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High dose vitamin B1 (thiamine)

Eastman

Senior Member
Messages
526
The adverse effects reported at the top of this page are probably related to an increased need for manganese and B6 to form GABA and process sulfur. Obviously B2 is also needed (+magnesium, Potassium). in some of his texts Dr. Lonsdale says that B1 isn't supposed to be taken in isolation since it is part of a bigger picture (think Citric Acid Cycle).

And B3?

My intention was to reach therapeutic levels with B1 but had to back off. I don't think I will tolerate it on it's own without B3 and folate due to the severity of the rash.

According to his book, Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, in some of his cases, Dr Derrick Lonsdale used a nutritional IV formulation that had equal amounts of thiamine HCl and niacinamide.
 

Gondwanaland

Senior Member
Messages
5,094
And B3?



According to his book, Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, in some of his cases, Dr Derrick Lonsdale used a nutritional IV formulation that had equal amounts of thiamine HCl and niacinamide.
I have now forgotten what I knew about it back then :confused::bang-head:
 

sb4

Senior Member
Messages
1,659
Location
United Kingdom
So far I seem to be having good effects on my POTS with 50-100mg transdermal allithiamine + making sure I get my magnesium.

It seems like thiamine needs B2, B3, Potassium, and other things to avoid induced deficiencies. Problem with this is, if I now start on B2 and B3, will these not also induce other deficiencies like B6 and B12 (random examples) and then they will induce deficiencies and on and on.

Eating liver pate I'm not sure helps as I have gone through periods eating lots of this with no noticable changes.

Taking a multi B complex has it's own problems. I cannot tolerate methylfolate and I strongly suspect that caused my rapid decline in POTS a year ago, maybe by inducing a thiamine deficiency?

I am hoping by keeping my dose at around 50mg I can skirt round induced deficiencies however there is a chance they will just creep up later. A real head scratcher...
 

JasonUT

Senior Member
Messages
303
@sb4

I share your same concerns about inducing other deficiencies. I am trying to take it slow. I have been using Lipothiamine since 7/23 and have worked up to 50 mg TID. The 50 mg spread throughout the day seems to smooth out the response. I wonder if transdermal also helps to smooth out absorption and response.

I definitely feel changes, but I can't tell if it's good or bad. My POTS has also improved. My typical bpm jump was from ~60 to ~110 upon standing and I couldn't stand very long. Lately, my bpm jumps from ~60 to ~85 bpm and I can stand much longer. Other unusual changes for me include increased pin/needles feeling in scalp, face, arms and legs. Some emotional instability, increased aches in leg muscles, and increased craving for high electrolyte foods, i.e. salted potato chips, salted corn chips, salted nuts, etc. Increased energy, but in a slightly uncomfortable restless way which is very difficult to explain.

I wish I had a better idea of what replenishment and healing looks like.
 

Asklipia

Senior Member
Messages
999
I am so happy for you Jason!
My POTS has also improved. My typical bpm jump was from ~60 to ~110 upon standing and I couldn't stand very long. Lately, my bpm jumps from ~60 to ~85 bpm and I can stand much longer.
Any improvement brings you to a better place to fight this fight. And this is a proof that you are in the right direction, at least regarding this symptom!
increased pin/needles feeling in scalp, face, arms and legs.
I had the same at different stages of healing. It probably means that something is happening in these places that did not happen before (oxygenation? repair?).
Now this could also mean that all this thiamine is suppressing the ethylmorphine, a natural morphine made by the liver, which was eliminating sensations in these places. In fact my husband was surprised to feel the pain at the dentist's more than usual (still very bearable). But we feel absolutely no pain where there should not be! Not a pinch of fibromyalgia or other unexplained pains.
From : G. Gordon Gibson, Paul Skett Introduction to Drug Metabolism 3rd Edition and not in the previous editions, 5.1.2.2 Thiamine (vitamin B1)
Thiamine deficiency has been shown to increase the metabolism of aniline and reduce hexobarbitone metabolism whereas excess thiamine inhibits aniline and ethylmorphine metabolism. The effect of thiamine is related to changes in the microsomal cytochromes (P450 and b5) and NADPH-cytochrome P450 reductase levels. The effects were not similar to starvation although it was suggested that the effects of thiamine were mediated via a reduction in blood glucose. More recently thiamine has been found to change the type of cytochrome P450 present – an increase in CYP2E1 and reduction in CYP2C11 – and this could account for the effects seen.
Some emotional instability, increased aches in leg muscles, and increased craving for high electrolyte foods, i.e. salted potato chips, salted corn chips, salted nuts, etc. Increased energy, but in a slightly uncomfortable restless way which is very difficult to explain.
Need for electrolytes but maybe also looking for MSG, a fake folate that is not a good idea. Better a spoonful of organic peanut butter.
For the emotional part, we have started an orgy of funny pictures and try to laugh as much and as long as possible! Then in bed as soon as possible! [/QUOTE]

I wish I had a better idea of what replenishment and healing looks like.
So do we all, but maybe the process will be different for different people.

This aspect of thiamine changing something at the P450 level is interesting, and the authors had on the previous page said :

ibid, 5.1.1.4 Starvation and re-feeding (haha, this re-feeding is popular here on PR!)
This may be further illustrated by looking at one particular aspect of diet, starvation. Starvation of female rats causes marked rises in some enzyme activities (contrast this with the effect of isocaloric protein deficiency) while having little effect on other activities while in male rats there is a marked reduction in aminopyrine N-demethylation and an increase in aniline 4-hydroxylation. It would appear that starvation can actually induce the synthesis of some microsomal proteins in contrast to the marked loss of protein from the liver as a whole. The effects of starvation in the male rat can be directly related to the change in the cytochrome P450 profile – CYP2C11 falls (thus the decrease in aminopyrine metabolism) and CYP2E1 rises (thus the increase in aniline metabolism). The rise in CYP2E1 is most likely a result of the breakdown of fatty tissue releasing free fatty acids that are partially converted to ketone bodies (e.g. acetone) that are known to induce this enzyme (see the effect of diabetes in Chapter 4). It is interesting to note that over-feeding of rats (a good model of human obesity) also causes an increase in CYP2E1 for the same reason, i.e. excess free fatty acids in the blood.
In humans the effects of starvation and re-feeding are also somewhat confusing, with the clearance of paracetamol (acetaminophen), chloroquine and metranidazole all decreased whereas in malnourished children, aspirin clearance may be enhanced.

I am not sure why I find this interesting, but someone might explain? :) A link between thiamine and refeeding maybe?

Be well! :hug:
 

Sidereal

Senior Member
Messages
4,856
Can you expand on how you determined the need for B3 and what effects it had on you? What form were/are you taking and what dosage? Thanks in advance.

Apologies for the long post in advance. Basically, once I worked up to high doses of allithiamine (300 mg x 2 daily), I started to develop sudden attacks of what people on this forum have often referred to as overmethylation or start-up symptoms. (I also developed classic symptoms of B2 deficiency [B1 seems to really deplete B2 as it cranks up energy production] which have been described on this forum many times and I was easily able to get rid of those with some sublingual FMN. Note that prior to taking thiamine I could NOT tolerate any supplemental riboflavin, it made me feel completely toxic and so fatigued I could barely move my limbs or keep my eyes open.)

The thing that was different this time round with thiamine (vs. previous episodes from B12/folate) is that it was no longer hypokalemia. In fact, the reverse was the case, my need for potassium went from horrible, constant, insatiable deficiency to zero and the taste of potassium salt water became repulsive to me which is sign that I don't need it and shouldn't drink it. So, the thiamine fixed the potassium abnormalities. I used to have to supplement potassium for years or get horrible muscle cramps and arrhythmia. This problem was eliminated by B1 repletion.

According to the literature on thiamine in starved surgical patients and refeeding syndrome, presumably it helps by reducing renal wasting of K and it helps with the low ATP issue which is screwing with the Na-K ATPase and producing these horrible electrolyte abnormalities many severe ME/CFS patients have when they take stuff that messes with their metabolism.

But I still had other symptoms of 'overmethylation' so on a hunch I said well if B3 helps with side effects of B12/folate, maybe it will help with this. Sure enough, taking maybe a quarter or third of a 100 mg niacin tablet would get rid of these attacks when they occurred.

My underlying condition continued to improve and I was able to gradually stop taking all supplements. The risk-benefit of thiamine isn't worth it to me anymore because I get a 10% bump from it now whereas when I was much sicker it used to get me a 50% bump so it was worth dealing with the hassle of constantly having to troubleshoot induced deficiencies.

Sorry, I know this is all very vague and impressionistic.
 

JasonUT

Senior Member
Messages
303
@Sidereal

Very insightful post. Thanks.

I am currently at 150 mg Lipothiamine. I am seeing increased physical and cognitive energy. Reduced POTS, reduced IBS. However, the increased energy is mixed in with a lot of restlessness and anxiety.

Lonsdale suggests in this article that B1 helps folate and B12 into the cell.
Folic acid and vitamin B12 simply collected in the blood because because they were not being used. As soon as thiamine restoration took place, the transmission became more efficient and the folate and B12 were consumed in the action.

Per SpectraCell, I am functionally B1 and B3 deficient, and borderline B6 and B9 deficient.

Maybe I don't need the mega doses of mFolate (20mg), adB12 (2 mg), and hB12 (2 mg) anymore? Maybe I am overmethylating?

Should I reduce B12 and folate or increase B3?
 

Sidereal

Senior Member
Messages
4,856
However, the increased energy is mixed in with a lot of restlessness and anxiety.

I experienced this also. I had to take B3 to deal with this problem.

Maybe I don't need the mega doses of mFolate (20mg), adB12 (2 mg), and hB12 (2 mg) anymore? Maybe I am overmethylating?

Should I reduce B12 and folate or increase B3?

The doses of B12 and folate you're on are massive. If I took even a fraction of that, I'd end up in the emergency room.

I take 2,000 mcg hydroxycobalamin once weekly because I get none from my diet, that's it. When I tried combining methyl B12 with thiamine (by using Lonsdale's transdermal cream which unfortunately includes mB12), it was a disaster of 'overmethylation' and massive inflammation.
 

Asklipia

Senior Member
Messages
999
@Sidereal Thank you so much for taking the trouble of giving us all these very precious details!
Which brand of hydroxycobalamin are you using if this is not too much to ask?
Thank you and best wishes :bow:
 
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JasonUT

Senior Member
Messages
303
@Sidereal

Did you experience any flushing when you tried the low dose Niacin? It appears you were taking about 25-30 mg per dose.

I tested 50 mg of Niacin at dinner yesterday and 50 mg of Niacin at breakfast this morning. I didn't experience any flushing. Is flushing a sign of B3 saturation? Do you know if lack of flushing indicates a larger need for B3?
 

Sidereal

Senior Member
Messages
4,856
@Sidereal

Did you experience any flushing when you tried the low dose Niacin? It appears you were taking about 25-30 mg per dose.

I tested 50 mg of Niacin at dinner yesterday and 50 mg of Niacin at breakfast this morning. I didn't experience any flushing. Is flushing a sign of B3 saturation? Do you know if lack of flushing indicates a larger need for B3?

I didn't get flushing at 25 mg doses. Not even at 100 mg doses but that was way too much and made me crash in terms of energy of course. Yes, I think one would want to stay below the flushing threshold. I don't really think what's happening here is that you're addressing a 'need for B3 (in the sense of a deficiency), it's more that B3 seems to be able to treat 'overmethylation' symptoms.
 

JasonUT

Senior Member
Messages
303
@Sidereal

Thanks for your reply. For me, B3 may be a delicate balance between overmethylation and replenishing B3. Per testing, I am functionally deficient in B1 and B3. Somehow I need to strike the appropriate balance so that I don't mess something else up. How to do this correctly seems like a mystery.
 

JasonUT

Senior Member
Messages
303
@Sidereal

I have been experimenting with B3 since August 9. It definitely has a calming affect. I am trying Niacin and niacinamide at different dosages and frequencies. I have held my Lipothiamine at 50 mg 4x per day for now as I test B3.