covid notes: thiamine reduces mortality and thrombosis

Covid Notes: Thiamine Reduces Thrombosis and Mortality

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A recently published retrospective study showed ICU patients receiving thiamine therapy had a significantly reduced thrombosis and mortality rate compared to patients not treated with thiamine. The study, conducted in two hospitals in Saudi Arabia reviewed the cases of 738 critically ill Covid patients admitted to the ICU. As this was a retrospective study looking solely at electronic medical records, there was no determination of thiamine deficiency or clinical criteria to determine who received thiamine or at what dose. This was simply a review of all cases during a defined period of time that were admitted to the ICU and who, based upon clinical judgement of the treating physician, may have been prescribed thiamine.

Study Details

Among 738 patients, 83 had received IV or oral thiamine in doses ranging 50-200mg per day for an average of 7 days. This was in addition to whatever medical or pharmaceutical interventions provided. Using a statistical tool called a propensity score, the researchers then selected pair matches to those 83 patients for further analysis of several endpoints. The endpoints evaluated included:

  • Association between thiamine use as an adjunctive therapy with in-hospital and 30 day mortality
  • Duration of mechanical ventilation, length of stay and complications such as
    • Acute kidney injury
    • Thrombosis
    • Respiratory failure
    • Acute liver injury


Across all variables, patients who received thiamine faired significantly better than those who did not. The most striking findings included mortality and thrombosis reduction. Thiamine reduced in-hospital and 30-day mortality by 61% and 63%, respectively compared to propensity matched controls. Additionally, critically ill ICU patients who received thiamine were 81% less likely to develop thrombosis, and non-significantly less likely to develop kidney damage or liver damage. Inasmuch as thrombosis is major contributor to mortality with COVID, this finding is huge.

Things to Consider

As this was a retrospective study and there were no determinations regarding deficiency or guidelines regarding dosing or other treatment protocols given concurrently, it is difficult to fully appreciate the role of thiamine in COVID recovery by traditional research parameters. Nevertheless, if we look at the role of thiamine in energy metabolism, in immune function, in controlling hypoxia, it makes sense that no matter what other confounding variables may detract from or enhance recovery prospects, thiamine, by its very mechanisms of action, would improve outcomes; something that we have been proposing since well before the pandemic began. Maybe now, more will listen.

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Chandler Marrs MS, MA, PhD spent the last dozen years in women’s health research with a focus on steroid neuroendocrinology and mental health. She has published and presented several articles on her findings. As a graduate student, she founded and directed the UNLV Maternal Health Lab, mentoring dozens of students while directing clinical and Internet-based research. Post graduate, she continued at UNLV as an adjunct faculty member, teaching advanced undergraduate psychopharmacology and health psychology (stress endocrinology). Dr. Marrs received her BA in philosophy from the University of Redlands; MS in Clinical Psychology from California Lutheran University; and, MA and PhD in Experimental Psychology/ Neuroendocrinology from the University of Nevada, Las Vegas.


  1. Dr. Marrs,

    Thank you for writing this. This is the perfect kind of article to give to my doctor, or the doctors of friends who are struggling with both Covid and long Covid. I have had no luck so far getting anyone to seriously consider using thiamine as a treatment. This kind of to-the-point article might help. I will print this out and give it to all the health practitioners I can.

  2. Thanks.Do you prescribe any therapeutic doses of lipoic acid together with TTFD?Because Dr.Lonsdale wrote here that sometimes you can miss other “catalysts” for “Citric acid cycle” rather than thiamine becasue so far using ttfd(400mg),Mg(260 mg) and b-complex dont show any improvments(1 month) despite of have trio of GI,Neurological and Cardiovascular symptomes.Paradoxical phenomenon wasnt observed also.

    • I don’t prescribe anything because I am researcher, not a physician. Having said that, it could be any number of things including: not enough time has passed to see a response. It takes time to heal and there is not much we can do to expedite. It could be that dose is still too low or a different formulation of thiamine is needed. Other cofactors may be missing and/or other toxicants need to be removed.

  3. Hello.Can you help me with 2 little questions please.Can lipothiamine be more effective in some cases rather allithiamine and whether it is necessary to cut all carbs down except vegetables and fruits during thiamine therapy?

    • Sometimes the added lipoic acid that comes with the lipothiamine is useful. Regarding cutting all carbs, no, not all. I would eliminate sugar and processed carb food products though and reduce or eliminate grains if you have a problem with them.

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