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Virginia Woolf and Me – Moments of Being Misunderstood

Published on July 14, 2025

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Did Virginia Woolf Suffer from Thiamine Deficiency

Virginia Woolf, an English writer who pioneered the use of stream of consciousness narration, was a tremendous diarist. Her diaries and her collection of autobiographical essays, ‘Moments of Being’¹, reveal her longstanding struggle with health issues that today might be classified as Myalgic Encephalitis/Chronic Fatigue Syndrome (ME/CFS). Reading her work for a creative writing class, I realized that her unrelenting fatigue, brain fog, and memory issues might have been due to unrecognized thiamine deficiency; an issue that I have struggled with, and published articles here and here and written two books about: The Missing Link in Dementia and Swimming in Circles.

‘My Brain Is Like a Scale’ – A Familiar Symptom of Thiamine Deficiency

Virginia’s diaries logged, in vivid detail, the symptoms she experienced – a condition which, like many today, had no clear diagnosis or treatment. She suffered with severe fatigue, ‘such an exaggerated tiredness’²(p.121), which fluctuated, ‘My brain is like a scale: one grain pulls it down. Yesterday it balanced: today it dips’²(p.260). The fatigue was noticeably worse after physical exertion, ‘But I am too tired this morning: too much strain and racing yesterday’²(p.263), but also deteriorated after socializing, ‘I’m too tired to go on with [reading]. Why? Talking too much I daresay. I thought, though, I wanted “society”’² (p.230). Her symptoms recovered with rest – ‘A day off today’²(p.230).

In my memoir, ‘The Missing Link in Dementia’, I describe an illness characterized by extreme fatigue, insomnia, post-exertional malaise and significant memory problems. My condition progressively deteriorated, and I became extremely tired all the time. Severe insomnia left me restless most nights, and I would awake each day feeling unrefreshed and permanently exhausted. Any physical exertion, even walking, worsened the fatigue, my legs would feel heavy like dead weights, powerless and clumsy.

The most frightening symptom was short-term memory loss. I would spend hours reminiscing; spectacularly clear distant memories were more easily retrieved than any recent event. I experienced brain fog, reminding me of my pregnancy-induced woolly brain. I was forgetting things – outcomes of discussions or meetings at work, names, and then faces. I struggled to concentrate. I feared I was developing early dementia, and that my brain was becoming encased in amyloid plaques. In my memoir I described how I imagined these smothering my brain like a fleece in winter. Over time I steadily deteriorated with frightening moments of being unable to recognize my surroundings.

I wrote my memoir before reading the description of Virginia’s vivid memories of a happy childhood that were, ‘more real than the present moment.’¹(p67). She tried to rationalize this experience – the strength of simple childhood memories compared with the weak later memories, describing ‘non-being’ as everyday activities that did not assimilate into our memory banks. She wrote, ‘I’m brain fagged’²(p.309), ‘I have already forgotten what we talked about at lunch; and at tea;’¹(p70) but she knew that ‘although it was good day the goodness was embedded in a kind of nondescript cotton wool.’¹(p70). Shortly before the end of her life she wrote: ‘I can’t concentrate’, ‘I can’t read’³. She had cognitive decline with short term memory loss.

The Emotional Component of Inadequate Thiamine

In contrast to my numbed senses, my emotions were far from muted, I was overly excitable or would burst into tears or become inappropriately angry at minimal provocation. I suffered with palpitations which were disconcerting, and at times, disturbing. Virginia wrote that she, ‘felt such rage’¹(p125) and that her, ‘heart leapt: and stopped: and leapt again…and the pulse leapt into [her] head and beat and beat, more savagely, more quickly.’²(p.179)

I was scared, not knowing where to turn to for help. My quality of life was extremely poor. I had always been an optimist, but I could see no future living like this. I even contemplated suicide, because I did not wish to become a burden. I thought I was going to die anyway, and I was extremely sad that I wouldn’t see my children grow-up, but I thought that they would be better off without me. It seems terrible now – selfish even, but I was unable to control how I felt.

Virginia had suffered with an illness that had features of depression, she felt ‘such anguishes and despairs’²(p.94).She wrote that she was spoiling Leonard’s life. Tragically, she committed suicide in 1941 shortly after completing the manuscript of her last novel. She was 59. In her suicide note she wrote that: ‘Everything has gone from me’³(p.481).

Anorexia: A Cause and Consequence of Inadequate Thiamine

As a young adult Virginia had a stressful seven years with multiple deaths in the family¹(p.117), sexual abuse during adolescence¹(p.69), and probably had anorexia according to her great niece, Emma Woolf. Virginia was almost 6 foot and weighed 7st 6lb (104lbs) when she was institutionalized for rest and feeding, her body mass index (BMI) was 14.5, a marker that she was significantly underweight.

I found out in my forties that I had a congenitally malrotated gut, presenting unusually as an adult. I had developed marked slowing of my guts, so that it was becoming impossible to eat. The slowing of my guts meant that I no longer felt hungry. I had to remember to eat, to force myself to eat. I lost weight, dropping from size 12 to 6. I lost muscle mass; where previously I had muscles there were now gutters. The muscles were constantly twitching – fasciculation’s, tics, tremblings or flutterings.

Neurasthenia: The ME/CFS of the Time

It is likely that Virginia was influenced by Jane Austen. Virginia’s first novel has many links to Austen’s novels, including the names of characters. Famous quotes from Austen’s Pride and Prejudice hint at Mrs. Bennet’s underlying condition: ‘Mr. Bennet…You have no compassion on my poor nerves.’⁴(p.7), ‘…I am frightened out of my wits; and have such tremblings, such flutterings, all over me, such spasms in my side, and pains in my head, and such beatings at heart, that I can get no rest by night nor day’⁴(pp.273-4).

Virginia Woolf and Jane Austen’s Mrs. Bennet were both thought to have suffered with neurasthenia, literally weak nerves, a term originally used in the nineteenth century United States, when it was associated with busy society women and overworked businessmen. The first description of neurasthenia was published by American neurologist Beard in 1869. Virginia wrote that she was ‘extremely social…for ever lunching and dining out…or going to concerts…and coming home to find the drawing room full…of people.’¹(p.163) She was obliged to participate because the ‘pressure of society was now very strong.’¹(p.128) She repeatedly spoke of a ‘world of dances and dinners’¹(pp.170, 172).

Low Thiamine Causes Low Energy Levels

One of the problems in ME/CFS/neurasthenia is that there are no tests. A clue is that the predominant symptom is fatigue. After excluding other causes of fatigue, a prime suspect must be faulty energy production. Another problem in ME/CFS/neurasthenia is that there is a lack of understanding about the basic energy producing processes or the fact that thiamine, or vitamin B1, is crucial.

ATP (adenosine with three phosphates) is the main energy currency. Energy is released each time a phosphate group is removed from adenosine, becoming ADP (adenosine with two phosphates). This is the human equivalent of a rechargeable battery.

Respiration is the breakdown of food-fuel to release energy. The predominant fuel, glucose, is broken down to produce pyruvate via glycolysis – literally glucose breakdown. This pathway doesn’t require thiamine (or oxygen). It produces two ATP. This is just small change in comparison with the energy produced in the battery factory – mitochondria.

Entry into the battery factory is through the gatekeeper enzyme – pyruvate dehydrogenase. This enzyme breaks down pyruvate, and importantly, requires thiamine as a co-factor – it malfunctions without thiamine.

Once inside the factory there are two production lines: one continuously uses recycled components (tricyclic acid cycle) and the other is a chain of reactions (electron transfer chain). These processes make significantly more ATP, producing more charge, more efficiently – like ultra-rapid charging for EVs. Obviously, this is a simplified version to hammer home the message that thiamine matters. A more accurate, detailed and scientific (less creative) description can be found here.

A shortage of thiamine (or oxygen) results in the excess pyruvate being converted to lactic acid. A familiar sensation to anyone who has sprinted 100m, when the demand for energy is higher than production, is the build-up lactic acidosis in the muscles, causing cramping, burning or weakness. This diversion of metabolism to an anaerobic (without oxygen or thiamine) pathway is inefficient, because another chemical reaction, requiring yet more energy, is required for the muscles to remove the lactic acid and recover. This results in an energy debt as it costs more energy to return the lactic acid to the usable pyruvate – akin to buying back the family silver from the pawn shop.

During exertion thiamine is required to ensure the higher power charge is readily available. Excess lactic acid results when energy requirements outstrip production, whether from a lack of oxygen or thiamine. In patients with ME/CFS, lactic acid accumulates more readily during exercise and before oxygen supplies are exhausted, and an elevated lactic acid level is found in the fluid surrounding the brain. Malfunctioning pyruvate dehydrogenase has been identified as key in ME/CFS. These patients feel like they are doing a 100m sprint whenever they try to walk. The (now debunked) treatment of patients with ME/CFS with exercise therapy, shows that their condition was misunderstood.

For those with a more sedentary existence, falling asleep with an arm above your head gives the same sensation. When the blood starts to circulate the arm temporarily feels like a dead weight. The arm is incredibly weak and lacks coordination. This is because the nerves no longer respond to the instructions from the brain.

Weak Nerves? Think Thiamine.

Nerves are highly susceptible to thiamine deficiency. The poorly insulated nerves – the autonomic nerves – are particularly vulnerable to thiamine deficiency. These autonomic nerves control the fight and flight response and regulate gut movement, sweating and heart rate – the ‘housekeeping’ functions which are outside voluntary control. After prolonged thiamine deficiency, eventually all nerves are affected, including the larger, better-insulated sensory and motor nerves. Arguably, the term neurasthenia is more appropriate than ME, it indicates the underlying problem – reduced nerve function.

According to the hypothesis that I describe in my memoir, excess thiamine-destroying bacteria, in the part of the gut responsible for absorbing nutrients, reduce thiamine availability. Vitamin D deficiency is common in bacterial overgrowth; it makes sense that it is a surrogate marker for thiamine deficiency. Vitamin D deficiency often occurs in patients with ME/CFS.

Rest, Recover, and Recharge

Back then, the best treatment for neurasthenia was the ‘rest cure’. Beard, a sufferer himself, astutely remarked that it was due to the body being drained of nervous energy due to an overtaxed supply of energy. Virginia was treated with rest and recognised that her nerves required respect: ‘Only nerve vigour wanted’²(p230). She was also treated with a high protein diet. Similar approaches have been popularised today. Diets such as paleo, South Beach and Mediterranean support a higher protein consumption. I ate a low carbohydrate diet for years and still avoid sugar now. I also took thiamine supplements, had corrective gut surgery and antibiotics. Popular techniques for resting the mind and body include meditation, yoga, relaxation and mindfulness. Resting helped me. It wasn’t easy, because I felt agitated and compelled to move. I spent hours doing jigsaws, aware that I was recharging my batteries – a term I’ve used but not reflected on. Strangely, this is the underlying problem: low charge, faulty charging, poor battery capacity. We have a far better understanding of modern technology that has been around for a few decades than the human system in existence for millennia which is reliant on thiamine.

Thiamine Deficiency, Modern Lifestyle, and Sugar Cravings

Humans have some design glitches predating our modern lifestyles. The first anomaly is that ATP is not stored, and the ATP generated is used 1000 times over each day – the body must constantly produce and recycle ATP. The second design fault is that thiamine, despite being essential, is not stored and is only poorly absorbed through the gut. Low thiamine levels are prevalent in society, leading to faulty recharging of our internal batteries.

Beard, who wrote about his neurasthenia in 1869, thought it was due to American modernization. He was right; we have made poor lifestyle choices. In the United States, sugar became readily available after 1864, following the civil war, with the construction of the biggest sugar refinery in the world on Long Island and a reduction in taxes. In the UK, sugar consumption escalated a century earlier, Britain was described as the ‘sweetshop of Europe’, thought to be in part due to our tea-drinking habit. By the time Jane Austen was writing, sugar was Britain’s most valuable import. Originally a condition affecting the upper classes, neurasthenia spread to the lower classes, as sugar became more affordable, although this may reflect access to medical care.

I had been craving sugar for years to gain short bursts of energy as I flagged, adding sugar to tea, one teaspoon became two, then three. Like topping up a meter constantly with small change, the sweet tea momentarily cleared the brain fog, allowing me to see another patient or simply make it to the end of the day. I experienced the same sensation in my colleague’s office after a dose of intravenous thiamine – the cotton wool vaporized.

The brain only uses glucose for energy production, whereas muscles can use protein as a fuel. I now understand that by drinking sugar-charged tea I had been supplying my glucose-dependent brain with glucose for the glycolysis pathway but because I was deficient in thiamine, the products of glycolysis could not enter the TCA cycle and progress to the electron transport chain where most of the ATP is made. The sugar craving was a sign that my brain was starving – desperate for energy – for titbits of ATP.

Factors Affecting Women

ME predominantly affects women. In many cases there is a deterioration during the peri-menarche or perimenopause, times of marked growth and/or hormonal changes. Progesterone slows gut motility. Estrogen improves nerve connections in the hippocampus – the part of the brain responsible for working or short-term memory, it also increases glucose uptake into the brain.

Being perimenopausal, my falling estrogen levels meant that the brain uptake of glucose was less efficient. Glucose offered short-term relief but exacerbated the bacterial overgrowth and malabsorption. It was clear that I had been breaking down muscle and using it as a protein source to produce energy outside my brain, contributing to the muscle wasting I experienced.

Thiamine is depleted during pregnancy, breast feeding, growth, infections and exercise. Having had four children, all breast fed, I had started exercising to get fit, and lost weight, initially intentionally. Other familial factors, immune deficiency causing recurrent infections or defective thiamine uptake genes, might have contributed. I had multiple factors, any one of which would deplete thiamine.

Was Virginia Woolf Deficient in Thiamine?

We will never know. What we do know though is that thiamine deficiency leads to poorly functioning housekeeping nerves and slow guts, predisposing to small intestinal bacterial overgrowth. This causes reduced appetite, trouble eating, reducing thiamine intake further. It is a physical problem caused by vitamin deficiency, poor nerve function initially, and eventually, nerve damage. Thiamine deficiency is treatable. It is not a psychiatric illness – the mental symptoms I experienced were caused by thiamine deficiency. Virginia Woolf was probably thiamine deficient too, having suffered with anorexia nervosa. She had a diagnosis of neurasthenia, now known as ME/CFS. Millions of people suffer with ME/CFS. Perhaps it is time we look into thiamine.

References

Woolf V. Moments of being unpublished autobiographical writings. Schulkind J (ed). New York and London: Harcourt Brace, Jovanovich; 1976.
Woolf V. A writer’s diary: being extracts from the diary of Virginia Woolf. Woolf L (ed). New York: Harcourt inc.; 1953.
Woolf V. The Letters of Virginia Woolf. Vol. 6, 1936-1941. Nicolson N, Trautmann J (ed). London: The Hogarth Press; 1980.
Austen J. Pride and prejudice. Vivien Jones (ed). London: Penguin Classics; 2003.

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Are You Attractive? Connections Between Low Thiamine and Mosquito Bites

by Mahmood Bilal PhD, DABCC, FADLM, TS(ABB)

Published on July 10, 2025

13191 views

A new study shows that you can be “highly attractive” if you have enough carboxylic acid on your skin. Highly attractive to mosquitos, that is.

Mosquitoes are an ideal vector for pathogen contraction and transmission between hosts. These pathogens include viruses such as Dengue, Yellow Fever, Zika, West Nile Virus, and Chikungunya. Parasites that cause malaria in tropical and subtropical countries are also transmitted by mosquito bites. It is therefore logical that increased exposure, or attractiveness, to mosquitos will increase the probability of contracting such pathogens. Why then do some individuals seem to be targeted by mosquitoes more than others?

A new study attempted to shed light on this age-old question of why some people are greater mosquito magnets than others. Indeed, some are victims of relentless mosquito bites and could in fact function as a “mosquito adsorbent” – a courtesy for those around them on a humid day at the park. It turns out that mosquitoes utilize their sense of smell to find food, as expected, but that those with higher levels of certain metabolites get bit more frequently than others. What is interesting is that some genes in mosquitoes allow this sensing to occur. To determine how all of this worked, researchers induced olfactory deficits by knocking out genes in mosquitoes. This caused less odor sensing to occur, but surprisingly mosquitoes were still able to distinguish between highly and weakly attractive individuals. This all indicates that attractiveness to mosquitoes is likely an amalgamation of mechanisms involving genetics and metabolomics.

The specific metabolites analyzed in this study are pentadecanoic, heptadecanoic, and nonadecanoic acids – all grouped as carboxylic acids. These are considered odd number fatty acids (ONFA), a minor group of the fatty acid repertoire in humans. Pentadecanoic and heptadecanoic acids are the most abundant ONFA, composed of 15 and 17 carbon chains, respectively. In contrast to other fatty acids, ONFA are thought to predominantly accumulate in the body from foods (e.g., dairy, meats). However, they can be synthesized in the body from straight chain fatty acids, through the mechanisms of alpha-oxidation.

The Thiamine Connection

It has long been rumored that thiamine could prevent, or at least reduce, mosquito bites. Is there research supporting this claim?

The literature is not clear, but does seem to indicate an indirect connection between thiamine (Vitamin B1) deficiency, or inadequacy, and attractiveness to mosquitos. For example, a research group studying yellow fever mosquitoes, showed that mixed with lactic acid, the carboxylic acid strongly synergizes to elicit mosquito attraction. The authors state:

Addition of lactic acid markedly increased the degree of attractiveness of formerly less attractive human odour samples and they were preferred over those which were originally the most attractive.

Indeed, lactic acid alone, acts as a sufficient mosquito attractant, but is relatively weak compared to the synergism with carboxylic acids. Another older study utilized a bioassay to identify attractants from human skin extracts. Here the mosquitoes were allowed to fly upwind toward odor sources (human skin wash extracts). They found that lactic acid was a major constituent of skin extract and that it was a necessary component for mosquito attraction.

What can cause lactic acid to build up (either in blood or tissues)? One mechanism would be the shunting of pyruvate into the lactate pathway. This can be measured in blood when someone has low thiamine. Indeed, in some conditions, the skin has been shown to carry higher amounts of lactic acid compared to blood levels, due to increased anaerobic glycolysis. Here we would expect lactic and carboxylic acids to suffuse below or above the surface of skin where it can be detected by mosquitos. In addition, a surfeit of lactic acid build up, in an overt thiamine deficiency, may not be required. This is because the mosquitos’ high sense of smell can pick small amount of odors, even when major olfactory-related genes are knocked out.

Contrary Research

On the other hand, a potential argument against the effectiveness of thiamine in repelling mosquitoes comes from a 2005 study. The authors gave individuals over the counter B vitamins in two experiments:

Experiment 1: B-complex containing 50 mg of B1(thiamine)/B2/B3/B5/B6, 400 µg Folate, 50 µg B12, 50 µg Biotin, and 500 mg Vitamin C. Vitamin C by itself was used as a control since the B-complex contained Vitamin C. Subjects (14 males, and 9 females) were utilized in a cross over experiments, meaning that they would start either placebo or the treatment for 7 days and then switch over to treatment or placebo, respectively. In this scheme each individual would act as his/her own paired experiment, statistically.

Experiment 2: Used 100 mg B1, with Vitamin C as a control. Subjects (10 males, and 7 females) were studied in the same manner to experiment 1, with 100 mg B1.

The authors did not find statistically significant differences between the groups, and concluded that B vitamins were not helpful in repelling mosquitos.

Possible Problems With the Research

There may be some caveats to the protocol used in this research, that likely masked the true effects of thiamine supplementation. First, the authors may have been limited, but should have used a non-Vitamin C formulation. Although somewhat inconsistent in the scientific literature, Vitamin C supplementation can reduce blood lactate levels in certain settings, “increase in free radical production and lactate levels….were offset by vitamin C supplementation”. This, in theory, would reduce lactate in skin and therefore the strong synergistic effects of lactic with carboxylic acids would be minimized. Second, and more importantly, the method only evaluated volatile components that can be transferred from the skin into the glass bottle used to attract mosquitoes. Lactic acid is a low volatility organic compound. The other positive studies discussed above had instead extracted skin organic compounds, including lactic acid, utilizing ethanol. Overall, the 2005 study was well designed for the questions asked and provided basic preliminary experiments. Unfortunately, the design of the study negated the effects of one key compound, lactic acid, due to volatility-based evaluation. Hence, a follow up study should be performed with these concepts in mind:

Premeasurement on skin extracts using organic acid extraction methods (ethanol or other compounds).
Treatment with higher dose thiamine. An example would be 0.5 – 1 gram of thiamine-HCl, for 1 to 4 weeks.
Mosquito attraction should be performed concomitantly with measurements of thiamine status (ETKA test). Similarly, measurements of lactic acid in skin extracts of treated and non-treated individuals should be performed in order to correlate quantity with phenotype.

The expectation is that individuals who are thiamine deficient would have increased lactic acid in their skin extracts and therefore would serve as a mosquito magnet.

Does Thiamine Status Play a Role in Mosquito Attraction?

The above studies combined elucidate some of the mechanisms in play in individuals who are highly attractive to mosquitos. These include interplay between genetics of mosquitos and organic compounds present in human skin. Individual differences in mosquito attraction may also be attributed in part to temperature, moisture, visual cues, and body odor. Out of these possibilities, body odor plays a major role in mediating these interactions. Specifically, both lactic and carboxylic acids play a synergistic role in attracting mosquitos, and therefore increase the odds of contracting disease. Mechanisms that result in increased lactic acid production such as exercise, and potentially low thiamine metabolism, are likely a risk factor for mosquito bites. Overall, the role for lactic acid in mosquito attraction seems to stir the arrows of mosquito-magnet theory, in-part, towards a mild/subclinical thiamine deficiency, or at least an abnormal metabolic activity. As suggested above, more studies should be performed in order to directly evaluate the effects of thiamine on lactic acid content of human skin in conjunction with effects on attracting mosquitos. In the meant time though, if you are one of those people who seems to attract mosquitos, consider looking into thiamine.

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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 February 27, 2023.

Maple Syrup Urine Disease at 52 Years of Age

by Derrick Lonsdale MD, FACN, CNS

Published on June 23, 2025

11033 views

There are some rare diseases that appear at birth known as inborn errors of metabolism. Their symptoms are nonspecific in most cases and each of them is unrecognizable clinically, with some exceptions. All of them are genetically determined. Most of them can be spotted from a tiny sample of blood that is sent to a central laboratory in each state in the United States and is known as “a screening test”. Perhaps the best known in the general population is one called phenylketonuria, also known as PKU. This disease is estimated to occur once in 10,000 births. If the infant is placed on a special diet he or she can grow up to be normal. If the diet is not initiated, as close to birth as possible, the infant will become intellectually disabled. This obviously emphasizes the importance of the screening test. Another of these rare diseases is known as Maple Syrup Urine Disease. It gets its name because the urine smells exactly the same as the characteristic odor of maple syrup. Although the abnormal genes responsible for the disease are known, the cause of the odor is not. It is just as deadly as PKU, but is estimated to occur only once in 100,000 births. The diet restrictions are extremely complex, involving protein metabolism.

An Infant with Maple Syrup Urine Disease

Fifty-two years ago, when I was a pediatrician at Cleveland Clinic, a physician from southern Ohio called and spoke to the secretary of the Department of Pediatrics. He said that he had an infant boy that he would like to refer because he smelled most peculiar. The secretary made a provisional diagnosis of Maple Syrup Urine Disease (MSUD) and assigned the case to me. It became a departmental joke because she was absolutely correct. There was no available commercial diet for a rare disease of this nature. It had to be constructed from scratch. The mechanism for the disease had only been described relatively recently. Because the genes control some important aspects of protein metabolism, the abnormality makes it necessary to devise a severely restricted protein diet. If such a patient has too much protein, the metabolic abnormality causes severe brain dysfunction, usually resulting in seizures and death. Well, such a diet was constructed and I was able to preside over his health for several years. As the family hailed from West Virginia, I inevitably lost sight of him. With the best of care, accurate treatment for such a complex problem is impossible. If the infant survives, it can be expected that there will be some degree of intellectual disability.

Half a Century Later

To my extreme surprise, I recently received an email from a physician in Virginia. He had been able to locate me through another physician who was known to each of us. He informed me that my former patient was now 52 years old and he had this extraordinary story to tell.

The physician, who had special knowledge of this kind of disease, said that he had been called to see the patient (JD) who was 30 years of age at that time and in a state of coma. The mother of JD was in possession of the details of the original diagnosis and his history. Evidently he had not remained on the restrictive diet, a fact that itself was unusual. However, his mother had given him “lots of fruit juice” if ever he had, as she described it, “acted drunk”. This, of course, had removed the dietary protein until stability returned. He had had no unusual crises until a strep throat had affected his abnormal metabolism and precipitated coma. JD was moved to a hospital where the proper treatment was established under the care of the consulting physician who had continued to follow his course. He told me that JD is able to carry on a reasonable conversation, fits in well with his community, mows the church grass and is a firm fan of NASCAR. He developed gout in his 40s and has since developed type II diabetes.

Lessons to be Learned

This genetically determined disease is caused by failure of an enzyme that has an integral part to play in protein metabolism. As has been mentioned a number of times in posts on this website, many enzymes require a vitamin and/or a mineral, known as a cofactor to the enzyme. The defective enzyme that causes MSUD requires thiamine and magnesium as cofactors. But, as has also been mentioned in other posts, both are vitally important in sugar metabolism. Gout has long been known to be related to an excess of sugar. The disease was common in Port drinking military officers in the British Indian Army before India became independent. Port wine has a high sugar content in addition to the alcohol. We also know now that thiamine in large doses is vitally important in the treatment of both diabetes and brain disease caused by alcohol. It is logical to conclude that JD really requires therapeutic doses of thiamine and magnesium as epigenetic stimulants to the defective enzyme, at least on clinical trial. This conclusion is reached because other enzymes that require thiamine and magnesium appear to be affected, besides the one responsible for MSUD.

Stressors Evoke Metabolic Crises

Those who have followed some of the posts in this website will be aware that an infection can act as a stressor. So it was no surprise that JD succumbed to a metabolic crisis as a result of contracting a strep throat. In previous posts we have tried to point out that an infection constitutes an attack on the organism and can therefore be thought of as a source of stress if the exact meaning of that word is applied. It was no surprise to me to hear that he had contracted gout and diabetes in addition to MSUD. Also the truly amazing thing to me is that no thought has been given to why a person with a rare, genetically determined disease has also been affected by two other diseases without thinking that they probably have a cause that is common to all three. He is being treated with a drug for gout and another drug for diabetes. Both gout and diabetes are related to sugar metabolism that is highly dependent on thiamine. The defective enzyme responsible for MSUD requires thiamine.

The point that I am trying to make is that it is the underlying biochemistry that is rapidly becoming vitally important in diagnosis. Yes, it is true that MSUD is a rare and exotic disease, but understanding its underlying principles enables us to think whether these principles are implicated in common diseases. To believe that two or three separate diseases can occur at the same time in one individual is reduction to absurdity, without thinking that they have a common relationship. I passed this idea to the physician who had contacted me and it is his decision whether he tries it or not. The outstanding reason for doing it is that it is impossible to do harm, even with megadoses of thiamine. It would also be a cheap experiment and the only two outcomes would be either some success or no change in the patient’s mental capacity.

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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 first published on August 10, 2016.

Rest in peace Derrick Lonsdale, May 2024.

Thiamine Deficiency: A Slow Road to Dementia

by Jo Dixon

Published on June 18, 2025

17356 views

‘Jo, you’ll be relieved to hear the tests are all normal.’

I’d heard this line so many times, and it wasn’t reassuring. Each time it became less likely that I had an illness that could be defined, diagnosed, and consequently cured, or even treated. If there was nothing wrong with me, why did I feel so awful? I had been gradually deteriorating over months, perhaps longer.

Fatigue and Other Seemingly Innocuous Symptoms

It’s difficult to say when I first felt unwell. One of the initial symptoms was terrific fatigue – struggling to find the energy to carry on each day at work. I was taking longer and more frequent tea breaks and relying on sugar to give me the buzz to carry on. Of course, it didn’t help that I didn’t sleep well. I would fall into a deep sleep early evening and then wake feeling strangely on edge with a racing heart, unable to sleep for most of the night. Even if I could sleep, it didn’t make me feel any better.

There were several other symptoms, which I could explain away, but one odd symptom was muscle twitches or fasciculations. These were worse when I was tired or had been more active. I also had dodgy guts – more about this later.

Even though I was exhausted I could continue working, being a mother to our four children – albeit a rather terrible one that repeatedly fell asleep in the middle of bedtime stories, until I developed brain fog. I felt like my thinking was occurring at less than half the usual speed. I struggled to hold a conversation, as this required listening, interpreting the other person’s words, formulating an answer, and talking. I would have to really concentrate to think about anything. I would forget things unless I wrote them down, which just meant I had unfinished lists scattered everywhere.

After falling on the ward where I had been working as a doctor, I finally acknowledged that I was sick, even if there was nothing apparently wrong with me. Once I stopped working, I deteriorated further, such that I was unable to recognize people and even places.

A Slow Road to Dementia

This was over 10 years ago. Clearly, I’ve improved since then. I’ve written a book to try to characterize my symptoms, explain what caused them, and why it was difficult to make a diagnosis. This seems even more pertinent since a lot of the symptoms I suffered with then resemble long Covid now.

My main concern was that I had developed dementia. I had many of the features: I struggled to remember recent events, I had problems following conversations, I was forgetting the names of friends and even commonly used objects, and I was repeating myself and having problems with thinking and reasoning. I also had difficulty recognizing where I was — this is visuospatial disorientation — a key marker of dementia.

Since the medical profession seemed to have no idea how to treat me I decided to try to work it out for myself. What choice did I have? Away from work, I had time to slowly read through medical papers, whilst I rested. I recognized that my symptoms improved after taking antibiotics for a gum infection. Any exertion made me markedly worse, but not immediately afterward, it would be the following day and last for several days. I improved if I rested. My other symptoms included pains in my hands and feet. I thought this was arthritis initially, but when I developed pins and needles and subsequently numbness, I realized this was a peripheral neuropathy – a problem with the sensory nerves in my extremities.

Some months earlier a close colleague had told me I was thiamine deficient, mainly because I had lost a lot of weight. I was taken aback, assuming he thought my diet was poor, or that I was drinking alcohol. I hadn’t drunk any alcohol for years as it made me feel rough after a few sips. I investigated thiamine deficiency and found that it causes loss of sensation as well as loss of balance; I already knew it affected memory from treating alcoholics under my care.

My friend kindly agreed to try high-dose intravenous thiamine on the ward. Neither of us really thought it would work, but it was worth a shot. I was astounded when after a few minutes of the infusion I started to be able to think clearer and even the pains in my hands and feet disappeared. I practically skipped off the ward to buy oral thiamine and dose up. Sadly, thiamine tablets didn’t work and two days later I was back on the unit begging for more shots. This thrice-weekly dosing of thiamine infusions continued for months.

The Gut Connection

I trained in Gastroenterology and General Medicine. They say doctors make the worst patients. For as long as I could remember I had suffered from intermittent severe central abdominal pains, which usually occurred after eating quickly on an empty stomach. According to my mother, I had been a colicky baby and had also returned to the hospital as a new baby with uncontrollable vomiting. Nothing abnormal was found.

In fact, not all the tests I had were normal. After several second opinions, I had a few abnormal tests. I had a CT scan of my abdomen, which showed that I had gut malrotation. The severe pains I had experienced throughout life were due to small bowel volvulus – twisting. I learned that if I stopped eating and lay down on my back the pain would gradually subside. Each time my guts twisted scar tissue formed adhesions, slowing down my gut movements.

My guts had been noticeably abnormal for many years. I had noisy guts and passed very loose, frequent motions. I don’t know many slim 20-year-olds who suffered from severe gastro-esophageal reflux as I did. As this progressed, I developed recurrent chest infections and required multiple courses of antibiotics. Eventually, I worked out that I was aspirating gut contents into my lungs each night, and I stopped eating in the evening and propped myself up with many pillows. All sorted – no more chest infections – no more antibiotics.

One of the other abnormal tests was an incredibly low vitamin D. Through late-night searches of anything vaguely relevant and my gastroenterology knowledge I worked out that a low vitamin D occurred in bacterial overgrowth. This made sense. I had developed bacterial overgrowth in my small intestines — the part of the gut responsible for the absorption of nutrients from food.

Small intestinal bacterial overgrowth or SIBO is due to an excess of bacteria in the small intestines. There are many risk factors including sluggish guts from adhesions, previous surgery, medications that slow the gut, but also multiple courses of antibiotics, poor immune system, and use of drugs that block acid production in the stomach, as well as pancreatitis. I’m sure that a diet high in sugar didn’t help.

I had another test specifically looking for bacterial overgrowth, which the nurse (a colleague I’d worked with many times) and I interpreted as abnormal. The consultant I saw thought the machine must have broken. This was frustrating; after so many normal tests to have a wildly abnormal test attributed to faulty equipment. I decided it was better to treat the patient (me) rather than a dubious test result. After starting antibiotics, I no longer needed the thiamine infusions. The diarrhea also improved.

I worked out that I had bacterial overgrowth from mal-rotated guts, obstructed from adhesions, which improved with antibiotics and were eventually treated with corrective surgery. I also had severe vitamin D deficiency, which was corrected with injections, and thiamine deficiency, which I subsequently managed with a fat-soluble thiamine analogue — benfotiamine. I found a paper online reporting thiamine deficiency in extremely obese patients who had undergone surgery on their small intestines to aid weight loss. Many of these patients had thiamine deficiency; they also had high folate, which was thought to be a marker of bacterial overgrowth. Oral thiamine had no effect on their thiamine levels, but after taking antibiotics the patients’ thiamine returned to normal. Interestingly, my folate was high.

What was less well known was that some bacteria produce an enzyme called thiaminase, which destroys thiamine. I can only assume that I had these kinds of bacteria in my gut. Interestingly these bacterial enzymes do not destroy benfotiamine.

I followed up on my theory of the underlying cause of dementia: that too many bacteria, producing a lot of thiaminase enzyme, destroy the thiamine in our food rendering us thiamine deficient. I found out that thiamine is essential for all living things, and it is necessary for the release of energy from food, particularly sugar or glucose. The brain only uses glucose as an energy supply. There are reports of low thiamine levels in the brain in patients who have died of dementia. Glucose metabolism in the brain is never normal in dementia. Benfotiamine has been shown to improve mild cognitive impairment. I speculated that this was the cause of my brain fog.

Thiamine Deficiency: The Missed Diagnosis

Why was it so difficult to make a diagnosis? I believe there are several reasons. Firstly, thiamine levels are rarely tested in the UK. Even though I had worked in the NHS for over 20 years I had never requested a thiamine test. Secondly, thiamine deficiency is known to present in widely differing ways. This is like many of the mysterious syndromes — a constellation of recognizable symptoms and signs with largely normal tests: irritable bowel syndrome, fibromyalgia, etc., and also long Covid. Thirdly, I wasn’t listened to. I’m not sure whether this is because I’m female, but I became extremely sick before anyone really tried to help, and even then I was reliant on friends I have in the medical profession.

I’m remarkably well now. I regained my memory and ability to think, although it probably took a couple of years. My guts still aren’t completely normal, but bacterial overgrowth is often a chronic condition. I still take supplements and I’m careful with my diet, avoiding sugar and alcohol. My diet is quite restrictive, but it’s worth it. I wouldn’t want to go back to how I was.

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This article was published originally on June 30, 2022.

Beyond Deficiency: Using Thiamine as a Metabolic Stimulant

by Elliot Overton, DipCNM CFMP

Published on June 12, 2025

30477 views

Throughout the past few years, I have been prescribing thiamine more and more often for individuals with a range of different health conditions. I have witnessed major symptomatic improvement in some people who displayed none of the key risk factors for thiamine deficiency, and many times had been following clean, whole-food dietary regimes which contained levels of thiamine beyond what is suggested by the RDA. I began asking myself:

Why does thiamine, in sustained high doses, work so well for such a wide variety of diseases? Is it merely addressing a deficiency or is there something else going on here?

I have since come to the conclusion that one does not need to be deficient in the nutritional sense to benefit from this type of therapy; that high-dose thiamine is not simply working by correcting nutritional deficiency. Rather, thiamine is functioning as a metabolic stimulant to restore oxidative energy metabolism in cells that have been inhibited by factors unrelated to nutritional status.

Overwhelming toxicity and chronic oxidative stress have the capacity to inactivate thiamine-dependent enzymes involved in the generation of cellular energy, producing biochemical changes which are similar to clinical thiamine deficiency. This could basically be referred to as “functional” thiamine deficiency. In a functional deficiency, dietary thiamine intake is somewhat irrelevant, because the concentrations obtained via the diet are simply not sufficient to overcome enzymatic inactivation.

Instead, high concentrations of thiamine are often necessary to overcome the “metabolic block” and restore the deranged metabolism back to normal. Dr. Derrick Lonsdale has discussed this concept on many occasions and laid out the theory in his various writings. In this article, I will explain the rationale behind high-dose thiamine therapy as a tool for bypassing these metabolic blocks and examine how this can be a useful therapy for chronic health conditions.

Understanding Enzymes

To appreciate thiamine’s potential utility in mega-doses, we should first look at the very basic function of enzymes. Enzymes are a type of protein that the body uses as a catalyst to facilitate or “speed up” the rate of biochemical reactions.

Enzymes are responsible for driving the reactions involved in practically every known function of the human body, including building things up, breaking things down, modifying or changing molecules, and converting one molecule into another. Vitamins and minerals act as necessary cofactors or “helpers” for specific enzymes to work as they should. In the hypothetical diagram below, the enzyme responsible for converting substrate “A” into product “B” can only fulfill the task once it has bound its cofactor/coenzyme.

Enzyme activity

The ability of an enzyme to bind with its respective cofactor is referred to as the coenzyme affinity (km). A simple way to conceptualized this is to think of the enzyme like a magnet. Enzymes with high affinity for their coenzyme/cofactor exert a strong magnetic pull and can bind very readily with their coenzyme.

With high coenzyme affinity and more binding, the activity of the enzyme speeds up and the rate of reaction (A->B) increases. In contrast, enzymes with low coenzyme affinity exert a much weaker “magnetic” pull, meaning that they are less able to bind with the cofactor/coenzyme. Less cofactor binding means that the rate of reaction decreases.

Genetic Enzyme Defects and Nutrients

A variety of inherited, genetic conditions feature the production of defective enzymes with poor cofactor affinity. For these unfortunate individuals, the concentrations of nutrients found in food are simply not sufficient to overcome the genetically determined lack of affinity.

nutrient cofactors enzymes

A successful strategy used for these conditions is the administration of pharmacologic/mega-doses of the nutrient cofactor. By saturating the cell, one can bypass the low affinity and restore enzyme function back to its normal state. Extremely high doses are often required to achieve this effect and this therapy must be maintained lifelong.

Thiamine-responsive maple syrup urine disease: A genetic defect in the branched chain ketoacid dehydrogenase enzyme results in remarkably low affinity for its coenzyme TPP. Continued high doses are necessary restore the function of this enzyme complex.
Thiamine responsive Leigh’s disease: Inherited mutation in the gene encoding Pyruvate Dehydrogenase, with a decreased affinity for its TPP cofactor. Treated with pharmacological doses of thiamine to stimulate defective enzyme activity.
B12-responsive Methylmalonic acidaemia: Genetic defect encoding the methylmalonyl-CoA mutase enzyme, causing low affinity for adenosylcobalamin cofactor and a pathological accumulation of methylmalonic acid. This condition can be treated with megadoses of B12.
Biotin-responsive holocarboxylase synthetase deficiency: Genetic mutation renders biotin-responsive carboxylase enzymes much less able to bind with biotin cofactor due to markedly decreased affinity. Supraphysiologic doses can restore normal enzyme function.
B6-responsive homocysteinuria: A rare defect in the cystathionine-B-synthase enzyme reduces affinity for its coenzyme pyridoxal-5-phosphate. This leads to the toxic buildup of homocysteine. Mega-doses of vitamin B6 can return enzyme activity back to normal.

It is worth noting that these genuine genetic defects are extremely rare and are not applicable to the large majority of people. Nevertheless, similar principles can also be applied when an enzyme has been inactivated by other factors.

Prolonged Oxidative Stress, Inflammation, and Enzyme Activity

The activity of different enzymes is tightly regulated depending on metabolic requirements, energy intake, and numerous other conditions within the cell. In simplified terms, if cells need to break something down, build something up, slow a process down, speed a process up, the activity of the enzymes involved in those pathways will reflect that. Enzyme activation/inhibition is a necessary part of normal cell physiology. However, the activity of specific enzymes can also be affected by other factors including toxins. There are certain enzymes involved in energy metabolism which are particularly susceptible to inactivation by free radicals and oxidative damage. Short-term, this is most likely beneficial, but under conditions of chronic oxidative stress, such as that found in chronic disease, enzyme inactivation can become pathological.

A key enzyme involved in mitochondrial energy metabolism called alpha ketoglutarate dehydrogenase (KGDH). Several nutrients serve as cofactors for this enzyme complex, with thiamine taking center stage. KGDH is a rate-limiting step in in the TCA cycle, meaning that when this enzyme slows down, every other downstream step also slows down. Whilst a deficiency of any of the necessary cofactors will reduce the activity of this enzyme, it is also exquisitely sensitive to oxidative stress. KGDH appears to be more sensitive to disturbed homeostatic factors than other enzymes, playing the role of a metabolic redox sensor, capable of switching oxidative phosphorylation “on” or “off” depending on the cellular redox state and requirement for energy. Reactive oxygen species will selectively inactivate the KGDH complex and slow down oxidative energy metabolism. This inhibition is functionally beneficial for cells in the short-term as an attempt to avoid energy overload and oxidation. Not only is KGDH a target of oxidative inactivation, but it is also a significant generator of oxidative free radicals. Here, it plays a regulatory role which clearly serves essential functions in maintaining cell homeostasis.

Under long-term conditions of oxidative stress, chronic KGDH inhibition is thought to be a driving factor underlying many neurodegenerative diseases. In chronic fatigue syndrome, recent metabolomic analysis found that one of the few metabolites (out of 800+) elevated with statistical significance was alpha-ketoglutarate, which is perhaps also consistent with chronic KGDH inhibition. Several toxic and inflammatory factors have also been shown to inhibit KGDH. Immune cells in the brain called microglial are involved in neuroinflammation and can be activated by a variety of stressors including toxins, trauma, and infectious insult (think Lyme, or lipopolysaccharide coming from a leaky blood brain barrier). Microglia produce myeloperoxidase and downstream products including hypochlorous acid and mono‐N‐chloramine – all of which are powerful inhibitors of KGDH. Heavy metals including aluminum and arsenic, along with fungal mycotoxins inhibit thiamine-dependent enzymes including KGDH and pyruvate dehydrogenase (PDHC).

Activated microglia caused by inflammation in the brain generate excess amounts of nitric oxide and its free radical peroxynitrite, both of which further inactivate KGDH. Polyunsaturated fats lining neuronal membranes are prime targets for oxidative damage in the brain, yielding a toxic byproduct called hydroxynonenal (HNE). Once more, HNE was shown to inactivate both KGDH and PDHC, whereas other mitochondrial enzymes were unaffected.

Endogenous neurotoxins such as and isoquinolone derivatives (breakdown products of catecholamine neurotransmitters) have been associated with Parkinson’s disease, and also inactivate KGDH. These metabolites include oxidized derivatives of dopamine and norepinephrine. Other KDHC and PDHC inhibitors include the breakdown products of halogenated toxic chemicals such as Tetrafluoroethylene (TFEC).

KDGH enzyme modulation
Oxidative stress and chronic inflammation are the hallmarks of chronic disease and both factors appear to inhibit/inactivate KGDH. As the rate-limiting step in oxidative phosphorylation, the chronic inhibition of this enzyme can spell devastating consequences for cellular energy turnover. A person could be obtaining a great amount of thiamine through their diet, but the underlying inhibition of these enzymes will produce the exact same outcomes as a dietary deficiency. In other words, these changes will induce a functional deficiency.

Mega-Dose Thiamine to the Rescue

When enzyme inhibition becomes pathological, we can apply similar principles as outlined above with nutrient-responsive genetic conditions. We can use high doses to bypass or overcome the metabolic blocks caused by enzyme inhibition. This concept was wonderfully illustrated in a study titled: Thiamine preserves mitochondrial function in a rat model of traumatic brain injury, preventing inactivation of the 2-oxoglutarate dehydrogenase complex.

For this study, researchers investigated the effects of traumatic brain energy (TBI) on energy metabolism, using several groups of rats who were not deficient in thiamine. They showed that the oxidative stress associated with TBI inactivated the KGDH enzyme, causing great reductions in energy synthesis, which was coupled with brain damage. Administering massive doses of thiamine to the rats before TBI was able to completely protect the KGDH enzyme. The thiamine-treated group maintained normal activity of KGDH, mitochondrial respiration, and ATP despite being exposed to the injury. Furthermore, the restoration/protection of KGDH might have also conferred some degree of cytoprotection by combating inflammation, which was demonstrated by reduced inflammatory gene expression at three days post-TBI.

KDGH and thiamine

What this study demonstrated was that very high doses of the cofactor could provide protection against an insult which was not related to deficiency. In fact, similar results have been shown in several other studies:

Thiamine administration protected neurons against inflammation-induced impairments in neurogenesis caused by exposure to radiation, both in vitro and in vivo. Thiamine treatment also significantly increased lifespan. Attenuation of these inflammatory effects are thought to be due to increased stimulation of KGDH activity.
A more recent study also looked at traumatic brain injury (TBI) with a focus on glutamate neuroexcitoxicity. They showed that excess nitric oxide and peroxynitrite found in neuroinflammation led to the inactivation of KGDH. KGDH inhibition reduced glutamate uptake into the Kreb’s cycle, producing glutamate excitotoxicity and neuronal cell death. Once again, extra levels of thiamine reversed this issue by stimulating KGDH, increasing glutamate clearance and protecting the cells against injury. The authors concluded:

Thus, the impairment of OGDHC [KGDH] plays a key role in the glutamate mediated neurotoxicity in neurons during TBI; pharmacological activation of OGDHC may thus be of neuroprotective potential.

Interesting choice of words, huh? They are basically telling us that the pharmacological use of thiamine might be helpful in conditions where KGDH is inactivated, and enzymatic stimulation can be protective against glutamate neuroexcitoxicity. For the reader’s reference, here are a quick list of conditions which are thought to involve neuroexcitoxicity as part of the disease-process:

Spinal cord injury leads to significant neuroinflammation similar to that found in TBI, with excess nitric oxide production and deficits in brain glutathione levels (an intracellular antioxidant). In one study: thiamine in high doses ameliorated excess nitric oxide levels and maintained brain levels of glutathione. The authors hypothesized that this was related to changes in precursor amino acid availability. However, this is likely also related to the stimulation of transketolase (TKT) activity (a thiamine-dependent enzyme involved in replenishing reduced glutathione). Under conditions of oxidative burden and increased requirement for glutathione recycling, there is a need for increased TKT activity and thiamine.

High doses of thiamine will stimulate the transketolase enzyme to maintain glutathione levels. This was shown in a different study using metabolomic analysis in cardiac ischemia, which found increased levels of ribulose-5-phosphate suggestive of increase TKT activity. Indeed, both thiamine and benfotiamine were found to increase the genetic expression and activity of the transketolase enzyme to counteractive oxidative damage and cell injury in diabetic vascular endothelial dysfunction. High doses of thiamine can also restore activity of the pyruvate dehydrogenase enzyme complex in the face of inactivation. Cardiac arrest was shown to markedly depress PDHC activity through inactivation.

In rats, high-dose thiamine post-cardiac arrest restored pyruvate dehydrogenase activity in brain, mitochondrial respiration, improved neurological function, reduced brain injury, and improved survival at 10 days. The quantity of the enzyme did not change, showing that thiamine worked by stimulating PDHC activity at high doses, thereby preventing injury-induced inactivation of this enzyme complex.

Pre-treatment with thiamine pyrophosphate protected against cardiac ischemia by maintaining mitochondrial function, ATP concentrations, and inhibiting mitochondrial fission.

Furthermore, copper toxicity was shown to inactivate the PDHC , produce mitochondrial dysfunction and neurological damage in rats. High doses of thiamine protected against the inhibition of Pyruvate dehydrogenase, markedly extended life span and protected against neuronal death.

The Use of Mega-Dose Thiamine in Clinical Practice

The late Italian neurologist A. Constantini published several case studies on the use of mega doses of thiamine for different conditions and saw impressive results. In one of the case reports on fibromyalgia, two patients saw an abrupt and immediate improvement only when they reached 1,800mg per day. At lower doses, improvements were negligible. High dose thiamine produced appreciable improvements in fatigue in 15 MS patients. Likewise, high doses were shown to produce remarkable and rapid improvement in the neurological condition essential tremor. Severe chronic fatigue in IBD patients with normal thiamine lab tests was reversed in most patients with megadoses.

Thiamine injections completely reversed gait abnormalities and motor failure in two patients with Freidrick’s Ataxia. Importantly, Constantini and colleagues concluded:

From this clinical observation, it is reasonable to infer that a thiamine deficiency due to enzymatic abnormalities could cause a selective neuronal damage in the centers that are typically affected by this disease.

Furthermore, in a case report of two patients, dystonia was reverse with thiamine administration. I have also seen this occur in several children with autism and/or neurodevelopmental abnormalities. Another case report detailed high-dose thiamine injection in patients with Parkinson’s disease, all of which had “normal” plasma thiamine levels, meaning that they were not classically diagnosed as having deficiency. The patients experienced between 30 and 77% improvement in motor coordination. We have seen from the research above that the neurotoxic metabolites which are thought to drive Parkinson’s also have the strong capacity to inhibit thiamine-dependent enzymes. It is therefore no wonder why thiamine can have such as tremendous impact on this condition.

Constantini and colleagues completed a larger study with 50 patients two years later, and found that 100mg thiamine injection twice per week produced massive improvement in both motor and non-motor symptoms, with some patients experiencing complete clinical remission.

Are these results simply addressing a deficiency or is something else going on here?

The daily recommended dietary intake of thiamine is merely 1 – 1.5 mg per day. Surely, if the benefits were simply due to nutritional repletion then we would see benefits at similar levels, or even 10x that amount? Except we do not. Rather, most people are required to consume 100 to 1000 times the daily recommended intake to see restoration of metabolism and symptomatic improvement. This is what I see in clinical practice on a frequent basis, and this is also what has been demonstrated in the case literature.

Beyond Treating A Deficit

The sheer amount of the nutrient necessary for clinical improvement is not consistent with simply addressing a deficit. Nutritional repletion is by no means an adequate explanation for this magnitude of effect. It IS consistent with stimulating enzyme activity to overcome inactivation, however.
Constantini hit the nail on the head with one quote from another paper:

We may suppose that symptoms decrease when the energetic metabolism and other thiamine-dependent processes return to physiologic levels. Our aim was not to correct a systemic deficit of thiamine, but rather to increase the activity of enzymes involved in cell production energy in selective brain regions.

Indeed, Constantini understood that thiamine could be used as metabolic enhancement to stimulate the enzymes involved in energy metabolism which had otherwise been inhibited by other factors. This is where we are dealing with a “functional deficiency” which can only be addressed by supraphysiologic concentrations to saturate the cell for improved bioenergetics. As I said mentioned previously, Dr. Derrick Lonsdale has highlighted on many occasions how thiamine’s effective is due to its pharmacological action, rather than nutritional repletion.

Rather than remaining hyper-focused on correcting a deficit, we should be using this molecule to improve bioenergetics regardless of nutrient status. This means that someone does not necessarily need to be nutritionally deficient to benefit from thiamine supplementation at high doses.

The Non-Enzyme Functions of Thiamine

It is worth noting here that there are a few other variables which I have not discussed thus far. Outside of the context of genuine inherited genetic defects, there are numerous polymorphisms in genes related to thiamine transport and metabolism. These polymorphisms can influence enzyme activity, albeit to a lesser extent, and can predispose one to developing a deficiency. Nonetheless, this does not alter the fundamental principles laid out in this article. It is also important to understand that the clinical improvements demonstrated are not just due to thiamine’s role as a cofactor to drive biochemical reactions to their completion. Rather, this nutrient exerts numerous non-coenzyme functions including allosteric regulation of other enzymes in energy metabolism, direct anti-oxidant and anti-inflammatory actions. It has been shown to influence the transcription of genes involved in modulating and dampening inflammation and oxidative stress upstream. Thiamine and benfotiamine supplements exhibit “anti-stress” properties in the brain, protecting against stress induced suppression of hippocampal neurogenesis. These effects stem from anti-oxidant, rather than coenzyme roles. A review of thiamine’s non-enzyme actions can be found here.

Thiamine as a Front Line Therapy

At this point, I hope that the reader can appreciate some of the potentially beneficial applications of thiamine therapy in high doses. Since this nutrient exhibits extremely low toxicity, is relatively cheap and easy to access, I believe that it should be considered as a front-line therapy, in conjunction with other interventions, for disorders involving mitochondrial dysfunction and chronic oxidative stress. This especially applies to neurological diseases. Whilst many people do not require pharmacological doses, there are many who DO benefit from this. I have seen it on many occasions, and I am sure that I will continue to do so in the future. As it currently stands, the therapeutic potential of this nutrient is untapped.

Disclaimer

I should note, before beginning any type of treatment, consult your physician. The work above represents the current state of research and observations from my own clinical practice. It should not constitute medical advice. Please be aware that although this vitamin is non-toxic and one cannot overdose, some individuals with longstanding health issues exhibit negative reactions upon taking even small doses of thiamine. These reactions are often associated changes in electrolyte homeostasis, other nutrient deficiencies and/or can be associated with the formulation of thiamine administered. There are a number of articles on these reactions on this site under the search terms, paradoxical reaction, refeeding syndrome, and more recently, calcium management and heart function.

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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 EONutrition on November 17, 2020 and edited and republished here with permission.

Parasites Ate My Thiamine!

by Brad Overbey

Published on June 2, 2025

9171 views

I’m a 36 year old male and I’ve probably been thiamine deficient my entire life. Everything about my body has always just been a little bit different compared to everybody else. I was always weaker, less coordinated, skinny, sickly, slow, low testosterone, always clammy to the touch, prone to mood swings, occasional hallucinations, and nightmares every single night. This was the only experience I knew and it never occurred to me that any one particular thing could be the underlying cause for this rogue’s gallery of symptoms. I took these challenges in stride, worked hard to overcome them all, and for the most part was a reasonably healthy person. However, nothing could prepare me for the nightmare experience that is dry beriberi deficiency caused by a parasitic babesia infection.

At age 33, my body began to rapidly deteriorate and present a wide variety of confusing symptoms such as intense nerve pain, aching joints, rapid temperature fluctuations, full blown panic attacks that made me want to pass out, confusion, upset stomach, nausea, vertigo, and mild hallucinations again. I went from being relatively healthy to having all of these symptoms in less than 72 hours. This was the start of a 3-year medical odyssey to discover the cause. I got very lucky with tests twice during this journey. At the 2-year mark a neurologist discovered that I was thiamine deficient. Then, at the 3-year mark, my internist discovered that I likely had a parasitic infection of babesia. This is my story.

Early Childhood Illness, Abuse, and Diet

I was born jaundiced and generally very sickly. This shouldn’t have been surprising given that my mother smoked and drank during the pregnancy. The first 3 months of my life were marked with difficulty eating and or keeping food down. In my early childhood, let’s say the ages before 7 years old, I was also prone to frequent ear infections and never grew out of wetting the bed.

My home life was also very abusive. I suffered from lots of neglect, emotional abuse, physical abuse, and thankfully only mild sexual abuse. Given the bad environment, I adopted a number of violent maladaptive behaviors and psychological issues. The night terrors came first. Then I started to hallucinate and see ghosts or demons. It was mostly visual hallucinations but every now and then they would talk or communicate without words. My extremely evangelical caregivers were not impressed by this and finally brought me to a series of psychiatrists.

I was given varying diagnoses which included Oppositional Defiant Disorder, antisocial personality disorder, borderline personality disorder, ADD, and/or schizophrenia. I was forced to take six different SSRI or antipsychotic meds before I was 12 years old. The only one I can actually remember is Tofranil (Imipramine), which I would later learn causes thiamine deficiency.

During this time I also started to experience rather severe migraines and rapidly decreasing visual clarity. My optometrist thought that he had discovered a massive tumor in my head but thankfully it was just a pseudotumor. This is another rare disorder that I did not fit any of the traditional demographics for. I would later learn that this is a symptom both of thiamine deficiency and several tick-borne illnesses. The pseudotumor was treated with bimonthly spinal taps such that I had received at least a dozen before I had turned 12. Some of them had to be anesthetic free for some reason too. After I began to get uncooperative with the spinal taps, the doctors recommended loop diuretics. This is another thing that I would later learn drains thiamine from your body.

The loop diuretics forced and unexpected change upon my system and highlighted a problem that I had never really considered before. Prior to being on diuretics I was drinking somewhere between 6 to 10 sodas per day, usually Pepsi or ginger ale. This was on top of eating a diet of mostly processed foods and desserts at every single meal. All of this was very normal to my parents and grandparents who were Boomers and Greatest Generation respectively. They didn’t grow up on high fructose corn syrup and probably didn’t have the best understanding of the danger that processed foods brought. I don’t know how much of my problem was influenced by soda, but I do know the soda definitely didn’t make things better. Looking back, this kind of diet is absolutely insane. However, it was also very common in my community and so I never thought to question what I was eating.

At age 13, I contracted pneumonia but did not have a caregiver at the time. I just had to deal with it for a couple of months. This would eventually lead to a change of custody and a massive change in medications. My father is a traditionalist and he never believed in any of the SSRIs that my mother had me take. When I moved in, I was cut off from all medication entirely including the diuretics. I stopped wetting the bed after 3 days and have never done so again. I also began to quite rapidly feel better.

Despite all of this, my teen years were comparatively more normal. I played football despite not being particularly athletic and hurt my back in a way that would catch up to me decades later. My mood leveled out and my hallucinations faded. I did have an atypical puberty. For some reason I developed gynecomastia and had no facial hair. I was always skinny and it was much harder for me to build muscle than it was for the other guys. I was also almost always cold even at extremely high temperatures. I found myself getting sick and shaking in 72F. However, weirdly I almost couldn’t feel hot at all. Little did I know then that many of these issues were probably symptoms of low testosterone which was probably caused by the low thiamine.

Insomnia, Nightmares, Zoloft, and Exceedingly Low Testosterone

I suffered from really bad insomnia in college because I was terrified of going to sleep. My nightmares were so bad that I preferred just being awake. They were also very specific and complex.

Much later I would be prescribed Zoloft for depression, which is yet another thing I can drain thiamine from your body. It worked quite well until I missed six doses due to travel. Afterwards, I could never quite get back on the medication right. I wanted to discontinue use of Zoloft but my psychiatrist insisted on doubling or tripling the dose instead. We had a disagreement and because of that I was forced to quit Zoloft cold turkey at age 29. It was a profoundly miserable experience and at the time the worst thing that I had ever felt. It was much worse than child abuse.

It took me about 6 months to stabilize from Zoloft withdrawals and then something else weird happened. I started showing symptoms of bipolar disorder but mostly mania. I was extremely aggressive, energetic, could not sleep at all, and hypersexual. I still had my intelligence about me so I noticed these changes and I knew something was wrong but didn’t know what.

I took the advice of a friend and decided to also get my testosterone levels checked. The testosterone tests revealed a level of 34ng/DL. For reference, this is off the charts low. This isn’t even 10% of what would normally be considered low. I also recognize that my symptoms of extreme energy and hyper-sexuality are kind of the opposite of what you would expect from low testosterone. Thankfully a urologist treated this with Clomid and anastrozole. Symptoms disappeared almost overnight.

The next year my L5 S1 facet joint broke and I suffered a debilitating disc slip for seemingly no reason. My only guess at this point is that perhaps I suffered an injury from football that only manifested itself later as an adult, or perhaps my body was truly failing and I didn’t know it. It took 18 months to reach full recovery, but I did achieve a near miraculous full recovery thanks to disciplined exercise.

The Bottom Falls Out

All of the aforementioned struggles combined pale in comparison to what awaited me in the winter of my 33rd year. My urologist instructed me to discontinue use of both clomiphene and anastrozole without any weaning. I think this stress on my body was the straw that broke the camel’s back. About three months after discontinuing the use of my medication, my entire body basically went on strike within 72 hours.

It started mildly with just a feeling of being more tired than usual. Then I started having a hard time keeping my food down. Next I noticed that my joints were starting to sprain somewhat easily and I was almost always cold. The symptoms were milder than most seasonal colds and were maybe comparable to just not getting enough sleep. Then suddenly, out of nowhere, on day three I had the most intense panic attack of my life. It was the most intense fear that I have ever felt. I felt that I was imminently about to die and that these were my last moments. The fear was deep and profound as if my body was recognizing some important process just got turned off but I had no idea which one or how to fix it. This attack also immediately coincided with vertigo bad enough to force me to lay down on the floor and wait for it to pass. Thankfully, the entire event lasted less than a minute. Sadly, it would not be the last time this happened.

I would continue to have panic attacks similar in nature to this over the next few months. My mental health almost immediately crumbled despite my best efforts. It felt like the emotions of agitation, irritation, and paranoia where artificially cranked up to their maximum. My mind was moving a million of miles per hour but it was mostly some sort of deep irrational fear. To make matters worse, after the first day I was hit by not fatigue but rather full blown exhaustion that left me nearly unable to move. Then the cold spells hit.

My body started going through hypothermic episodes for no clear reason. I would drop from 97.7F (my normal) down to his low as 94.8F within a matter of minutes. I only know this because my wife is a former nurse who decided to take my temperature after I had complained enough. After seeing sub 95F temperatures her expression went from frustration to deep concern. Hypothermia was a painful experience that would also light up all the nerves in my hands and feet. It often came with mental confusion, agitation and at least a few times hallucinations. Seemingly nothing could warm me up either. No amount of blankets or clothes or heating pads made any difference. The only thing that seemed to work was a really hot bath and that would only work while I was in the hot water. These episodes were scary.

The next day, I started to experience burning feet. Both of my feet suddenly felt weak and as if they were being burned by a cold fire or perhaps an electrical burn. I had no idea of what was going on at the time but this is actually a classic symptom of dry beriberi onset. At this point everything was just way too intense and I felt like I had to seek medical care. This was the start of a very long medical odyssey.

Over the next 6 months I would bounce around between about a dozen different specialists who had various degrees of skepticism about my symptoms. A truly huge number of doctors were instantly dismissive. I got a lot of hand waves of this just being stress, or a mental disorder, or that I just need to take a vacation. The dismissal of symptoms became even more prevalent when every test I was given indicated not only that nothing was wrong but that my blood work was much healthier than normal. Eventually, I saw a pituitary endocrinologist who felt that the symptoms I was experiencing could be related to the testosterone drop. So we did a series of labs while on Clomid and then while off of Clomid to see if anything was being pushed out of balance. There was absolutely no difference between the tests, other than T levels, but I felt much better on Clomid. I felt like I had been cured after resuming Clomid for about 2-3 months. Sadly, this was a false hope. Before we move on to the next section I wanted to mention my back again. During the 6 months of dealing with exhaustion and various body pains every day, I was not able to maintain my disciplined exercise schedule. So while nothing was injured during that time, I now realize almost all of my supporting muscles were probably very weak.

A New Low

My wife convinced me to go on vacation to celebrate my recovery into good health. This might be the last vacation that I ever will ever get to take. About two days into the vacation, my left hand suddenly got De Quervain’s tenosynovitis. My right wrist started suffering from severe tendonitis about 12 hours after that. Then I started feeling a burning nerve pain in both hands. Both of my hands were limp, weak, painful, pale, and in braces within 48 hours. The old familiar feelings of exhaustion, confusion, and difficulty keeping my food down returned the day after that. I foolishly decided to try to finish the last few days of my vacation and get healthcare at home. For some reason, I didn’t connect the issues with my hands to my greater health problems and instead had assumed that perhaps I use them too hard while on vacation. I don’t know, maybe I was getting old and could not go for as long anymore? Maybe I tweaked them by lifting heavy luggage or playing the Switch on the plane? It probably didn’t help that I was getting increasingly delirious too. I made a huge mistake during the next few days of the vacation and hurt my back very badly. This is perhaps the biggest L of my entire life. This back injury never healed properly because I was suffering from thiamine deficiency and a babesia infection at the same time. My body just had no ability to heal, so I was left semi-bedridden.

Upon returning home, I once again immediately sought medical assistance wherever I could get it. Orthopedic clinics were very confused with my hands. They had symptoms similar to carpal tunnel and bad tendonitis, however no MRI or x-ray would ever show even mild versions of such things. My nerve conduction studies were also very normal, which is surprising. Most of the doctors once again recommended mental help but were willing to sign me up for physical therapy to see if that made a difference. I did physical therapy for about a year and never got consistent results. I did sometimes get stronger but that strength was easily lost if not maintained. Any minor injury could set me back for months. I felt like my joints just wouldn’t heal.

Discovering Thiamine Deficiency

I continued to push forward and request more tests from more new specialists to try to figure out what in the world was going wrong with me. I’m going to be honest with you, I was terrified. I had no clue what was going wrong and could tell that none of my doctors did either. After nearly a year of begging doctors for various tests that revealed nothing, I finally gave up and accepted that I was crazy. The first step in this process is to get evaluated by a psychiatrist. I’m thankful every day that I went to see a truly S-tier psychiatrist who sincerely listened to my story. My psychiatrist was not convinced that my problem was a traditional mental disorder. He said that I had some very abnormal labs with my testosterone levels that could not be faked even with the most severe of mental disorders. So he recommended that I see several other specialists including a neurologist before he was willing to move forward with any kind of diagnosis of his own.

The neurologist I saw was equally helpful. He actually believed the symptoms that I described and believed that while I was stressed, I wasn’t mentally ill. The neurologist told me he believes I have a neurological problem but he doesn’t know which one. He put me on an ultra-priority referral to the best neurology clinic in the state and ordered 15 different very rare and unusual labs. He told me that my problem was probably weird and that the specialist he was referring to would probably want at least some of these labs already done. All of the results were perfectly normal except… my thiamine levels were low. This neurologist actually called me about 30 minutes after the lab results came back to tell me to go buy thiamine supplements and take them immediately. I felt a tremendous improvement in all areas within 24 hours of starting supplementation. At the time, I immediately knew that we had found the thing that was causing me all this suffering. Or at least I thought I did. As it would turn out, there was one more surprise in store for my medical journey.

Something Still Wasn’t Right

Now knowing my issue, I immediately researched everything I could about thiamine deficiency and reached out to the handful of experts on planet Earth that exist for this rare disorder. That’s how I got in touch with Dr. Chandler Marrs who not only runs this website but was also able to give me a lot of helpful advice. The next year of my life was basically me thinking I was right around the corner from getting cured now that we discovered I had a thiamine deficiency. There was also some element to trying to figure out why I was thiamine deficient because I didn’t meet any risk factor or demographic for it. During this time I have come to believe that my family possesses genes that aren’t as good at processing thiamine as normal. I think that for almost my entire life I was dipping in and out of mild thiamine deficiency and had no idea it was happening.

I spent a year trying to recover to normalcy but failed spectacularly. I couldn’t seem to quite shake all of the symptoms despite the thiamine supplementation. I was probably just too happy that the constant 24/7 burning hands finally ended. I spent pretty much all of the previous year feeling like my hands were burning and almost no medications would make it stop. It was really difficult to sleep or focus when you feel like you’re on fire. Being relieved from this probably skewed my perspective away from having any more objective take on my situation. While my symptoms were lesser, they were still inconsistently present.

New symptoms began to appear too. I noticed that all of my joints were even weaker. It felt like my connective tissue was falling apart and my muscles were all so atrophied. I had assumed this was from the inactivity due to exhaustion in the previous year or just some lingering nerve damage. However, another year of healthy living, proper supplementation, and all sorts of physical therapy made no difference to my situation. In several ways my joints actually got worse and weaker. It became incredibly easy for me to sprain ankles, strained my hands, get tendonitis in my wrist, or even experience a lot of pain in my knees and hips. This pain continued to spread until it was affecting basically every single joint in my entire body. At this point I returned to seeking medical care and was pretty uniformly told that I should be instead seeking mental health care.

Stubbornly, I decided to work only with the handful of doctors that believed I did not have a mental disorder. I also begged them to give me a wide variety of unusual tests for rare disorders. I knew that whatever this problem was, it had to be unusual. One of these random tests actually popped positive for something interesting. I was positive for a babesia and bartonella infection but did not have Lyme or any other tick-borne illnesses.

Parasites

Babesia aren’t even bacteria. What I had was technically a protozoan infection. These ultra-tiny parasites live inside your red blood cells. They have also been known to take up residence and intracellular spaces, joints, and sometimes nerve tissue. It was extremely difficult to find even a single infectious disease doctor was willing to take me as a patient. Most of them did not feel qualified to treat this particular type of infectious disease. I did find one however and she did believe that my symptoms were within the ballpark of a babesia infection. She believed the bartonella may have been a false positive. Unfortunately we were not able to confirm this diagnosis with repeated testing with local labs, though it should be noted that both babesia and bartonella are extremely difficult to test for. We decided to move ahead with treatment for babesia given that the treatment was just a round of antibiotics that had relatively low risk. There was definitely some risk given that I was already thiamine deficient. Many of you reading this website or article are probably already thiamine deficient so in case you didn’t know, antibiotics tend to really disrupt thiamine absorption and make beriberi worse. However, I decided I certainly wasn’t going to be getting any better as long as these parasites were in me. So I worked with several doctors including Dr. Marrs, to come up with a plan to protect my gut biome as much as possible during this process.

The babesia treatments were almost immediately successful. Within 48 Hours of starting antibiotics, I already felt much better. About 3 days after taking antibiotics, I stopped having nightmares entirely. I used to have nightmares every single night and suddenly they just stopped. After completing the entire course of antibiotics, I overall felt much healthier. My body was still weak, my muscles still atrophied, and my joints still in pain, however they suddenly felt as if they were improving and also recovery times were much faster. The biggest improvement is that my recovery times are now probably about two or three times what a normal person’s would be for the same activities. Even that is probably still 10 or 20 times better than where I was before. My tolerance to cold got better and the last of my lingering minor mood swings disappeared. I started feeling good enough to resume physical therapy and this time I think it’s actually working. The strength in both my hands, my knees, and my back are slowly improving this time. I fear that a 100% recovery is probably impossible from this much damage. However, I would be happy to hit about 80% again.

Parasites Probably Ate My Thiamine

So how did this happen? That’s a question I ask myself almost every single day now. Babesia is about as well researched as thiamine deficiency which means that there’s very little research about either of them. They barely even have standard treatment protocols. However, in my deep readings I did discover that a babesia infection can cause low testosterone and thiamine deficiency. My peasant non-doctor understanding is that babesia and other tick-borne illnesses will actually sap thiamine directly out of your bloodstream. They can also cause SIBO, which is known to lower thiamine absorption in the stomach as well. This is of course on top of damaging joints and causing a great deal of mental stress, which increases my thiamine need. All of these are ultimately systemic problems that can disrupt not just thiamine absorption. I now know that my family absorbs thiamine worse than other people. So my assumption is that I have probably been somewhat deficient my entire life and this babesia infection was the perfect straw to break the camel’s back and send me into full blown thiamine deficiency. It’s also entirely possible that given my incredibly low income and frequently outdoors upbringing, that I had contracted babesia as a child and had carried that infection with me my entire life. Maybe even my body got used to it? It’s also theoretically possible that it could have been congenital. I really don’t know how I contracted a super rare tick-borne illness but I do know that it was the perfect thing to sap the tiny bit of remaining thiamine of my body.

Between the two, I think the thiamine deficiency caused much more severe problems for me than the babesia infection. Moving forward, I’m just going to keep supplementing, testing to make sure the infection doesn’t return, sticking with physical therapy, and hope that it all works out in the long run. I’m 36 years old now which isn’t young but in the medical field I’m told it’s young enough to have a much better chance of recovery than most patients. It is frustrating to know that this kind of recovery will take years instead of months. Thankfully, I still have plenty of discipline to keep pushing through.

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This story was published originally on January 18, 2024.

Healing Our Daughter, Healing Ourselves

by Joanna

Published on May 27, 2025

12563 views

Healing our daughter with thiamine and vitamin K2

Our Little Tadpole

Abby is our little tadpole. Sensitive to seemingly everything, she morphed into something she should never have been. Many people openly stare quietly, thankful their kids aren’t like her and go about their business without much thought. Or worse were those who only stood by saying “God, somebody DO something!” when our daughter was screaming in pain in public as if WE weren’t there. There is much to be learned from them, if we only had eyes to see. We’ve made mistakes in our journey with our daughter, but the 10 specialists we’ve taken her to in the last nine years have provided numerous test results with little to no answers. The last allergist I took her and told me to “stay off the internet” as he was handing me free pharmaceutical samples as I was walking out the door. They made it as far as the trash can in the restroom. And so began our journey of doing something different, looking for answers outside of what we’ve been told. In our journey to heal our youngest daughter, we are healing ourselves too as we all seem to be dealing with very similar issues of low stomach acid, connective tissue dysfunction, and nutritional deficiencies/dependencies. I will start with her story first, since it is because of her that we’re figuring ourselves out.

The Early Red Flags: Hypermobility, Digestive Issues, Speech Problems and Intense Reactivity

Abby was adopted from China in September 2010 at the age of 10 months. Her birth and family history is unknown. She was found in a very poor district at three weeks old, underweight and jaundiced. She also had a congenital heart defect called atrial septal defect, which later closed up on its own. She was kept in ICU for a period of time. She was bottle fed until 10 months, then introduced to gluten and dairy. Orphanage caregivers reported she had a much heartier appetite than other babies (an early red flag that we all missed).

When we adopted her, we found her to be a very happy and social baby, who transitioned well. Her eye contact was always good. We did notice, however, her hips, elbows, knees, and fingers were hypermobile. In hindsight, we recognized that she played differently with infant toys. More red flags.

In October of 2010, she had her first post-adoption doctor’s appointment.
In December 2010, she was walking on her own. She tested positive for TB exposure and put on Isonaizid. She tested negative for lead. She became ill and was in pain for 10 days with diarrhea 3x day. We switched to Rifampin for the next 6 months. She was on Isonaizid and/or Rifampin from December 2010 through July 2011. Anti-tuberculosis antibiotics required monthly liver checks. She was vaccinated during this time as well, a mistake we came to regret. Our once happy child now became stoic and would remain so for nearly a year, but things had changed.
In spring of 2011, she experienced continuous and severe congestion along with loose stools.
In July we stopped Rifampin. She was a good eater, often ravenous.
In spring of 2012 we began speech therapy, 3x per week, but progress was slow. After removing gluten she spoke her first three word sentence.
July 2012 her hearing was checked. “Possibly mild frequency decrements. Minor issues”.
July 2013, probiotics stopped her diarrhea, unless she was exposed to a problematic food.
In 2014, we found she was a MTHFR 677ct double mutation. We strongly suspect she has a CBS mutation due to very strong reactions to various things: ALA, NAC, Epsom salts, CLO, methylated B12/Folate. Though over time, some of these we have been able to get in her in small amounts.
Over the next few years, and a multitude of negative tests, all we were able to determine was that her B12 levels were consistently high, even when not supplementing much, as were her B6 levels (though iodine brought her B6 levels down into the normal range). Creatinine was low, and a few amino acids were only slightly elevated. Prostaglandin F2 were extremely high and liver enzymes were elevated.

Despite all of this, Abby is a very happy, socially engaged and intelligent girl. Her speech has always been intermittent, ranging from very slurred to full complete clear “normal” sentences. It switches at random. Her former teacher of 5 years doesn’t think it is ASD, but in truth, it doesn’t really matter. Our kids are often labeled for the convenience of others.

Altered Pain Sensitivity

Abby appears to have a high pain threshold, except stomach pain. Since she was young, she has preferred to be barefoot and wore few clothes, even in winter. Over time this has changed and she has grown more “normal” in her body’s adjustment to temperatures.

The only observable nervous system affect was that she tightens/clenches her fingers when very excited. Excitement seems to trigger degranulation in her unstable mast cells. She had been extremely reluctant to draw, write, or color when young. She’s doing all this now, not as age-appropriate, but gaining.

She has had many problems with probiotics in the past; often creating an immediate OCD/stuffing whatever she could get her hands on behavior, under furniture, peeling birch tree bark for hours, etc. Her brain was almost immediately affected.

Severe Reactions to Triggering Substances

Trying to solve her medical problems has been difficult. She has had so many reactions in the past when trying various vitamins/minerals and supplements recommended by her physicians. The results were always mixed and reactions could be extreme. We often, and still do, dose her vitamins and minerals separately, mixed together. Many reactions were not to the main ingredient, but to the binders or fillers added to the supplement. Some treatments would spur a short snippet of normal speech but only 1-2x then nothing more.

Below are the symptoms that we have been navigating.

Dry, itchy skin. Rashes, hives, angioedema, large welts from some foods/chemicals and insect bites. Her skin feels like it’s on fire and she tore at her clothing after a small amount of Pure Vegetable Glycerin (99.9% pure) was applied. In 2015, her skin peeled off her arm, wrist to shoulder in a 3” wide band of deeply reddened dry/cracked skin, after eating non-organic strawberries. It looked like a third-degree burn, minus the blisters. Epsom salts, baking soda, Vick’s Vapor Rub, various other skin oils like jojoba, or almond oil, all caused painful reactions.
Severe abdominal pain. She experiences severe abdominal distress and pain after ingestion of various foods or charcoal-grilled food. She may also develop constipation/diarrhea, headaches/migraines. Probiotics often dramatically changed her behavior within an hour to severe OCD. Fruit-based digestive enzymes would cause facial rashes and behavior changes. Pancreatic enzymes caused much less speech, very quiet per her teachers.
Urinary. She was unable to urinate 9+ hours after ingesting cough syrup on two occasions. She was not dehydrated either time. She formerly had urinary incontinence on occasions and enuresis. The enuresis resolved with the addition of vitamin K2 MK7.
Insomnia. Occasionally she would develop insomnia, often after ingesting or exposure to an offending food or chemical. Tap water seems to be particularly problematic.
Behavioral. She has experienced severe OCD, irritability, extreme aggression/anger, hyperactivity.
Heart and Lungs. She develops a rapid heartbeat at rest and persistent coughing for 6+ hours following ingestion of a trigger.
Head and nose. Congestion, puffiness/eyes, headaches/migraines (based on focused tearing behavior).
Speech Problems. Her ability to speak various greatly relative to exposures. It goes from single words to full clear “normal” sentences. With gummy vitamins, recommended by her doctor, she developed a very notable and immediate regression in speech when she was four years old. The day before she took the vitamins, she had clearly-spoken emerging speech, i.e., “I eat” “I do” “I wash”. Immediately after giving her the vitamins, she walked about the entire day just saying “mmmmmm” over and over. Unsure of the cause, I was thinking dyes, rancid hydrogenated oil, or some such. I would not make the sugar connection for a few more years.
Severe pain after exposures. She had a strong reaction to Cassia cinnamon. In class, she and other children were making Christmas ornaments with lots of Cassia cinnamon. Although none was ingested, her teacher said she was inhaling it and handling it for hours. Near pickup time, the teacher said she was not feeling well, began to be irritable, like her head hurt. As we were walking out of the building, she went down fast onto the ground and began writhing in pain (not sure if head or gut related). Teacher held her head to keep her from hitting it on the pavement, while I ran to get my Lavender essential oil rollerball. Applied it, and within a few minutes she was fine and got into the car. No further incident. Ceylon cinnamon causes no problems. Cassia can affect B1 levels, or so I read.

Our Journey to Healing Began With Vitamin K and Thiamine

In October 2018, we learned about thiamine and suspected that many of her problems may have been the results of a longstanding thiamine deficiency. We began in August slowly increasing Thiamine HCL. She began to improve at school, but results were inconsistent. We then moved to Benfotiamine for a while and results seemed better, but still inconsistent. By October, she was taking Sulbutiamine and we worked our way up slowly to 200 mg. Organic Acid Test (Great Plains) showed her lactic acid levels came down with the addition of the high dose of thiamine.

Nighttime enuresis persisted several years beyond toilet training. In 2016, we added approximately 700 mcg of vitamin K (MK7) working up slowly to this dose and her nighttime accidents completely stopped. The addition of vitamin K (MK4), reduced her food intolerances and allowed her to eat a broader diet, but that form of the vitamin did not stop the enuresis, the MK7 form did. We have since lowered her doses and now she just takes a D3/K2 liquid form with no return of the enuresis and food tolerances seem good, though we monitor her diet closely.

We use a variety of homeopathic remedies to treat reactions, illnesses, and injuries and reduce chemical exposures at home. Once her lactic acid levels came down into the normal range with the thiamine, we were able to add probiotics without negative reactions.

Her diet is mostly organic, grass-fed beef, organic chicken, wild-caught fish, cage-free eggs, local raw honey, coconut and olive oil, ghee, no GMOs. MTHFR mutations seems to be sensitive to gluten and dairy, but I wonder if that’s because of our need for the TTFD form of thiamine. She has been sugar free since July 2018.

My Big Takeaway: Healing Requires Resolving Nutrient Deficiencies Dependencies

EDS and ASD both share very similar nutritional deficiencies and/or dependencies. I wonder how much of autism isn’t simply the undiagnosed trio of EDS/MCAD/POTS. As most genetic testing is beyond the reach of most family budgets, it is difficult to know. It seems like it would be worth looking into one’s broad family history. A friend once told me that the foods we crave the most can be our biggest problems.

Years ago when Abby was in preschool, her teacher had me in for a conference. She showed me her notebook, which sadly only had a few scribbly lines in it. She slowly closed the book and moved it to one side. She looked me straight in the eyes and said “this isn’t autism”. Her son was on the spectrum. She said “Abby is smart, very, very smart. I think she’s gifted”. I looked at her dumbfounded, asking “then why?”. She said, “I don’t know what’s going on, but she knows… she knows!” She proceeded to tell me something Abby did that proved to her unquestioningly her assessment. Giftedness and learning disabilities seem to share many commonalities.

We sort of figured some things out in reverse. For example, the MK4 form of vitamin K2 allowed for more food tolerances, and the MK7 stopped her enuresis. Bacteria in the gut (bacillus subtilus) produces K2, but then too much lactic acid was a problem because her thiamine was low and the CBS mutation seeming caused trouble as well. K2 seems to be very important in the distribution of calcium in the body.

We often see admonitions to heal the gut on the internet; so many opinions and recommendations. As Abby’s case suggests, it is far more complicated than simply taking a probiotic. It is also highly individual. Our daughter’s journey may not be applicable to someone else, but perhaps something can be gleaned.

We continue to avoid triggers, eat and live clean, heal the gut, use holistic remedies, play and laugh a lot. Thankfully, her reactions are now infrequent and fairly mild, but it was long road to get to this point. Her appetite is now normal with no real cravings or hunger extremes. We use vitamins/minerals, fish oil, and probiotics less cautiously now. She is gaining speech rapidly. She may still not be typical, but she is a far cry from what she had morphed into and much more normal than even a year ago.

We’ve been fortunate to avoid prescription drugs overall and use natural remedies, diet, and vitamins and minerals to affect change. We are avoiding further vaccinations, as our belief is her body has had enough and can’t deal with the stress at this time. Overall many people’s demeanor changes rapidly when mentioning alternative approaches to western medicine. If outside the norm, we may even be deemed a quack, but since we’ve been able to heal various family members of numerous ailments, if we’re seen as strange, so be it. We can heal our bodies, probably not 100%, but often without prescription drugs.

Perhaps even the most complicated puzzles among us are not as hard to put together after all. We are still healing and our journey is not over. We tell ourselves and our kids to eat less junk because a nutrient-dense diet is helpful to everyone, but it seems that it is even more vital to those who suffer both the blessings and curses of a good brain.

Our brightest lights are ever so vulnerable.

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 story was published originally on August 19, 2020.

Health Shattered By Poor Diet and Conventional Medicine

by Tawnya Bareis

Published on May 22, 2025

13296 views

My health has declined over the last few decades, to the point that I am totally disabled and haven’t driven in 10 years. I have severe POTS with high blood pressure while sitting and laying down. Previously, it was low. I am not able to stand up as my heart rate goes too high and I feel as though I’ll pass out. I have coat hanger pain, jaw tension, and headaches daily. I am very irritable and impatient. Emotional outbursts crying spells, depression. I feel like I am a completely different person. I am in survival mode. My body cannot shift out of sympathetic dominance. All of this has developed over the last 20 years; a progressive decline until everything hit the fan.

I thought I had a relatively healthy childhood and into my early 20s. I did have mono in 7th grade. Looking back though, I ate poorly growing up and did a lot of crazy starvation diets. I also consumed a lot of alcohol in my later teens through my early 20s. I stopped drinking in 1994. However in 2006, I started drinking on and off again and the night I had the severe vertigo attack, I had been drinking. Since then I haven’t touched alcohol.

My mom passed away when I was 22 and I had my first child at 23, which was a C-section. At 26, I developed rosacea. This was really my first health problem. At 27, I was divorced (1993). I remarried a year later and had another child at 30 years old. Three months later, I had my gallbladder removed. With all of this, I was still active and healthy with only rosacea that would come and go, but it would get really bad on occasions and was very distressing. This was until 2007, when life stressors, poor diet and illness caught up with me.

Unending Vertigo and the Protracted Decline of Health

I started working again in 2000 after we relocated to Arizona. I was a preschool teacher, a wife, and was raising my two sons. I had a very full schedule. I was always a high achiever. In 2004, I opened my own school with another teacher. Things got even more stressful. In January 2007, I had a very emotional falling out with my father and a couple weeks after that I was diagnosed with viral pharyngitis. Within a couple weeks of this diagnosis, I was thrown out of bed with the worst vertigo you can ever imagine. This went on for three days and I was unable to walk for over two weeks. As things were improving, the dizziness never did go away. I sought out multiple practitioners, including neurologists and audiologists, but none were able to help.

I went back to work but I was never the same, having to deal with constant dizziness and feeling of being off-balance. In October of 2007, I wound up in the ER with a resting heart rate of 160. This had come on out of nowhere over the day and by the evening I was very frightened. They gave me lorazepam and sent me on my way. I continued with the constant dizziness and then the anxiety and panic attacks started. My GP gave me a script for benzodiazepine and offered an anti-depressant. I tried the antidepressant and I had a bad reaction. I felt completely numb. I couldn’t laugh smile or have any sort of reaction. That was after just try half a tablet. I never tried that again.

In 2009, I had an ankle injury and was wearing a boot for most of that year. In October, of that year I ended up having a surgery on it. What was interesting is that I was not experiencing much of the dizziness for most of that year. It wasn’t until a couple months later when I had a sudden onset of the dizziness during my physical therapy session. So the dizziness had come back and the anxiety and panic attacks were getting worse. In September 2010, I basically collapsed at work. It was about four or five days later at home, I experienced a severe shift of my energy. I was severely fatigued and now was experiencing POTS.

Is it Lyme? Maybe. Maybe Not.

November 2010, I was diagnosed with Lyme, however, my test was not conclusive. The Lyme literate doctor said my immune system was so weak that it was hard to get a positive result. He diagnosed me clinically. This set me off on a seven year journey of protocols that included benzodiazepines, two IV chest ports, supplements, herbs, homeopathics, bio-hormones, coffee enemas, detoxification therapies, chelation, IV and oral antibiotics, Flagyl, anti-fungal drugs, and every diet imaginable. You name it I did it. We had spent our life savings and I was still disabled and incredibly ill.

I became addicted to the benzodiazepines that he prescribed. He never told me about how addictive they were. I was on them for three years and they made me so much worse! I tried to come off of them several times. They turned me into a 3 year old. I was so fearful I couldn’t leave my bedroom even to cross the hall into bathroom. Finally, in 2014 I was able to kick the addiction. It took me six months of liquid titration.

As If Things Weren’t Bad Enough: Cancer Too.

Also in 2014, I had a huge fibroid and had a procedure called UFE ( uterine fibroid embolization ) to cut off blood supply so it would shrink. I know now I had severe estrogen dominance.

In 2017, I hit menopause and stopped menstruating. I was using sublingual progesterone at the time. The doctor also had me on hydrocortisone for adrenals and a time-release thyroid supplement. These supplements never helped and only made me worse. I was in such bad shape. I wasn’t sleeping for 3 to 4 days at a time and then when I would sleep it was only couple hours. This sleep regime went on all year.

In May of that year, I woke up one morning and left breast had shrunk significantly overnight!! The doctor I was seeing, had me come in. He physically examined me and felt that it was not anything to worry about. He said that I needed to detoxify my breast because it was probably blocked lymph. He told me to do skin brushing on it. I was in such bad shape that I wanted to believe him but I was so frightened. In October, I saw a different doctor and she said I had to get a biopsy. It was cancer. I did not see an oncologist. I did not have any lymph nodes removed or chemo radiation. I just had a surgeon remove it. I left the rest up to God. At this point, I could not endure anything else mentally or physically. The pathology report indicated the cancer was 98% estrogen driven.

A Dysautonomia Specialist Prescribed More Antibiotics

In 2018, I tried one more doctor. He was an autonomic dysfunction doctor and his protocol was quite simple. It was focused on lowering inflammation in the brain and body and balancing gut bacteria. At this point, I had suffered from chronic constipation for at least 10 years, on top of POTS and all of the other health issues. I was put on fish oil, olive oil, Rifaxamin and Flagyl for the possible SIBO and a vagus nerve stimulator. He told me not to use any other supplements of any kind. He claimed that most all supplements were fraudulent and using them would interfere with progress. I could not finish the Flagyl. I was feeling severely agitated and I thought it was due to the drug. I took most of it though. He assured me that the Rifaxamin was very safe and that they actually have renamed this antibiotic as a eubiotic. I did see my rosacea clear up. I had read some research and trials were they used Rifaxamin for rosacea and had a very positive outcome. So over the last 2 1/2 years I’ve been faithful on this protocol. It seemed like I had periods of time where I was able to stand up longer and do more around my house but I always relapsed. I was using the Rifaxamin on and off as per his direction for 10 days at a time. This year he put me on it indefinitely to use daily. I’ve been on it now for 8 months straight, but in July I started to go downhill very fast. I was having a decent spell able and had been able walk around for a a bit, do some limited chores and even able to be out in the pool, but one night my heart just went crazy and began to race. The vertigo came back too. I have been bedridden again since.

Discovering Thiamine Deficiency

After going back to doing some research, I came upon Dr. Lonsdale and Dr. Marrs’ book Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition. I am thinking thiamine deficiency could be a piece of my puzzle. After reading one of Dr. Lonsdale’s articles on high B12 correlating with thiamine deficiency, I remembered two of my B12 tests. One in 2014, where it was 2000 and one in 2017 was 1600. The max upper range is 946.

Although my ill health was progressive at first, over time, everything has just become unbearable. I have been bedridden now for 10 years. The POTS symptoms are severe and I think I have the hyperadrenergic POTS. My blood pressure is very high when both sitting and laying and when I stand up, both my blood pressure and heart rate climb. I feel as though I’ll pass out. As I mentioned previously, I also have coat hanger pain, jaw tension, and headaches daily. I am very irritable and impatient. Emotional outbursts crying spells, depression. I feel like I am a completely different person. I am in survival mode. My body cannot shift out of sympathetic dominance. I am hoping to get some direction and advice on using thiamine to possibly help my condition.

Supplements, Medications, and Diet

Upon learning about thiamine and mitochondria, I stopped taking the Rifaxamin about two weeks ago. Below is a list of supplements I currently take and some information about my diet.

Magnesium hydroxide, Magnesium glycinate, 100mg, magnesium citrate, 100mg and some magnesium oxide in an electrolyte drink, in some variation for the past 3 years
3000mg daily (6caps) DHA 500 by Now Foods for past 3 years
Liver capsules 4 daily past 3 months
Camu Camu powder, a natural Vitamin C, 100-300 mg just started about two weeks ago
Rice bran 1 tsp before bed started two weeks ago
Bee pollen 1/2 tsp daily, started 3 months ago
I follow gluten free diet. I eat beef, chicken, raw liver, raw dairy, raw kefir, cheese, bone broth, some fruit, oatmeal and some vegetables like tomatoes, green beans, onions.

Since learning about thiamine, I have begun using Thiamax but am having a rough time of it. I took my first half dose (50mg) of Thiamax on December 26, 2020 and continued that dose through December 31st. It seemed to increase my fatigue more than my normal, which is already pretty debilitating so I switched to 50mg thiamine HCL on January 1st. By January 3^rd, I had a big crash. Hoping to minimize these reactions, on January 4th I took 25 mg thiamine HCL with 12 mg Thiamax in two divided doses. The next evening, however, I rolled over at 2 AM and my heart rate went crazy. I was shaking and went into a panic attack. It took hours to settle down. I haven’t had anything like this in quite a few years and I can’t imagine this would be from the tiny doses of thiamine I’ve been taking. I also took 600mcg of biotin that night at around 6pm. This was for a longstanding fungal infection. The biotin may have contributed to my reaction, but I do not know. I skipped the thiamine and biotin the next day and was able to sleep. I have resumed the thiamine once again and so far, I am tolerating it. I understand that people with chronic health conditions have difficulty adjusting to thiamine and I am trying my best make it through to the other side, but these reactions are difficult to manage. Any input from others who have been through this would be appreciated. I desperately want to recover my health.

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Image by (El Caminante) from Pixabay.

Rest in peace Tawnya, 2023.

This story was published originally on January 11, 2021.

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