A Sick Brain Spells Death: Cases from the Past

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sick brain syndrome
When I was a newly graduated resident in my teaching hospital in England, I encountered a case that was so dramatic that I have never forgotten the slightest detail. It probably was my very first introduction to the concept that I came to understand as the all-consuming dominance of the brain over the body. The patient was probably in his late 50s or early 60s and was known to have chronic tuberculosis. One night I had to admit him to the hospital with an acute attack of pneumonia, obviously much more dangerous because of the tuberculosis. This was before the days of antibiotics. In fact we only had the very earliest sulfonamide that existed under a code name of M and B 693. The sulfonamides were eventually displaced by the discovery of penicillin that led to the antibiotic era. A sulfonamide had limited powers at the best and was totally useless in this case.

Hospital Wards

In order to describe my experience, I have to describe how patients were admitted to the hospital. There were no private rooms as we have them today. A man was admitted to a male ward and a woman to a female ward. A ward consisted of about 24-28 beds. There was a partition down the center of the ward and the beds were arranged in two rows of six or seven on each side of the partition. The only privacy that the patient could get was a curtain that ran on a rail around each bed. Each ward was presided over by a head nurse who was called Sister. She wore a uniform that distinguished her from the rest of the nurses, including a specialized cap that was derived from the hood worn by lay sisters in the days when the monasteries were the hospitals. The lay sisters were the nurses and the monks were the doctors.

The Dying Patient

On the morning after this patient had been admitted, I was awaiting the arrival of my chief. In those days a chief was virtually a god to a young resident lucky enough to obtain a job under his skilled care. I was standing by the desk that was used by the Sister in the forefront of the ward when I heard my chief, who had quietly entered the ward behind me, say “I see you have a dying patient, Lonsdale”. I respectfully said “How do you know that Sir?” He went on to explain: pointing at my patient, “Notice how that gentleman is picking at the bedclothes with his fingers. Sometimes he picks at thin air. That is evidence for a sick brain and he will die”.

Well, of course he did die and the autopsy not only revealed the presence of tuberculosis and pneumonia, but the entire body and brain were infiltrated with micro-abscesses filled with staphylococcal pus. In the short time that he survived under our care, he never showed any elevation of body temperature, no increase in circulating white blood cells and in fact no laboratory data that was out of the normal range. If I had shown the data to a colleague without telling him the history and asked him to tell me what was wrong with the patient, he would have said that it was a normal laboratory result and therefore no disease. It was my introduction to the basic fact that the brain is the master organ. It is responsible for directing all the mechanisms that the body uses in responding to the attack imposed by an infectious microorganism. This man’s  brain was so near death that it could not direct and organize bodily defenses. The useless action of “picking at thin air” was merely automation of action conducted by a sick brain. The reason for this repetitive format of action in similar cases, easily recognized by my chief, is unknown.

Chronic Infection, Poverty, and Malnutrition

Chronic tuberculosis is commonest in impoverished people with inadequate shelter and nutrition, unfortunately all too common in London at that time. This patient’s immunity, his ability to defend himself from infection, had been wrecked, permitting an onslaught of pneumonia and a death dealing staphylococcal infection. What impressed me so much was that this was defined as a sick brain, not a sick body. It was my initiation into an understanding that it is the brain that organizes defense against infections and indeed virtually any form of stress that forces us to adapt. The body is a living framework, a chassis that transports our brains, relying on a continuous brain/body dialogue that enables us to survive in a hostile environment.

Another Sick Brain

A few years after this, I was in practice in a Midland city called Leicester. One evening at the end of office hours, two young women came into my office and said “We want you to come and see dad”. When I asked what was the problem they said that he had had a cough for about 10 days. I suggested that he could wait until the following day but they insisted on an emergency house call. When I entered the house and climbed the stairs I was confronted by a middle-aged man who was kneeling on all fours on a bed under an un-shaded blue light and “picking at thin air”. He was admitted to hospital and found to have meningitis, caused by a pneumococcus, a bacterium that usually results in pneumonia. The 10 day old cough probably represented a pneumococcal infection of the lung that had spread to the meninges and caused meningitis. Like the patient described above, his sick brain killed him. I came to understand that an infection is an attacking agent, perhaps testing our right to survival. Mother Nature is simply asking us whether we are fit enough to procreate and support the survival of the species, a Darwinian concept. The phenomena that follow are the defenses going into action, a battle organized and conducted by the brain.

The Fortress Analogy

Although I have used this analogy in a previous post, it bears repeating because it illustrates the all important dominance of the brain over the body. The commander of a fortress is in a central location. Soldiers, placed on the battlements, have to spot an approaching enemy. A message is sent to the commander who must then organize the defense. If he is asleep, drunk or otherwise unable to respond, the defenses are never initiated and the fortress conquered. After it has perceived that an infecting organism has started an attack, the brain has this function over the body. Acting as commander, it raises the temperature of the body. This is because attacking micro organisms are programmed to operate at 37°C, the normal temperature of the human body. Raising the body temperature works against the efficiency, or virulence, of the infecting organism. White blood cells are the equivalent of soldiers in the fortress and messages from the brain cause them to pour out from the storage organs, increasing in number as they circulate in the blood. Lymph glands may swell because they act as traps for the organisms. Indeed, all the phenomena that we call illness really represent the complex defense systems going into action. To reduce the fever with medication like aspirin is to increase the risk of defeat by the organism. Every infection represents attack and defense. There are only three possible outcomes, a complete restitution of health, death, or a stalemate where the “battle” continues on an indefinite basis without resolution. Many organisms, known as opportunists, become aware that the defenses of the body are weak or broken. They seek their “opportunity” for winning the battle. Yeast (Candida albicans) is a well known opportunist organism and explains why this infection is so common in people who have a poor defensive program. Children with autism are good examples.

The Secret is Oxidative Metabolism in the Brain

The only way to maintain oxidative efficiency, particularly in the brain where oxygen utilization is maximal, is to eat the healthiest diet available. The noncaloric vitamins and essential minerals are vitally important and are becoming progressively insufficient in the everyday Western diet. Indeed, this seems to be so common that I visualize their supplementation as a necessity to maintain health. There can be no cutting of corners in a world where civilization is an absurd form of continuous stress. Our environment is hostile in many different ways. Assuming that the “fortress” is well-built, it is the “commander” that decides the issues as they face us on a day-to-day basis. All that the “commander” requires is energy and whether we like it or not, this has to come from ideal nutrition.

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This article was published originally on Hormones Matter on May 9, 2016. 

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22 Comments

  1. Dear Dr. Lonsdale,

    Thank you for your wisdom, curiosity, devotion and calling. I’ve been reviewing my 23 and me raw data. It suggests plenty of genetic variations at SLC19A1,A2, and A3 (the thiamine transporters). I will now add lipothiamine or allithiamine to my treatment regime. (I already take magnesium glycinate, vitamin C, a multi mineral and a multi B.)

    I also cope with Hashimotos, Ehlers Danlos, classic type (everything is stretchy), Mast Cell Disease and POTS. Significantly, all my conditions worsened after I took the H1N1 and flu vaccine 6 years ago.

    My POTS has been explained as a result of the EDS and the mast cell disease. But my genomic data suggests there are other sources for this health challenge such as poor norepinephrine transport, variations with dopamine beta hydroxylase and now thiamine transport. So, I believe everything reflects some kind of crosstalk, and I can only make so much progress healing if I’m minus some nutritional building blocks.

    At this point, I’m wondering what the daily dosing of thiamine might be for someone with an hereditary connective tissue disorder and an autoimmune disorder that probably impacts nutritional absorption. Is the 200 mg you suggested for Chris the way to go? I’m also wondering how much biotin might be reasonable to take along with any alpha lipoic acid?

    Thanks in advance and please know that I recognize you are not treating me if you choose to share any dosing considerations.

    1. you obviously have dysautonomia and I would guess that it is mitochondrial in nature. It might respond to very big doses of Lipothiamine that you can get from Ecological Formulas in California. I would suggest 400 mg +300 mg of magnesium and a well-rounded multivitamin. Intravenous water-soluble vitamins might be necessary

      1. Thank you Dr. Lonsdale. I’ve begun the lipothiamine with my magnesium glycinate. I’m delighted to let you know I am experiencing decreased head and neck pain. The thiamine is generating an analgesic effect for me. Living in the realm of a chronic complex condition, I’m often faced with the limitations of contemporary medicine. It’s wonderful when a relatively simple intervention helps.

        I’m continuing to search for a local physician who can further help me address the mitochondrial nature of my dysautonomia.

        I enjoyed reading your book, A Nutritional Approach to a Revised Model for Medicine. I will look forward to reading more of your essays here. Thanks again for tending to our health and pushing folks to open their minds.

  2. Dr. Lonsdale,

    Ihave been strugle for many years with varius phisical problems, the main one is the fatigue, and others sporadicals, like glottis spasms and numbness in the feet.

    Two years ago I was diagnoticated as celiac, so I started a non gluten diet. My health improve a lot (may be because as I don’t eat refined food, I don’t eat right now almost any sugar).

    But as I don’t feel 100% healthy, I investigate from my own the B1 topic. In my country (Spain), as far as I know, there are two laboratories in Barcelona that carry out the TPPE analysis. So I made it and the result was:

    Vitamina B1 –>normal
    Transketolasa actvity –> normal
    TPPE –> 28,56%

    So it seems that I am B1 deficient.

    So I have several questions:

    1. Is it common that celiac people suffer B1 deficiency? [my doctor didn’t tell me anything…]

    2. Instead of allithiamine, would it be the same to ingest B1 HCL with crush garlic (I could buy allithiamin on internet, one bottle from the States and other from Tawian, but I don’t feel very confortable buying medicenes on internet, and I don’t know even if it is legal).

    3. From your experience, is the B1 deficiency related with genes or with lifestile? (I am trying to convice my elderly mother to take the test, but I would need an argument)

    4. Which other components are necessary for treating the deficiency?. I have read: magnesium, vitamin C, other B vitamins, etc. All of them?? [if you were so kind to send me a protocol for treatment, I appreciate it a lot]

    Many thanks.

    1. This is an interesting example of the typical symptoms associated with or caused by thiamine deficiency. Please note that the blood level of thiamine and transketolase activity were in the normal range. Only the part of the test called TPPE was abnormal and proved the deficiency. Let me be clear about this. The blood level of thiamine and the baseline activity of transketolase is almost always normal unless the deficiency is very prolonged, genetically determined, or unusually severe. The TPPE is performed by repeating the test for transketolase activity after adding thiamine to the reaction. If it accelerates (56% is the measure of increased acceleration of the enzyme over baseline activity and strongly indicates that the enzyme was deficient and could not reach its action potential).I have long been interested in the potential relationship of gluten sensitivity (this is NOT celiac disease) with thiamine deficiency and the appalling wideworld ingestion of sugar, but there is no scientific proof at the moment. Do we have to wait until we are sick to obey the rules of nature in terms of what we are designed to eat?

  3. Ok so now i put my new email adress from a another provider in the email field from this comment so i hope you can see it and it hopefully works now!
    Thank you a lot!

  4. Dr. Lonsdale
    My own case is pretty similair to the one described above: I am also pretty sure to be severly thiamine deficient/dependent because of a real lack of thiamine in my diet for over a year now, high stress, malabsorbtion issues etc. Most of my symptoms could be explained by thiamine deficiency. Also my doctors don’t see it as a problem so I actually can’t get i.v. Thiamine and i think in my area there a no doctors specialised who know about thiamine because i am from austria.
    So do you think it would also work as well to help oneself and just take high dose oral thiamin?
    So could i take let’s say 500mg of benfotiamin a day? I know that i doesn’t cross the blood brain barrier per se but thiamine hydrochloride does neither right? And with benfo one could achieve a lot higher plasma levels in which case it would be more likely to get in the brain? Unfortunately i don’t have access to allithiamines…
    I also struggle greatly and am really concerned, also if i may already have wernicke’s (can’t really assess that).
    So like K.C. I’d also like to ask the question whether there’s a point where it’s too late to repair the damage?
    I really love your articles and also have a high respect for your work!
    Thank you a lot in advance!
    Chris

      1. Thank you for your answering!
        so at the neurology department in the hospital they checked a lot including basic neurological examination, blood tests, nerve conduction study on the feet and an mri brain scan without contrast agent and couldn’t find anything (they didn’t do lumbar punction). They said it’s no encephalopathy and these slight balance problems could be from stress..
        These are my symptoms: constant fight or flight mode and panic attacks, very slight balance problems when walking with eyes open but more pronounced when eys are closed (tandem gait with open eyes possible without falling or stepping aside but impossible with closed eyes, standing on one foot again no problem with eyes open but not with closed eyes, didn’t fall at romberg), pain and heaviness in the legs and needles in feet, extreme fatigue, perceived slowness in and clouded thinking, concentration issues, short attention span, irritability, “infomation overload”, mood swings, difficulty breathing, getting stuck on a thought, little hard to execute sometimes… They dveloped gradually in the last 2-3 years, some came sooner, others later…
        So I’d be glad to know if in that case instead of i.v. thiamine, 500 mg of oral benfotiamine a day could be an option (also in regards to the bbb), whether it would be superior to mega dose oral thiamin hcl and if fursul- and sulbuthiamin would be that superior to both or even absolutely necessary(even though it’d be very hard/ maybe not possible for me to get allithiamines here)?
        And also if it is likely that it is too late to repair all the damage if it is related to thiamine deficiency?
        I know a lot of words but i’d really really glad for an answer!
        Thank you a lot!
        Chris

        1. I am answering Chris independently by email, but I want to make a comment here. This is absolutely typical of early beriberi. As I have said many times in these posts, thiamine deficiency affects the part of the brain that deals primarily with the autonomic(automatic) nervous system. Notice that his doctors said that some of his symptoms were due to “stress”, implying that they were psychosomatic. This is because of two basic facts: 1. Vitamin deficiency diseases are considered to be extinct in developed countries. 2. When lab studies do not identify the cause of symptoms, the disease is considered to be “psychological”. The reality is that “stress” must be considered as a mental or physical force to which each of us must adapt. In this case the machinery that enables the adaptation to take place is compromised. It is exactly the same as suffering a mild deficiency of oxygen and that is why thiamine deficiency is sometimes referred to as pseudo-hypoxia (false lack of oxygen). Unless the diet of Chris is the same catastrophe as it often is in America, there is a genetic background associated with this pseudo-hypoxia.

              1. It should finally work now! I also contacted you at “contact us” with this adress and now there was written it is valid.
                I’d be very glad if you tried again (again with the one provided in this comment) and sorry for the trouble..

                1. I’d really appreciate it if you were so kind and tried once again Dr Lonsdale, because a friend of mine (in my country) wrote me an email to this adress and I could receive it, but when I tried to contact you at the „contact us“ field there was written that this adress is invalid. I looked and changed it to standard adress and then it worked and I could successfully contact you and get an email from another friend from another country. So I think the problem was that I had to change it to standard maybe for sending abroad or something so I really think it should work now!
                  Thank you a lot!

        2. The email address simply does not work since it appears to be on a different system. Your symptoms are absolutely typical of beriberi and your needs are clearly for the following: 1. Stay away from all kinds of sugar, alcohol, soft drinks, candy, chocolate, desserts, cookies etc. 2. You may be able to get relief from thiamine hydrochloride but it would have to be in extremely large doses. There is absolutely no doubt that the best supplement would be Lipothiamine (Ecological Formulas,1061-B Shary Circle, Concord, CA 94518), probably about 200 mg a day, together with magnesium, vitamin C and a well-rounded multivitamin. 3. There is almost certainly a genetic background, but it is not the only factor and you will be using the nutrients as an epigenetic form of treatment. epigenetics is a relatively new science. It tells us that our genes can be manipulated by the nature of nutrition and lifestyle

          1. Thank you!

            In one of your posts you wrote that to get the enzymes activated again one would have to get TTFD through i.v. and I also read somewhere that oral TTFD is metabolized in the liver to another thiamine derivative which can’t traverse the blood brain barrier like actual TTFD does anymore (first pass effect).
            So do you think that could be an issue in my case or would the oral 200mg of Lipothiamine (as the only thiamine source) be enough for my problems (I finally found Lipothiamine in Europe so I’ll order it tomorrow)? How long do you think I should take it and can I combine it with Benfotiamin and maybe switch completely to Benfo after a while (because that is much easier for me to get)?
            Thank you a lot!

  5. Dr. Lonsdale –
    I highly respect your work. And beleive I am severely thiamin deficient / dependent after several vaccines that have seriously knocked me off my feet physically among other things such as diabetes and recent malnutrition / malabsorption. None of my physicians, not even my neurologist or my functional medicine Doctor will acknowledge this problem and I am in need of some help. I am wondering if you are still in contact with any doctors in the Cleveland area that you can recommend that understand the importance of thiamine and the role it plays in mitochondrial and brain health. Is there any way that you could pass on that nfoation if possible? I am fighting for my life and cannot find anyone to help in the area. Also, is there a point at which it is too late to repair the thiamin deficiency?
    Thank you for your consideration!

    1. I have replied separately to this person. However, I would like it to be better known that diabetes types one and two have abnormal thiamine metabolism. They require pharmacological doses of the vitamin in order to protect them from the complications that are so well known in this disease. To anyone reading this comment, please understand that this is new medical information, not my imagination or enthusiasm. Doctors in practice should be aware of this. Thiamine is being used as a drug, not as a vitamin replacement. Its advantage is that it has no toxicity in these large doses. In co-authorship with Dr. Marrs we are in the process of writing a book for physicians and health workers that will be published at the end of this year. It seems that American medicine is in the dark ages and everybody thinks that it is the greatest bonanza that has ever evolved. Oddly enough, Hippocrates was on a better level of understanding 400 BC.

        1. Hi, I feel on ice and was given many injections within 2 months SI injection back epidural hip injection ans knee injections and referred to psychiatrist for depression anxiety and prescibed trazadone and Zoloft. I got insomnia and have only slept 2-4 hours a night for months, I can’t sleep have lost 30!pounds I have hand and voice tremors my teeth chatterand can’t think, I am dying and no one knows what is wrong I have a bachelors degree and now I can’t spell I can’t add and subtract my eyes feel weird like they are being pulled I have migraines and horrible social anxiety due to my lack of cognitive skills I stopped all medicine had hip arthroscopy and still am not better my dr doesn’t know what to do where do I get help please help me I am desperate I thought seratonin syndrome ans dr says it’s too rare I can’t live like this please help me

          1. To answer your questions, we need more information. The migraines and social anxiety indicate to me that energy metabolism in your brain is compromised. Do you take sugar in your diet and is there a family history of alcoholism? There is no doubt in my mind that you have mitochondrial disease. At what age did your symptoms begin? Fill in a few more details. Intravenous vitamin therapy would be the most likely approach to help you. Try to find a doctor who works this way. I suggest you call acam@acam.org to find if there is a physician that you might be referred to

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