Journal Of Neurology Research
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Volume 2, Number 5, October 2012, pages 211-214
The Beneficial Role of Thiamine in Parkinsons Disease: Preliminary Report
Khanh vinh quoc Luonga, b, Lan Thi Hoang Nguyena
aVietnamese American Medical Research Foundation, Westminster, California, USAbCorresponding author: Khanh vinh quoc Luong, FACP, FACE, FACN, FASN, FCCP, and FACAAI , 14971 Brookhurst St., Westminster, CA.92683, USA
Manuscript accepted for publication August 24, 2012Short title: Thiamine in Parkinsons Diseasedoi: https://doi.org/10.4021/jnr145e
| Top |
Keywords: Thiamine Transketolase Parkinsons disease Movement disorders
| Introduction | Top |
| Case Reports | Top |
Case 1
Case 2
Case 3
Case 4
Case 5
| Discussion | Top |
Thiamine may have a beneficial role in PD. Further investigation of thiamine in PD patients is needed.
Conflict of Interest Statement
The authors, Dr. Khanh vinh quoc Luong and Dr. Lan Thi Hoang Nguyen, report no competing interests.
Treating Parkinsons Disease With High
Parkinson’s disease is a progressive neurological condition. Although it may start out with something as simple as a tremor in a single finger, it can progress over the years to complete disability. Its hallmark is the dying off of brain cells that make the neurotransmitter dopamine.
Without sufficient dopamine, movement becomes increasingly difficult and finally almost impossible. PD’s non-motor symptoms include anxiety, depression, fatigue, insomnia and other sleep disorders, hallucinations, cognitive impairment and dementia.
Although dopamine replacement and enhancement drugs can control motor symptoms for a while, they don’t reverse or stop the underlying disease process. When these medications lose their effectiveness, a surgery may be done to control symptoms. But again, because the surgery doesn’t address the underlying disease process, it too becomes less effective with time.
However, a novel therapy addresses both symptoms and the disease process.
Using Thiamine to Address Parkinson’s Symptoms
Italian neurologist Antonio Costantini published several small clinical trials before his unfortunate passing from COVID in 2020 showing that intramuscular injections of megadoses of thiamine led to remarkable reversals in Parkinson’s symptoms.
Behind the Research
It’s possible to replace injections with oral thiamine supplements however, finding the right dose can be tricky, as this article indicates. There is extensive information on Costantini’s website about using HDT.
Results Of A Fully Functional Methylation Cycle
To summarize: The methylation cycle affects:
- Neurotransmitter levels. This is why so many individuals diagnosed with Parkinsonâs have persistent anxiety and a deep depression that never seems to lift.
- The immune function. This is why so many persons with Parkinsonâs symptoms get some relief from taking Low Dose Naltrexone which tricks the immune system into becoming stronger.
- This is why so many individuals have pursued one detox regime after another with limited success. The problem does not reside with the detox protocols per se, but a breakdown in the methylation cycle.
- Production of glutathione . This is why so many persons diagnosed with Parkinsonâs are known to have dangerously low levels of glutathione.
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How High Does The Thiamine Dosage Need To Be
The recommended dosage varies considerably from patient to patient and is determined only after a medical checkup. Many factors influence the dosage that is prescribed. Possibilities range from 1 gram up to 4 grams a day of Vitamin B1 which is 1,000 to 4,000 times the normally recommended dose.
For some patients requiring the higher doses Dr. Costantini may administer B1 injections of 100 milligrams twice a week for a total intake of 200 milligrams each week of treatment.
Why Is The Methylation Cycle Short Circuited
Taking a normal dose of B1 and other B vitamins will not convert to the enzymes needed if the methylation cycle that has short circuited. The key question turns on the question â what causes the methylation cycle to bomb out?
The answer is ⦠excessive and unrelenting stress. Anyone who experiences Parkinsonâs symptoms knows that stress has a direct and immediate impact on making symptoms worse. When stressed to the hilt, there is a heavy demand on the methylation cycle. The cycle requires greater quantities of B1 and Thiamine for conversion to the essential enzymes.
- When you are continuously stressed,
- When your sympathetic nervous system is choosing to run away or fight ,
Your body is expending all of its available energy to survive. Critical functions have to be protected. The body is designed for survival, not to insure that we feel good.
The heart needs to continuously pump. The lungs need to continue processing oxygen. Simply put, when we are anxious and stressed all the time, there is no energy available to manufacture enzymes which are needed for a less important role of helping us feel better and heal. The within normal range quantity of B1 is unused and discarded. The feel good relax chill out parasympathetic nervous system is deactivated in the interest of survival.
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Mechanisms Of High Dose Thiamine Therapy
Although we know a lot about the activity of thiamine in the body, there are aspects about it that are still shrouded in mystery. We have known for a long time that it is a cofactor for many enzymes that function to produce energy. There is little doubt that Parkinsons disease, like many other human diseases, is an energy-deficiency condition, so the use of thiamine in its treatment would make sense. However, much more information is required concerning its non-enzymatic functions. To become active in the body, thiamine has to have two molecules of phosphate added to it to act as a cofactor. Its non-enzymatic form includes thiamine triphosphate about which we know surprisingly little, in spite of the fact that it was discovered 70 years ago. This treatment of a severe crippling disease forecasts the arrival of Orthomolecular Medicine as the orthodox form of therapy.
Looking To The Future
So many people could benefit from this therapy today. But for every patient in the world to receive High-Dose Thiamine therapy through trusted medical channels, it must be approved by various international Drug Administrations such as the US Food and Drug Administration and the European Medicines Agency .
Only successful results from a well-designed clinical trial will satisfy the approval process. Specifically, we must conduct a multi-location randomized double-blind placebo-controlled trial covering a representative number of patients and spanning the relevant time frame. Such research requires adequate funding, sustained for the trial duration.
Discovering suitable sources of possible funding and submitting applications to them demand constant focus and effort. But we must take up the challenge, because successful results from a robust clinical trial would confirm the effectiveness of the therapy scientifically and with statistical significance, allow us to understand and describe its mechanisms, and potentially show us how to further improve its efficacy.
To this end, we launched a GoFundMe campaign with the ultimate goal of raising funds to move HDT therapy forward into the approval process, and to make information about our experiences so far directly available to patients, practitioners, and other health professionals through efforts like this site.
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What Results Have Your Parkinsons Patients Experienced
It depends in part on whether the person has been recently experienced symptoms of Parkinsons or has had them for several years. For the newly diagnosed taking high dose thiamine reduces motor symptoms on average by 50% to 70% for persons who have recently begun experiencing Parkinsons symptoms. In selected cases a patient can celebrate experiencing no symptoms. Improvements in motor symptoms are common.
For patients who have experienced symptoms for a long period of time, Dr.Costantini prescribes L-dopa and other more traditional medications. Such patients are also reported to experience symptom relief but results are generally not as dramatic.
If The Dose Exceeds Patient Need
First of all we learned that if the initial dose of thiamine is too high for the patient, they will experience a worsening of the symptoms after a few days characterized by an initial improvement.
In this case we invite the patient to halt the treatment with high dose thiamine for a week or so, and when the worsening regresses we restart the therapy with lower doses, often half the original dose.
In our experience the correct dose should not lead to collateral/unwanted effects, only to benefits for the patient.
This includes an improvement of UPDRS symptoms by at least 50%, and normalize the pull test.
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Results Of A Methylation Cycle That Has Short Circuited
When the methylation cycle is under functioning, you will be fatigued, depressed, irritable, anxious, susceptible to infections and confused. The reason why the detox therapies have limited success can be often explained by a dysfunctional methylation cycle. All of these symptoms are tied to persons diagnosed with Parkinsons.
Finding The Correct Dose
The correct dose varies on the basis of:
- Duration of the disease (the longer is the duration of the disease, the higher will be in general the doses
- Severity of the symptoms and rate of progression of the disease
- Weight and physical characteristics of the patient
- Sensitivity/responsiveness to the treatment.
In order to determine the right dose, we usually stick to the following protocol.
In case of recent onset of the disease in patients whose weight is between 50 to 65 kg , we begin the therapy with two grams of thiamine per day, before and after lunch.
In case the patient weighs more, the dose can be three grams per day, always divided into two administrations.
Oral thiamine should not be taken with juices or any sour beverage, water only.
The equivalent Intramuscular administration of thiamine would be:
- For 2 grams/day orally = 1 x 100mg injectable solution per week
- For 3 grams/day orally = 2 x 75mg injectable solution per week
- For 4 grams/day orally = 2 x 100 mg injectable solution per week.
NOTE: When it is administrated through intramuscular injections treatment could lead to allergic reactions . Mainly there are dermatological rushes and allergic phenomena.
NOTE: It is not suggested to use IM high dose thiamine for patients under treatment with anticoagulants since the injection may cause a hematoma in the location of the shot.
The correct dose of high-dose thiamine therapy reduces greatly the symptoms. What remains responds readily to the use of l-dopa.
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How Quickly Do Parkinsons Patients Begin To Experience Relief From Symptoms
If they are taking Thiamine in tablet or powder form, it typically takes 2-3 days to experience symptomatic improvement. When shots or injections are administered the improvement can typically be experienced in 30-45 minutes.
Once a patient begins taking high dose thiamine Dr. Costantini reports that they typically must continue taking it to receive continued benefits. It is possible to take short breaks without incurring troublesome setbacks.
Effect Of Suspending Thiamine Treatment
When the high dose thiamine is suspended after a cycle of treatments of three months, the beneficial effects do not cease right away but start to diminish within the next two months. We believe that this happens because the mechanisms of action of the disease have a certain buffer effect which in turn requires a couple of months before getting back to the status of the symptoms before the use of high dose thiamine.
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Hdt + Vitamin Supplements L
Even though in our experience thiamine is well effective alone, it is possible to add other group B vitamins, including folic acid.
However, we do not begin the therapy with high dose thiamine in addition to multivitamin compounds, especially if these contain vitamin B6. This because vitamin B6 is a facilitator of the peripheral decarboxylase and in PwP may interfere with the amount of L-dopa that reaches the brain and thus worsen the symptoms.
Usually the L-dopa compounds contain inhibitors of such action however since this interference may occur even in presence of inhibitors, we would not be able to detect whether the effectiveness of the high dose thiamine is maximized or if it could be further fostered.
It could also be useful to take a tablet of extended-release magnesium twice a week only. Some thiamine supplements on the market also contain high shares of magnesium and/or other elements. These should be avoided because the patients who do the high-dose thiamine therapy do not benefit from the relatively high doses of other supplements that are inadvertently taken at the same time as the thiamine.
For instance, some thiamine tablets contain 500 mg of thiamine HCL and 100 mg of magnesium. Given the high number of such tablets a patient would take for the thiamine dose throughout the day and the week, and lifelong for that matter, the risk of hyper-concentration of magnesium would be high.
The Rational For High Dose Thiamine
In this video, Elliot of EONutrition succinctly explains the rational behind high dose thiamin therapy as a tool for bypassing metabolic blocks caused by factors unrelated to nutritional deficiency.
And he examines with well chosen illustrations how this approach could be a useful therapy for chronic health conditions characterized by mitochondrial dysfunction.
You cannot wish for a clearer explanation
Amazing video. All make sense.. Thank you for sharing
Doctor Antonio Costantini is quoted in second half of the video.
Very interesting B1 presentation. However, he kept talking about Mega and HDT, but never mentioned what that mega or high dose is except for MS patients. My husband still experiments different doses and still not sure what the “magic” one is. He also didn’t mention that each patient is different, therefore, requiring different dose of Thiamine.
I think mega dose and high dose are the same in this context .Since High dose thiamine is almost 3000 times more than RDA.
This is the first time I have heard a possible explanation of why HDT seems to work, at least for some people. I worked well for me for about 6 months, then became less effective. Note that if part of the cause of PD is oxidative stress and neuroinflammation, then HDT will be acting on one of the consequenses of the cause rather than the cause itself. Could this be why it works well for early stage PD or only for a limited time?
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Effects Of Overdose Of High
Antonio Costantini1* and Roberto Fancellu2
1 Department of Neurological Rehabilitation, School of Physiotherapy, Italy
2 Neurology Unit, Italy
*Corresponding author: Antonio Costantini, Department of Neurological Rehabilitation, Italy
Submission:December 03, 2018December 06, 2018
We treat Parkinsons disease with high dose thiamine inaddition to the classic therapy since 2012. On this topic, wepublished three studies carried out with Italian patients . Thetreatment consisted in performing 2-3 intramuscular injections of100mg of thiamine per week. The highest dosage was reserved topatients whose disease severity was the greater, long past onset, andpatients whose weight was more than 90kg. We also treated patientson anticoagulants. In this case, the thiamine was administratedorally . We noticed that in order to obtain comparableresults of the intramuscular therapy with the oral therapy weneeded to administrate a dose of thiamine 140 times when treatedwith tablets or capsules . In otherwords, in order to obtain the same clinical effect of 1 intramuscularinjection of 100mg of thiamine once a week, it was necessary toadministrate 14 grams of thiamine orally per week, or 2 grams perday. This dosage, when appropriate for the patient, has always beenwell tolerated and we did not observe collateral effects.
Why Should High Dose Thiamine Therapy For Parkinsons Disease Reverse Symptoms
The problem has nothing to do with the actual quantity of B1 vitamin in their body. Rather, the body is not converting B vitamins to the enzymes that are essential for the body function well. In more formal terms, this is known as a breakdown in the methylation cycle.
Persons diagnosed with Parkinsonâs disease are very likely to have a breakdown in their methylation cycle. I learned this from conducting a series of interviews with BioAcoustic Pioneer Sharry Edwards who has done a series of diagnostics for persons diagnosed with Parkinsonâs. Sharry has identified a series of factors that cause neurological imbalances. One of the factors that jumps to the top of the list is a breakdown in the methylation cycle. In simple terms, a person has a sufficient quantity of the B vitamins such as B1, but their body is not converting them to the enzymes that are essential for a body to function normally.
Once the B vitamins have been thoroughly processed by the methylation cycle, the body uses various methyl-groups to make healthy cells. These cells facilitate the production of neurotransmitters such as â you guessed it â dopamine. A fully functioning cycle makes it possible to remove toxins in the liver and elsewhere in addition to fighting infections successfully. In other words, B vitamins play an indirect, but essential role in promoting healthy neurons.
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Effect Of Treatment On The Pull Test
The improvement of the results of the pull test are only observed with the treatment with high dose thiamine.
A normal person receiving the pull back either stays steady or takes one single step back to avoid falling. This is a normal response.
However, if a patient with PD is pulled strongly backwards , he or she will take two or three steps back before recovering, or requires support to avoid falling backward.
This symptom is improved only with the use of the high dose thiamine protocol, as we have never observed its improvement with other treatments.
Once high-dose thiamine therapy begins, the patients performance on the pull test usually becomes normal within a month in rare cases it is necessary to adjust the dosage. For this reason it may take up to three months in total to see improvement of the pull test.