Thiamine for Fatigue in MS

[Ecoclimber]

Costantini A, Nappo A, Pala MI, Zappone A High dose thiamine improves fatigue in multiple sclerosis. BMJ Case Rep. 2013 Jul 16;2013.
Abstract
The majority of the patients with multiple sclerosis (MS) experience fatigue. Some observations indicate that fatigue and related manifestations concomitant with MS could be associated with an intracellular mild thiamine deficiency.

We recruited 15 patients with MS who also experience fatigue and assessed the severity of the fatigue using the Fatigue Severity Scale. Although blood thiamine and thiamine pyrophosphate levels were within normal limit in all the patients, high-dose thiamine therapy administered orally or parenterally led to an appreciable improvement of the fatigue.

The absence of apparent decrease in blood thiamine despite the presence of symptoms referable to a mild thiamine deficiency suggests that these patients may have a dysfunction of the mechanisms of intracellular transport or structural enzymatic abnormalities.

The administration of large quantities of thiamine was effective in reversing the fatigue in MS, suggesting that the abnormalities in thiamine-dependent processes could be overcome by diffusion-mediated transport at supranormal thiamine concentrations.
Eco

 

[A.B.]

I wonder what will come out of these studies (the author has made several on different illnesses). They suggest that high-dose thiamine supplementation is an useful intervention in several (probably many) illnesses with chronic fatigue component. Hopefully these findings will be confirmed in other studies taking place elsewhere.

Thiamine is involved in intracellular energy metabolism. Chronic fatigue could be the symptom of a defective cellular energy metabolism. In that case, it should be objectively measurable.

 

[Dan_USAAZ]

Has anyone been able to find out the thiamine dose they are using in this study? It looks like the RDA in the US is 1.5mg. My multivitamin has 30mg. Just taking my multivitamin, I am already at 2000% of the RDA and that does not include thiamine sources from the food I ingest.

I checked a few thiamin specific supplements online and they contain anywhere from 50mg to 500mg per serving. If you were to take two 500mg pills a day, you would be at 66,666% of the RDA.

Any ideas on how to find out what their “high dose” is?

Thanks.

 

[Dan_USAAZ]

It appears that these same researchers also studied the effects of high dose thiamine on people with Fibromyalgia. As reported by a third party, the doses in that study ranged from 600mg to 1800mg. It was a small study(3) and a short duration.

http://www.ncbi.nlm.nih.gov/pubmed/23696141

http://www.healthcentral.com/chronic-pain/c/5949/161190/fibromyalgia-symptoms

·Patient 1: 71.3% reduction in fatigue; 80% reduction in pain.
·Patient 2: 37% reduction in fatigue; 50% reduction in pain.
·Patient 3: 60.7% reduction in fatigue; 60% reduction in pain.

 

[A.B.]

Has anyone been able to find out the thiamine dose they are using in this study? It looks like the RDA in the US is 1.5mg. My multivitamin has 30mg. Just taking my multivitamin, I am already at 2000% of the RDA and that does not include thiamine sources from the food I ingest.
Thanks.

The RDA is the minimum required amount to avoid overt disease in healthy individuals. It was developed in the 50's to make sure that military personnel doesn't go malnourished. The RDA isn't useful to decide what a safe or individually appropriate dose is.