Thiamine Megadoses (Vitamin B1) and Thiamine Analogs

[kosmo35]

I've heard that choline supplements (cdp choline, alpha gpc, etc.) although they can be very beneficial at first, tend to have a depressive effect over time. Unlike these, eggs don't seem to have any side effects at the same amount of choline they contain. We can speculate on this. Perhaps the choline bound to the fats in egg yolk makes it more absorbable. I've read that cdp choline has a half-life of 3 days, which causes it to accumulate rapidly in the system, leading to symptoms of overmethylation. I thought that perhaps to get an effect similar to that of eggs, you need to take a third of the equivalent choline, or take it once every three days.
As for omega-3, in the past I've benefited from eating salmon and taking supplements, but personally it hasn't had the same effect as eggs.

[berlin1984]

I've been on the Benfotiamine regimen for two months and a half now and am very close to normal.
Two weeks ago I wanted to increase the dose to 900 mg because the anal itching I had had eased considerably with the 600 mg dose but it still gave me slight discomfort during the night.

Do you think this itching is "neuropathy"?

[berlin1984]

Regarding Thiamine transporters. For those who did genetic tests, what are your SNPs regarding those here. List thanks to ChatGPT, hopefully accurate and relevant:

1. SLC19A2 (Thiamine Transporter)

    rs1801198 (Gln174His): This SNP affects the SLC19A2 gene, which codes for a thiamine transporter protein. Variants here may affect the efficiency of thiamine uptake.

2. SLC19A3 (Thiamine Transporter)

    rs150741487 (A138V): This SNP in the SLC19A3 gene is associated with thiamine-responsive encephalopathy. Variants in this gene can affect the transport of thiamine across cell membranes.

3. TPK1 (Thiamine Pyrophosphokinase)

    rs7331990: Variants in the TPK1 gene can affect thiamine pyrophosphate production, which is the active form of thiamine.

4. TKT (Transketolase)

    rs1802407: This SNP affects the TKT gene, which plays a role in the pentose phosphate pathway that requires thiamine as a cofactor.

5. ALDH1L1 (Aldehyde Dehydrogenase 1 Family Member L1)

    rs1042357: This SNP is linked to thiamine metabolism, particularly in relation to aldehyde detoxification, where thiamine acts as a cofactor.

I only have a measurement for the first one:
rs1801198   CG
which is quite common though https://www.snpedia.com/index.php/Rs1801198

[Andre2505]

Hi Andre2505
I believe you've only been on this protocol about a month, is that correct? From what I've read, if the thiamine is working, at first your symptoms should get worse before they improve ("paradoxical reaction"). Have your symptoms got worse?

If and when I start benfotiamine, I don't intend to supplement with either magnesium or potassium unless a blood test shows they are low or if I get muscle cramps and/or constipation. I get a lot of potassium and magnesium in my diet. I know others feel you need to supplement with these - (though I didn't see any mention of potassium in Constantini's work) -  but I guess everyone's different.

Maybe the keto diet is having an affect on things?

Good luck with month 2 

well guys, I've been doing this protocol with benfiotiamine for a month and a half, I ended up trying it up to 400 mg a day, now it's over and having ttfd I've been taking it for less than a week, on the first day 200 mg, now I take 300 mg a day, I don't know if it's too much considering that with benfotiamine I reached 400 mg, I have to say that I don't know if I had the symptoms of the paradoxical reaction, I feel good as always some days some days not so much, some moments of the day well and a few moments of the day less, classic symptoms of polka dots, it certainly didn't cure the symptoms after the orgasm.
Now that I have reordered the benfotiamine, I will try to increase the dose.

[b_jim]

I see 3 interesting points if I try to connect POIS to thiamine.

- I am very sensitive to alcohol. As if my liver wasn't filtering.
- I am very sensitive to sugar.
- Short term memory problems might be explain by B1 (Korsakoff syndrome)

[berlin1984]

- a lot of people report bloating etc with starch and improve on a more carnovire diet. (thiamine for carb processing lacking?)
- a lot of people report low motility and/or SIBO and there is claims of thiamine able to improve the motility and then (after it is restored) fixing SIBO

[b_jim]

For carbs, yes this is what I suspect.
But for the vegetal/animal proteins I think taurine is the culprit. Even  with 30-35g proteins (cereals + legumes for all essential amino acids) it does'nt work.

[berlin1984]

it does'nt work.

Could you clarify what do you mean by this?

[b_jim]

I mean I have more symptoms with vegetal diet. It's possible to have correct level of methionine with vegetal food but not taurine. 

[berlin1984]

Someone on reddit posting about TTFD (special form of thiamine) for his success:

https://www.reddit.com/r/POIS/comments/1fb2go7/after_trying_all_possible_solutions_ttfd_is_pois/

[Sisyphus]

Sisyphus's thiamine protocol

aim: I am hoping a high dose thiamine protocol might help with fatigue because that's the main benefit that has been reported with other chronic illnesses with a success rate of about 67%. As for other pois related symptoms, only time will tell.

previous protocol; Before starting any thiamine, for around the first half of 2024 I was taking the following daily: vitamin D 1000iu, vitamin K2 100mcg, methylated B complex (low dosage), 1 probiotic and adhoc occasionally the antihistamine fexofenodine 180mg (just before/after O).

Since then I have added the following:-
1. I increased vitamin D to 3000iu, vitamin K2 to 200mcg - kudos to Warrior for making the point about getting enough Vitamin D.
2. After 4 weeks I added thiamine as sublingual thiamine mononitrate 100mg.
3. After 4 weeks I added thiamine as benfotiamine 150mg - kudos to kosmo35 for the recommendation to take this at a different time from other thiamine.

Mg and K: I've read that others take Mg and K supplements to support thiamine protocols. I'm trying to avoid doing that. I have tried to take Mg various times but I don't tolerate it very well (it gives me diarrhea) so I am hoping I am getting enough Mg and K from my diet.

for scientific reasons: I am trying to keep everything else the same throughout ie. lifestyle, diet, exercise, frequency of O's etc.

blood tests: I had routine blood tests done before starting thiamine so it will be interesting to get some new blood tests sometime soon to compare.

next: I will try to increase the thiamine dosage again and then in around 4 to 8 weeks report back on how things have gone for me.  I've not had any significant side effects so far.

So that's my situation but I wondered how others are getting along with thiamine protocols? I hope it is working for some people. kosmo35 and Andre2505, I wish you well.
It would be great to hear from Berlin and Hope One Day about thiamine because you have been on this forum a long time and I have the impression you have tried thiamine before. Did it benefit you and are you still taking it regularly?

[Sisyphus]

Here's my update on a thiamine protocol after 3 months:-

Summary
I've been taking thiamine supplements to see if it helps with pois symptoms, especially fatigue, and overall I would say that it's been a positive experience. Protocol is as follows: healthy diet and lifestyle (most important), vit d, vit k2, probiotic, 100mg thiamine mononitrate sublingual or 150mg benfotiamine. I sometimes take boron 3mg for a few weeks (when my shbg is high in a blood test), I sometimes take taurine 500mg (when my libido is lousy), but I'm not taking either at the moment. Occasional fexofenadine 180mg (before/afer o).

Pros
Thiamine seemed to reduce my fatigue in general. I've been more active than normal with less brain fog, which has been good and the main result I was hoping for. 

Cons
Thiamine did not seem to prevent me from getting certain symptoms after an o ex/ flu like, allergy like symptoms. 

Side effects / issues
No significant side effects in my case. I've had quite loose stools the past few months and have been awake at night more than normal but I don't know if either was due to thiamine supplements or something else (stress etc).

Caveats
Usually Mg supplements are recommended on a thiamine protocol but I don't take them (intolerance). I've not increased thiamine to high levels which typically others seem to do because I'm not keen on high doses of anything. I've had an exceptionally stressful 3 months. These things mean it's not been conclusive test. It's challenging to change one thing and keep everything else constant but I did my best. I imagine that's challenging even in a lab.

What paradox?
I had read that when taking thiamine, symptoms are supposed to get worse before they get better, a so called "paradoxical reaction". This didn't happen in my case. Maybe I haven't taken a high enough dose? Another reason? I don't know. I just got a gradual benefit after a few weeks which has stayed fairly constant.

combining with antihistamines
What I've started doing is continuing to take thiamine every day but if I have an o, I take an antihistamine I have used a lot previously (fexofenadine 180mg) either before or after. This has worked well so far. Maybe thiamine is helping with fatigue, maybe the antihistamine is reducing the likelihood of a sniffle, allergy like symptoms etc. I think I will continue.

doctor
My doctor and my Allergy Specialist want my feedback on antihistamines. I will also let them know about thiamine at my next appointment (late November) and hopefully they will find that interesting. They are new to pois but have given me a diagnosis and are willing to listen.

conclusion
So, whilst not a resounding success, it's mostly a thumbs up for taking thiamine supplements from me for my pois so far, using quite small doses in my case. I feel 3 months is quite a short term test especially due to some recent stress potentially affecting results so I plan to test for an additional 3 months.

@kosmo35 and @Andre2505. Any update from you guys or anyone else trying thiamine? I hope you've had success  but even if you haven't it would be good to know.

[Progecitor]

@kosmo35 and @Andre2505. Any update from you guys or anyone else trying thiamine? I hope you've had success  but even if you haven't it would be good to know.

I also took daily 10 mg of thiamine mononitrate for half a year. This is considered a high-dose, but it is certainly not a mega-dose. I stopped when I read about possible adverse effects, but earlier I did not want to dissuade anyone from a promising treatment. Since then I have used it sparingly mostly when I wanted to have an O as it can certainly increase sexual endurance especially if used with other NO boosters like Catuaba or Guarana. I haven’t yet tried benfotiamine as a comparison, but I plan to sometimes soon. At least it is reassuring that kosmo35 mentioned that it may alleviate anal itching which I certainly have. Nevertheless one may still need to be aware of an increased risk of cognitive decline as discussed in the following study. According to the researchers everything beyond 0.68 mg/day counts as too much.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882293/

[Sisyphus]

@kosmo35 and @Andre2505. Any update from you guys or anyone else trying thiamine? I hope you've had success  but even if you haven't it would be good to know.

I also took daily 10 mg of thiamine mononitrate for half a year. This is considered a high-dose, but it is certainly not a mega-dose. I stopped when I read about possible adverse effects, but earlier I did not want to dissuade anyone from a promising treatment. Since then I have used it sparingly mostly when I wanted to have an O as it can certainly increase sexual endurance especially if used with other NO boosters like Catuaba or Guarana. I haven’t yet tried benfotiamine as a comparison, but I plan to sometimes soon. At least it is reassuring that kosmo35 mentioned that it may alleviate anal itching which I certainly have. Nevertheless one may still need to be aware of an increased risk of cognitive decline as discussed in the following study. According to the researchers everything beyond 0.68 mg/day counts as too much.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882293/

Are you sure you've not got the findings in that article the wrong way round Progecitor? My understanding is that this article, and similar research, say the same thing, which is that if you're old and are thiamine deficient, you're slightly more likely to lose your marbles.  I don't think it says you increase your dementia risk by taking more than 0.68mg of thiamine. If that were true, I might as well sign up for the old folks home tomorrow.

Re anal itching, I get that too and in my case that's not something that's improved despite taking thiamine / Benfotiamine the past 3 months. Maybe I'm not on a high enough dose. It's kinda annoying.

I don't like taking high does of thiamine (or anything) either but I believe it's water soluble so I tell myself it's therefore relatively difficult to overdose on thiamine or have toxicity and from I've read, probably safe (although there's very little completed research for long term high amounts of thiamine).

[Progecitor]

@kosmo35 and @Andre2505. Any update from you guys or anyone else trying thiamine? I hope you've had success  but even if you haven't it would be good to know.

I also took daily 10 mg of thiamine mononitrate for half a year. This is considered a high-dose, but it is certainly not a mega-dose. I stopped when I read about possible adverse effects, but earlier I did not want to dissuade anyone from a promising treatment. Since then I have used it sparingly mostly when I wanted to have an O as it can certainly increase sexual endurance especially if used with other NO boosters like Catuaba or Guarana. I haven’t yet tried benfotiamine as a comparison, but I plan to sometimes soon. At least it is reassuring that kosmo35 mentioned that it may alleviate anal itching which I certainly have. Nevertheless one may still need to be aware of an increased risk of cognitive decline as discussed in the following study. According to the researchers everything beyond 0.68 mg/day counts as too much.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882293/

Are you sure you've not got the findings in that article the wrong way round Progecitor? My understanding is that this article, and similar research, say the same thing, which is that if you're old and are thiamine deficient, you're slightly more likely to lose your marbles.  I don't think it says you increase your dementia risk by taking more than 0.68mg of thiamine. If that were true, I might as well sign up for the old folks home tomorrow.

Re anal itching, I get that too and in my case that's not something that's improved despite taking thiamine / Benfotiamine the past 3 months. Maybe I'm not on a high enough dose. It's kinda annoying.

I don't like taking high does of thiamine (or anything) either but I believe it's water soluble so I tell myself it's therefore relatively difficult to overdose on thiamine or have toxicity and from I've read, probably safe (although there's very little completed research for long term high amounts of thiamine).

Of course this is only one study and may not prove anything. Who knows, it may actually work differently in our specific case. Perhaps we are very deficient in acetylcholine and mega-dosing thiamine is needed to achieve a sufficient level. Nevertheless we still need to be aware of possible risks. I think the matter is explained clearly in the discussion part, so here is the quote:

Our study provides several novel insights. First, we established a J-shaped relationship between dietary thiamine intake and cognitive decline, with an inflection point at 0.68 mg/day of dietary thiamine intake. Before the inflection point, the cognitive decline rate showed a decreasing trend with increased dietary thiamine intake, although the results were not significant, probably due to the small sample size. Thiamine deficiency may lead to an insufficient supply of energy to the neurons of the brain and decreased acetylcholine signalling in the brain, which may impair cognitive function. As such, maintaining optimal thiamine intake is necessary for cognitive function in older adults. However, beyond the inflection point of dietary thiamine intake, thiamine intake was significantly positively associated with cognitive decline. This finding is consistent with our recent studies, which found that long-term excessive intake of thiamine was associated with an increased risk of new-onset diabetes and new-onset hypertension in the general population. This series of studies consistently shows that excessive intake of thiamine may have adverse health effects on Chinese adults. Of note, both diabetes and hypertension are risk factors for cognitive decline or dementia. Moreover, thiamine can regulate acetylcholine levels by inhibiting the activity of cholinesterase. High levels of acetylcholine in the brain can adversely affect cognition. Therefore, we speculate that high levels of dietary thiamine intake may lead to cognitive decline by inducing elevated levels of acetylcholine in the brain. More research is needed to confirm our results and further explore the underlying mechanisms.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10882293/

Regarding the anal itching I am quite sure that it is an indicative symptom for prostatitis and more generally to gut inflammation. In the past when my POIS was completely untreated it was a very common symptom for me, but nowadays it bothers me much less. Besides sexual stimulation it is most often due to eating some POIS mimetics several hours earlier, thus it is a late symptom of food sensitives as well. Specifically coffee was an every day inducer until I stopped drinking it about half a year ago. For a partial treatment I would recommend supplements that specifically help with gut problems like dandelion root, Q10, black cumin, etc.

[Sisyphus]

You're right about that article Progecitor and I was wrong (I should have read it a little more carefully). Thanks for the clarification.

Nonetheless, as far as I can tell, most research on this subject theorises the opposite of that article ie. they typically theorise that thiamine protects against cognitive decline. Two examples below:-
https://pmc.ncbi.nlm.nih.gov/articles/PMC9585656/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4846521/

Re anal itching, I don't think I have prostatitis as I don't have any of the symptoms of that condition. That's good if you've managed to treat it. I could be wrong but I think mine is probably a symptom of pois.

[Progecitor]

You're right about that article Progecitor and I was wrong (I should have read it a little more carefully). Thanks for the clarification.

Nonetheless, as far as I can tell, most research on this subject theorises the opposite of that article ie. they typically theorise that thiamine protects against cognitive decline. Two examples below:-
https://pmc.ncbi.nlm.nih.gov/articles/PMC9585656/
https://pmc.ncbi.nlm.nih.gov/articles/PMC4846521/

Re anal itching, I don't think I have prostatitis as I don't have any of the symptoms of that condition. That's good if you've managed to treat it. I could be wrong but I think mine is probably a symptom of pois.

Regarding thiamine I also often bump into contradictory studies, so hopefully it is as you say.

Regarding the itching I meant to say that it is primarily due to POIS for me as well, but lately it wasn’t so bad as it used to be. In the past 20 years before beginning to treat myself with anything it was quite brutal at times. Just yesterday I had an O and about an hour later the itching began. This is also the time when my eyes tend to deteriorate the most rapidly. Nevertheless it had become hardly perceptible just a short time later probably due to the medications I take. However in the past it was an almost incessant feeling, which had driven me crazy. I remember that at those times I had been much more susceptible to sexual stimuli, and merely fantasying about women even just for a short time would lead to the dripping of some precum. After that the waves of unrelenting itching were inevitable. Of course this may be regarded as an inconvenience, but it also clearly shows that something is really wrong. Later I also realized that there were times when I had no sexual activity, but the itching would still surge. This was clearly caused by dietary elements, that were really hard to figure out as this only happened several hours after the actual meal, that was often varied. One thing that absolutely caused this was coffee, which I drank in a daily manner in great quantity. Exercise intolerance can also elevate this symptom, though it does not happen right away, but only after I reach some point in the exertion, then it progressively gets worse. If I don’t stop working then after a while it turns into a bad burning pain actually. Being simply tired can also elevate this symptom as it tends to be a common occurrence a few hours before going to bed. When it occurs that is when my eyes also begin to get really dry and hurt. On a few occasion in the past I also experienced a few episodes of what I call superPOIS. It seems to happen when I remain awake more than 22 hours or more and at one point this itchiness becomes very-very strong without pause. At the same time I also get very cold and unwell. I remember that it was a hot summer day and my teeth were clattering and I was shaking under the blanket as I felt like I was freezing and of course there was the crazy itchiness at the same time. Then I slept several hours and woke up feeling just alright. This thing happened at least 3 times and I have no mood to try it again as it felt like my body was collapsing.
Thus the itching is clearly due to POIS, but other factors can also interplay in determining its actual strength. It is also clearly correlated to the intensity of the anal burning, which is due to the inflammation of the rectum. And the only logical association to sexual activity is that it is due to the inflammation of the prostate, ergo prostatitis. Of course I also had other ideas in the past like there was a time when I was convinced it was caused by some parasites or worms and I went to the lab many times to prove it. However after a while I had to accept the truth of the many negative results. Of course I was also at the Urology, but they have never found anything wrong and told me that it can’t be anything serious, thus they only advised me to drink some herbal teas. I actually did so, however they hardly ever did anything significant. I only wish I knew the term POIS, so I could have told them how wrong they were, but all I could do at the time was to remain silent and accept how stupid I was.
If you can’t feel the burning pain, but only the itching, then it shows that the inflammation is only moderate at best and did not reach a critical threshold to turn into actual pain. Of course this doesn’t mean that you would not develop systemic symptoms as the inflammation would still spread as a dilution process. The supplements I mentioned were only a few examples, however I believe that technically almost all supplements on the market work to some degree and even those herbal teas that were recommended by my doctors are beneficial. However the real question was always the one of efficacy, as the POIS inflammation is so strong that even combinations of supplements can barely do any significant change. And I don’t even want to mention drug resistance, which makes almost all effort a futile attempt.

[Warrior]

I used to take a 150 B Forte Complex almost daily, sometimes twice daily (https://www.chemistwarehouse.com.au/buy/124176/nature-s-own-ultra-b-150-forte-60-tablets). This contains 150mg of thiamine nitrate per pill. This supplement was so transformative for my POIS, I took it for years. I could never find another B complex that made me feel so damn good. I could never really figure out what within it was so responsible for the medicinal benefits.

I always put it's medicinal effects down to replenishing methyl donors, but now I'm not convinced thats the whole picture.

I had to stop the B complex recently because it began giving me side-effects. Just making me more apathetic/anhedonic than usual. I took this as too many methyl donors and probably running out of certain nutrients that are methyl buffers. I also got lots of bloodwork done recently, and it all showed adequate B6, high B12 and folate. So I knew my methyl donors were adequately replenished. I eat and eggs and meat very frequently as well. So I stopped taking it and felt fine for a while, until recently began noticing my mood has been really off. Taking electrolytes seemed to exascterbate the problem as well, as I had just recently switched to keto which has been a gamechanger for my libido and energy. Every time I took potassium and magnesium, my mood would become more apathetic and less motivated.

I've always seemed to have electrolyte issues even on AB, and now that I was reacting to electrolytes after 4-5 weeks of no issues, I decided to research and came across thiamine as an important nutrient for regulating electrolytes.

3 days ago I finally decided to take TTFD 100mg and am already experiencing a significant improvement in mood and energy. I don't know for sure, but I'm more bullish than ever that thiamine is really important for our condition. Not to mention all the interesting thiamine megadosing info for complex chronic diseases i.e., POTS, long-covid, etc.

I seem to also be tolerating my electrolytes better as well, but this whole thing will probably be a work in progress for a while too. In hindsight though, I think I was actually megadosing B1 (150-300mg per day) through my B complex unknowingly. That was probably providing a lot of medicinal benefit that I over attributed to methyl donors.

Basic plan at this point is to take a moderately dosed B complex vitamin maybe 1-3x per week, but thiamine daily for a while. Eventually maybe switch thiamine to every 2nd day or so. Will come to understand it all better with time.