high calorie malnutrition

Diet Induced Pseudo-Hypoxia and Hypertension

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pseudo-hypoxia hypertension

Although hypertension has become almost exclusively used to indicate high blood pressure, it is worth examining the true underlying meaning. The prefix “hyper” is from the Greek, meaning over or above. Tension is defined as “the state of being stretched tight”. Perhaps then it is worth looking at how this applies to blood pressure.

When a blood pressure is measured, there are always two figures represented. The higher number is known as “systolic” and the lower one as “diastolic”. The systolic is when the heart is contracting and indicates the ability of the arterial system to expand enough to accommodate the pressure from an increased volume of blood. The diastolic indicates the pressure in the arterial system when the heart is resting between beats. We are therefore looking at the highest and lowest pressures in a closed tube system that must be capable of expanding and contracting.

Since the system is made from live cells, it does not behave like a rubber tube with elastic recoil. The arteries where blood pressure is measured are lined with muscles. It is the contraction and relaxation of these muscles that control the capacity of the artery to accommodate the amount of blood arriving from the heart. The muscles are controlled by nerves carrying messages from the brain. These muscles are completely different from those that are activated willingly, such as those in the limbs. They are contracted and relaxed automatically by a part of the brain that acts more like a computer. The body muscles are activated by a nervous system known as “voluntary”. The arterial muscles are activated by a completely separate an involuntary nervous system known as autonomic (ANS). We therefore have to examine the control mechanisms.

Understanding the Autonomic Nervous System

I have discussed this nervous system many times in Hormones Matter because, when it goes wrong, it is a potent source of disease. The nerves of this system go to every organ within the body. The control system is in the lower part of the brain. It consists of two channels. One is known as sympathetic: the other is known as parasympathetic. Although they work together, their actions oppose each other and I will try briefly to outline this dichotomy.

Sympathetic. The sympathetic nervous system is designed for both physical and mental action through a reflex mechanism known as the fight-or-flight. It prepares us to meet an enemy or escape from danger. One of its actions is to raise the blood pressure. It does this by contracting the arterial muscles already described.

Parasympathetic. When the action is completed, the brain controls automatically withdraw the activity of the sympathetic and initiate those of the parasympathetic nervous system. When this happens, the body is prepared for resting.

Chronic Activation of the Sympathetic Nervous System

There is a large amount of evidence in the medical literature that this is the primary cause of chronically high blood pressure. If the system is healthy, the blood pressure will go down on completion of the action. If not, the blood pressure remains elevated. From here, I am going to hypothesize why this happens. Please remember as you read it that it is a hypothesis, not a proven fact.

Hypoxia. This word simply means lack of oxygen. Obviously, this is a dangerous state for the brain and it is not surprising that it will activate the sympathetic component described above, including raising the blood pressure.

Pseudo-hypoxia. The prefix “pseudo”, meaning false, or sham (from the Greek, lying, false) has been used in the medical literature to describe a state that is exactly like that of hypoxia when the presence of oxygen is normal. In order to understand this, focus on the fact that oxygen must be introduced to the body but is completely useless unless it is consumed. Therefore we must try to indicate how oxygen consumption occurs.

Oxidation and burning. All forms of burning are derived from oxygen combining with a fuel, liberating heat energy. That is why we are warm blooded, but other forms of energy are produced to drive physical and mental function. Because the burning is incomplete, ash is formed. Our cells derive their energy by the oxygen, delivered in the blood from the lung, combining with glucose. The “ash” is carbon dioxide and water, discarded in the breath. The oxidation of glucose is governed by a set of enzymes that require the vitamin B complex for their action. The leader of this orchestration appears to be vitamin B1 (thiamine). That is why many papers have appeared in the medical literature that describes thiamine deficiency as a cause of pseudo-hypoxia. Its function is to catalyze the enzymes essential for oxidation. Its deficiency results in lack of sufficient energy. It is therefore not surprising that one of the symptoms of thiamine deficiency is fatigue.

Calorie/thiamine ratio. A healthy diet provides us with calorie producing elements that are broken down to glucose and used as fuel. The amount of thiamine provides a normal calorie/thiamine ratio that enables efficient oxidation. If we load the diet with empty calories (calories without essential non-calorie nutrients that include thiamine) the calorie/thiamine ratio becomes abnormal. Measuring the concentration of thiamine in the blood would be normal for a healthy diet but inadequate to meet the demand of the empty calorie load. The laboratory method for identifying thiamine deficiency is by measuring it in the blood. If the result is reported by the laboratory as normal, the relevant symptoms produced by inadequate oxidation may well be ascribed to causes other than thiamine deficiency.

Hypothesis: High Calorie Malnutrition Induces Chronic Sympathetic Overdrive

I suspect that a common cause of hypertension is high calorie malnutrition, inducing a state of chronic sympathetic overdrive. It may be why obesity in children often foretells their rise in blood pressure. Perhaps another cause is the gradual diminution of oxidation associated with aging. There are genetic mechanisms that are turned on by hypoxia and these also may be activated by pseudo-hypoxia, e.g. thiamine deficiency.

Spontaneously Hypertensive Rats

Lipothiamin is a synthetic derivative of thiamine. Its biologic properties enable it to be used as a drug. A rat known as SHR (spontaneously hypertensive rat) is used as the animal model for studying the effect of antihypertensive drugs. Many years ago I took a group of these rats and treated them with Lipothiamin to see if it would prevent the rise in blood pressure that always occurs in these animals. There was a statistically significant difference between the experimental rats and the controls, indicating that this thiamine derivative did indeed prevent the spontaneous rise in blood pressure. This experiment is published in our book (Lonsdale D, Marrs C. Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition). It obviously requires human subjects to research the use of this completely non-toxic, nutrient/drug derivative but nevertheless provides us with solid clues about hypertension.

Conclusion: Diet Matters

It has been said that simplicity must be distilled out of complexity in order to make complex issues usable. The brain/body, whether we like to recognize it or not, is an “electrochemical machine” that must obey all the physical laws designed by Mother Nature. Health is governed by only three factors:

  1. Genetics: the enormous complexity is dictated by a code written in DNA. Passage from generation to generation makes mistakes and represents our inheritance.
  2. Stress: defined as anything that requires physical/mental defensive response. The response, designed for relatively short term action, demands a huge consumption of energy.
  3. Nutrition: this is the only one of the three issues that we can control. It must supply both fuel and the multiple factors that enable the fuel to be turned into energy.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

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Metformin: Medical Marvel or Magical Medicine?

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Metformin magic

I am not a big fan of metformin (Glucophage). My disdain for metformin stems not from its efficacy. Metformin is quite adept at lowering blood sugar. In that sense, it is a medical marvel. Consider a pill that will ensure that no matter the individual’s intake of sugar, blood glucose measurements will magically fall within a normal range. What a wonderful invention – to have one’s cake, eat it too, and all the while, maintain normal blood sugar – who wouldn’t want that?

Alas, however, like all magic tricks, when the sleight of hand is revealed, the luster is lost. In the case of metformin, the underlying prestidigitation is not so magical after all. Metformin, like other wonder drugs, treats a symptom of a much greater problem; a symptom that in reality is just a visible sign of a necessary and protective innate process designed for cellular survival. The symptom is insulin resistance, the problem is too much dietary sugar and too few nutrients – an insidious form of high-calorie malnutrition that at once overloads cellular and mitochondrial processing capacities and starves the cells of critical nutrients.

Nutrients – They’re Necessary

A little-appreciated fact in modern medicine, vitamins and minerals power all of the machinery involved in cell function and in mitochondrial energy production. No nutrients, no energy, cellular starvation (even in the face of weight gain), inflammation, dysfunction, and ultimately, death. In the face of too much sugar and not enough nutrition, insulin resistance seems perfectly logical. If cellular fuel is waning, why not keep a little extra floating around, but since the apparatus to process said sugars is crippled, we have to turn down the intake valves. I would argue that it’s not obesity causing insulin resistance, after all not all overweight folks have type 2 diabetes, and not all insulin-resistant diabetics are overweight. It’s the damned sugar and lack of other nutrients initiating insulin resistance. Both the insulin resistance and fat storage are survival mechanisms; ones that ultimately have pathological consequences, but survival mechanisms nevertheless. In fact, folks who are diabetic and overweight have a lower all-cause mortality rate than those who are diabetic and thin.

If the problem is high-calorie malnutrition, which manifests as elevated blood sugar and in many cases, increased fat storage, wouldn’t the more prudent solution be to rectify the problem, to cease sugar intake, and address the nutrient deficiency? Wouldn’t that unwind the damage and heal the body? I think so, but alas, that’s not what we do in modern medicine. No, we don’t correct the problem, we treat the symptom(s) and then we revel in all the cool mechanisms we can interrupt, never considering the bigger picture.

Metformin Usurps Cell Signaling

Metformin bypasses our cells’ innate response to too much of anything – downregulation or desensitization – by overriding the communication systems that control these functions. In this case, metformin becomes the signaling molecule that tells the liver if and when to release glucose into the bloodstream. From an engineering standpoint, it’s a fantastic workaround. No need to address the core problem, just rewire the communication and continue on as if nothing is wrong. The added bonus is that for all intents and purposes, it works. Blood sugar declines, as does some of the pathology associated with elevated blood sugar. A medical marvel, right?

Well, not so fast. It just so happens that we need those pesky nutrients to function and to survive. When we give metformin to individuals who are already in a state of malnutrition, we are effectively ignoring and extending the underlying deficiencies that initiated the insulin resistance in the first place. More importantly, and this is something that is missed almost entirely in western medicine, we are adding to the metabolic mess a chemical that directly leaches a whole bunch of nutrients on its own (which further disables cell function, increases insulin resistance, increases fat storage in the long term and all of the associated pathologies we have come to know and love). Furthermore, we’re disrupting energy metabolism – energy that all cells need to function – and while that may quell some pathologies in the short term, in the long term, we’re all but guaranteeing a progressive decline into ill-health, despite the cheerleading that suggests otherwise.

We Get It. Metformin Treats a Symptom Not the Root Cause. So What?

Why am I blustering on about metformin now, when I have done so on several occasions previously (here, here, and here)? Well, an emerging body of research is showing yet another set of mechanisms by which metformin derails health. It turns out, that in addition to depleting vitamins B12 and B9, which are responsible for 100s of enzymatic reactions and particularly important in central nervous system function including myelination (how many cases of diabetic neuropathy or multiple sclerosis are really vitamin b12 deficiency?) and tanking CoEnzyme Q10 which effectively cripples mitochondrial ATP production in muscles (and likely exercise capabilities) with the resultant loss inducing a whole host of pathological processes (muscle weakness, cognitive decline among a few), metformin also blocks vitamin B1 – thiamine – uptake by multiple mechanisms. And for kicks and giggles, it appears to interfere with the body’s innate toxicant metabolism pathways, the P450 enzymes, rendering those who use this drug less capable of effectively metabolizing a whole host of other medications and environmental toxicants.

Thiamine is Critically Important to Health

For those of you who don’t read our blog and/or are not familiar with thiamine and thiamine deficiency, let’s just say, thiamine is the granddaddy of nutrients, an essential cofactor at the top of the fuel processing pyramid. Without thiamine, food fuel from carbs and, to a lesser extent, fats cannot be converted into ATP. With declining fuel sources, mitochondrial functioning degrades as well and all sorts of diseases processes ensue.

Sit with that for a moment. We’re giving folks who already have an issue with converting foods to energy and who are already very likely nutrient deficient, a medication that blocks the very first step in that conversion process. Since metformin also blocks the lactate pathway and acetyl-coenzyme A carboxylase (an enzyme necessary to process fatty acids into fuels), blocking thiamine effectively shunts the mitochondrial input pathways. Mind you, this is in addition to blocking the critical electron transport functions – via CoQ10 – found at the back of ATP processing. Talk about an induction of energetic stress.

So What If a Few Vitamins Are Depleted?

I bet you’re thinking if these nutrients are so important and metformin is so dangerous, why isn’t metformin more toxic? After all, metformin has been on the market for over 50 years, is considered the first line of treatment for type 2 diabetes, and just about every research article published on this drug begins with a blanket statement that metformin has an excellent safety record.

Why, indeed? Let us consider what constitutes a safe drug?

In modern medicine, the notion of drug safety and toxicology are equated with acute reactions. For decades, we have been operating under the false assumption in medical and environmental toxicology that if something doesn’t kill us immediately it must be safe (and the equally false assumption that toxicological responses are necessarily linear). Many drugs (and environmental toxicants) are much more subtle in their damage. They disrupt systems that, in many cases, have the capacity to compensate, at least for a period of time and until a critical threshold is met. Mitochondrial energetics is one of those systems that is remarkably resilient in the face of a myriad of stressors, sometimes taking years for the damage to be recognized. With nutrient deficiencies, in particular, compensation is aided by continuously changing environmental and lifestyle considerations. Sometimes we eat very well and other times we don’t; sometimes life is good, other times, it is not. Stressors vary.

Nutrient Deficiencies Wax and Wane

With nutrients deficiencies, especially essential nutrients that require dietary intake, there can be waxing and waning of the symptoms that these deficits evoke as diet and other variables change. It’s not until one reaches a critical threshold that the deficiency is recognized if it is recognized at all. With thiamine deficiency, in particular, animal research suggests the threshold for severe symptoms may be as high as 80% depletion. Imagine a system that can maintain life in the face of up to an 80% deficiency. That is remarkable.

Symptoms of severe thiamine deficiency include those associated with a condition called Wernicke’s Encephalopathy, a serious and potentially fatal medical emergency with neurological and cognitive impairments, oculomotor and gait disturbances, and cardiac instability. With milder deficiencies, however, we see things like fatigue, muscle pain, mental fuzziness, GI disturbances, autonomic dysregulation, and a host of symptoms that can easily and incorrectly be attributed to other conditions and/or modern life in general.

Interestingly, once thiamine depletion reaches that critical threshold, it doesn’t take much thiamine to begin seeing improvement in the symptoms. In those same animal studies mentioned above, it took an increase of only 6% of the total thiamine concentration to begin the improvement. So with a change from 20 to 26% of recommended thiamine concentration, symptoms begin to dissipate, at least temporarily. Sit with than one for a moment – what a remarkable bit of resilience. It takes a full 80% reduction in thiamine stores before serious symptoms are recognized but improvement begins with only an additional 6% – when the system is still depleted by 74%.

Given the metabolic capacity to maintain survival in the face of all but critical deficiencies, it is easy to see how and why blocking these nutrients would not be considered dangerous or at least obviously so. The decline is so gradual in most cases, and likely waxes and wanes, that it becomes near impossible to attribute symptoms and underlying nutrient deficiencies to the offending medication(s). Unfortunately, just because we don’t recognize those patterns, doesn’t mean that they do not exist.

How Metformin Blocks Thiamine: The Technicals

Backing up just a bit, it is important to understand the mechanisms by which metformin reduces thiamine. When metformin is present, a set of transporters that normally bring thiamine into the cell to perform its task as a cofactor in the machinery that converts carbs to ATP, brings metformin into the cell instead, replacing thiamine altogether. The transporters involved are the SLC22A1, also called the organic cation transporter 1, [OAT1], and the SLC19A3. Conversely, when metformin is not present or at least not overwhelming all of the transporters as it is during the initial phases of absorption post intake, thiamine becomes available for transport. Since these transporters are not completely and continuously blocked (and there are other thiamine transporters), thiamine uptake occurs, just not continuously and just not at full capacity. This may be one reason why metformin is not as acutely damaging as some of the other drugs in its class, but make no mistake, it is still dangerous. Thiamine deficiency is deadly. With the right combination of thiamine blocking variables (other medications/vaccines block thiamine as well), thiamine concentrations can tank and even if the thiamine concentrations hover at a subclinical deficit, the likelihood of chronic illness is high.

Thiamine and Diabetes: Connecting a Few More Dots

A little over a year ago, I stumbled upon some research showing a high rate of thiamine deficiency in individuals with both type 1 and type 2 diabetes (75% and 64%, respectively). I wrote about that research in Diabetes and Thiamine: A Novel Treatment Opportunity. According to several studies, diabetics appear to excrete higher amounts of thiamine than non-diabetics. The research attributes this to either poor kidney reabsorption and/or mutations in the thiamine transporter genes that prevent absorption. None of the research detailed the medication usage of the participants, but one might expect a good percentage of the type 2 diabetics were using metformin. It seems reasonable that if metformin supplants thiamine uptake via the thiamine transporters mentioned above, then the body would excrete the unused thiamine, leading to a higher rate of thiamine excretion than observed in non-diabetics and a higher rate of thiamine deficiency in diabetics versus non-diabetics. Based upon this, additional clinical research has shown that thiamine supplementation normalizes, the aberrant processes activated by sustained hyperglycemia including:

Metformin, in treating a symptom rather than a root cause, is likely exacerbating, and perhaps even initiating, some of the very disease processes that it is intended to prevent. Although metformin is not often acutely toxic, the underlying mechanisms manipulated by this drug suggest that it is likely to induce and not prevent, as is so frequently suggested, chronic illness. From my perspective, that makes metformin a very dangerous drug.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

This article was published originally on Hormones Matter on February 16, 2016. 

Image by kalhh from Pixabay.

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Health Requires Energy. Energy Requires Nutrients.

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Health requires energy

A Fundamental Issue

I was horrified to watch the “60 Minutes” program Sunday, April 12th, 2020 on television that dealt with the colossal number of Americans suffering from obesity, chronic fatigue and diabetes, both types I and II. About half of the program dealt with the essential consumption of natural food, reminding us that Hippocrates, 400 BCE said “let food be your medicine and let medicine be your food”. This must have been said thousands of times but everything in our modern civilization is totally destructive to the whole idea. I have seen so many hundreds, if not thousands, of people whose illness was caused by themselves. It was treatable by making sure that each individual understood the fundamental issue. So before I illustrate a typical illness situation within my experience, I will try to state what I mean by describing what I consider to be the “fundamental issue”.

“We behave according to what we eat”.

I have stated this so many times but unfortunately the American medical profession is the major inhibitor to its clinical success. When a suffering patient with many symptoms arising from what I call “dietary mayhem”, goes to his or her physician, they simply do not recognize the clinical expression of the popular high calorie malnutrition. The many symptoms are usually referred to as psychosomatic and the unfortunate patient is told that “it is all in your head”. I have witnessed this so many times; I cannot understand why the physicians don’t pay a little more attention to what the patient is trying to tell them. Often the patient has discovered the real cause of the problem but find that her words are considered to be the voice of ignorance and delusion.

Food and Energy

Our food consists of fuel that must be burned (oxidized) to liberate energy. In any text this element of the food is described as “calories”. The energy quality of our food intake is measured in kilocalories and a single one is defined as “the energy needed to raise the temperature of 1 kg of water through 1°C”. Notice the use of the word energy, the result of oxidation. Now, as everyone knows, vitamins and minerals, known as non-caloric nutrients, are vital to the release of energy from the caloric elements. To understand how this combination of chemicals works, there must be a ratio of calories to the noncaloric elements. That is why high calorie foods without vitamins or minerals are known as empty calories. It is the consumption of empty calories across America that has given rise to the idea of high calorie malnutrition. I have actually seen a written statement that this is an oxymoron. “How can excess of calories be considered a form of malnutrition?” It seems that few people understand this vital ratio and they seem to think that as long as you are consuming calories, you will flourish. Also, the food industry fills the grocery store with cartons of temptation and seems to have no regard for the well-being of its consumers. They keep using the term “all natural” so much, it becomes meaningless.

A Typical Case of Energy Deficiency

I was a pediatrician at Cleveland Clinic and one of my interests was sudden infant death (SIDS). So one day I was having lunch with one of the surgeons who practised ear nose and throat surgery. He told me that he had been called to the medical ICU because a woman had stopped breathing and he had performed a tracheostomy. He was intrigued by the reason for this disaster and, knowing my interest, he suggested that I should take a look. Pediatricians are assumed to be familiar with diseases of children but ignorant of adult disease and I knew that I was  not welcome. I found a 50-year-old woman who was grossly edematous and unconscious. Without considering the technical details, I proved that she had the vitamin B1 deficiency disease beriberi. With injections of thiamine she became conscious and the edema disappeared. During her recovery she developed a progressive anemia, thought to be evidence of internal bleeding, but all the tests were negative. I took some urine from her and subjected it to a special type of test. It showed that she was deficient in folate, another B vitamin. It is important to note that she did not develop folate deficiency until she began her recovery from thiamine, it was masked by cellular energy deficiency. When she began to receive folate there was an immediate recovery from the anemia but she had been given at least one injection of thiamine by then.

She was discharged from hospital, wheelchair bound, taking both thiamine and folate. When she returned as an outpatient, I found that she had a skin rash and that her legs were, if anything, weaker. It had long been known that anemia would develop from either folate or B12 deficiency, but the folate deficient variety required B12 supplementation as well as folate. If B12 was not provided, the patient would develop paralysis of the legs and I had forgotten this. Also, it is not well-known that vitamin B12 deficiency can cause a skin rash. I gave her an injection of B12 and the rash disappeared. However, for a few days she had muscle aches and fever that I did not understand at that time. Looking back I would now assume that this was what we call “paradox” on Hormones Matter. To those that may not have read about this it is the temporary worsening effect by introducing an essential nutrient to someone who has long been deficient in that nutrient. One of the things that had probably been a serious indictment on self cause was that she was a chronic cigarette smoker, a well-known habit that damages oxidation.

Energy Metabolism

Can we extrapolate from this case any general ideas about how medical treatment should advance? Perhaps the general opinion would be that this is a rare and unusual case, an outlier from the “usual and customary diagnosis”. But if we consider the facts; long-term cigarette smoking, dietary indiscretion and genetic risks appear to be quite common. I treated a 12-year old girl  with a conventional diagnosis of Juvenile Rheumatoid Arthritis, using a  nutritional supplement. Without discussing the technicalities of laboratory evidence, it was clear that defective energy metabolism was the underlying cause. The combination of genetic risk, failure to adapt to any form of stress (infection, trauma, chronic useless brain activity etc) and inadequate energy metabolism are the three factors that either collectively or singly lead to breakdown of health. As Selye predicted, energy for adaptation is the essential ingredient.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter. 

Image by Inns-Web from Pixabay.

This article was published originally on April 22, 2020.

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dysautonomia thiamine deficiency

Dysautonomia and Hypoxia

Every profession has its jargon that enables its practitioners to communicate relatively easily but is incomprehensible to those outside the

What Is Thiamine to Energy Metabolism?

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Thiamine -key to energy metabolism

What Is Energy?

Energy is an invisible force. The aggregate of energy in any physical system is a constant quantity, transformable in countless ways but never increased or diminished. In the human body, chemical energy is produced by the combination of oxygen with glucose. This reaction is known as oxidation. The chemical energy is transduced to electrical energy in the process of energy conservation. This might be thought of as the “engine” of the brain/body cells. We have to start thinking that it is electrical energy that drives the human body.

The production of chemical energy is exactly the same in principle as the burning of any fuel but the details are quite different. The energy is captured and stored in an electronic form as a substance known as adenosine triphosphate (ATP) that acts as an energy currency. The chemical changes in food substances are induced by a series of enzymes, each of which combine together to form a chain of chemical reactions that might be thought of as preparing food for its ultimate breakdown and oxidation.

Each of these enzymes requires a chemical “friend”, known as a cofactor. One of the most important enzymes, the one that actually enables the oxidation of glucose, requires thiamine and magnesium as its cofactors. Chemical energy cannot be produced without thiamine and magnesium, although it also requires other “colleagues”, since all vitamins are essential. A whole series of essential minerals are also necessary, so it is not too difficult to understand that all these ingredients must be obtained by nutrition. The body cannot make vitamins or essential minerals. There is also some evidence that thiamine may have a part to play in converting chemical energy to electrical energy. Thus, it may be the ultimate defining factor in the energy that drives function. If that is true, its deficiency would play a vital role in every disease.

Energy Consumption

Few people are aware that our lives depend on energy production and its efficient consumption. A car has to have an engine that produces the energy. This is passed through a transmission that enables the car to function. In a similar manner, we have discussed how energy is produced. It is consumed in a series of energy requiring chemical reactions, each of which requires an enzyme with its appropriate cofactor[s]. This series of reactions can be likened to a transmission, consuming the energy provided from ATP and enabling the human body to function. If energy is consumed faster than it can be synthesized, or energy cannot be produced fast enough to meet demand, it is not too difficult to see that an insufficient supply of energy, a gap between supply and demand, would produce a fundamental change in function. This lack of function in the brain and body organs presents as a disease. The symptoms are merely warning the affected individual that something is wrong. The underlying cause of the energy deficiency has to be ascertained in order to interpret how the symptoms are generated.

Why Focus On Thiamine?

We have already pointed out that thiamine does not work on its own. It operates in what might be regarded as a “team relationship”. But it has also been determined as the defining cause of beriberi, a disease that has affected millions for thousands of years. Any team made up of humans requires a captain and although this is not a perfect analogy, we can regard thiamine as “captain” of an energy producing team. This is mainly due to its necessity for oxidation of glucose, by far and away the most important fuel for the brain, nervous system and heart. Thus, although beriberi is regarded as a disease of those organs, it can affect every cell in the body and the distribution of deficiency within that body can affect the presentation of the symptoms.

Thiamine exists only in naturally occurring foods and it is now easy to see that its deficiency, arising from an inadequate ingestion of those foods, results in slowing of energy production. Because the brain, nervous system and heart are the most energy requiring tissues in the body, beriberi produces a huge number of problems primarily affecting those organs. These changes in function generate what we call symptoms. Lack of energy affects the “transmission”, giving rise to symptoms arising from functional changes in the organs thus subserved. However, it must be pointed out that an enzyme/cofactor abnormality in the “transmission” can also interrupt normal function.

In fact, because of inefficient energy production, the symptoms caused by thiamine deficiency occur in so many human diseases that it can be regarded as the great imitator of all human disease. We now know that nutritional inadequacy is not the only way to develop beriberi. Genetic changes in the ability of thiamine to combine with its enzyme, or changes in the enzyme itself, produce the same symptoms as nutritional inadequacy. It has greatly enlarged our perspective towards the causes of human disease. Thiamine has a role in the processing of protein, fat and carbohydrate, the essential ingredients of food.

Generation Of Symptoms

Here is the diagnostic problem. The earliest effects of thiamine deficiency are felt in the hindbrain that controls the automatic brain/body signaling mechanism known as the autonomic nervous system (ANS). The ANS also signals the glands in the endocrine system, each of which is able to release a cellular messenger. A hormone may not be produced in the gland because of energy failure, thus breaking down the essential governance of the body by the brain. Hypoxia (lack of oxygen) or pseudo-hypoxia (thiamine deficiency produces cellular changes like those from hypoxia) is a potentially dangerous situation affecting the brain and a fight-or-flight reflex may be generated. This, as most people know, is a protective reflex that prepares us for either killing the enemy or fleeing and it can be initiated by any form of perceived danger. Thus, thiamine deficiency may initiate this reflex repeatedly in someone that seeks medical advice for it. Not recognizing its underlying cause, it is diagnosed as “panic attacks”. Panic attacks are usually treated by psychologists and psychiatrists with some form of tranquilizer because of the anxiety expressed by the patient.

It is easy to understand how it is seen as psychological, although the sensation of anxiety is initiated in the brain as part of the fight-or-flight reflex and will disappear with thiamine restoration. It may be worse than that: because the heart is affected by the autonomic nervous system, there may be a complaint of heart palpitations in association with the panic attacks and the heart might be considered the seat of the disease, to be treated by a cardiologist. The defining signal from the ANS is ignored or not recognized. Because it is purely a functional change, the routine laboratory tests are normal and the symptoms are therefore considered to be psychological, or psychosomatic. The irony is that when the physician tells the patient “it is all in your head”, he is completely correct but not recognizing that it is a biochemical functional change and that it has nothing to do with Freudian psychology.

A Sense Of Pleasure

We have known for many years that dietary sugar precipitates thiamine deficiency. A friend of mine had become well aware that alcohol, in any form, or sugar, will automatically give him a migraine headache. He still will take ice cream and suffer the consequences. I have had patients tell me that they have given up this and that “but I can’t give up sugar: it is the only pleasure that I ever get”. They still came back to me to treat the symptoms. We have come to understand that we have no self-responsibility for our own health. If we get sick, it is just bad luck and the wonders of modern medicine can achieve a cure. The trouble is that a mild degree of thiamine deficiency might produce symptoms that will make it more difficult to make the necessary decisions for our own well-being. Let me give some examples of symptoms that are typically related to this and are not being recognized:

  • Occasional headache, heartburn or abdominal pain
  • Occasional diarrhea or constipation
  • Allergies
  • Fatigue
  • Emotional lability
  • Insomnia
  • Nightmares
  • Pins and needles
  • Hair loss
  • Palpitations of the heart
  • Persistent cough for no apparent reason
  • Voracious, or loss of appetite

The point is that thiamine governs the energy synthesis that is essential to our total function and it can affect virtually any group of cells in the body. However, the brain, heart and nervous system, particularly the autonomic (automatic) nervous system (ANS) are the most energy requiring organs and are likely to be most affected.

Since the brain sends signals to every organ in the body via the ANS, a distortion of the signaling mechanism can make it appear that the organ receiving the signal is at fault. For example, the heart may accelerate because of a signal from the brain, not because the heart itself is at fault. Hence heart palpitations are often treated as heart disease when a mild degree of thiamine deficiency in the brain is responsible.

We have known for many years that sugar in all its different forms can and will precipitate mild thiamine deficiency. It is probably the reason why sugar is considered to be a frequent cause of trouble. If thiamine deficiency is mild, any form of minor stress may precipitate a much more serious form of the deficiency. An attack by an infecting organism is a source of stress imposed on the affected person and requires a boost of energy consumption. Therefore the illness that follows can be regarded as a “war” between the attacking disease producing organism and the brain/body that has to mobilize a defense. Either death, recovery, or a “stalemate” might be the expected outcome. If this is the truth, then any disease will respond to the ingestion of nutrients, particularly thiamine. It strongly suggests that Holistic or Alternative medicine could add a huge benefit to health preservation or the treatment of disease.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Image by PDPics from Pixabay.

This article was published originally on August 25, 2020.

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Dysautonomia and Hypoxia

Every profession has its jargon that enables its practitioners to communicate relatively easily but is incomprehensible to those outside the

Zooplankton: Aquatic Markers of Our Impending Nutritional Demise

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Ever think about zooplankton? Yeah, me neither. Heck, until recently I had only a vague understanding of what these creatures were. I thought they were sea plants of some sort. Perhaps the ‘zoo’ in the name should have clued me in. It didn’t. Go ahead, you can laugh. My knowledge of fifth-grade ocean biology appears to be lacking. For the similarly ignorant among us, zooplankton are the microscopic animals that drift along the ocean and lake currents eating algae. They look a bit like shrimp except minus the shells. Jellyfish are also considered zooplankton, despite not being microscopic. What is so interesting about zooplankton that I should write an entire article about them? It turns out, that despite an ample supply of food, these creatures are struggling to survive. Hmm. Well fed, but struggling to survive, sounds familiar doesn’t it? Could there be similarities between their situation and ours? I think so. In fact, I think what is happening to the zooplankton via their environment is emblematic of what is happening to us and the environment as a whole.

Growing Too Quickly?

Backing up just a bit, a few decades ago, scientists in a lab in Arizona discovered that by shining more light on algae, they could expedite their growth cycles, producing bigger, fatter algae in less time. Similarly, they also noticed that when these bigger, fatter algae were fed to the zooplankton, the animals began to struggle and eventually die off. None of the biologists could figure it out. How was it that by simply adding more light and increasing the yield of algae blooms the health of zooplankton would be affected? There was plenty of food. There were no added chemicals or plastics to the environment (a common cause of toxic algae blooms). The only variable that changed was the additional light. The light made the algae grow, which provided lots of food for the zooplankton. How in the world does increased food availability become deleterious?

It took a few years, but a mathematician named Irakli Loladze figured it out.

“The increased light was making the algae grow faster, but they ended up containing fewer of the nutrients the zooplankton needed to thrive. By speeding up their growth, the researchers had essentially turned the algae into junk food. The zooplankton had plenty to eat, but their food was less nutritious, and so they were starving.”

See where I am going with this? The quick grow algae had become junk food and the zooplankton were essentially suffering from what we call ‘high-calorie malnutrition’. Sound familiar? It should. High-calorie malnutrition accounts for a staggering number of modern disease processes, wreaking metabolic havoc on human health. In humans, however, the high calories typically come from heavily sweetened, starchy, highly processed junk foods, not plants. Or do they? It seems that we are witnessing a similarly disturbing shift in plant ecology. Current agricultural practices are turning normally nutrient-dense plant crops into junk food. Worse yet, those practices are part of a larger ecological disaster, which some have appropriately termed, the great nutrient collapse.

Junk Food Crops, Junk Food Algae, and the Circle of Life

Among the myriad of problems associated with modern agriculture is the insistence on breeding plants for size and appearance. This, by nature, diminishes crop variability. Accordingly, 95% of the genomic variability, about 200,000 metabolites, have been bred out of modern crops compared to just a few decades ago. Considering that 70% of our foods come from just 15 crops, the implications of even the most benign breeding programs are staggering. The human diet now consists of fewer crops that contain significantly fewer nutrients than those of previous generations.

Our crop breeding programs, however, are anything but benign. Not only have we purposefully winnowed out some 200,000 plant metabolites from our food chain and reduced the overall variety of those already nutrient-poor crops to just a few mono-crops, but to achieve these goals, we add millions of tons of toxic chemicals annually – 12.5 million kgs of glyphosate alone in 2014. Since these chemicals are toxic to native plants (and us), we have to add back a few non-native gene products that allow the plant to withstand the toxic onslaught. While industry supporters contend these chemicals and practices are perfectly innocuous and in no way impact human health or the environment, a slew of independent scientists with a large body of research suggests otherwise. Indeed, the use of these chemicals, along with the tendency to grow just one crop, rather than rotate crops, has depleted the topsoil of minerals critical to plant and human health by some 80% in western countries. That alone should be cause for alarm, but there is more.

Though some contend otherwise, the environmental damage done by agricultural practices adopted over the last several decades contributes to rising atmospheric CO2 levels. By some figures, CO2 levels have increased from 280 ppm in 1958 to over 400 currently. Estimates suggest the manufacture and use of these chemicals along with current monocrop and deforestation practices contribute to approximately 21% of the overall emissions. Of that, livestock farming, particularly methane release certainly plays a large role. Remember, of course, 95% of the soy and crops are grown for use in livestock farming and those products rely heavily on agricultural chemicals. It is a vicious ecology. All of this aside, rising CO2 levels are problematic to crop foods even if we did not also have to contend with the myriad of other problems associated with current growing practices, but we do and this is part of an iterative cycle of damage.

Why is high CO2 detrimental to plant nutrition? Plants rely on light, water, and CO2 to grow, absorb the minerals from the soil, and convert those minerals into the raw nutrients contained within the plant itself – the ones we and other organisms will ultimately ingest and need to survive. Much like adding light to the algae, increased CO2 expedites plant growth, but comes at the cost of diminished nutrients.

“The elemental chemical composition of a plant (that is, ionome) reflects a balance between carbon, obtained through atmospheric [CO2], and the remaining nutrients, obtained through the soil.”

Skew that balance and we have problems.

When all of these variables are combined, that is, when we breed these plants for size and appearance, effectively reducing all manner of likely useful genetic material, deplete the soil of nutrients, force these plants to withstand all sorts of toxins, and then expose them to ever-increasing CO2 levels, we get junk food. We get crops that look good but are little more than sugar bombs.

The Nutrient Collapse Cycle

In much the same manner that ingesting garbage food diminishes mitochondrial capacity, alters human metabolism, and elicits deleterious compensatory reactions (inflammation, obesity, diabetes, and the like), the shortcuts we have employed in agriculture to expedite crop yield have changed the elemental composition of the plants and the atmosphere in which these plants are grown. Although it is somewhat easier to recognize the deleterious effects of the agricultural chemicals on organismal health, there are discrete measurable mechanisms by which these chemicals affect aspects of cellular function, it is significantly more difficult to measure the broader effects, the cumulative changes on atmospheric composition. Here, these chemicals are but one part of a much larger environmental catastrophe. Ultimately, however, the net result is elevated CO2, which then feeds back to alter plant composition even more.

Higher CO2 increases the rate of photosynthesis resulting in larger plants. This, according to opponents of climate change, is a net benefit. Like the algae, however, the nutrient density of the plants shifts rather dramatically. The crops become very efficient sugar factories pulling more and more starch into their tissues. A process much like the metabolic shift of type 2 diabetes that is continuously reinforcing itself. As CO2 levels continue rise:

“…every serving of bread, pasta, fruits, and vegetables delivers more starch and sugar but less calcium, magnesium, potassium, zinc, protein and other essential nutrients.”

It is a feedforward loop; one that will be difficult to unwind. More sugar equals fewer nutrients, demands and produces more sugar, and so on. From the environmental perspective, the continued use of these chemicals will alter the plants in such a way as to demand the use of more chemicals, all the while fundamentally changing the environment in which these plants grow, which again changes the composition of the plants.

Just how bad is this? A study looking at the impact of rising CO2 on the nutritional decline of 18 varieties of rice, a staple food for much of the population, found significant

“…declines in protein [10%], iron [8%], and zinc [5%] … also find consistent declines in vitamins B1 [17%], B2 [16%], B5 [12%], and B9 [30%] and, conversely, an increase in vitamin E…”

Although this study was limited to evaluating the nutrient content of just one crop, a similar pattern of nutrient decline would be expected across all crops, and indeed, all plants. That means that every organism up and down the food chain would be affected physiologically by the reduction in nutrient availability. If this continues, it is not difficult to imagine that even if food production remains consistent (and there is evidence, that it may not), the quality of the food will continue to decline, and at some point, fail to provide sustenance.

Zooplankton: Aquatic Markers of Our Demise

Like the canary in the coal mine, the zooplankton reminds us of an impending collapse of health. Unlike the canary, however, death is more gradual and complicated. It is brought on, not by one, solitary action or event, but by an entire system of ill-conceived practices that reverberate across ecosystems. The zooplankton, like many humans, suffers from the ill effects of high-calorie malnutrition.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

This article was published originally on August 27, 2018.

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The Oceans Are Hypoxic and So Are We

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Increasingly, I am struck by the repetition of patterns across biological ecosystems. In my research on mitochondria and thiamine, I have learned that nutrient deficiencies cause a sort of molecular hypoxia; one that is due entirely to the failure of the requisite respiration enzymes to perform adequately. The hypoxia is not due to blockage or constriction of airways or related to exertion. There is plenty of oxygen floating around, at least initially. It is due solely to nutrient-starved enzymes that are incapable of processing oxygen effectively or at all. Inevitably, the hypoxia leads to inflammation and the host of other adaptive cascades endemic to modern illness.

The cause of this type of hypoxia is entirely related to the synthetic nature of the modern diet, agricultural practices, medicine, and modern living in general. It is the lack of essential nutrients available in the modern diet in combination with near-constant exposure to chemical compounds that the body recognizes as toxicants; toxicants that demand even more nutrition and energy to clear. Together, the combination of decreased nutrients with increased chemical exposures taxes the enzymes responsible for consuming oxygen; the ones responsible for converting food to energy and clearing the toxins. Overloaded, they become starved for oxygen – hypoxic – and a series of stress responses ensue. We wrote about it extensively in our book, but also in a number of articles published on Hormones Matter.

Quite similarly, soil, plant, and ocean hypoxias have become increasingly common, arguably due to the same mechanisms by which we humans have become hypoxic: a steady diet of garbage and chemicals. Modern agricultural practices bombard the soil with toxicants, depleting essential soil bacterial species, and nutrients. The depleted soil, along with those chemicals, then runs off into the waterways and oceans, where further damage ensues. Just as diseases of metabolism e.g. hypoxia are reaching epidemic proportions in human health, so too are ocean dead zones, all because of the same processes.

If we look back over the last 60 years of tracking, the number and size of oceanic dead zones have grown significantly. In the 1960s there were only 49 oceanic dead zones but in 2008, there were 405 and in 2018, that number has grown to 500 distinct sites that cumulatively mirror the size of the European Union.

“Open-ocean oxygen-minimum zones (OMZs) have expanded by an area about the size of the European Union (4.5 million km2, based on water with <70 μmol kg−1 oxygen at 200 m of depth) (10), and the volume of water completely devoid of oxygen (anoxic) has more than quadrupled over the same period.”

By some estimates, the oceans have lost an estimated 2% of the total oxygen available. In the dead zones, of course, the oxygen loss is much higher and sometimes total. There is a pattern. It is the same process. Sure, some of the chemicals are different and the exact mechanisms are species-dependent, but overall, biological systems are largely conserved, repeated ad infinitum, with only minor changes. Garbage in eventually equals hypoxia.

Industrial Food Production and Hypoxia

A year or so ago, I stumbled upon the work of a mathematician studying the decline of nutrients in algae and food crops. Through a series of experiments and a fair degree of mathematical modeling, Dr. Irakli Loladze found that plant life no longer carried the nutrient value that it once did and as a result, the organisms that rely on these plants, everything from zooplankton to humans, were becoming ill. Though there was a confluence of factors that resulted in the diminished nutrient content, the bulk of the blame rested with industrial agriculture. It seems that the shortcuts taken to increase crop yields beyond what nature allowed and the attendant chemicals used to expedite those processes, changed the elemental composition of the plants and the atmosphere within which these plants are grown. The resulting changes yield not only more starchy, sugary, and markedly less nutritious crops, but also, contribute significantly to the rising CO2 levels, which coincidentally, feeds back and encourages evermore starchy crops.

“Every leaf and every grass blade on earth makes more and more sugars as CO2 levels keep rising,” Loladze said. “We are witnessing the greatest injection of carbohydrates into the biosphere in human history―[an] injection that dilutes other nutrients in our food supply.”

The atmospheric changes alone are troubling and result in changing ocean dynamics, with increased temperature being the most widely discussed. More subtle, but no less troubling, the higher CO2 levels increase the rate of plant photosynthesis. This, according to opponents of climate change, is a net benefit.  Unfortunately, the increased growth is in parallel with decreased nutrient density within the hyper-growing plants. Like the crops for human consumption, oceanic plant life such as algae become efficient sugar factories pulling more and more starch into their tissues. This, of course, leads to downstream problems in all aquatic life, which from a metabolic standpoint inevitably ends in hypoxia. And this is the key: the initial increased abundance is the telltale sign of molecular hypoxia, at least in humans and I would argue in other ecosystems as well. For all of the complicated explanations of hypoxia, its cause is really quite simple. It is nothing more than the culmination of a decades-long decline in food nutrients in parallel with the ever-increasing concentrations of chemical toxicants dumped into our bodies, into the waterways, and into the environment as a whole.

The growth in oceanic dead zones, where oxygen is insufficient to support life, parallels the rise of not only industrial agricultural practices but also, the decline in human health. Think obesity. Think high-calorie malnutrition where the excessive growth is representative of metabolic changes, of survival mechanisms, brought on by diminishing nutrients, and the inability to metabolize oxygen. The elevated sugar content of modern food sources changes metabolism negatively. On the surface, it looks like an excess of ‘nutrition’ and indeed, the term ‘over-nutrition’ is bandied about regularly by researchers of human metabolism and those in oceanic health too, but it is a misnomer. In reality, what we call over-nutrition represents the diminishment of actual nutrients with corresponding cell level hypoxia. It is malnutrition. In our oceans and our crops, we see a trend towards apparent nutrient density in the plant life, but only inasmuch as we consider the quantity and not the quality of nutrient availability; the size or mass of the plant versus its composition. For while it is true that industrial agricultural practices can grow bigger and more abundant crops, those crops contain more sugar than actual nutrients and those nutrients are needed for oxygenation.

In much the same way that researchers of human metabolism equate the density of calories to nutrition or over-nutrition, oceanic researchers seem to do the same. They consider the areas agricultural of agricultural runoff to be nutrient-dense, not because the algae that bloom are nutrient-dense but because the algae blooms themselves are dense. But like the plants onto which those fertilizers are heaped, the algae that grow from the runoff are also junk food. And, as with human metabolism, when sugar intake increases, vital nutrients (vitamins and minerals) decrease and so too does the ability to utilize oxygen. Metabolic hypoxia sets in. Slowly at first, but gradually and over time, it grows, becoming self-reinforcing, a death spiral of sorts, particularly when the contributing factors continue. This is the funny thing about respiration, it requires micronutrients. Just like us, the oceans have become increasingly unable to process oxygen. They are hypoxic and so are we. The question is what are we going to do about it.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Image by João Braun from Pixabay.

This article was originally published on February 20, 2019. 

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Thiamine Insufficiency Relative to Carbohydrate Consumption

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Thiamine (vitamin B1) is an essential micronutrient responsible for key reactions involved in the conversion of the foods we consume into the chemical energy substrate requisite for cellular function, adenosine triphosphate (ATP). Absent sufficient ATP, all sorts of metabolic functions become disordered leading to the disease processes that dominate western medicine. Chronic inflammation, altered immune function, hormone dysregulation, cognitive and mood disorders, and dysautonomias, all can be traced back to insufficient thiamine > inefficient mitochondrial function, reduced ATP, and the compensatory reactions that ensue.

Among the most common but least well-recognized contributors to thiamine deficiency is the regular consumption of a high carbohydrate/highly processed food diet. Although most of these foods are enriched or fortified with thiamine, perhaps staving off more severe deficiencies, the density of sugars overwhelms mitochondrial capacity to process these foods, both the thiamine and any other potential nutrients are excreted, while the carbohydrates themselves are stored as fat for future use. High-calorie malnutrition is a common contributor to thiamine deficiency in obesity but also may develop in presumed healthy athletes whose diets focus heavily on high carbohydrate intake.

Thiamine, along with other B vitamins is often deficient in vegetarian and vegan diets as well. Not only do fruits, vegetables, and carbohydrates contain minimal, if any, thiamine, but some have anti-thiamine factors and are high in what are called oxalates. Anti-thiamine factors found in some fruits and vegetables interfere with the absorption or digestion of thiamine. Oxalates are mineralized crystals of sorts that tend to build up and store in places like the kidneys (kidney stones), but also may store and cause problems anywhere in the body like bones, arteries, eyes, heart, and nerves. Effective oxalate metabolism and clearance requires thiamine. Since vegetarian and vegan diets are also carbohydrate intensive, thiamine deficiency and oxalate issues may be compounded. Thus, a number of common diets not only contain reduced thiamine content but cause an increased need for thiamine by at least three mechanisms; higher carbohydrate consumption overwhelming capacity, which is then magnified by poor carbohydrate and oxalate processing.

Add daily coffee, tea, and/or alcohol consumption to any diet, and whatever thiamine that is consumed is either inactivated by enzymes before being used or is unabsorbable. Add a medication or four and thiamine availability will tank simultaneously with an increased need. Medications both block nutrient uptake and/or increase the need for nutrients by inducing mitochondrial damage. Given that 70% percent of the US population takes at least one medication regularly, while 20% take four or more, it is safe to say, that a good percentage of the population is consuming insufficient thiamine to maintain mitochondrial function and health.

Are We Really Thiamine Deficient?

As an essential nutrient, thiamine must be consumed regularly to maintain sufficient concentrations. The question is how much thiamine is sufficient to maintain health? Current RDA values for daily thiamine intake suggest a little over a milligram per day is adequate for most adults. If this is true, then the minimum value can be attained through just about any diet including those dominant in highly processed, carbohydrate-dense foods, which are commonly either enriched or fortified with thiamine. Everything from bread to cereals and even junk food like Oreos have thiamine. Per the RDA values, none of us ought to be thiamine deficient and none of us ought to require thiamine supplementation, and yet, many of us are and do. Indeed, several studies, across disparate populations show that even by this minimum standard, deficiency is a serious health problem. From our book:

  • 76% of diabetics (type 1 and type 2)
  • 29% of obese patients, 49% of post-bariatric surgery
  • 40% of community-dwelling elderly, 48% of elderly patients in acute care
  • 55% of cancer patients
  • 20% ER patients (random sample, UK)
  • 33% of congestive heart failure patients
  • 38% of pregnant women, more with hyperemesis
  • 30% of psychiatric patients

It takes approximately 18 days to completely abolish endogenous thiamine stores in a diet that is completely devoid of thiamine. Except under total starvation, medical or industrial food production mishaps, and experimentally contrived situations, thiamine consumption is never completely abolished. It waxes and wanes by dietary choices and life stressors. According to rodent studies, it takes a reduction of greater than 80% of thiamine stores before the more severe neurological symptoms are recognizable. In humans, these symptoms include those associated with Wernicke’s encephalopathy, the various forms of beriberi, and dysautonomic function. These include but are not limited to: ataxia, changes in mental status, optic neuritis, ocular nerve abnormalities, diminished visual acuity, high-output cardiac failure with or without edema, high pulse pressure, polyneuropathy (sensorimotor), enteritis, esophagitis, gastroparesis, nausea and vomiting, constipation, hyper- or hypo-stomach acidity, sympathetic/parasympathetic imbalance, postural orthostatic tachycardia syndrome (POTS), cerebral salt wasting syndrome, vasomotor dysfunction, respiratory distress, reduced vital capacity, and/or low arterial O2, high venous O2.

With a less severe thiamine deficiency, symptoms are rarely recognized as such and often attributed to psychological manifestations. A not entirely ethical study done in 1942 involving 11 women on a low thiamine diet over a period of ~3-6.5 months found striking symptoms.

  • During this time all subjects showed definite changes in personality.
  • They became irritable, depressed, quarrelsome, and uncooperative.
  • Two threatened suicide. All became inefficient in their work, forgetful, and lost manual dexterity.
  • Their hands and feet frequently felt numb.
  • Headaches, backaches, sleeplessness, and sensitivity to noises were noted.
  • The subjects fatigued easily and were not able to vigorous exertion.
  • Constipation was the rule, but no impairment, of gastrointestinal motility, could be demonstrated fluoroscopically.
  • Anorexia, nausea, vomiting, and epigastric distress were frequently observed.
  • Low blood pressure and vasomotor instability were present in all patients.
  • At rest, pulse rates were low (55 to 60 per minute) but tachycardia followed moderate exertion. Sinus arrhythmia was marked.
  • Macrocytic, hypochromic anemia of moderate severity (3.0 to 3.5 million red cells) developed in 5 cases.
  • A decrease in serum protein concentration occurred in 8 subjects.
  • Basal metabolic rates were lowered by 10 to 33 points.
  • Fasting blood sugar was often abnormally high.

The study above demonstrated a rapid and dramatic onset of symptoms relative to a diet with limited thiamine. Depending upon caloric intake, the amount of thiamine allowed was approximately 1/3 to 1/5 of the amount recommended by the RDA. Admittedly, the RDA for thiamine is low, to begin with, but even so, this was not a complete absence of thiamine. Since the study took place in the early 1940s, it is difficult to ascertain the specifics of the diet. Nevertheless, it demonstrates a clear association between general health and one’s ability to function, and thiamine insufficiency.

High Carbohydrate Diets Equal Lower Thiamine

More recently, a short and very small study (12 days and 12 participants) of active young men and women (ages 25-30) investigated the relationship between carbohydrate intake and thiamine status. Thiamine was measured in blood, plasma, urine (creatinine), and feces at four time points: at baseline, before the study began, during an adaptation phase where carbohydrate intake represented 55% of the total caloric intake, and during the two subsequent intervention phases, where carbohydrate intake was increased to 65% and 75% of the total caloric intake, respectively. Both caloric and thiamine intake was held constant throughout the study despite the increased intake of carbohydrates. Activity levels were also held constant. Across this short-term study, as carbohydrate intake increased, plasma, and urinary thiamine decreased. Excretion through feces remained unchanged. Transketolase enzyme activity was also measured but remained unchanged. Given the short-term nature of this study, the fact that transketolase remained unchanged is unexpected. In addition to the decreasing thiamine values, there were several changes in lipid profile as well. Despite the short duration of this study, however, the results show a clear relationship between carbohydrate intake and thiamine status; one that would likely be magnified over time and certainly if other life stressors and medical and environmental toxicants were added to the mix.

It is important to note current dietary guidelines suggest carbohydrate consumption should fall between 45-65% of total calories, percentages which, per this study would decrease thiamine availability significantly. From the baseline diet to the 55% adaptation phase, thiamine dropped precipitously, only to drop even further at the 65% phase. A recent study surveying macronutrient consumption showed that average carbohydrate consumption across the US population represented approximately 50% of total caloric intake. Importantly though, the study found that 42% of the carbohydrate consumption came in the form of what researchers termed ‘low-quality carbs’ e.g. sugary processed foods with no nutritional value. Thiamine is only found in pork, beef, wheat germ and whole grains, organ meats, eggs, fish, legumes, and nuts. It is not present in fats/oils, polished rice, or simple sugars, nor are dairy products or many fruits and vegetables a good source. Indeed as mentioned previously, some fruits and vegetables may contain anti-thiamine factors. A diet that is 42% empty calories, that contains limited to no nutritive value, save except what has been added post hoc via enrichment, begs for mitochondrial damage and the illnesses that ensue. And yet, that is precisely the nutritional landscape in which most of us exist.

Admittedly, both studies were very small, but the research connecting thiamine deficiency to ill-health and carbohydrate consumption to thiamine loss is clear. Given the dominance of ultra-processed carbohydrate-dense foods in the modern diet, is likely that high-calorie malnutrition underlies much of the chronic illness that plagues western medicine. To learn more about thiamine deficiency and the havoc it wreaks on health: Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, and like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

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Dysautonomia and Hypoxia

Every profession has its jargon that enables its practitioners to communicate relatively easily but is incomprehensible to those outside the

The Thiamine Book: What Reviewers Say

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Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition

Since releasing our book: “Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition,” we have received many positive reviews. Here are what the readers say.

What the Reviewers Say

From Erin:

As a patient, this book has really opened my eyes. For over two years now, I’ve suffered from debilitating symptoms due an adverse drug reaction to metronidazole (aka, Flagyl). These symptoms mysteriously wax and wane—some days I barely notice them and then, due to a mild illness or physical exertion, they resurface, sometimes forcing me to back to bed to rest and recoup for days at a time or longer…

…Every single one of my symptoms is listed in this book. It even explains why they keep flaring up.

From Metabolic Mom:

This book was life changing to say the least! After reading it, I was able to see thiamine issues back into my childhood and discovered I was presently dealing with full blown beriberi. After 6 weeks of supplementing with thiamine, my thyroid function is coming back to normal levels without medication. That’s pretty incredible since Drs tell you that you have to take medication for the rest of your life. I’m so thankful for this book! It’s expensive but the information is invaluable! Read it and then read it again!

From Jean:

This book is a god send, it addresses many specific ailments that have accumulated because of B1 deficiency, now I have a scientific reference tool to aide in my healing…

From Healthytoo:

…“Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition” will rapidly become the authoritative source on thiamine, and, hopefully, will stimulate fruitful medical research on this important topic.

From Integrative Doc777:

Chandler Marrs and Derrick Lonsdale have written a wonderful, informative, well-researched book on thiamine (vitamin B-1). They cover the history of thiamine deficiency disease (Beriberi), thiamine’s importance to the functioning of the autonomic nervous system, its importance in mitochondrial aerobic energy production, and specific health conditions along with case studies that demonstrate that targeted thiamine supplementation can be profoundly useful for seemingly hard to understand health conditions. I’m hoping the authors will write books on the other B-vitamins because they are masters at covering the essentials and beyond. Dr. Dean Raffelock

From Simon:

…This book outlays the entire model on how many of the “common” diseases, seen in the 21st century, is a result of this high calorie malnutrition, with Thiamine acting as a gatekeeper all the way down to the mitochondrial level.

I highly recommend this book, from my hero Dr Derrick Lonsdale and his co author on this Dr Chandler Marrs.

From Kelly Brogan MD:

As a conventionally trained physician who came to see the limitations of the allopathic approach, I am so grateful to have this science-based text supporting the vanguard of natural healing. The truth is that we are getting sick in more and more complex ways, and dysautonomia is emblematic of the ways in which our bodies are struggling in the setting of malnutrition and toxic burden. This text is clinically relevant, evidence-based, and entirely readable. In fact, a deep desire to contribute to the healing of “mysteriously” sick patients comes through in the tenor of this writing. For clinicians and struggling patients alike, this text is a one-of-a-kind essential resource on the newest biology of healing.

From Edward Manning:

As a primary care physician, I can attest that the book “Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition” by Lonsdale and Marrs should be required reading for all physicians. It points out a glaring deficiency in our concept of disease. We all see puzzling clinical presentations that often may be explained by nutritional deficiencies.

From Russell Johnson:

As a non-medical professional, I read Dr. Lonsdale’s book for two reasons: The first was to know even more about Dr. Lonsdale,whose knowledge, skills, and persistence literally saved my youngest daughter and later her second born son from having less than a full and normal life. The second was to better understand for myself, why given today’s medical advances, many patients are still condemned to a life of less physical and/or mental potential because their doctor followed the “standard treatment.” Obviously, for non-medical people, such as myself, the book is a “tough read” in terms of the scientific vernacular it uses – but it can be done, and by working through it, I think that any non-medical person will become a better patient or caregiver. When I am finished with the book, I intend to donate it to the Chief Medical Officer of our State with the recommendation to send it to all of the Doctors in the State.

From Kenneth Hull:

This amazing information.
Giving real direction to so many of us that have a wide spectrum of mystery illnesses.
I learned so much following Dr. Marrs’ Facebook page, Hormones Matter. Reading Dr. Lonsdale’s articles.
Real Hope. Real Help.
The book was a must have. It does not disappoint.
I suggest buying a copy for your Doctor too!

From Amy (Dr. Russell Schierling):

Incredible Book that Covers Much More than the Title Suggests. Back in my days at Kansas State University, I was a dual major in their nutrition / exercise physiology program, where I naturally took lots of classes on diet. There were any number of 3rd world diseases that I learned about, including beriberi. Dr. Marrs’ book explained how relevant beriberi (vitamin B1 deficiency) is to our modern Western culture as well as the fact that it’s not just a third-world phenomenon —- another example of what living a high carb lifestyle does to metabolic function. From a ‘Functional Medicine’ point of view, this book is groundbreaking, showing how numerous metabolic pathways are fouled up when people consume too much processed junk. “Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition” is not only relevant to today’s primary care provider, it’s a primer for thinking outside the box, with every point made backed by peer-review. When I first got this book several months ago, I was writing notes in a spiral notebook for a book review on my website (which I hope to do this summer). Before long I realized that my review might end up being longer than the book itself. Since reading the book I’ve become a regular follower of Dr. Marrs’ work on her Hormones Matter website, where she covers any number of equally important and related topics. Dr. Russell S Schierling (using my wife’s account), Dr. Schierling.com.

Buy Now and Receive a Discount

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Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition

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