had the biggest practice in town. Everybody got the same medicine. He had a large bag of sodium bicarbonate in the basement and he just extracted a handful for each patient. Whether it was acting as a placebo or whether it was neutralizing an acid environment in the body is questionable but it apparently worked.

    • Dear Dr.Lonsdale,
      Happy New Year!
      I’m very thankful for your great insights in articles and blogs, which is more like a Prophet’s view .
      As I know, niacin and fresh calf liver extract(juicing)are used in the Gerson Therapy(against Cancer) .

  9. Dr. I have been using b vitamins a great deal. I am not a scientist or a medical person in any way.
    I was bounced to several specialists. I was diagnosed incorrectly for many things.
    So i began studying things myself.
    Long story short.
    I began with removing all the bad food ingredients. Gluten..aspertame..plastics..canned food..microwaved food..msg..dyes..supplements with additives. Anything with a nano particle.
    I was afraid of b supps as the made me sick.
    Due to my husbands weight loss surgery bs are essential for his survival. I purchaced all of the bs in seperate containers.
    The culprit of my sick from bs was thiamine in multis. When i take thiamine mononitrate i have no sickness.
    Our bs are riboflavin
    Thiamine mononitrate
    Niacinamide…which we used liberally to “cure” many issues including weaning off zoloft for Ken and prozac for me and vicodin for Ken tramadol for me. There were other meds but my focus was those meds as they are difficult to wean off.
    Methyl folate
    Choline inositol
    Methyl b12
    After much experimentation and getting conclusion is the b question is solved mostly by the forms we used.
    This is our family of 6 and each with different problems but has been true.
    The most effective help to digest for us and utilize these and other supps we use ..adding baking soda 1/2 tsp 2x a day made all the difference. My grandma would have agreed. It was the go to thing in our family in previous generations.
    The difference of the 2 thiamines was life changing for me. My mom has the same problem. She still cannot make herself take bs at all.
    I have to say i did ease myself into it by starting with dehydrated beef liver. Which again is rich in bs.
    The big difference for my husband was he now gets nutrients that were unavailable to him as he had r&y surgery and has no digestion of his own. The impact was obvious when he switched to these forms.

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