Dietary mayhem and thiamine deficiency with simple sugars

How Dietary Mayhem Causes Disease: The Choked Engine Syndrome

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Over the past year, I have written extensively about thiamine deficiency post Gardasil vaccination (here, here, here, here). We now have five cases where thiamine deficiency was identified and clinical symptoms remediated with supplementation. Many more are suspected but recognition and testing have been slow. Thiamine deficiency may not be limited to the post Gardasil population, although that is where we first recognized it. Symptoms of thiamine deficiency and dysfunctional oxidative metabolism have been observed amongst the post fluoroquinolone and post Lupron populations and likely other populations adversely affected by a vaccine or medication, though data are limited. For the current paper, I should like to offer an explanation of the effect of thiamine deficiency in relationship to the stress of the vaccination or medications.

Thiamine Deficiency and Diet

With the widespread ingestion of simple carbohydrates that is almost a hallmark of Western civilization I suggest that the Gardasil vaccination and certain other medications represent “the last straw to break the camel’s back”.  I have included a case report, from my clinical practice, as an example of the effect of a simple nutritional stressor – sugar – imposed on an individual who’s oxidative metabolism was marginal at the time. I have included the references for anybody that wishes to check on how much of this is published.

Cellular Energy and Diet

Present knowledge indicates that cellular energy arises only from oxidation of food sources. The prevalently common form of nutritional mayhem in the U.S. is a high calorie content from simple carbohydrates with insufficient vitamin/mineral content to catalyze efficient oxidation. This form of malnutrition might be compared with functional decline in a choked internal combustion engine. Evidence presented in this case report presented below indicates that simple carbohydrate ingestion can have far-reaching consequences.  A review indicates that a common manifestation of its effect is oxidative stress in the brain, particularly in the limbic system where emotional reflexes originate and where the controls of the autonomic and endocrine systems react automatically to sensory input. Beriberi is the classic example of high calorie carbohydrate malnutrition and is the prototype for dysautonomia (abnormal function of the autonomic nervous system [ANS] ) in its early stages. A later stage results in degeneration of autonomic ganglia and irreversible disease. Symptoms arising from thiamine deficiency or abnormal homeostasis are protean and diverse in nature.

Dysautonomia, Oxidative Stress and Thiamine

Dysautonomia, a common presentation of functional disease and often associated with variable organic diseases caused by loss of oxidative efficiency in the brain, has been reviewed. A hypothesis was presented that there is a combination of genetic risk, different forms of sensory input defined as stress, particularly those imposed by present civilization, and high calorie malnutrition that are collectively responsible. This was presented diagrammatically by the degree of overlap in the “three circles of health, named genetics, stress and nutrition” (1).  It is also known that mitral valve (a heart valve) prolapse (MVP) is widespread in the population and is associated with dysautonomia, although the cause and effect relationship is said to be unknown (2-4). MVP is associated with adrenergic overdrive (the well-known adrenalin rush) in the normally balanced adaptive reactions of the autonomic/endocrine axis (5-8). (The autonomic nervous system and the glands of the endocrine system are under the control of the brain).  Panic disorder, also sometimes associated with MVP, is seen as an example of falsely triggered fight-or-flight reflexes engendered in the limbic brain.  Pasternac and associates (6) showed that symptomatic patients with MVP demonstrated increased resting sympathetic tone and that supine bradycardia (slow heart rate) suggested increased vagal (the vagus is a nerve that runs from the brain to many parts of the body) tone at rest. Davies and associates (7) demonstrated physiologic and pharmacologic hypersensitivity of the sympathetic system in a group of patients with MVP. Sympathoadrenal responses were noted in rats exposed to low oxygen concentration (9) and impaired cerebral autoregulation has been reported in obstructive sleep apnea in human subjects (10). It has also been shown that thiamine deficiency produces traditionally accepted psychosomatic or functional disease (11,12).  A low oxygen concentration results in changes in brain structures similar to those induced in thiamine deficiency (13).

A Case Study of Thiamine Deficiency and Dietary Influence: The Sugar Problem

The Table below shows laboratory results from an 84-year old man who had begun to experience severe insomnia for the first time in his life. He also had painful tenosynovitis (also known as “trigger finger”) in the index finger of the left hand.  He had edited a journal for some 14 years and for several years, had been a member of a bell choir in which he played a heavy base bell in each hand, involving repetitive trauma to the index fingers.  He did not crave sugar, his ingestion of simple carbohydrates being minimal to moderate. The only treatment offered was complete withdrawal from all forms of simple carbohydrates.

Serial laboratory studies revealed a gradual improvement over six months and his weight decreased from 182 to 170 pounds without any other change in diet. Insomnia and tenosynovitis gradually improved. The Table shows that serial laboratory tests over a period of six months, from February to August, showed continued gradual improvement. In September, the day after a minimal ingestion of simple carbohydrate, there was an increase in triglycerides and TPPE.

Understanding the Labs

Notice that the triglycerides dropped from 206 in February to 124 in August, then rose again in September only one day after a minimal amount of sugar.  Triglycerides are part of the routine lipid profile test done by doctors and are well known to be related to the ingestion of simple carbohydrates.  Fibrinogen and HsCRP are both recognized as markers of inflammation.  Notice that both of them decreased between February and August but HsCRP rose again in September like the triglycerides.  The TPPE is the important part of the transketolase test.  The higher the percentage, the greater is the degree of thiamine deficiency.  Notice that it dropped from 35% to zero between February and August, but that it jumped to 8% in September, the day after the ingestion of sweets.  I have provided the normal laboratory values for the discerning reader.








































Consecutive laboratory blood tests

Cholesterol N <200 mg/dL. Triglycerides N< 150 mg/dL. Fibrinogen N 180-350,g/dL
HsCRP N 0.1-1.0 mg/L. TKA 42-86mU. TPPE 0-18%. *Next day after ingestion of simple carbohydrate.


The abnormal TPPE indicated thiamine deficiency in this patient (14). The increased triglycerides and their steady decrease over time indicated that sugar ingestion was a potent cause of his symptoms. An increase in fibrinogen and hypersensitive CRP are both laboratory markers of inflammation, although the site is not indicated.  Recent studies in mice (15) have shown that high calorie malnutrition activates a normally silent genetically determined mechanism in the hypothalamus, causing either obesity, inflammation or both. The potential association of thiamine with electrogenesis (formation of electrical energy) (16) may have some relationship with brain metabolism and the complex functions of sleep.

Compromised Oxidative Function: Thiamine Deficiency, Beriberi and Diet

It has long been known that beriberi is a classic disease caused by high consumption of simple carbohydrate with insufficient thiamine to process glucose into the citric acid cycle. (This complex chemistry represents the engine of the cell, meaning that it produces the energy for function).  Widespread thiamine deficiency has been reported in many publications(17-20), producing the same brain effects as low oxygen concentration (13,21). In rat studies, this produces an imbalance in the autonomic nervous system (9). Thiamine  deficiency is easily recognized in a clinical laboratory by measuring TKA and TPPE (14).

Thiamine and the Brain

Thiamine triphosphate (TTP) (this is synthesized from thiamine in the brain) is known to be important in energy metabolism. Although its action is still unknown, the work with electric eels has revealed that the electric organ has a high concentration of TTP and may have a part to play in electrogenesis, the transduction of chemical to electrical energy (16,22). The energy for its synthesis from thiamine comes from the respiratory chain. This is also complex chemistry in the formation of energy synthesized within mitochondria, the “engines” of the cell (23), so that any form of disruption of mitochondria would be expected to reduce adequate synthesis of this thiamine ester. Although slowing of the citric acid cycle appears to be the main cause of the biochemical lesion in brain thiamine deficiency (24), the part played by TTP is not yet known. Alzheimer’s disease has been helped by the use of therapeutic doses of thiamin tetrahydrofurfuryl disulfide (TTFD) (25), a more efficient method of administering pharmacologic doses of thiamine (26).

Acetylcholine, the neurotransmitter used by both branches of the autonomic nervous system, is generated from glucose metabolism, requiring  B vitamins, particularly thiamine. Choline is a “conditional nutrient”, meaning that it is derived mainly from diet but is also made in the body. The presence of all these nutrients leads to the synthesis of this neurotransmitter.  It’s depletion would affect both branches of the autonomic nervous system, resulting in dysautonomia.

There is evidence that high-dose thiamin increases the effect of acetylcholine (27). Animal studies have shown that TTFD improves long term memory in mice (28) and it has been shown that it extends the duration of  neonatal seizures in DBA/J2 mice, seizures that normally cease in a few days with normal maturation (29).  These seizures are naturally related to a prolonged effect of this neurotransmitter in this strain of mouse.  The experimental prolongation of the seizures by administration of TTFD indicated that it enhanced the effect of the neurotransmitter. A pilot study in autistic spectrum disorder showed clinical improvement in 8 of the 10 children treated with TTFD (30), a disease that has been shown to have reduced  parasympathetic activity in the heart (31,32). Neural reflexes regulate immunity (33).  Dysautonomia was found in a large number of patients with cancer at Mayo Clinic (34).

Dysautonomia and Thiamine Deficiency         

Evidence has been presented that a common connection exists between dysautonomia, inefficient oxidative metabolism produced mainly by high calorie malnutrition, and organic disease (1). Thiamine enters the equation in terms of its relationship with carbohydrate ingestion and its use by the brain as fuel (35). Decreased transketolase activity in brain cells induced by thiamine deficiency contributes to impaired function of the hippocampus (36) each, part of the limbic system control mechanisms that affect autonomic sympathetic/parasympathetic balance. Erythrocyte (red cells) transketolase indicates abnormal thiamine homeostasis that is commonly achieved by carbohydrate ingestion and deficiency of vitamin B (14).  Beriberi gives rise to functional changes in the autonomic nervous system in its early stages and produces irreversible degeneration in its later stages (37). This, because it represents a largely forgotten aspect of disease, might equate with the wide use of simple carbohydrates in Western civilization. Deficiency of other essential non-caloric nutrients has been associated with dysautonomia (1).

The Role of Nutritional Stress in Post Vaccination and Medication Reactions

Two results of post- Gardasil vaccination have been reported, Postural Orthostatic Tachycardia Syndrome (POTS) and cerebellar ataxia.  POTS, a disease easily confused with beriberi, is one of the many syndromes reported under the general heading of dysautonomia and stress related intermittent episodes of cerebellar ataxia were reported in thiamin dependency (38).  Since the inflammatory reflex has recently been found to be involved with the sympathetic branch of the ANS (39), enhancement of its dysfunction by TD might explain some of the Gardasil affected illnesses.


Thiamine deficiency is now accepted as the major cause of the ancient scourge of beriberi. The underlying mechanisms are still not fully understood for we do not yet know the complete roles of thiamine. The clinical effects are protean and unpredictable. It is, however, clear that thiamine has a vital effect on many aspects of oxidative metabolism and its deficiency can be used as a model for the clinical effects produced by disruption in energy synthesis. It can be summed up under the general heading of dysoxegenosis and thiamine is certainly not the only component that governs this vital life process. The example of beriberi indicates that the brain, peripheral nervous system and the heart are the tissues most affected by the disease, the tissues that rapidly consume oxygen.

The limbic system is a complex computer that organizes all our adaptive survival reflexes and its sensitivity to hypoxia is well known. It is evident that non-caloric nutrient deficiency, especially thiamine, gives rise to the same symptoms and histopathology as mild to moderate hypoxia (oxygen deficiency) and that the leading symptomology is that of dysautonomia. Since the limbic system gives rise to emotional reflexes and mild to moderate hypoxia enhances sympathoadrenal response, it can be expected that an affected individual would be more aggressive and more likely to experience exaggerated fight-or-flight reflexes. A “nursed” emotional grievance might be expected to explode in violence that would otherwise be curtailed or suppressed by normal brain metabolism. It suggests that high calorie malnutrition, particularly that provided by excessive consumption of simple carbohydrates, gives rise to uncontrolled pathophysiological actions that might explain some of the widespread incidence of emotional and psychosomatic disease in contemporary society. It may also explain some of the “hot” juvenile crime and vandalism, much of which is poorly understood in our present civilization. It is also hypothesized that a marginal state of oxidative metabolism, perhaps asymptomatic or with only mild symptoms that are ignored, might be precipitated into clinical expression with a mild degree of stress imposed by a vaccination. The individual in the case reported above appeared to be unusually sensitive to sugar ingestion and this may be an additional genetically determined risk.

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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. Dr. Lonsdale,

    I am a part of a group of moms who are studying and working with your research on thiamine. We have a question.

    You said above, “The prevalently common form of nutritional mayhem in the U.S. is a high calorie content from simple carbohydrates with insufficient vitamin/mineral content to catalyze efficient oxidation.“ our question is, is it necessary for the vitamins and minerals that catalyze oxidation to be eaten AT THE SAME TIME as the foods that need this catalyst?

    Specifically, we are wondering about the “grazing” eating patterns so many of our kids have. There are snacks everywhere they go. Many older kids eat many “small meals” each day, but a meal might be a hamburger from McDonald’s at 11:00, a salad at 2:00, crackers at 3:00, and so on. Obviously there is not much vitamin content eaten with the hamburger to act as a catalyst, but there are vitamins in the salad eaten later. Does the body use vitamins and minerals that are stored to “burn” the burger even if vitamin-rich foods are not eaten at the same time?

    Many of us are using smoothies to add vitamins and minerals to our kids’ daily diets. We are wondering if this is an effective strategy, or if this vitamin/mineral hit apart from other foods eaten at other times of the day doesn’t work to act as a catalyst.

    Thank you! We are so happy to have found your books!

    • It is not necessary to eat these foods/supplements concordantly, however, from your description of the diets – e.g. McDonald’s, I would argue that while supplementation with vitamins/minerals and/or additional more nutrient dense foods may help, deficiencies will still build up. There is no amount of supplementation that can overcome a bad diet. These types of foods, which are nutrient poor, calorie and toxicant rich (all sorts of chemical additives) overwhelm the mitochondrial processes forcing subtle adaptations that accrue over time and ultimately lead to serious disruptions in metabolism. This places the child at risk for serious illness, as just one more stressor, an illness, a vaccination or medication would precipitate. It also induces long term inflammation and other immune system dysfunction that will lead to all sorts less acute, though no less serious, illness.

  2. In 217 I was diagnosed with B1 deficiency ETKA measured at 21.5
    2018 16.2 was measured after a year dosing at 1,000 mg of TTFD daily. Many improvements proved thiamine was and is getting into my cells. A1c, triglycerides and fibrinogen were elevated but now in normal range now through supplementation.

    This week I’ve been waking up with trigger finger and feeling of sensitivity of the bottom of both of my feet when I walk. It’s not painful but feels unwell. I have not done anything strenuous to aggravate conditions. Can these be symptoms of B1 deficiency? I suspect my new black garlic snacking (naturally high in carbs) the past two weeks, triggered the change in my body suddenly. I hadn’t realized the amount of sugar the bulbs contained.

    I have variants on both thiamine transporters in addition to variants in all four other cellular enzymes that require B1. BCAAs build up, poor NADPH conversion and impaired and carnitine production and transport are examples. I take mega doses of other supplements to correct my labs but still have CFS, insomnia and hashis.

    1.Is it impossible to overcome CFS when one has multiple genetic variants that effect ATP production?

    2.Could the feet sensitivity when walking be a sign of neuropathy?

    3.Can I still be Thiamine deficient with an ETKA at 16.2?

    4.I have always had coagulation when getting my blood drawn, but recently is has become severe, is there a relationship with B1?

    5. I’ve been experiencing a dry cough can that be a sign of B1 deficiency?

    • The trouble is that thiamine deficiency results in energy deficit. Because the brain is the energy hog, most of the symptoms are brain related including the autonomic system, hence the cough. Has I/V thiamine been tried?

      • I tried Myers Cocktails once a week for a year last year, they worked okay on some days and perhaps I need to keep going and see if the newer symptoms clear out.

  3. Thank you so much for raising awareness on sugar and thiamine. I noticed xylitol in my sublingual B vitamins and also in toothpaste. Is this sort of highly concentrated sweetener an issue for thiamine deficiency?

    Would stevia or other concentrated natural sweeteners contribute to thiamine deficiency?

    My last question is on fructose vs glucose. Dr. Gary Fettke reckons fructose is the problem not glucose. Is there any truth to that?

    Thank you!

    • This question raises some extremely important points. The reason that the food industry puts sugar (and sweetness) into virtually everything is because it sells. In other words, they are appealing to our taste buds! The sense of taste is in the brain and the signal from the tongue causes (as everybody knows) an extreme sense of pleasure. This causes reactions in the brain that, on the long-term, results in electrochemical distortions interpreted as psychologic disease. As I have said many times, you never find sugar in a free state in nature. It is always wrapped up in a fruit or vegetable. There is absolutely no indication for free sugar in our diet. If you read my book “A Nutritional Approach to a Revised Model for Medicine”, available on Amazon books and written for the reading public, you will find that I compare the nutritional devastation in America with the incipient lead poisoning that was part of the decline of the Roman empire.Thus, the question on fructose versus glucose is important. Fructose is extremely sweet and delivers a powerful signal to the brain, even though it is broken down to glucose that is then stored in the liver. The liver releases glucose as needed to fuel the brain. A better understanding of sugar metabolism in preparing glucose for oxidation is an absolute necessity if we are ever to get people to understand the extraordinary danger that they experience on a daily basis. It is so widespread and is a potent cause of disease that is not being recognized

  4. Since starting lipothiamine I have noticed I am hungry all the time. I used to never be hungry so I would eat 3 meals a day to make sure I ate enough as I got very skinny. Now I am starving all the time. I am hungry within minutes of eating. I have tried increasing water, increasing fiber, increasing protein and increasing fat. None of those things help.

    When I go to bed I am starving but here’s the weird thing… when I wake in the morning I’m not especially hungry. The hunger starts after taking lipothiamine. I’m not getting overweight as the hunger is so bad. I’ve gone from one extreme to the other. Before I was never hungry and now I’m pretty much always hungry. What’s your advice?

  5. Thanks for the helpful article. I have low blood pressure and it seems to me that lipothiamine lowers BP further. Does this seem likely to you?

      • Thank you for that helpful tip. I do match a lot of the dry beriberi symptoms but my BP tends to be low e.g. 90/70 95/60,100/75

        I will keep up with the alcohol and sugar free and lipothiamine

  6. I know thiamine is implicated in insomnia due its role in the production of GABA. Is thiamine also implicated in sleep disorders? I have Epic Dreaming Disorder and start dreaming as I’m falling asleep, dream continuously throughout sleep and continue dreaming as I wake. I also have low thiamine symptoms and respond well to thiamine and benfotiamine. On your recommendation I am starting Iipothiamine.

    I appear to have a severe thiamine deficiency as I have noticed improvement in high doses of thiamine and that even a few drops of alcohol in a tincture will cause my eyelids to twitch. Excess sugar does the same. Benfotiamine or thiamine will resolve this issue. It also helps a little with aching muscles, mood and energy. I have had muscle pain every day of my life. Even smiling hurts!

    I am curious as to whether
    1. the low thiamine could be causing the excess dreaming and lack of refreshing sleep
    2. I’ve been taking high doses of thiamine for over a year now. Although there are improvements I have a long way to go. How long does it take to restore thiamine? As well as a significant genetic predisposition to problems with thiamine transporter I also have a history of high sugar intake from childhood. My family fed me a lot of chocolate, cookies and potato chips. I’m sure my mother indulged heavily in sugar when I was pregnant. Is the damage irreversible?
    3. Is sugar from fruits such as bananas and dates a problem with thiamine?
    4. What can you suggest to help with carb cravings when willpower isn’t enough?

    • 1.No evidence that I am aware of.
      2.You will never be well as long as you indulge your sugar.
      3. Sugar in fresh fruit is how Mother Nature designed it and is OK.
      4. NO short cut available: exercising it is the only way that I know of.

      • Thank you! My doctor isn’t interested in exploring thiamine deficiency but I’m working on all the necessary dietary changes.

        I see that you have an out of print book on thiamine on Amazon. Is there somewhere that I can purchase this book? I would love to continue to educate myself.

        • Lonsdale and Marrs. “Thiamin deficiency, dysautonomia and high calorie malnutrition” will be published by Elsevier, probably some time this year. No publication date yet

          • Wonderful! As I have dysautonomia on top of chronic fatigue syndrome I will look forward to reading this book.

            Are you aware of any doctors in New Zealand who are knowledgeable about your work with thiamine deficiency?

  7. Most people who go on Accutane like my daughter were already given long courses of antibiotics in an attempt to treat acne. Antibiotics deplete biotin. Accutane depletes biotinidase. This can set up an environment for infection:

    Clostridium difficile is the pathogen responsible for most cases of ppseudomembranous colitis and many cases of antibiotic-associated diarrhea. The bacterium produces toxins A and B. An earlier study showed that the production of these toxins by c. difficile is enhanced in a biotin-limited medium (biotin effect) and it was hypothesized that administration of excess biotin to a patient with c. difficile colitis may have a therapeutic effect.


    This is not a good scenario for dealing with a (clostridium) tetanus vaccine administrated too early. Recovery was impaired by the administration of glutamine which increases tetanus by three practitioners over the three following years. Also the use of lotions with excitatory properties in physical therapy. There were actually two porphyric crises during this period.

    Perhaps this was all really a biotin issue – and perhaps the people known to have hyper responses to the tetanus vaccines actually have some mutations in some of the biotin dependent enzymes – and/or histories of extensive antibiotics.

  8. 1.No need to accuse! Thiamin deficiency is proved by the transketolase test. 2. These dietary factors have been well known for years and published in the medical literature. 3. Accutane has been associated with Crohn.s disease as a cause. My take is that Accutane depletes energy stores as ATP and that she was in a marginal metabolic state when she received the toxoid. The toxoid was a “stress factor” 4.Milk and gluten sensitivity have become very common. I believe (the evidence has to be construed from many different sources) that sugar is the villain common to both in many cases.5. I obviously agree on the vital importance of diet. However, people do not want to hear that they need self responsibility in maintaining health. We have been brainwashed to believe that this is the responsibility of the doctor to “cure” us when health goes haywire.

  9. Very good point, but also it would be a shame if there were a case where someone might be falsely accused of a bad diet or bad habits if in fact they are careful in these areas and still end up thiamine deficient after certain therapies.

    There are a few more things which decrease thiamine, apparently. Tannins deplete thiamine and show up in certain foods and beverages – even ones which aren’t generally thought to be harmful – and even in new water towers (we almost lost our ten year old dog – from drinking our water in the days after a cedar water tower was installed in our building).

    Also – I have questions about tetanus toxoid.
    I see that they give thiamine to goats who have tetanus and that thiamine can be protective against tetanus (at least somewhat). So wouldn’t tetanus toxoid deplete thiamine? Therefore – what would happen if someone is given a tetanus booster when they already have a very high titer? Too high a titer can cause problems, apparently.

    It just so happens that my daughter was unbeknownst to us given a tetanus booster out of schedule – five years too early – and while on Accutane. The dermatologist was doing routine labs and found that her triglycerides and liver enzymes shot up at this time. And she also almost immediately went into health meltdown not unlike what I have observed occurs with some who are “floxed” and injured on Gardasil. The pediatricians never told us about the tetanus booster. Four years later we found out about it and had the titer tested, and found it was 12 times higher than the norm. Yet even then we had no idea what the significance might be.

    However, my daughter was subject to many different kinds of accusations as to how she may have caused the illness herself – diet being one of the things which came up. What do you say for someone who all of a sudden has all food running through her? Finally we found out she is genetically lactose intolerant and is celiac and that GFCF works.

    We also appear to have some extra vulnerability in that apparently we have no DPD enzyme (an association here I believe, with thiamine issues); we have deleterious mutations in a few other thiamine associated genes, and then there’s also the mitochondrial transketolase issue – which I now understand is quite likely – as well.

    And this does bring me full circle to agree with you anyway that diet is really important. I also think one of the big challenges is to convince people of this fact. Sometimes it’s easier if you can get them the lab work and show them the science to make them realize why there is a reason they have a vulnerability and that there is something they can do about it.

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