Vitamin Therapy Paradox: Getting Worse before Getting Better

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Derrick Lonsdale, MD
Does modern medicine accept the idea of vitamin therapy? The answer is a resounding no!  It has only been a little over 100 years since vitamins were synthesized. Of course, as everybody knows, all of these chemical substances were found to exist in natural food. They were very much part of the mystery of evolution. Essential to all animal life, they were there for the picking. Later, it was also found that a number of essential minerals were required. Both the vitamins and minerals need to be present in minute doses, covered under the eponym of recommended daily allowance (RDA). All we had to do was to obey the rules set out by Mother Nature. Our ancestors were classified as “hunter gatherers”.  They hunted animals and gathered the bounty of nature. Yes, we were primitive savages and life was not the ideal by any means, but the food contained all that was necessary for life.

An Evolutionary Imperative to Eat Real Food

To ascertain what kind of food is required by an animal, you simply look at the teeth. We have front teeth called incisors for cutting, the pointed teeth called canine for tearing meat and the back teeth molars, used for grinding. Cows and horses are vegetarian and only have molar grinders. Human beings are omnivores (all foods edible) meaning that we are designed to eat meat, fruit and vegetables. Some of the vitamins are recycled through eating other animals. Others are recycled by being returned to the soil and passing into plants. That is why I have said to many people in answering the question as to what diet they should pursue, eat only nature made food and leave the man made food alone. Well, of course, you know that we didn’t do that.

We now have a food industry and it is quite unbelievable, at least to me, to see some of the stuff that passes as food, based solely on taste and appearance. Sometimes I find a person with these typical symptoms who is very careful with diet and does not practice taste hedonism, but because farming practices have changed in modern times, the produce does not have the same kind of non-caloric nutrient content. It may not be coincidental that such persons are almost invariably intelligent and physically and mentally active. It is reasonable to assume that their nutritional demand exceeds supply and they need non-caloric nutrients.

Sugar and the Vitamin Paradox

Now let me turn to the reason that I used “vitamin paradox” in the title. Anyone that wants to follow my reasoning can look back at previous posts on this website. You will find that there is a significant emphasis on the calamity of sugar ingestion and its association with vitamins, particularly thiamine. I am sure that I will look like a broken record to many people, but here is what happens to your health. Although it is obvious that all the vitamins and essential minerals are required, I am taking the example of thiamine because of its close association with the wide consumption of things called “goodies” or “sweets”.

All simple carbohydrate foods are broken down in the body to glucose. Research has shown that overloading the metabolism with sugar overwhelms the capacity of cellular machinery to burn (oxidize) it by producing a relative deficiency of thiamine, the vital catalyst that ignites (oxidizes) glucose to synthesize cellular energy for function. Recently it has been found that thiamine is required for the oxidation of fats, making the doughnut a perfect example of high calorie malnutrition. This is so important in the brain that I simply cannot overstate it.

High Calorie Malnutrition, Oxygen Deprivation and Brain Function

High calorie malnutrition is exactly equivalent to a mild degree of oxygen deprivation, so it is sometimes referred to as pseudo-hypoxia (false oxygen deprivation). If this is induced by poor diet where the pleasure of taste (hedonism) overrides appropriate nutrition, a curious thing happens! The lower part of the brain that deals automatically with your ability to adapt to a hostile environment becomes much more susceptible in its responsiveness.

I will give you one example: panic attacks, so extraordinarily common in our culture, are simply fight-or-flight reflexes that are triggered by pseudo-hypoxia. Messages go out to the body from this part of the brain, falsely initiated as though you were actually being “chased by a tiger”. Such an affected person will begin to experience the following symptoms as examples: palpitations of the heart, unusual sweating, a sense of anxiety or panic, irritable bowel syndrome, manifestations of allergy, emotional lability (emotions out of control) etc.  He or she will go to the doctor who will do a series of tests. If they are all normal, you will then be told that this is “all in your head” (psychosomatic). On the other hand, the doctor might find evidence for “mitral valve prolapse” (MVP), now known to be an early sign of “wear and tear” damage in the heart and the focus becomes “heart disease”(often used to explain heart palpitations) rather than its original cause, associated with nervous system dysfunction. I have seen MVP disappear in people from correcting their nutrition. It is rare for a patient to be asked about diet and rarer still to question the possibility of a vitamin deficiency.

Vitamin Deficiency: The Walking Sick

This kind of health situation may go one for a long time. The patient has symptoms but is not really a sick person. I refer to people like this as the “walking  sick”. Life continues as usual, but medications have failed to relieve the symptoms, or worse yet have introduced side effects. Over time, the loss of metabolic efficiency gradually leads to damage in cellular machinery (e.g MVP) because the energy need to drive daily function is not being met. Thiamine activates the most important enzyme in energy synthesis and, in the early stages of nutritional deprivation, a thiamine plus multivitamin supplement would quickly abolish the symptoms. If neglected and the marginal malnutrition continues, it will be gradually more difficult to repair the damage.

Vitamin Therapy with Chronic Deficiency: Expect a Decline before Improving

Physicians who practice Alternative Medicine have found that it is possible sometimes to retrieve function at this late stage of development by the use of a course of vitamins given intravenously. They have also learned that the symptoms of the patient actually get worse (paradox) in the initial stages of intravenous treatment but begin to get better following an unpredictable period of worsening. Naturally, the patient concludes that the treatment is bad or that it is causing side effects as in the use of pharmaceuticals. That is why I have christened it paradox, meaning that the unexpected happens.

Over the years of administering intravenous vitamin therapy for all kinds of conditions, irrespective of conventional diagnosis, I quickly learned to inform a patient about paradox before instituting treatment. Surprisingly, this paradoxical response usually heralds a good outcome. I do have some ideas about the cause of paradox, but it is so technical that I cannot attempt it here, perhaps in future posts. Intravenous vitamins are tremendously effective in the improvement of most chronic diseases, an effect that is almost impossible to achieve with the standard treatment of drugs as used in modern medicine today.

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  1. Dr. Lonsdale,

    Have just concluded my first full week of the thiamine + magnesium/ potassium/ aspartate supplements. Having read that a ‘healing crisis’ should only last a few days, I’m concerned that every day my areas of concern (feet/legs) are MUCH worse. Not having ingested any thiamine whatsoever for years, would it be logical to assume this ‘paradox’ would last for a longer period of time? Thank you for sharing your knowledge, and blessings to you for a happy and healthy New Year!

  2. Being on high dose B12 supplementation for the last two weeks, I am indeed experiencing what you have coined as ‘the paradox’. I am very interested on your thoughts as to what you believe causes this to occur. Thank you for your time.

    1. This is a complex answer. Of course, I do not know why paradox occurs. However, beriberi is the disease caused by vitamin B1 deficiency. We know from early studies of thiamin as the underlying cause that treatment could indeed result in paradox. For example, a beriberi patient with too little acid in the stomach would develop too much after treatment started, before becoming normal. The ancient Chinese knew that the symptoms helped by treatment with acupuncture could get worse again if the acupuncture continued for too long a period on a given day of treatment. They recognized that the word pictures of Yin and Yang represented two extremes and that the objective in all things, moderation was always the ultimate answer.

      1. I’ve pondered your inciteful response for the last hour, and am heeding a key word you wrote…moderation. Having read a protocol on-line to take megadoses of methylB12 to heal the body, I’ve been taking many times the RDA listed dosage to heal faster, thinking I was just experiencing the ‘paradox’. I think that occurance is inevitable when starting the methylation process after it’s been dormant for many years, but 90,000 units per day is probably way too excessive (understatement), and I’m probably feeling sicker than I need to be. I can’t begin to imagine how ‘off’ my yin and yang are due to this extreme daily sublingual dosage. Moderation… thank you.

        1. How did you arrive at the conclusion that you “required” methyl B12 when you read someone’s “protocol”? It makes no sense.

          1. Suffering from unexplained foot numbness, my journey for an explanation eventually took me to a naturopathic doctor. In doing bloodwork, he said my B12 levels were unacceptably low – that the AMA criteria was faulty and the parameters should be lowered immediately. Consequently, he started me on ‘methyl’ B12 supplementation (as opposed to the other types available), saying that it is the only one that readily crosses the blood/brain barrier, and is the only one that could address my numbness issue. He prompted me to do further research to educate myself about the vitamin, which is what led me to the need to take higher doses to regain the feeling in my feet. Being that he had previously assured me that any excess B12 I ingested wasn’t detrimental to my body, that anything extra would simply be excreted through my urine, I had zero concerns until I read your article about the need for ‘moderation’. Sorry, I neglected to mention that he has had me on very high doses as well, each sublingual pill being 16,667%DV (looking at the bottle) and I was instructed to take 5 of those pills throughout the day. So beginning this new ‘protocol’ (as he has referred to them) didn’t seem remotely abnormal or out of the ordinary to me. I hope I’ve answered your question properly. Thank you for your time, Dr. Lonsdale.

            1. Foot numbness is much more likely to be an energy deficit and I would expect it to respond to big doses of thiamin. You can try ordinary thiamin that you can get from the health food store and I would suggest 100 to 200 mg a day, together with 300 mg of a magnesium salt

              1. Thiamin…how wonderful! Tablets I presume? I want to make sure I follow your recommendations precisely. And when you say ‘together’ with magnesium salt, am I looking for a supplement that contains both the MS and the thiamin? And lastly, do you suggest I consume these supplements on an empty stomach or with food? Thank you SO much for taking the time with me. Your knowledge/expertise on this matter has been phenomenal!

                1. To say I’m in stunned disbelief would be an understatement. Out of curiosity I looked up ‘thiamine deficiency’ on the internet…and I have EVERY one of the listed symptoms, leg muscle weakness, lower leg swelling – right down to something I was never able to accurately describe…it feels like I’m wearing a sock when I’m not! I am flabbergasted that no physician ever considered this as a possibility before. Looking at which foods contain thiamine, I will sadly admit that I eat none of them. Dr. Lonsdale, from the bottom of my heart, THANK YOU!!! I will begin to take the supplements this evening – with sincere hopes that it’s not too late to address these issues. Thank you, again!!!

                  1. Thank you, again. As I’m prohibited from taking folic acid (homozygous MTHFR 1298c), I am able to take everything except the multi-vitamin which generally contains this. And I’ll have to special order the magnesium compound as that is not an item (so I’m told) traditionally stocked.

                    I am so looking forward to getting back with you in the future with a positive update. Happy Holidays!!!

                    1. Incidentally, have you authored a book on this subject? I’d rather refer to an expert on this subject, than arbitrary writings on the Internet.

                    2. Sincerest apologies for my incredible ignorance. I had no idea that I’ve been speaking with a world renowned physician this entire time. I am beyond honored that you took the time to address my concerns, providing information that none of my other MANY doctors have been intuitive enough to discern might be the issue for my years of numb extremities. With deepest respect, Dr. Lonsdale – thank you!

  3. Dear Dr. Lonsdale!

    I’ve been eating a paleo diet the last 2 years and also experienced a lot of stress and was mentally as well as physically very active. I was probably undereating and found out the there weren’t hardly any sources of b1 in my diet. I’ve been experiencing a lot of symptoms which could be related to thiamine deficiency (although some of these symptoms I already had before this time). I was already checked by a neurologist, they also did an MRI, checked B1 in whole blood and didn’t find anything.
    They said to me that I don’t have to worry about it being Wernicke’s Encephalopathy, so I really hope that’s true (therefore I didn’t get Thiamin i.v.)!
    Nevertheless I am really concerned and not really sure what I should do about it, do you have any suggestions? I don’t think that I can get thiamine i.v. in my place and because I live in Europe I also can’t find allithiamine.
    Do you think it would be okay to take high dose benfotiamine or Thiamin HCL to reverse my symptoms? Because I think with high dose oral Thiamine HCL one could also achieve pretty high plasma levels (, (
    Would this be sufficient to penetrate the blood brain barrier enough if at all?
    My symptoms are pain in the calves, slight gait unsteadiness and problems with balance with closed eyes, brain fog, slow thinking, slight drowsiness, poor emotion control, poor concentration, fatigue etc…
    Do you think if it’s due to b1 deficiency that my symptoms are reversible?
    Would really appreciate a response and thank you a lot in advance!

    with best regards


  4. Dr. Lonsdale,
    Any suggestions for supplementation for mitochondrial damage or neuropathy caused by fluoroquinolones. Example b1, b6, b12 or coq10.

    1. All of them. All non caloric nutrients work as a collective team. Suggest Fursultiamine + magnesium + multivitamin

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