thiamine deficiency - Page 8

Quick Thoughts: Hyperemesis and Early Thiamine Deficiency

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A while back, I published an article about expanding the symptoms considered to be associated with thiamine deficiency. Conventionally, we tend to look only at the end stage results of long term thiamine deficiency as being the indicators of disease, forgetting that to get to this stage there was a prodrome, which, except in rare cases, proceeds across many months, if not years. Even with a severely thiamine restricted diet, it can be weeks to months before the more traditionally recognized neurological or cardiovascular symptoms manifest. A series of studies conducted in early 1940s found that among the most common early symptom of thiamine deficiency was GI dysfunction ranging from nausea, vomiting, and constipation, to severe food intolerances and complete anorexia. The prominence of vomiting in this scenario got me thinking about hyperemesis, the severe and near continuous vomiting experienced by some women during pregnancy, but also, about the exploding numbers of illnesses that involve GI dysmotility and dysbiosis. From IBS to SIBO, gastroparesis to constipation and really everything in between, could they also be a consequence of insufficient thiamine? According to the research, yes. Indeed, these non-pregnant cases of GI dysfunction, easily fall under the umbrella of gastrointestinal beriberi – thiamine deficiency that manifests in GI system, sometimes months before the onset of the more traditional cardiovascular or neurological forms.

Pregnancy, Vomiting, and Thiamine

With pregnancy, we know that the energy demands upon the mom are enormous, which means that given its role in energy metabolism, thiamine demands are enormous as well. Some older research estimates the demand for thiamine increases by at least 5X that of a non-pregnant woman. Other research, which I seem to have lost the reference for, posited the demand increased by a factor of 10. Personally, I believe the demand and need for thiamine and other nutrients during pregnancy is higher yet.

The RDA for thiamine during pregnancy is 1.4mg per day, just a fraction over the RDA for non-pregnant women (1.1mg). A quick scan of prenatal vitamins shows that most include from 1.5mg – 3mg of thiamine, woefully below the estimated need of 5-10X non-pregnant levels. That discrepancy alone could cause problems in women who may have been borderline thiamine deficient pre-pregnancy. The pregnancy itself would tip her over into deficiency territory. This then could very easily lead to increased vomiting, which then would further hamper the intake and absorption of thiamine, exacerbating the deficiency, and cause more vomiting; a cycle that becomes especially dangerous to both mom and the baby as time progresses.

While it is easy to see how thiamine deficiency is a common consequence of hyperemesis, it is possible that it is also a contributing cause. Dr. Lonsdale and others have long asserted a role for thiamine deficiency as a causative contributor to hyperemesis. Just based upon the estimated need versus the availability in prenatals and diet, especially once vomiting has begun, this makes sense. Importantly, these types of symptoms have been observed across many case studies unrelated to pregnancy, so much so that gastrointestinal beriberi is a legitimate, though woefully under-recognized form of thiamine deficiency disease. As mentioned previously, the symptoms include GI distress in the form of vomiting, gastroparesis (delayed stomach emptying, which results in vomiting), disturbed GI dysmotility, either too much or too little, and dysbiosis. All of this is documented to be attributable to insufficient thiamine in non-pregnant people. Is it so difficult to see that pregnancy too could elicit or exacerbate gastrointestinal beriberi?

But Wait, What About Carnitine and CoQ10?

If you follow my work, a few years back I mapped one of the causes of hyperemesis to a carnitine deficiency. Carnitine is critical to the metabolism of fatty acids, and its deficiency along with another mitochondrial co-factor, CoQ10, have been linked to a condition called Cyclic Vomiting Syndrome (CVS). Supplementation with l-carnitine and CoQ10 appears to resolve the vomiting with CVS. After publishing that paper, anecdotal reports came back suggesting that l-carnitine and CoQ10 was useful in preventing and resolving hyperemesis. I believe that it is still involved in many cases, but it is possible that thiamine is involved as well and it may be a contributing factor to the carnitine deficiency. Thiamine, in addition to its role in key enzymes involved in carbohydrate and protein metabolism, is also involved in fatty acid metabolism and positionally, it sits a step above carnitine.

Here we have a few options beyond the traditional and largely ineffective anti-emetic medications given to women with hyperemesis; options that I would argue are significantly safer and healthier for mom and baby and likely far more effective. If thiamine and/or l-carnitine deficiency are at the root of hyperemesis, correcting those deficiencies early should give women a much easier and healthier pregnancy.

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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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This article was published originally on May 24, 2021. 

Energy Loss as a Cause of Disease

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I graduated from London University in 1948 and retired at the age of 88 years in 2012, so I have seen some remarkable changes in the practice of medicine. I have entered many reports on this website, detailing what should be a medical revolution. One of the best professional associations that I have ever made has been with Dr. Chandler Marrs, the editor of Hormones Matter. Both of us have tried hard for years now to explain the details of our experience, hoping to reach those many individuals who are being misdiagnosed and treated extremely badly. My recent experience has come from retiring in an excellent retirement home.

I am surrounded by people of my age, many of whom are taking numerous medications to treat their symptoms. The most recent example was in a gentleman who has been in and out of hospital several times with a set of symptoms whose origins are clearly due to cellular energy deficiency. When approaching him as a friend and asking him how he is faring, he told me that his list of symptoms remains as a medical mystery. In addition, two women, with whom I had become acquainted, had symptoms that were similar to his. One of them passed away without a diagnosis and the other one is presently being treated symptomatically. The reader might well ask the obvious question as to what happens if I should state an opinion. The answer is very simple; the offered explanation would fall on deaf ears. Unfortunately, this is eminently predictable and is the major reason why innovation that contradicts the medical standards of the day is regarded as heresy throughout history. Of course, “new” concepts must be backed by evidence to become accepted. We are trying to provide the evidence on this website for defective cellular energy as a major cause of disease.

Heresy in Medicine

I am pretty sure that I may have recorded the story of Dr. Semmelweiss on this website but it is a story so poignant that it is well worth repeating. It is a story that illustrates the difficulty of introducing innovation in medicine, or indeed anything new. Semmelweiss was a German Hungarian physician who lived before the discovery of microorganisms. He presided over an obstetrics ward in which there were perhaps 10 beds on one side of the room and 10 beds on the other. The physicians of the day would come in and deliver their patients without washing their hands or changing their clothes. It is difficult for some people to comprehend the total lack of any form of hygiene that doctors practiced before microorganisms were discovered. Semmelweiss observed that the physicians would often come into the ward directly from the morgue and concluded that they must be bringing something in on their hands that caused the patient to die from child-bed fever, as it was then called. From this observation, he organized the first controlled experiment in medicine. He directed the physicians on one side of the ward to wash their hands in chlorinated lime before they delivered the patient. The physicians operating on the other side of the ward carried on in the same old way.

The results were dramatic as we would expect today. Child-bed fever was reduced by 85% when the physicians washed their hands. The medical profession, including his colleagues, said that “because Semmelweiss could not explain what was on the hands of the physicians, his explanation was unscientific”.  It is important to note that they simply ignored the obvious benefit. He was discharged from his job and excluded from the hospital. He died as a pauper in a mental hospital.

The major point is that the concepts of the medical profession of the day were completely wrong,  He had clashed with the current medical model that was then accepted by mainstream medicine as “the truth”.  If we apply this lesson to today’s model of medicine, it is impossible not to wonder if the outstanding principle of the use of pharmaceutical drugs in medical practice is fundamentally wrong. Is treating symptoms without addressing their underlying cause scientifically justified? A glance at the Physicians’ Desk Reference that supplies information on the many prescription drugs available might put off the reader’s use of a prescription. For each drug there is a short description of its use, often with an admission that its action is only partly understood. Then follows a page or two describing its side effects. Does this not suggest that the use of pharmaceuticals to treat symptoms causes more problems than it solves? Are we approaching another Semmelweiss moment in medical history?

Envisioning an Alternative Approach

I envision the profession of medicine as like a traveler, hoping that the road leads to the best solution in the treatment of disease. For my analogy the traveler comes upon a fork in the road with a signpost. One sign says “Kill the Enemy“, (referring to the discovery of infecting microorganisms) and our traveler takes that road because the sign for the other fork is blank. “Kill the enemy” became the first paradigm (a model accepted by all) in medicine. We had to find means of killing bacteria, viruses, cancer cells or any other attacking agent and many years were spent in trying to find ways and means of doing this without killing the patient. The information was hard won and a lot of patients suffered untold hardship and even death until the discovery of penicillin. This in itself “proved that the correct fork in the road had been chosen”. As we know, this discovery led to the antibiotic era, but even these drugs are running into new problems.

To continue the analogy, our traveler goes back to the fork in the road and finds that the other sign has now been filled in. It reads “Assist the Defenses” and I believe that it should represent a new paradigm. Louis Pasteur and his colleagues discovered the disease producing microorganisms, but on his deathbed he is purported to have said “I was wrong, it is the terrain that matters”.  He meant that the terrain represented the defensive functions of the body that should be assisted.  Perhaps he formulated what I believe must be the second paradigm in medicine.

The Second Paradigm

How should we approach the introduction of this concept? It seems to me that the problem is that few people are aware of the basic principles of body function so I must provide another analogy that I have used before in Hormones Matter. The human body can be compared with a symphony orchestra in which part of the brain represents the conductor. The organs represent the banks of instrumentalists that make up the orchestra. Like the instrumentalists who, although they are experts in their own right, still have to obey the conductor, the cooperative function of all our cells must obey the automated signals from the brain to play the symphony of health. Each of us comes with a “blueprint” that is our inheritance and although we are all the same in principle, we are all uniquely different because of accidental or inherited variations in the “blueprint”. The autonomic (automatic) nervous system, controlled by the lower part of the brain, coordinates the function of organs in the body, behaving like a computer. It receives sensory information, enabling it to receive from and send signals to those organs, thus collectively playing the symphony. The endocrine system consists of a group of glands that produce hormones. Their function, also under the command of the brain, is to release the hormones that travel in the bloodstream to the organs and are thus signaling agents.

The voluntary nervous system, controlled by the upper part of the brain, gives us what we call willpower. The voluntary and autonomic systems are completely separate but have many connections, so some of the reflex activity conducted by the autonomic system can be influenced and overridden by an act of will. Perhaps the best example is the fight-or-flight reflex that is activated by a sense of danger but can be modified voluntarily. For example, the reflex response to an insult might result in violence if it is not modified by the voluntary system. Assuming that the blueprint provides all the machinery of survival, all it requires is energy.

The Production and Consumption of Energy

We cannot survive without food and water. There is, however, an overall tendency to ignore the appropriate nature of the food, in spite of the fact that it provides the fuel that gives us energy. Taste is the dominating influence, driving sales for the food industry without an appropriate consideration of calorie/micronutrient balance. It is clear that “vitamin enrichment” has hoodwinked us. Chemical energy is liberated from oxidation of fuel (food), but it must be transduced in the body to an electrical form of energy that enables us to function. The electrocardiogram and the electroencephalogram are both tools that identify the electrical nature of this function. The human body is well equipped with an enormously complex system of defense but its complexity requires energy that has to be increased when a person is under any form of physical (trauma, infection, severe weather etc) or mental (divorce, grief, business deadlines etc) stress. It is very important to think of stress as a “force” to which we have to adapt. The lower part of the brain, acting like a computer must automatically organize the complex defense machinery, including the immune system, so its energy requirement exceeds that required by the rest of the body and must be automatically increased to meet the required response to stress. What we call the “illness” (fever, swollen glands, inflammation, etc.) is evidence that the brain has gone into action to generate a defense. In fact, war is declared and the result is recovery, death, or prolonged chronicity where the attacker has not been completely defeated. A nutritionally deprived individual cannot muster the energy to initiate defensive action and may explain why stalemate or the stress of vaccination can be evidence of failure to adapt.

Of all the aspects of health maintenance, exercise, appropriate rest, socialization and fulfilling job assignment, perhaps nothing is more important than the nature of the food. Genetics, stress and nutrition are visualized as the “three circles of health“. I want to illustrate this relationship by retelling an incident that we reported in “Hormones Matter” a few years ago. The mother of an 18-year-old girl reported by email that her daughter had received the HPV vaccination (to increase immunity against the virus associated with cancer of the cervix) four years previously. Throughout the four years she had been more or less crippled by a condition known as postural orthostatic tachycardia syndrome (POTS). She had been seen by many physicians without any success. Her mother did her own research work and had come to the conclusion that her daughter had the vitamin B1 deficiency disease known as beriberi and she wished to prove it. A blood test clearly showed that she was correct. Because of this, several young people who had also suffered from POTS following the HPV vaccination were also found to be thiamine deficient. One young woman who had not received the vaccination also had POTS and was found to be thiamine deficient. One of the observations that had puzzled the parents of these young people was that, without exception, each of them had been recognized as an exceptionally good athlete and student before they had received the vaccine. We deduced from this that a superior brain was more likely to consume  more energy than someone less well endowed, thus increasing the risk of poor  nutrition and the ability to adapt to a potentially powerful stressor.

Although proof is not possible, we have accumulated a lot of evidence that has enabled us to hypothesize that the vaccination acted as a nonspecific form of stress in people who were marginally thiamine deficient, but asymptomatic before receiving the vaccine. For the youngster who had not received the vaccine, but who had succumbed to POTS, poor nutrition alone, with or without genetic risk, had to be blamed. Genetics, stress and nutrition are visualized as the “three circles of health“.

The Medical Revolution

We are proposing that energy loss is the major cause of disease and that it results commonly from a less than ideal diet or dysfunctional mitochondria. Failing in the balanced need of the caloric content and the  necessary non-caloric vitamins and minerals for efficient oxidation, the result of poor diet is energy deficiency. There is considerable evidence that thiamine plays a vital part in both the production of chemical energy (ATP) and its conversion to electrical energy for bodily function. We have concluded, also from evidence, that genes may or may not usually cause disease on their own. Either nutrition or overwhelming stress may be variable factors that create genetic risk. The prevailing addiction to sugar creates a variable degree of thiamine deficiency by the catatorulin effect. We further hypothesize that a mild to moderate thiamine deficiency leads to a gradual decay in the efficiency of the critical enzyme(s), insufficiently supported by the cofactor(s). Attributing the easily reversible symptoms to other causes and allowing them to continue, leads to chronic disease. This may or may not respond to pharmacological doses of cofactor, used to resuscitate the associated enzyme(s).

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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This article was first published on July 1, 2019.    

What Is Thiamine to Energy Metabolism?

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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.

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This article was published originally on August 25, 2020.

Thiamine for Fibromyalgia, CFS/ME, Chronic Lyme, and SIBO-C

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The Road to Thiamine

In August 2020, I was at my wits end. I had developed gastroparesis in March 2020, after 10 days of metronidazole (Flagyl), for a H. Pylori infection and SIBO-C symptoms. After seven days, I developed the symptoms usually associated with the intake of this drug – nausea, confusion, anxiety, paranoid thinking and mild gastroparesis symptoms. I no longer had bowel movements initiated by my body and had to use enemas twice a week. This state continued and worsened until the end of July 2020, when I also had a surgery for stage 4 endometriosis.

I managed to stay alive those months by eating an elemental diet (90%) and a few bits of solid food such as white rice, goat cheese, or lean meat. After the surgery, however, my gastroparesis got worse. I contacted my family doctor at the end of August and told her that I could no longer eat any solid food without severe nausea and that I need to be in a hospital to be fed intravenously or with a gastric tube. She agreed that my situation demanded immediate attention and she wrote me the referral for an inpatient hospital admission.

I was lucky though that at that exact time, I stumbled upon the low oxalate diet mentioned by a member of a Facebook group. I joined the Trying Low Oxalate (TLO) group on Facebook and read what researcher Susan Owens wrote about oxalates. I started implementing it and realized that small portions of low oxalate food every 2-3 hours were accepted by my body. In a few weeks my gastroparesis symptoms were reduced and my belly pain diminished.

From the Low-Oxalate Diet to Discovering Beriberi Disease

At some point in September 2020, while researching oxalates, I found Elliot Overton’s videos on oxalates and I listened to them. I also read his articles on this website where he talks about allithiamine, a thiamine supplement that contains something called TTFD, as being something radically different in terms of its unparalleled effects on the human body. I was skeptical, because I had spent about 20,000 euro on supplements in the previous four years, each of them being promoted as health-inducing by big names in the field of chronic Lyme disease, MTHFR, CFS/ME, SIBO and so on, while their effects on my health were only partial and temporary at best.

I decided that this would be the last supplement I’d buy. The worse would be losing 40 euros and I had already spent too much on worthless treatments. I took 150 mg allithiamine + magnesium + B2 + B3 for 3 weeks and I was less tired, could move more around the house, and overall was feeling much better, even my extreme light sensitivity was subsiding. Then I stopped taking it, not sure it was doing anything. That’s when I knew that it had worked and that I needed it badly. I took the same dosage for another 2 weeks. The next three weeks I had to wait to receive it from the USA, and I was again completely bed ridden.

However, I used this time to read most of Dr. Derrick Lonsdale’s book on thiamine deficiency. I became convinced that I had dry beriberi and that most of my neurological symptoms were caused by thiamine deficiency. I also noticed that the dosage is highly individual and some individuals needed very high doses of thiamine per day in order to function.

I now understood, why 2015 was the year I became bedridden for most than 90% of the time: I spent 6 months in a very hot Asian country, as part of my master degree studies. The energy requirement to deal with the hot weather and the demanding job depleted my already low thiamine levels. At that time, I was on my way to diabetes as well. I had fasting blood sugar levels of 120 mg/dl. I could no longer assimilate/use carbs in the quantities my body required (70% of the daily caloric intake) and I was always hungry and always thirsty. Looking back on my childhood and my ever-declining health from 2008 onwards, it was clear to me that I had problems with thiamine.

The Astonishing Effects of Thiamine

In December 2020, I increased my thiamine dosage to 300 mg per day and I was astonished at the changes I experienced – an 80% reduction across all my symptoms and some even completely disappear.

Mid-January, I decided to increase my allithiamine dosage to 450-600 mg because I felt like my improvements were stagnating. I also noticed that during the days I was more physically active (meaning: I cooked food for longer that 10-15 minutes, my energy levels were higher when I was taking more allithiamine and I didn’t experience the typical post-exertional malaise I was used to in the past). I also noticed that taking allithiamine alone in high doses doesn’t work so well and that the active B complex capsules and the B3 I was taking did have an important part to play in how I felt.

In the beginning of February, I was craving sugars so badly, that I gave in and bought a cake for my birthday. I ate two slices and discovered that my mental confusion, the brain fog and generally poor cognitive skills improved “overnight”. I was astonished, since I had been led to believe that “carbs are bad”, “sugar is bad” and “gluten is bad” and that the problem was with the food itself rather than with my body missing some vital nutrients. I didn’t experience any side effects from the gluten either, even though my food intolerance test shows a mild reaction to gluten containing cereals.

By February 20th, this high-dose allithiamine ‘protocol’ and the ability to eat carbs again, eliminated all of my symptoms of SIBO-C/IBS-D/slow transit constipation, endometriosis, CFS/ME, fibromyalgia, constant complicated migraine with aura, severe food intolerances, including a reversal of my poor cognitive skills. I was able to discuss highly philosophical concepts again, for one hour, without suffering from headaches and insomnia.

Early Metabolic and Mitochondrial Myopathies

On February 21st, I decided to go for a walk. I walked in total that day 500 meters AND walked up four flights of stairs, because I live on the 4th floor without an elevator. By the end of that day, my disease returned and I became bedridden again. I could not believe it. This was the only thing I did differently. I just walked slowly.

And so I searched the internet for “genetic muscle disease”, because my sister shares the same pattern of symptoms. A new world opened before my eyes. I found out that in the medical literature, exercise intolerance, post-exertional malaise and chronic fatigue are well known facts and are described in conditions known as “myopathies”. That there are several causes for myopathy and that they can be acquired (vitamin D or B1 deficiency, toxic substances impacting the mitochondria, vaccines and so on) or inherited. It was also interesting to find out that while doctors manifestly despise and disbelieve CFS/ME symptoms, they are not utterly unknown and unheard of or the product of “sick” minds.

When I read this paper, although old and maybe not completely accurate in the diagnostics, I understood everything about my health issues.

I remembered my mother telling me that my pediatrician said he suspected muscular dystrophy when I was one years old, because I could not gain weight. I weighed only 7 kg at the age of one year, but he wasn’t convinced and so no tests were done in communist Romania. In addition to being overly thin, throughout my childhood, I always had this “limit” that I couldn’t go past when walking uphill or if I ran up a few flights of stairs, no matter how fit and in shape I was. Otherwise, I would develop muscle weakness such that my muscles felt like jelly. I would become completely out of breath, which I now know is air hunger. I couldn’t climb slightly steeper slopes without stopping 2/3 of the way up. My heart would beat very hard and very fast. I would feel like I was out of air and collapse. I first experienced this at the age of 5-6 and these symptoms have been the main feature of my physical distress since.

Because of these symptoms, I have led a predominantly sedentary lifestyle with occasional physical activity, never daily, apart from sitting in a chair at school. I didn’t play with classmates for more than 5 minutes. I couldn’t participate in physical education classes. Any prolonged daily physical activity led to general weakness, muscle cramps, prolonged muscle “fever”, and so I avoided them.

Now, I know why. Since reading this article, I was able to present my entire medical history to a neurologist and my symptoms were instantly recognized as those of an inherited mitochondrial or metabolic myopathy. I am currently waiting for the results of the genetic tests ordered by the neurologist, which will make it possible to get the right types of treatments when in a medical setting.

Before Thiamine: A Long History of Unexplained Health Issues

In addition to the problems with gaining weight and inability to be active, I had enuresis until 9 years old, along with frequent dental infections, and otitis. I had pain in my throat every winter, all winter and low blood pressure all the time. At 14 years of age, I weighed about 43-45 kg. I remained at that weight until age 27. I had a skeletal appearance. I also had, and continue to have, very flexible joints. For example, my right thumb is stuck at 90 degrees, which I have to press in the middle to release. I can feel the bone repositioning and going into the joint. This happens at least once a week.

My diet was ovo-lacto-vegetarian diet, with 70% of the calories coming from carbohydrates from when I was able to eat until 2015. In 2015, I could no longer process carbohydrate due to severe thiamine deficiency.

Since the age of 18, I have had quasi-constant back pain in the thoracic area. I have stretch marks on thighs, but have had no sudden weight gain/loss. Among the various diagnoses I had received before the age of 18 years old:

  • Idiopathic scoliosis – age 18. No treatment.
  • Iron deficiency anemia – at 18. Treatment with iron-containing supplements. No result.
  • Frequent treatments for infections (antibiotics)
  • Fasting hypoglycemia (until 2015).

The Fibromyalgia Pit

In 2008, my “fibromyalgia” symptoms began, although looking back at my history, many of these symptoms were there all along. I made a big change in my physical activity levels and this began my 12 year decline in health. In 2008, I started my philosophy studies at the university and decided to get more “in shape” by walking daily to and from the university. A total of 6 km per day.

  • Constant fatigue, no energy.
  • Worsened back pain.
  • Weak leg muscles at the end of the day.
  • Frequent nightmares from which I could never wake up. I felt like I couldn’t find my way out of sleep. After waking up, I would sit down and after 10 minutes I found that my head had fallen on my chest and I had fallen asleep involuntarily, suddenly.
  • Sensations of waves of vibrations passing through me from head to toe, followed by the sensation of violent “coming out” of the body and out-of-body experiences.
  • Heightened menstrual symptoms.
  • Fairly frequent headaches.

Over the summer, I recovered completely as I resumed my predominantly sedentary lifestyle. Then, in the fall, I began walking to and from university again, and my symptoms just got worse. This cycle continued for the next few years. My symptom list expanded to include:

  • Migrating joint pains.
  • Frequent knee tendinitis.
  • Pain in the heels.
  • Generalized pain, muscles, joints, bones.
  • Frequent headaches.
  • Sleep disturbance with insomnia beginning at 2-3am every night.
  • Frequent thirst, increased water intake (3-4 l/day).
  • Frequent urination, especially at night (woken 2-3 times).
  • Bumping my hands on doors/door frames.
  • Unstable ankles.
  • Painful “dry” rubbing sensation in hip/femur joint.
  • Prolonged angry spells.
  • Memory problems (gaps).
  • Difficulty learning new languages.

I underwent a number of tests including, blood tests, X-ray + MRI of the spine, and a neurological consultation. All that came back was high cholesterol (180 LDL, 60 HDL), low calcium, iron deficiency anemia, scoliosis, and hypoglycemia. No treatment was offered.

From February 2010-August 2010 I had a scholarship in Portugal. Philology studies interrupted. I was using public transport to go to classes, which were about only 3 hours a day. I required bed rest outside classes with only the occasional walk. I had a complete remission of all symptoms in July 2010 when I returned home and resumed my sedentary lifestyle. This was the last complete remission.

From August 2010 – December 2010, I resumed day courses at both universities and resumed the walking.

All of my symptoms were aggravated enough that by December I was bedridden. I stopped attending classes due to back pain in sitting position. I wrote two dissertations lying in bed. Once again, I sought medical advice and had a number of tests and consultations with specialists. I was diagnosed with peripheral polyneuropathy and “stress intolerance”, fibromyalgia. The treatment offered included:

  • Medical gymnastics: aerobics, yoga and meditation presumably to get me in shape and calm me down.
  • Calcium and iron supplementation, gabapentin, and low-dose mirtazapine.

The physical activity worsened symptoms, as it always does. The mirtazapine improved my sleep. I took it for 2 weeks and then stopped because I was gaining weight extremely fast.

From 2011 – October 2012, I was almost completely bedridden. I had to take a year off because I couldn’t learn anything, my head hurt if I tried.  The physical symptoms improved after about a year, as did the deep and total fatigue. I tried to get my driver’s license in 2012, but failed. I couldn’t remember the maneuvers and the order in which to perform them. I couldn’t concentrate consistently on what was happening on the road. There was too much information to process very quickly.

From 2012-2015, I was getting my master’s in France. This aggravated all of my symptoms of exertion, both physical and intellectual. In 2013, I underwent general anesthesia for a laparoscopic surgery due to endometriosis, after which something changed in my body and I never fully recovered to previous levels of health. I took another year break between the two years of master’s studies. I couldn’t learn anymore. Symptoms relieved a bit by this break. After three months in Thailand for a mandatory internship, in one of the most polluted cities in the world, I got sick and developed persistent headache, with very severe cognitive difficulties. At this point, 90% of my time was spent in bed.

A general anesthetic in the autumn of 2015 for a nose tumor biopsy was the “coup de grâce”. Since then, I only partially recovered a few hours after a fluid infusion in the emergency ward and a magnesium infusion during a hospital stay in Charites Berlin in 2016. Other improvements: daily infusions of 1-2 hours with vitamins or ceftriaxone.

How I Feel Since Discovering Thiamine

In order to recover from the crash I experienced in February, I increased my B1 (TTFD) intake mid-March and made sure I was eating carbs every three hours, including during the night. I need about 70% of my total caloric intake to come from carbs.

I am currently taking 1200 mg B1 as TTFD, divided in 4 doses, 600-1200 mg magnesium, 500 mg B2/riboflavin, 3 capsules of an active, methylated B vitamin complex, 80-200 mg Nicotinamide 3X per day and 1-2 capsules of a multi-mineral and a multi-vitamin. I make sure I eat enough proteins, especially from pork meat, because it contains high amounts of BCAAs and helps me rebuild muscles.

I walked again the last week of April 2021, 500m in one day, because of a doctor’s appointment. I did not experience a crash that day or the following days. I did not have to spend weeks recovering from very light physical activity.

I can now use my eye muscles again, and read or talk with people online. I can cook one hour every day without worsening my condition.

After 5 years of constant insomnia, only slightly and temporarily alleviated by supplements, I can finally sleep 7.5 hours every night again. I no longer wake up 4-5 times a night.

My wounds are healing and my skin is no longer extremely dry and cracked.

My endometriosis, SIBO-C, gastroparesis, food intolerances, “fibromyalgia” pain, muscle pain due to hypermobility, are all gone.

And to think that all of this was possible because of vitamin B1 or thiamine, in the form of TTFD and that I almost didn’t buy it, because I no longer believed in that ONE supplement that would help me!

I will always be grateful for the work Dr. Derrick Lonsdale, MD, researcher Chandler Marrs, PhD and Elliot Overton, Dip CNM CFMP, have done so far in understanding, treating and educating others about chronic illnesses. More than anything, more than any physical improvement I experienced so far thanks to their work, what I gained was truth. Truth about a missing link, multiple diseases being present at one time and about why I have been sick my entire life.

Physical Symptoms and Diagnoses Prior to Taking Thiamine

  • Fibromyalgia and polyneuropathy diagnostic and mild, intermittent IBS-C since 2010;
  • Endometriosis symptoms aggravating every year, two surgeries, stage 4 endometriosis in 2020;
  • Surgeries under general anesthesia severely worsened my illness and set my energy levels even lower than they were before;
  • CFS/ME symptoms, hyperglycemia/pre-diabetes, constant 2-3 hours of insomnia per night and constant 24/7 headache since 2015, following an infection and during my stay in a very hot climate;
  • POTS, Dysautonomia, Post Exertional Malaise Symptoms from minor activities, starting with 2016;
  • Increased food intolerances (gluten, dairy, sugar/sweets, histamine, FODMAPs, oxalates, Sulphur-rich foods), to the point of eating only 6 foods since 2018;
  • Chronic Lyme disease diagnostic based on positive ELISA and WB test for IgM, three months in a row, in 2017;
  • Weight gain and inability to lose weight after heavy antibiotic treatment, skin dryness, cracking, wounds not healing even for 1.5 years, intolerance to B vitamins and hormonal preparations, since 2017;
  • Complicated migraine symptoms and aura, light intolerance, SIBO-C and IBS-D, slow intestinal transit, following a 4 month period of intermittent fasting that made me lose 14 kg, living in bed with a sleep mask on my eyes 24/7, severe muscle weakness, since 2018;
  • Two weeks recovery time after taking a 10 minute shower;
  • Gastroparesis, living on an elemental diet, in 2020;
  • All my symptoms worsened monthly, before and during my period.

Treatments Tried Prior to Thiamine

Gluten, dairy, sugar/sweets, FODMAPs, histamine, oxalate, Sulphur-rich foods/supplements free diets; AIP, SCD, Wahl’s protocol, candida diets; high dose I.V. vitamins and antibiotics, oral vitamins and antibiotics, liver supplements and herbs, natural antibiotics (S. Buhner’s protocol), MTHFR supplements, alkalizing diet, essential oils, MCAS/MCAD treatment, SIBO/dysbiosis diets and protocols, insomnia supplements, and any other combination of supplements touted as helpful for such symptoms.

And this is just what I remember top of my head. Their effect was, at best: preventing further deterioration of my body, but healing was not present.

Additional Literature

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This case story was published originally on May 11, 2021. 

Thiamine Deficiency Gaining Recognition: New Book

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In the 5 years since Dr. Lonsdale and I published our book: Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition (and 50 years since Dr. Lonsdale first began working with thiamine) recognition of the role of thiamine in health and disease have increased steadily year over year. Sales of the book double each year. Admittedly, the numbers were low and remain low in comparison to other popular topics, but the increase in awareness is heartening. Unfortunately, much of this awareness has not reached the medical profession. We regularly see reports in the medical literature boasting recognition of ‘rare’ cases of thiamine deficiency diseases like beriberi and Wernicke’s. If only physicians knew how common these conditions were and that they are only rare because we are not looking. Insufficient thiamine is Hiding in Plain Sight.

A New Book

In 2020, a UK physician by the name of Jo Dixon published a new book on thiamine deficiency, a personal account of her declining health, her discovery of thiamine, and her efforts to get treatment and spread the word. The book, called The Missing Link in Dementia, A Memoir, documents her journey. Unfortunately, she neither mentions thiamine in the title, the description, or even in the text until halfway through. One would not know the book is about thiamine until one reads it or unless it is recommended, so I will recommend it here. This would be a great starter book for someone beginning their health journey.

She has a second book listed on Amazon, Swimming in Circles that I have not read, but I suspect it details thiamine deficiency in fish in other animal populations.

While I would have preferred her to mention thiamine deficiency in the title or introduction, I found the book quite telling of the lengths one has to go to uncover this deficiency, even as a physician. Her case, unfortunately, is highly typical of what we see in patients everywhere. She had longstanding bowel dysfunction, which limited her ability to eat and maintain nutritional status. She led a busy life as a physician and mother of four children, which put pressure on thiamine stability. Even so, she functioned quite well for a long time. It wasn’t until her health took a severe turn for the worse that thiamine deficiency was recognized. Like others who develop issues with thiamine, she was forced to diagnose herself. No other physician, and she saw many, could provide any answers to her declining health. She had to figure it out herself. She was also forced to treat herself. Fortunately for her, she convinced a physician friend to provide IV thiamine, a protocol that was not accepted by her hospital and one she could not readily provide to other patients when she identified their deficiencies.

All of this is typical. We believe that thiamine deficiency was solved and thus any cases that do appear must be rare (to a tee, most case reports include ‘rare’ in the title or introduction). In reality, they are only rare because we do not look for them. We believe falsely that thiamine deficiency emerges acutely, and while it does in some cases, mostly it sits in the background, quietly and insidiously destroying one’s health. We have cases of high functioning individuals whose health begins to decline and whose thiamine levels are tested as low and should merit treatment but ignored for years as not being pertinent. And those are the lucky ones. Most physicians refuse to test for thiamine.

Thiamine deficiency is easily treatable if recognized early. It becomes more complicated as the years pass, and it is impossible if we never bother to look.

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Talking About Thiamine

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Do you suffer from a chronic, treatment-refractory illness that no physician or medical treatment seems to be able to fix? Are you constantly fatigued, have weak or painful muscles, or have coordination difficulties? Do you have brain fog, memory, or language processing issues? How about GI symptoms like IBS, gastroparesis, SIBO, or other dysmotility or dysbiotic syndromes? If any of these things ring true, you might have a problem with thiamine.

Thiamine (vitamin B1) is critical for the metabolism of food into cellular energy or ATP. Without sufficient thiamine, cellular energy wanes, and with it, the capacity to maintain the energy to function declines. Chronic, unrelenting fatigue is a common characteristic of insufficient thiamine. At its root, fatigue is the physical manifestation of poor energy metabolism.

Why is this nutrient such a problem? Two reasons. First, it is the gatekeeper to energy metabolism and so if it is low, everything downstream gums up and does not work well. Second, modern diets, medicines, and other chemical exposures contain numerous anti-thiamine factors that derail thiamine absorption and metabolism. This pushes many people into states of chronic deficiency, one that is simple to correct if identified. Unfortunately, however, patients can go years before the deficiency is recognized.

Last week, I had the great pleasure of speaking with Scott Scott Forsgren, FDN-P, the BetterHealthGuy, about the myriad of ways thiamine deficiency expresses itself in modern illness. If you or someone you know might be deficient in thiamine, have a listen.

Thiamine Deficiency Disease – Video Link

For Audio Only

To find other listening platforms, view show notes, and review the transcript, visit https://betterhealthguy.com/episode163

And if you would like a more in-depth look at this issue: Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition.

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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.

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Why Do We Use Nasal Oxygen?

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I live in a retirement home and I see many residents who are receiving nasal oxygen, so I am going to try here to address the reason. They may have been diagnosed with either heart disease or lung disease and they have probably been observed clinically to be “short of breath”. Of course, I do not know the specific reason for a given individual receiving this treatment, but does the average patient understand why he or she has to tolerate this inconvenience? I strongly suspect that they have merely been told that they need oxygen administration without explaining the underlying reason. Generally speaking, most people take for granted that they are alive and have little interest in why or how, unless their health becomes threatened. Obviously, when nasty things start to occur, they ask a physician why it is happening to them and the physician tries to diagnose the affliction. It usually winds up by the patient being told that it is disease A or B and a superficial description of the disease is provided. Each disease is regarded as having a specific treatment and a specific cure that is usually being sought by a drug company. The most up-to-date drug is offered. Unfortunately, with the exception of bacterial infection, most drugs only treat the symptoms and do not address the underlying cause. Modern research focuses almost exclusively on genetics and for the most part little consideration is given to prevention other than making a diagnosis of early disease. So why are these people receiving nasal oxygen?

Why Do We Need Oxygen?

Of course, we all understand that our environment must supply us with oxygen, water and food, without any of which we die. Although I have written about oxygen utilization in many posts on this website, it bears repetition because of what I want to say about nasal oxygen administration as described above. First of all, it must be stated that the main three gases in air are nitrogen, oxygen and inert gases. Seventy-eight percent of air is made up of nitrogen, 21% is oxygen, just under 1% is argon and the remaining part is made up of other gases such as carbon dioxide and water vapor. In other words, our oxygen intake is dosed. Too much oxygen is as lethal as none at all, illustrating the wisdom that was propounded in ancient China called Yin and Yang, not too much and not too little. The thing that always amazes me is the concise nature of the natural world and how we should fit into it. The more I get to know about the human body the more I realize how little we know. However, we do know what we do with oxygen. It is called oxidation.

Understanding Oxidation

It is surprising to me that many people appear not to understand that when a fuel burns, it is because the fuel is combining with oxygen. The result is the production of energy in the form of heat, the simple physics that we learned in school. The word oxidation is defined as “cause to combine with oxygen”. But consider that a piece of newspaper will not burst into flame by itself. It has to be ignited. If we use a match, the heat generated from striking it on a rough surface is enough to make it burst into flame and that energy in the form of the flame is transferred to the newspaper. What we are looking at is simply the transfer of energy from one action to another. Even striking the match requires the energy of the individual who performs it. But there is another factor that comes into play here. The newspaper will produce what we call ash, representing the fact that the newspaper has not been completely consumed (oxidized). I am providing these simple principles to explain now that this is exactly what happens in the body. The principles are identical: the mechanisms are different.

Cellular Oxidation

Starting with first principles, as we breathe, our lungs are taking in air and extracting oxygen from it. The oxygen is transferred into the bloodstream and picked up by combining with hemoglobin that coats red cells. This represents a transport system and the oxygen has to be delivered to each of the 70 to 100 trillion cells. This in itself is an amazing representation of the blood circulation. The deoxygenated blood is transferred to the venous circulation and transported back to be re-oxygenated. It is now that the process of oxidation takes place in the cells that have received the oxygen. To put it as simply as possible, glucose, the primary fuel, combines with oxygen to yield energy that drives the function of the cell in which the oxidation takes place. Just like the analogy of the newspaper, the combination of glucose with oxygen has to be “ignited”. Thiamine and other vitamins and minerals are the equivalent of a match. Carbon dioxide and water are the equivalent of ash from the newspaper. They have to be got rid of and so they are expired in the breath. Gasoline in a car engine has to be ignited so the explosion in a cylinder might be referred to as oxidation. The smoke in the exhaust pipe is the “ash”.

Nasal Oxygen and Hypoxia

It is my experience is that the use of nasal oxygen, although completely correct in itself, seems to be associated with ignorance of the fact that the sufferer is probably lacking the vitamins and minerals that enable the oxygen to be utilized in the body. Indeed, the lack of vitamins and minerals may be the main issue in the underlying cause of the disease, a fact that is flatly denied by the vast majority of physicians. The word for lack of oxygen in medical literature is hypoxia. The effects of thiamine deficiency, because it causes exactly the same symptoms, is referred to as pseudo-hypoxia (false lack of oxygen). In reality, the symptoms of the patient are caused by lack of oxidation, resulting in lack of cellular energy and consequently, their loss of function. Using the above analogy, it would be like holding a piece of newspaper and expecting it to burst into flame spontaneously. The most recent medical literature is full of manuscripts reporting the relationship of thiamine deficiency with chronic disease, even cancer, and various forms of traumatic surgery. It is not sufficiently recognized that the widespread ingestion of empty carbohydrate calories easily induces inefficient oxidation. This is but another reason why Dr. Marrs and I have written our book “Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition“, available at Amazon books. ‘

Conclusion

Why do so many individuals require nasal oxygen? With the present thought process, the patient is considered to have a condition that would benefit from its administration, perhaps heart or lung disease, operating on the present disease model. Physicians are not really thinking in terms of oxidative metabolism as the underlying mechanism. The point that we are trying to make here is that no amount of extraneously supplied oxygen will be effective unless the vitamins and minerals are present in sufficient quantity for the oxygen to be used in the creation of energy. Oxidation requires the presence of glucose, oxygen and the requisite vitamins and minerals and deficiency of any one of the three will be responsible for the symptoms.

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This article was published originally on April 5, 2018. 

The Appalling State of American Health

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Mental Illness As Brain Energy Deficiency

The February 3 issue of Time magazine had an entry entitled “When Every Day is a Mental Health Day”. The Blue Cross Blue Shield Association reportedly found that in people between the ages of 24 and 39 in 2020, depression is the fastest-growing health condition. Fainting attacks, known as syncope, reportedly occur in 15-39% of the general population when they suddenly stand up from a chair.

It was also reported from Kaiser Permanente that “depression is a leading cause of illness among young people and anxiety is on the rise. Suicide ranks third as a cause of death for 15 to 19 year olds”. It is interesting that a picture of a young woman is shown whose anxiety level is described as medium-high. Her favorite pick-me-ups are described as “hugs, candy, conversation”. This is the cryptic message that invokes the methods which she uses to calm herself in the face of stress. Yes indeed, it is true that candy is often used as a kind of solace for the misfortune of stress.

I will show that far from helping an individual to adapt to stress, candy is often the underlying cause of the depression and anxiety that represents maladaptation to the stresses of daily life.

Stress: Anything That Demands a Physical or Mental Response

I turn to the work of Hans Selye who proposed that human diseases were the “diseases of adaptation”. Hans Selye was a Hungarian medical student. He was in a class where the professor was bringing patients into the classroom to describe the disease that was diagnosed in each of these individuals. Selye was not listening to the professor. He was engaged in looking at the facial expressions of each of the patients as they were brought in. He came to the conclusion that the facial expression was similar from patient to patient, irrespective of the disease that was being described, that they were all suffering from the stress of the disease, irrespective of its diagnostic category. He immigrated to Canada and set up an institution in Montréal to study the effects of stress. Of course, he was unable to study this in humans so he inflicted physical trauma to rats by the thousand and did laboratory studies to show the effects. He found that the laboratory showed changes in the blood that were similar to those found in human beings afflicted with chronic illness. He formulated his findings under the heading of “the General Adaptation Syndrome” and labeled human disease as “the diseases of adaptation”. The remarkable conclusion was that the resistance to whatever was responsible for causing the disease (stress) required huge amounts of energy in the brain for the process of adaptation. I am suggesting that the vulnerability of the American population is because so many people are unable to adapt to the everyday incidents encountered in just living.

This of course makes a world of sense because infections, trauma and prolonged mental pressures such as ugly divorce or business assignments (stress) are known to initiate disease and sometimes even death. At the time of Selye little was known about the way that the body manufactures the energy derived from food so his conclusion was the mark of genius.  He actually did recognize his own genius and firmly believed that he would be the central figure in 21st century medicine. I believe that he could have been right but his work has been largely ignored for at least two reasons. The cruelty to animals got him into trouble with the antivivisection league and the pharmaceutical industry captured the field.

Energy and Illness

We now know a great deal about the way this energy is produced and consumed in the body to produce function. The conclusions of Selye now make perfect sense in analyzing the cause of human disease. The only change that I would make would be to call human diseases “the diseases of maladaptation” because  Selye pointed out that succumbing to stress was nothing more than the failure of energy production in adapting to whatever form of stress was being imposed. In order to understand this, you have to remember that infection, trauma, and problems involving mental work all come under the dominant heading of stress and that they all demand consumption of mental energy in the solution by adaptation.

Thus, we can begin to see that disease, irrespective of diagnosis, is nothing more than a combination of genetic risk coupled with a failure to meet the energy demands required. The initiation can be represented by the integrative action of one or more of three interlocking circles labelled Genetics/ Sress/Nutrition. There is now evidence that most genetically determined disease, including cancer, does not usually produce disease on its own. For example, diabetes is genetically determined but does not develop until middle age and often following a “stress event” such as an infection, trauma or a prolonged and nasty divorce. We have to recognize that the body’s ability to manufacture sufficient energy to meet whatever stress is imposed comes from the quality of the food. A relatively new science is called epigenetics and is the study of how our genes can be affected by nutrition and lifestyle.

I know that I am repeating myself (for emphasis) when I write that the ability to adapt to any form of physical or mental stress depends on brain/body energy and that if bad news, injury, infection or a nasty divorce, has to be faced in the modern world, Selye would point to the need for brain energy in meeting and adapting to that stress. Of course, if we are healthy, the adaptation is automatic and we don’t even think about it. In short, we adapt. That has given rise to the idea of “good, and bad, stress”. However, if a person becomes sick at such a time we are most unlikely to think of it as mild to moderate brain energy deficiency. Without this, the brain “complains by initiating symptoms”. In other words, individuals developing mental disease have biochemical deviations in their ability to adapt. Depression and anxiety are merely examples of the way in which the brain shows energy failure, the result of simply being alive. Note that depression and anxiety are perfectly normal as we adapt to the appropriate stimulus. They are abnormal when they exist chronically for no apparent reason or stimulus. The underlying mechanism has been exaggerated and is a reflection of abnormal brain function.

The January 2020 issue of National Geographic magazine states that “stress plays a major role in many illnesses that kill us. It also drives unhealthy eating, poor sleep, alcohol and drug misuse, and other bad habits. Modern medicine really sucks (their word) at preventing chronic disease”. In the same issue, “food allergies have become so widespread that many schools restrict what kind of lunch kids can bring from home for fear of setting off a classmate’s allergic reaction. Oddly enough, allergy is a brain sensitivity, resulting in abnormal organ action, so it is in reality brain related. For example, a woman who was known to be allergic to rose pollen enters a room where there is a bowl of roses. She succumbs to an attack of asthma that requires hospitalization, only to find later that the roses were artificial. The point is that the asthma could be initiated by more than one sensory input.

In the United States 5.6 million children suffer from food allergies. This translates to two or three in every classroom”. I will illustrate the unifying concept of energy deficiency by discussing a number of diagnoses in which the medical literature supports it.

Energy and Brain Autonomic Function: Parkinson’s and Alzheimer’s Diseases

The classic prototype for dysautonomia is beriberi, the vitamin B1 deficiency disease. Although this is not by any means the only cause of energy deficiency in the brain, it acts as a model for clinical expression. To put it as simply as possible, it represents an unbalanced ratio between calories ingested and the density of the micronutrients contained in the food source that catalyze the complex mechanisms of energy production. For example and contrast, the diet in Okinawa, Japan, that boasts a high concentration of centenarians, is nutritionally dense, meaning that it contains the vitamins and essential minerals that enable the calories to be burned (oxidized). It is also calorically poor, while in the US it is the reverse and where chronic disease is common. It has been shown in animal studies that a calorie poor diet correlates with the prolongation of youthful activity and even life itself.

In this presentation, I will try to show that brain energy deficiency is the major cause of disease. Because the controls of the autonomic nervous system in the lower part of the brain are quickly affected by energy deficiency, (the commonest cause in America is TD) it is not surprising that dysautonomia is common and occurs as part of other diagnostic categories. What I mean by that is that many diseases have been described in the medical literature associated with dysautonomia. For example, Parkinson’s and Alzheimer’s diseases are in a group of conditions that have a causative relationship. Both are associated with dysautonomia.

Megadose thiamine treatment has been reported to be successful in Parkinson’s disease.This information comes from a physician in Italy and it amply supports the concept that this chronic disease is caused by brain energy deficiency. The importance of the word megadose means that thiamine is not simply replacing a dietary vitamin deficiency. It is being used as a drug. The multiple actions of thiamine are all known to be essential in energy synthesis. If two diseases such as Parkinson’s and Alzheimer’s have a common cause, you might well be asking how is it that they are different in character? I think that this is an extremely important point. The disease in the brain depends on the distribution of the deficiency and hence the function of the affected cells. There is always symptom overlap in the two diseases. Variations in the presentation of disease can be extraordinarily variable.

Panic Disorder, Autonomic Dysregulation, and Energy

Supposedly psychological in nature, it is really a sympathetically initiated fight-or-flight reflex, originating because of brain oxygen, or oxidation, deficiency. The association between panic disorder and cardiovascular disease has been extensively studied. Some of these studies have shown anxiety disorder co-existing with or increasing the risk of heart disease. Heart disease almost always occurs in vitamin B1 deficiency beriberi, because the heart functions continuously throughout life and requires a continuous supply of energy. But heart disease occasionally does not occur, depending on the severity and the cellular distribution of the deficiency.

Recent interest has focused on whether some modern heart disease is caused by energy deficiency. What is confusing to people is that tachycardia (accelerated heart), occurring for no specific reason, is caused by an erratic signal from the brain via the autonomic nervous system. If the heart muscle is also deficient, the autonomic signal may result (for example) in atrial fibrillation. The treatment would therefore be energy stimulus in both brain and heart. This is why beriberi, the disease that is the well accepted result of vitamin B1 deficiency, causes defective function in the controls of the autonomic nervous system and the heart as the commonest result of this disease.

It also raises eyebrows when I say that beriberi is common in America, but is unfortunately not recognized by physicians whose overall philosophy is that “any sort of vitamin deficiency simply never occurs in America because of vitamin enrichment of foods by the food industry”. The trouble with that philosophy is that the extraordinary ingestion of empty calories in this population overwhelms the vitamin dependent machinery that oxidizes the calories. The best analogy that I can offer is a choked car engine. The input of gasoline must match the capacity of the spark plug to initiate gasoline ignition.

Overall, results suggest that rates of epilepsy are elevated among individuals with panic disorder and that panic attacks are elevated among individuals with epilepsy. An article reviewing the causes of epilepsy includes recent reports on the effects of inefficient cellular use of oxygen as a causative factor. Hyperventilation (over breathing) occurred in 25% of a group of patients with a relatively common form of dysautonomia (POTS) associated with fainting attacks. The authors hypothesized that the hyperventilation in this condition arises because of brain hypoxia.

This is supported by the fact that people prone to panic disorder are known to develop one of their attacks when situated on the top of a mountain. One of my patients was an elderly lady who indulged in square dancing once every two weeks. Invariably she would develop a feverish illness lasting several days after returning home. Without going into the complex details I was able to conclude that her energy requirement was increased by the physical effort required for square dancing. Because her energy synthesis mechanism was depleted from thiamine deficiency, these episodes of fever were exactly similar to the condition called mountain sickness. With megadose thiamine she was able to continue her square dancing without suffering these repeated illnesses. This patient’s problem could not have been addressed by the orthodox assumption that each episode of illness was due to an infection; Because of a rigid concept that these recurrent episodes were only the result of an infection, we tend to forget that the “illness” is really an exhibition of the complex mechanisms of defense organized by the brain. Lacking in a full complement of energy, its organizational capacity is depleted.

Many examples of manuscripts appearing in the medical literature describe the presence of multiple diseases occurring in a single patient. We suggest that this stretches credibility because we cannot predict the incidence of one disease in a person, let alone the incidence of two or three at the same time. Rather we should be seeking a single causative factor to explain all the symptoms. In the reports of multiple conditions occurring in one individual, one of them is invariably described as dysautonomia, strongly suggesting that the cause in common is brain energy deficiency affecting the controlling mechanisms.

Energy Deficiency and Health Across Generations

Mental illness, including depression, anxiety and bipolar disorder, accounts for a significant proportion of global disability and poses a substantial social, economic and health burden. Treatment is presently dominated by pharmacotherapy that averts less than half of the disease burden and is purely treatment of symptoms.  In the January 2020 issue of the National Geographic under the heading of “A World of Pain”, a case is described of a pregnancy in which the patient called Karen “begins bleeding profusely so is taken to the operating room, where doctors perform a hysterectomy. After the operation, she suffers multiple organ failure and has a cardiac arrest from which she does not recover. Karen dies of pre-eclampsia”. This is a high blood pressure disorder that is unfortunately all too common in pregnancy. I recently learned from a book written by an American Ob/Gyn specialist that this kind of tragedy could be completely prevented by the initiation of a megadose of thiamine routinely given daily during the pregnancy. It is indeed stunning to claim that pregnancy complications are all manifestations of beriberi and that this cheap and simple ingestion can prevent all pregnancy complications, a fact that most people would find hard to believe.

But this also makes sense. The food that the mother ingests must be able to provide the energy, not only for herself but for the rapidly growing infant that she has to support. It is no surprise to me that dietary indiscretion by the mother, such as the use of alcohol and the lunacy of smoking, provides a legacy to her yet unborn child that adds to the burden of child development both before and after birth. It is now well known that sudden death syndrome in infants can be a legacy of the pregnancy. Breast milk thiamine deficiency has long been known to be responsible for sudden death in a breast fed infant and breast fed infants are associated with a higher risk of autism in our modern world.

What about other nutrient deficiencies as a cause of disease? People suffering from depression, schizophrenia and dementia often have measurably lower levels of serum folate compared to people not experiencing psychiatric disorder. Even the use of methyl folate, an important part of the chemistry of folate, as a stand-alone monotherapy has been observed to exert antidepressant properties. Earlier in this presentation, I mentioned that sugar was the cause of anxiety, not a treatment for it. The fact is that the processing of sugar is extremely complex and can initiate energy deficiency in the brain. Obviously, energy deficiency represents a threat to the organism and so there is an automatic initiation of the sympathetic nervous system that results in the fight-or-flight reflex. In other words, under these circumstances the initiation of this reflex is because the sugar has caused thiamine deficient pseudo-hypoxia. The obvious safety measure, automatically governed by the brain, is to alert the organism to the perceived danger, however that interpretation or brain misinterpretation might arise.

Brain Energy Deficiency and Violence

There is a link between mental illness and firearm violence, reported to be a significant and preventable public health crisis. Hypoxia and hypercapnia (too much carbon dioxide in the blood from inadequate breathing) excite the sympathetic branch of the autonomic nervous system. Excitation of this system generates the fight-or-flight reflex that is associated with aggression. Pseudohypoxia (imitates true hypoxia) is caused in the brain by thiamine deficiency. Therefore, there should be a serious look at the diet history of gun violence perpetrators.

Early Diet and Behavior

Many years ago, when I was in practice as a pediatrician, I saw many children who were brought because of emotional disease such as hyperactivity, learning disability, unusual temper tantrums and sleep problems. The current and false explanation for this was poor parenting, but on discussion with the parents I found that in almost every case the parenting was perfectly healthy. The diet of these children was appalling, however, very high in empty calories, particularly as those from sweets and I began to keep records of the dietary mayhem that was so common. In many cases I measured the intake of carbonated beverages in gallons per week. When I instructed the parents concerning an appropriate diet for their children, the emotional symptoms disappeared. This was so impressive and the children’s response to drugs so unpredictable, I decided to practice what has become known as Alternative Complementary Medicine. Please note that complementary is spelled with an ‘e’ not an ‘i’ and it indicates that it strives to take the best of orthodox medicine and complement it with the use of nutrients that represent the elements essential to energy metabolism. The two physician organizations that have developed are the American College of Advancement in Medicine (ACAM) and the International College of Integrative Medicine (ICIM).

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Photo by karatara: https://www.pexels.com/photo/male-statue-decor-931317/.

This article was published originally on February 24, 2020. 

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