More thoughts on thiamine deficiency

More Thoughts on Thiamine Deficiency

It should not surprise anybody when I question the current medical model for its accuracy and the use of potentially toxic compounds that often make things worse or do little or nothing toward relieving the disease.

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Thiamine Dependency and Intermittent Ataxia

Readers of this blog will recognize that there are many posts concerned with thiamine deficiency and that is associated with a huge number of symptoms. I want to use this post to illustrate the difficulties experienced by a boy whose thiamine deficiency was proved. His case was written up in the medical literature because it was the first example of thiamine “dependency“. That meant that he was required to take massive doses of the vitamin in order to prevent intermittent recurrences of the brain disease known as cerebellar ataxia. Curiously, each episode was self-limiting, but as they recurred, each one left him with a little bit more brain effect. It was this case that forced me to devote myself to library study and change in medical practice throughout the remaining years before my retirement.

Although this boy’s problem was an example of a condition, thought to be extremely rare, it illustrated the kind of medical problems that occur as a result of dietary deficiency. In fact, I have come to the conclusion that prolonged dietary deficiency of this vitamin will make it difficult to restore health by its administration as a supplement. The enzymes in the body that require it seem to degenerate over time if the deficiency persists. Huge doses are required and it is not a simple vitamin replacement. We are using the vitamin as a drug in an attempt to coerce the enzymes back into a healthy state. We know from the history of beriberi, the traditional vitamin B1 deficiency disease, that large doses of the vitamin were required to restore health.

This case was reported in 1969 and the last time that I saw him was in the 70s. He had grown into a handsome boy with a marvelous personality. For example, he cut the grass for the neighbors without charging them and his customers were delighted with him on his paper route. This escape from a potentially lethal disease by the use of what might be called a megadose of vitamin B1 was incredibly impressive to me, making me wonder whether a healthy dose would benefit everyone. Is the modern diet so artificial that vitamin deficiency is common, in spite of their enrichment by the food industry?

I recorded the fact that the family had visited Florida. While they were in a store that was cooler than the outside temperature, it was without air conditioning and John became suddenly unconscious and was taken to an emergency room where his examination proved to be quite normal. On the following day, he went from a 95° temperature into a store with an estimated air-conditioned temperature of 60 to 65°. He immediately experienced difficulty in breathing and produced a kind of strident asthma that was self-limiting. He was again taken to the emergency room where his examination once again proved to be quite normal. The diagnosis given at the time was that it was due to “nerves”. A similar episode occurred on the way home when the air-conditioning was put on in the car. Note that an environmental temperature difference was enough for him to lose consciousness on one occasion and produce asthmatic breathing in another similar situation. He had never been known to experience asthmatic breathing previously. One can readily see that he would be a complete mystery to the doctors in the emergency rooms to which he was taken.

My interpretation would be as follows: as repeatedly pointed out in various posts on this website, his brain had an energy problem from the poor association of thiamine with its energy enabling enzymes and the stress of a sudden change in temperature, requiring an energy surge to adapt, could not be met. The energy deficiency affected the functions of the brain, causing syncope in one example and asthma in another. The diversity of this response illustrates the fact that different parts of the brain can be affected by the overall deficiency, perhaps even on a day to day basis. It is not surprising that such episodes are a diagnostic problem for ER physicians or any physician for that matter.

Syncope and Sudden Death

A very common incident occurring in dietary deficient people is a sudden fainting attack, known as a syncope. They invariably wind up in the ER where it is usually written off as being due to “nerves”. It is impossible to understand this without knowing the chemistry involved. It reminds me of two siblings, a boy and a girl, both of whom had been surviving on a junk-filled diet. The girl was a champion swimmer and was practicing one day by swimming laps. She swam the last lap, touched the pool wall and remained still. When she didn’t start to climb out of the pool, someone investigated and found that she had evidently died as she touched the pool wall. Her brother had been climbing ropes in a gymnasium. After he came down from a climb, he passed out and was taken to a hospital where he received intravenous fluids. It was recorded that he had 11 bloodstained bowel movements and expired. Although there was no proof that thiamine deficiency was the cause of death, I would be willing to bet that the fluid given intravenously to the boy was glucose saline and we know that an excess of sugar will seriously precipitate marginal thiamine to a deficiency state that would produce symptoms. It strongly suggests that the death was from thiamine deficiency.

Febrile Lymphadenopathy

In another post, I recorded the history of two boys with recurrent acute febrile lymphadenopathy (fever, swollen neck glands and high-temperature), both of whom responded completely to thiamine supplementation. The story bears repeating. This kind of illness is inevitably thought of as throat infection and treated with an antibiotic. Both boys had a marked increase of folate and vitamin B 12 in their blood that returned to normal levels after thiamine administration. I won’t go into the mechanism but it is interesting to speculate on how often children with a very common condition like this would have a similar underlying cause that would never, under any circumstances in the climate of modern medicine, be considered. The two cases were published in a medical journal but I have never seen a reference to it, probably because it is totally unbelievable.

I kept a diary at the time and want to make a few comments about one of these boys. When the supplemental thiamine was removed to see what would happen, he relapsed about three weeks later. The relapse began with recurrent abdominal pain, irritability, and a return of the fatigue, causing him to nap during the day as he did when he had his recurrent episodes. There were some abnormalities in his blood pressure, which are too technical to describe here. When I stroked the skin of his leg gently, it provoked a white streak that gradually faded, a phenomenon that is associated with abnormal activity of the autonomic nervous system, a system that is inevitably damaged with thiamine deficiency. He had large lymph nodes in his neck and there was an elevation of folate and vitamin B12 measured in his blood. All of this resolved when the thiamine was restored. It is interesting that he had a first cousin who suffered from Hodgkin’s disease, a malignant form of lymphadenopathy. I wondered whether this recurrent swelling of glands was potentially precancerous. From my reading of the vitamin B1 deficiency disease beriberi, I found that swelling of the glands in the neck could be seen in infants dying from the infantile form of the disease and fever was almost always present.

Mononucleosis: A Mistaken diagnosis?

On May 14, 1976, I made a note that we had a new patient admitted under the care of another physician. He had massively swollen lymph glands in his neck and the diagnosis was mononucleosis. The history recorded that his brother had also “died from mononucleosis” the previous April. A biopsy of one of his glands was reported that it was definitely not malignant. His case was discussed among my pediatric colleagues and I asked the responsible physician what he would do if the lymphocytes in the gland were reported as healthy and mature. The answer surprised me because it was obvious that the diagnosis of mononucleosis had been rejected. He stated that the boy would be treated for cancer “but we would soft-pedal it” I found his answer extremely confounding. We were confronted by a familial situation with an unknown diagnosis and yet he was to be treated as though it was known.

This reminded me of a situation that affected one of my granddaughters. She came home from school and went white water rafting with her friends. Evidently she fell in the water and when she got home she was so fatigued that she went to bed. Her mother, who was a university nurse took her to her workplace where a diagnosis of mononucleosis was made. I persuaded my son to bring her to my office where I gave her several infusions of intravenous vitamins. Her response was so good that she was able to return to school well. The obvious question that I asked myself was whether the diagnosis of mononucleosis was valid or whether it was an inappropriate mistake. The reader may or may not know that a diagnosis of mononucleosis, also known as “kissing disease” is associated with extreme fatigue and can prevent the unfortunate adolescent from returning to school sometimes for months. Once again I am confronted with the question, is our present medical model even close to being accurate?

I am reporting actual cases of thiamine deficiency that are a sampling of literally hundreds of similar cases that I encountered over the years. It should not surprise anybody when I question the current medical model for its accuracy and the use of potentially toxic compounds that often make things worse or do little or nothing toward relieving the disease. It is high time for sick people to seek the services provided by Alternative Medicine physicians whose medical societies are known as the American College for the Advancement of Medicine (ACAM) and the International College of Integrated  Medicine (ICIM).

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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. L,
    I was recently diagnosed with Clostridia HPHPA (organic acids) and connecting to this to a thiamine deficiency as well as a PST pathway blockage. All steming from a surgery 4 years ago that catalyzed my system-wide symptoms and constant ‘sailor drunk’ feeling. No wonder why I am sensitive to sulfur/phenols. Now that we have the culprit trying to figure out how to attack this. Slow n steady. Low carb/keto diet, limbic work, etc. is on the list along with B1/Mag combo. Two questions: are any objective tests available to confirm and if you have an infection how would you treat? Too much risk in anti-biotics I would think.
    Thank you,

  2. Dr Lonsdale,

    My uncle had a stroke 2 years ago and has gotten progressively worse. Hes’s has a very unsteady gait even with the walker, extreme fatigue and has developed spasmotic dystonia
    where is voice is breathy sounding and strained. He can’t speak over a minute without being short of breath. When you have a stroke does your thiamine go down? Could the fatigue and gait problems be b1? Oh, also he developed a very slow pulse rate as a result of the stroke. Thank you for your help.


  3. Hello Mr Lonsdale, how are you doing? I have three questions if you would be so kind:

    First is what’s your opinion on ozone therapy for the activation of mitochondria?
    Second is, if TTFD isn’t available, what kind of thiamine would you recommend (sulbutiamine, benfotiamine, hcl, mononitrate)?
    Third is that I know magnesium should be taken with B1, but do you also need to take B-complex? Or should you take a multivitamin?


    • I have not studied ozone therapy and it was not available when I was in practice. However, it is a good question and I will try to do some research on it and maybe write a post. Your second question is about the type of thiamine. The natural way in which thiamine was ordained was of course in food. There are three ways in which thiamine can be taken In a megadose if prolonged deficiency has existed and please understand that under these circumstances it is being used as a drug. Thiamine hydrochloride and thiamine mononitrate are water-soluble salts and are readily available. There are two types of thiamine derivative, a group of disulfides ( Lipothiamine, Allithiamine, Sulbutiamine) whose chemical name is thiamine tetrahydrofurfuryl disulfide and a group known as S acyl derivatives, the best known of which is Benfotiamine. There are minor differences between the benefits of the two groups but they all have only one action and that is to deliver thiamine to cells. If the ingestion of the chosen derivative results in benefit, it simply means that the thiamine dependent machinery Is functioning better. Once that has occurred, it is necessary to add magnesium, B complex and a multivitamin for continued use and it may be necessary to add vitamin D.

      • Thank you so much! I have just one more question out of curiosity. I’ve been studying about metabolism and I reached the theory of cancer as a metabolic disease. What’s your take on that? Because as I understand, cancer metabolism is basically fermentation of lactate (just like normal metabolism of pyruvate sans thiamine) or glutamate in the presence of oxygen. I’m not a medic, nor am I on the biological fields, so please pardon my ignorance. Could it be related to thiamine deficiency and if so, how could that relationship occur?

        I’ve been dealing with chronic sibo/ibs for about 10 years and got really good results with a carnivorous diet, but even then added back carbs to my diet it seemed like all of my symptoms came back. I’m currently exploring the theory of a thiamine deficiency that couldn’t be fullfilled through diet alone and my mood/energy levels/digestion have really improved since I started taking sulbutiamine/magnesium malate/b-complex.

        I find it intriguing how simple this concept is, but I was never taught that: Food has three macronutrients (proteins, carbs, fat) and micronutrients (vitamins and minerals). If you eat something like an icecream, you get the carbs and the fat, but you don’t get the micronutrients required for the metabolism of carbs and fat, thus creating a deficit. This is just so simple it blows my mind when I think about it, how is this not common sense?

        In anyway, I really appreciate the work you do and I hope to read your book in the near future. God bless you.

  4. Dear Dr Lonsdale,
    What does it mean if allithiamine or lipothiamine cause an “old tire” taste in the mouth? My 17 yo daughter, who experienced an acute onset of gastroparesis and POTs symptoms about a year and a half ago, is experiencing this weird taste in her mouth with the supplement. She took it once by mouth and once through her feeding tube which goes into her jejunem. Obviously she knew about it when she took it by mouth, but the second time I mixed a powder into her feeding tube without her knowing. Same taste in her mouth occurred both ways.
    Thank you!

  5. It is interesting that milk contains a substance that must be processed separately in the cell and requires thiamine. If there is thiamine deficiency this can result in production of something called phytanic acid that can influence brain function

  6. Dr. Lonsdale,

    Several family members and several friends are using Allithiamine, magnesium and a multi with very good results. I have a question about diet, especially for our teens and adults who travel. Is it acceptable to cover the body’s daily fruit and vegetable requirements by drinking a smoothie each day, along with a good dinner that includes protein and vegetables–but possibly a burger and fries for lunch, or a typical McDonald’s breakfast sandwich for breakfast?

    The diets of the teens especially can be very unbalanced, and they are not at home to manage. We are trying to add additional nutrients with things like smoothies, and a good multivitamin, to make up for the “junk” they routinely eat outside the home.

    You talk at length about the synergistic effects of multiple nutrients in the diet–do they need to be eaten at each meal, or can they just be added in anytime during the day? In your book you mentioned that thiamine, for instance, was found to be “stored” in the body for several days. I assume the body accesses it when it needs it, but I am not sure if that’s true for other nutrients as well.

    We certainly are trying to teach our kids to eat well, but it is a difficult fight. And the sugar is the biggest fight of all. Thank you for your book, but your articles are almost as valuable as they are an extremely useful tool to explain the thiamine problem to others.

    • I agree. Unfortunately I learned years ago that children and adolescents are totally committed to their lousy diets. That is why I have advocated vitamin supplements because that seems to be the only way in which one can restore the proper ratio between ingested calories and the catalysts that enable them to be oxidized. There is no question that, given an absence of a genetic risk factor, a natural diet is the best method by far. An additional problem is that a good diet is expensive and is the reason for an association between poverty and poor diet.

    • Yes, unfortunately children and adolescents are completely glued to their lousy diets. That is why I have advocated supplements. It is the ratio of calories to the catalysts that enable them to be oxidized. That is one of the reasons that when a person has obvious thiamine deficiency, the measurement of thiamine in the blood is found to be normal. The excess calories creates the imbalanceYes, unfortunately children and adolescents are completely glued to their lousy diets. That is why I have advocated supplements. It is the ratio of calories to the catalysts that enable them to be oxidized. That is one of the reasons that when a person has obvious thiamine deficiency, the measurement of thiamine in the blood is found to be normal. The excess calories creates the imbalance

  7. I started supplementing thiamine 100 mg benfotiamine and stopped eating processed carbs and sugar and I get paradoxical reaction. I do eat whole grain carbs and fruit like banana and plums and pears, but have lost appetite with the supplementation of thiamine, so I don’t eat a ton these days.
    I tried ketogenic diet a couple of times and always got a keto rash on my chest, that’s how I knew I was in ketosis.
    And now with the thiamine and no simple carbs and sugar I again got the keto rash and upon testing my urine, it’s full of ketones!
    Anyone else get this? Is this a good/bad sign or does it not matter at all?

    Also, when I feel calm and I take benfotiamine, I get paradoxical reaction and feel awful, but when I am in ketosis like that (even after having eaten a sweet banana!) and feel awful in ketosis, and THEN take benfotiamine it makes me feel better immediately. Isn’t that paradox?

  8. When increasing the dose of thiamine does one increase the dose of magnesium too? For example 100mg Lipothiamine to 200-300mg magnesium, 200mg Lipothiamine to 400-600 magnesium, etc.

  9. Dear Dr. Lonsdale, dear Dr. Marrs,

    Is it still possible that I have a thiamine deficiency if I have been supplementing thiamine for years?

    For 3 years now I have been taking 2 antidepressants (SNRI and SARI) for my lack of energy and sleep trouble including restless legs and palpitations at night. In the years prior to that I have occasionally experienced panic attacks. I also used to take a lot of pain medication for back pain (for approx. 2 years) until I finally had surgery 2 years ago, and together with this I had to take proton pump inhibitors to protect the stomach.

    Together with the SNRI and SARI (Trazodone) my doctor prescribed me Vitamin B1 in the form of Thiamine Disulfide (100 mg a day) together with B6 and B12, which I have been taking also for a couple of years.

    Only recently have I started to add Magnesium.

    I am still tired a lot, am lacking energy and can not fall asleep without the Trazodone. My nerves seem to be getting weaker and weaker, I can not manage things anymore that seemed easy to me 5 years ago.

    Via a friend I came to learn about Thiamine deficiency and paradoxical reaction and out of curiosity I tried her Benfotiamine 100 mg and had an immediate reaction to it: heavy brain fog. The next day I took another one and felt nothing. So I took a second one a couple of hours later and got palpitations, feeling of cold shivers in my chest and suddenly feeling very restless and tired like before you get a flu. This effect lasted several hours.

    Is it even possible that I do still have a thiamine deficiency if I have been taking 100 mg of Thiamine Sulfide daily for a couple of years (although without magnesium), or how can it otherwise be that I react to Benfotiamine in such a way?

    I would love to come off the antidepressants and was hoping that maybe I could if I supported the mitochondria by providing them with what they really need.

    Your advice or any input is highly appreciated!

    Thank you!

    Melanie L.

    • Yes, I think you still have thiamine deficiency. Two antidepressants, proton pump inhibitor and trazodone all may contribute. Panic attacks are typical of energy deficiency in the brain. When you took Benfotiamine you had at classical paradoxical reaction. This occurs when you take a big dose of thiamine after long-standing deficiency. You can look up “paradox” as a post on “Hormones Matter”. Paradox can last as long as a month while taking the thiamine but you have to persist through this period in order to get relief

      • Thank you, Dr. Lonsdale! This is great information! I will read up on it and keep taking the benfotiamine then. Thank you!

  10. Dr Lonsdale,

    Thank you very much for all your work!! I am a 32 year old COVID Long Hauler… came down with the virus in March and have been suffering a variety of “post COVID” issues ever since. Chest pain, horrible fatigue, cold hands/feet, sleep disturbances, brain fog, swollen glands, sore throat, amongst other minor things.

    Have you read about the COVID Long Haulers? Many are young and previously fit and in good health.

    Do you think the Long Haulers may just be suffering from a post-viral mild/moderate beriberi? Thiamine defiency? Since viruses are a severe stressor that can deplete stores of B1.

    I also have a history of somewhat “unexplained” GI problems and array of mild neurological things.

    Many other Long Haulers I talk to have POTS, dysautonomia, GI problems, skin issues, SOB, air hunger, just an incredible range of symptoms that seemingly overlap Thiamine deficiency.

    Please let me know your thoughts!

    Thank you!

    • This is very interesting because I have been thinking for some time that thiamine deficiency represents the ultimate pathology of Covid. In fact, I sent a letter to the editor of a newspaper suggesting that TTFD might be used as a treatment. Whether they will publish it or not remains to be seen .TTFD (thiamine tetrahydrofurfuryl disulfide) is a derivative of thiamin and has a very powerful biologic effect on stimulating energy. If you cannot get it I suggest that you look into getting it from Ecological Formulas, a vendor in California. It also needs to be taken with magnesium and a multivitamin

      • Thank you!! There are thousands of Long Haulers in the USA and doctors cannot figure us out with traditional organ scans and bloodwork.

        I feel like thiamine deficiency could be the cause because of the symptom overlap and the fact that western medicine would never consider a thiamine deficiency as the cause.

        I will order the TTFD. What do you suggest for dosing as a trial? I already take a methylated B complex and Magnesium Glycinate.

  11. Dear Dr. Lonsdale and dear Dr. Marrs,
    in August 2019 I abruptly became very sick and after three very intense months (nine times in the hospital and multiple medical specialists) was finally diagnosed with Beriberi (dry and wet, unrelated to alcohol, as I drink very little) by an amazing functional medicine physician assistant who has read your book and started treating a lot of her patients according to your studies. I improved within a week of taking thiamine and magnesium. I felt good for 7/8 months but a month ago I started having daily abrupt episodes of fainting (mostly after eating – even small meals). My diet is very healthy: mostly veggies, grains, fruits, cereal, very little carbs and almost no sugar. I am currently taking 4 Allithiamine 50mg and 2 Magnesium Taurate a day. Could you please recommend what I could try? Many thanks, Stephanie

    • I am happy that you found some relief with the thiamine. I am afraid, grains, fruits, cereal are quite high carbohydrates and any alcohol consumption will be problematic. Is there not any protein or fat in the diet? Those are necessary for health. I suspect your reaction after eating is relative to these carbohydrates and will necessitate either additional thiamine and/or the reduction or elimination the carbohydrates, this along with the addition of protein and fats to your diet may help. It is also possible that you need additional B and other vitamins.

    • You need to remember that thiamine and magnesium are members of a complex team. They do not work on their own. I suggest that you add a well rounded mulltivitamin. If that doesn’t work then request I/V supplementation

      • Thank you Dr. Lonsdale. I am thankful for your answer and for your generosity sharing your knowledge.

  12. Dear Dr. Lonsdale,
    have you ever come accross any thiamine deficient patient who’s had the following symptoms or does this sound plausible to you?:

    Waking up early morning like 4 or 5 a.m. (almost every morning) with palpitations (heart rate goes up to 140 – 160 according to holter monitor) plus shivering, sweaty chest, feeling like I’m about to die – and all of this ceases 10 minutes after ingestion of carbohydrates like fruit juice (which I keep at my bedside since this all started). It surely feels like hypoglycemia but when I take blood glucose levels upon waking up in this state, it always appears in the normal range between 80 and 100.

    I’ve called the ambulance several times when it happened, but ecg and blood work always come back normal, except for slightly low serum potassium (which never concerns any of the doctors, even if I tell them that my diet is rich in potassium). Holter monitor 24 hrs confirms high heart rate, but no dangerous arrhythmias or anything. The cardiologist says the heart is fine and the tachycardia is probably due to hypoglycemia and the extreme fatigue and weakness (not being able to walk even 1 kilometre in spite of looking healthy) I have been experiencing the last few months is probably a post viral thing or “psychological”. Regarding my nightly “hypoglycemic” episodes, he would want me to do a glucose tolerance test (5 hours), but there is no way on earth I would currently make it to the lab in the morning with the required empty stomach, as I can’t even get out of bed without the fruit juice/carbs.

    I have only recently been diagnosed with POTS and have had all the symptoms of Chronic Fatigue Syndrome for quite some time (years…), but they have gotten quite severe a couple of months ago.

    The POTS is way worse when my stomach is empty (like in the mornings) or if I forget to eat during the day (I have hardly any appetite these days).

    Is it plausible that my body or heart can’t make it through the night properly anymore without getting carbohydrates for glucose, if I’m thiamine deficient, due to impaired mitochondrial function?
    The cardiologist says he’s never heard of such a thing. He only seems to know postprandial hypoglycemia and it doesn’t make sense to him that my episodes come at 4 or 5 am in the mornings when I ate 7 or 8 hours ago.

    I have just come accross your work on thiamine deficiency and I am so hopeful that this is it in my case too. I am currently waiting for TTFD to be delivered to me via mail and am using Benfotiamine (50 mg) in the mean time. I got paradoxical reaction from Benfotiamine right away (palpitations even when I have eaten well, severe brain fog, feeling uneal, suddenly tired in a very heavy untypical way, POTS more severe than usual and a general feeling of anxiety).

    I understand this is a good sign and I should stick to it. I was just wondering if these early morning palpitations and feeling of impending doom that is stopped only by carbohydrates is something that you might have come accross at all and if you think it all makes sense.

    I’m particularily worried because it feels like I would die if I didn’t ingest the fruit juice when the palpitations happen, but I have no appetite/thirst for sugar or anything else whatsoever. I have to force it down every morning and am worried what would happen if I couldn’t one day, because I got sick or something and just couldn’t force them down anymore.

    Until recently I thought that in such case I would probably go to hospital and they would have to give me IV glucose and then I’d be fine, but then I read your account of how IV glucose probably killed a thiamine deficient boy. And now I fear that if I had to go to the hospital again with a pulse of 160 and feeling sick and tell them I just need IV thiamine hcl, they would probably think I am a mental health patient.

    I guess my questions are: have you come accross such phenomenon in thiamine deficiency and what is your opinion of what would happen if I didn’t manage one day to eat or drink carbs when my heart is going crazy like that in the mornings?

    I’ve only started to take Benfotiamine 2 days ago, so during paradoxical reaction I am probably looking at more palpitations like that happening in the next weeks.

    I’m very hopeful though that things will get better again with thiamine supplementation (I am also taking Magnesium, B complex, potassium, multivitamin).

    Thank you so much for your work and your relentless efforts to educate people on thiamine deficiency. It’s so unbelievable that doctors don’t seem to know about this at all!

    Thank you!

    Sincerely yours,

    • You have classic beriberi and a combination of thiamin and magnesium will relieve you when the paradox has subsided. Your treatment with fruit juice will make things worse. Use fresh fruit rather than juice.

      • Dear Dr. Lonsdale,
        thank you so much! You don’t know how happy this makes me! I will spread the word as soon as I’m up on my feet again.

        Thank you and Dr. Marrs for your work and for saving peoples’ lives!

        Yours Anna

  13. Dr.Lonsdale, despite good (even great) initial reactions to TTFD, benfothiamine and cocarboxylase I repeatedly crash and can’t get onto consistent supplementation regime. I read everything you posted and your book as well, and aware of refeeding paradox, need for magnesium etc.
    Recently I found 1963 article which reviews vitamins effect on growth of Candida albicans. Thiamine (including allithiamine and cocarboxylase) and especially B12 significantly stimulated fungal growth. I have long suspected that candida is part of my problem so not sure what to do now. I clearly need thiamine, but 1-3 days after starting supplementation symptoms become unbearable. Last year I forced myself to continue supplementation with TTFD for a month hoping things will get better, they didn’t.
    Have you seen any connection between thiamine supplementation and candida infection? In your opinion, is there anything one could do to be able to supplement?
    Thank you.

    • You say nothing about diet, particularly concerning your intake of alcohol and sugar, both of which will precipitate thiamine deficiency. I was not aware of the connection between thiamine and yeast and have not got an explanation. When you state that you “crash” after two or three days of thiamine supplementation, I am not sure what you mean. What are the symptoms associated?

      • No alcohol for many years. Don’t tolerate even the smallest amount. No sugars for a year now, very low carb for last 7 months. Overall very clean diet without processed/junk food for many years – vegetables, meat, fruit.
        Started to have strong anxiety several years ago, with an avalanche-like worsening two years ago after stressful event. Extreme sensitivities, brain fog, lots of unrelated symptoms which are “all in my head” as they say.
        Intolerance of carbs, they make anxiety much worse very quickly.
        Some time after anxiety started couldn’t tolerate any supplements or foods, and by doing trial and error found that sublingval cocarboxylase clears most symptoms in 10 minutes.
        Read your book and articles, tried TTFD – feeling totally normal for a day, then crashing back to anxiety, brain fog, etc. Added magnesium, took ttfd+magnesium for a month, same reaction. Though magensium alleviated some symptoms. First two hours after taking TTFD were the worst.
        Now a year later, trying to take benfothiamine, or ttfd or sulbuthiamine in order to get rid of brain fog and other things. Benfothiamine is the most tolerable (lowest potency in the nervous system I assume). Fog clears after an hour, but the same reaction of increased anxiety, racing thoughts starts and accumulates over several days, so I quit, then try again and so it goes.
        Reaction to carbs and other foods is so quick that I suspect some weird flora high in the GI or even in the mouth.
        High functioning before onset of anxiety – university, phd, demanding work. Still work but brain fog is often overwhelming.
        The paper I mentioned says that B12 was the most powerful stimulator for candida, but thiamines also had some effect. I found that myself, taking any b12 during thiamine supplementation crashes me twice as strongly as thiamine alone.
        Here is the link to the abstract I mentioned:
        Thank you!

        • I am not a doctor. I do, however, have a child (now in her 20s) who had a lifetime of severe anxiety issues, as well as the range of thiamine deficiency issues written about in this blog. I wanted to comment that we began to get ahead of her anxiety issues (of four possible levels of severity, hers was the worst level) when I began reading old medical texts that focused on the basics of nutrition to build a healthy, well-functioning body.

          One of the main things we changed was adding calcium back into her diet. Reading your post above, I suspect that you are doing what many young people are doing today (including my own kids)–meat and vegetables with some complex carbs, but possibly avoiding milk products. Many of my kids’ friends are vegan.

          We took milk out in the first place because we felt it made her feel angry and depressed. We thought that adding in a plant-based milk product fortified with calcium would be good enough to fill her calcium needs (the doctors thought so too, by the way.) But after a couple of years of 100% avoidance, we had a pizza–and she slept through the night for the first time in a long while.

          That was my introduction to the importance of the basics. I’d like to encourage you to find a REAL nutrition book–and that would probably be an old one. Read about the basics and check to make sure you have your important building blocks in place. One of the best fixes for the anxiety we found for my daughter was having a high-protein, high-fat breakfast, with no carbs; no carbs until after 3:00; and then loading carbs at night. This “technique” was written about in a book called “The Circadian Prescription” by Dr. Sidney M. Baker. It’s an older book and you could get it on Amazon for a few bucks–and it’s an easy and enjoyable read.

          Another discovery we made was the importance of rhythm in my kids’ lives–getting up at the same time each day, eating at the same times each day, and bed at the same time each day, or at least reaching toward that goal.

          And something very important for our times–media use is VERY stressful. And addictive. I have read good studies that say electronic stimulation of the brain by all kids of media cause similar brain changes and life issues as alcoholism and drug addiction. Sometimes worse. This means, I think, that you will see the same thiamine depletion issues as a result of electronic stresses as you see in alcoholism. But it has been almost impossible to manage this with my kids, and even we adults are forced to use these tools extensively–and run the danger of stress damage from them too.

          Anyway, I wanted to encourage you to think about the big picture, and look at older nutrition texts to guide your nutritional choices. I am a believer in supplements, and take allithiamine, etc. every day, but supplements are sort of like the antidote to poison. It’s been important here for us to rebuild basic health foundations along with taking the supplements. It’s really very easy to have big gaps in nutrition, even when you’re working hard on your food. I also think life’s stressors today are FAR beyond what we realize, and it’s important to try to recognize them and weed out what you can.

          Best of luck!

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