Research on High-Dose Thiamine


Bager P, Hvas CL, Rud CL, Dahlerup JF. Randomised clinical trial: high-dose oral thiamine versus placebo for chronic fatigue in patients with quiescent inflammatory bowel disease. Aliment Pharmacol Ther. 2021;53(1):79–86. doi:10.1111/apt.16166.

Bager, P, Hvas CL, Rud CL & Dahlerup JF. Long-term maintenance treatment with 300 mg thiamine for fatigue in patients with inflammatory bowel disease: results from an open-label extension of the TARIF study, Scandinavian Journal of Gastroenterology, 2022; 57:1, 37-43, DOI: 10.1080/00365521.2021.1983640

Costantini A, Fancellu R. An open-label pilot study with high-dose thiamine in Parkinson’s disease. Neural Regen Res. 2016;11(3):406–407. doi:10.4103/1673–5374.179047

Costantini A., Nappo A., Pala M.I., et al. High dose thiamine improves fatigue in multiple sclerosis. BMJ Case Rep Published online (2013a).

Costantini A., Pala M.I., Tundo S, et al. High-dose thiamine improves the symptoms of fibromyalgia. BMJ Case Rep Published online (2013b)

Costantini A, Pala MI, Compagnoni L, et al. High-dose thiamine as initial treatment for Parkinson’s disease. BMJ Case Reports 2013;2013:bcr2013009289. (2013c)

Costantini A., Pala M.I. Thiamine and fatigue in inflammatory bowel diseases. An open label pilot study. J Altern Complement Med. Published Online First: 4 Feb 2013.

Costantini A, Pala MI, Grossi E, Mondonico S, Ercoli Cardelli L, Jenner C, Proietti S, Colangeli M, Fancellu R. Long-term treatment with high-dose thiamine in Parkinson disease: an open-label pilot study. J Altern Complement Med. 2015;21:740–747.

Costantini, A., Tiberi, M., Zarletti, G., et al. Oral High-Dose Thiamine Improves the Symptoms of Chronic Cluster Headache. Case Reports in Neurological Medicine Volume (2018)

Lonsdale, D. Chapter One — Thiamin. Advances in Food and Nutrition Research. Volume 83, 2018, Pages 1–56 (2018).

Lonsdale, D and Marrs, C. Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition. London, UK: Academic Press (2017).

Nishimoto, A., Usery, J., Winton, J. C., & Twilla, J. (2017). High-dose Parenteral Thiamine in Treatment of Wernicke’s Encephalopathy: Case Series and Review of the Literature. In vivo (Athens, Greece), 31(1), 121–124.

Özdemir, Z.O., Şentürk, M. & Ekinci, D. Inhibition of mammalian carbonic anhydrase isoforms I, II and VI with thiamine and thiamine-like molecules, Journal of Enzyme Inhibition and Medicinal Chemistry (2013), 28:2, 316–319.

Pavlović, D.M. Thiamine Deficiency and Benfotiamine Therapy in Brain Diseases. Am J Biomed Sci & Res. 2019–3(1). AJBSR.MS.ID.000621. DOI: 10.34297/AJBSR.2019.03.000621

Praharaj, S. K., Munoli, R. N., Shenoy, S., Udupa, S. T., & Thomas, L. S. (2021). High-dose thiamine strategy in Wernicke-Korsakoff syndrome and related thiamine deficiency conditions associated with alcohol use disorder. Indian journal of psychiatry, 63(2), 121–126.

Smithline HA, Donnino M, Greenblatt DJ. Pharmacokinetics of high-dose oral thiamine hydrochloride in healthy subjects. BMC Clinical Pharm 2012;12:4 (2012)

Thornalley PJ. The potential role of thiamine (vitamin B1) in diabetic complications. Curr Diabetes Rev. 2005;1(3):287–298. doi:10.2174/157339905774574383

Vatsalya, V. Li, F., Frimodig J. et. al. Repurposing Treatment of Wernicke–Korsakoff Syndrome for Th-17 Cell Immune Storm Syndrome and Neurological Symptoms in COVID-19: Thiamine Efficacy and Safety, In-Vitro Evidence and Pharmacokinetic Profile. Frontiers in Pharmacology, Vol. 11 p. 2312 (2021). DOI=10.3389/fphar.2020.598128 .

Winkler G, Pál B, Nagybéganyi E, Ory I, Porochnavec M, Kempler P. Effectiveness of different benfotiamine dosage regimens in the treatment of painful diabetic neuropathy. Arzneimittelforschung. 1999;49(3):220–224. doi:10.1055/s-0031–1300405


Bager, P, Hvas C, Rud C, Dahlerup J, Letter: future studies of high‐dose thiamine should consider whether its effects on fatigue are related to the inhibition of carbonic anhydrase isoenzymes. Authors’ reply, Alimentary Pharmacology & Therapeutics, 10.1111/apt.16293, 53, 7, (853-854), (2021).

Lubell JM. Letter: future studies of high-dose thiamine should consider whether its effects on fatigue are related to the inhibition of carbonic anhydrase isoenzymesAliment Pharmacol Ther. 2021; 53: 851– 852.


Eliot Overton has resources on what he calls mega-dosing of thiamine, available here: . This article summarizes his hypotheses on mega-doses of thiamine. This page contains links that he compiled to an extensive body of research on TTFD, a form of thiamine that crosses the blood-brain barrier.

The website Hormones Matter includes many articles about thiamine, including some that focus on high-dose thiamine. This comment by Derrick Lonsdale summarizes his hypothesis on the mechanisms of action for high-dose thiamine.

Lubell, Jeffrey. Why does High-Dose Thiamine Relieve Fatigue in Individuals with Diverse Conditions? — Hypotheses Grounded in Thiamine’s Role as a Carbonic Anhydrase Inhibitor. Medium, Jan. 10, 2021.

Lubell, Jeffrey. Could High-Dose Thiamine Improve Post-Exertional Malaise and Brain Fog in Individuals with ME/CFS and Ehlers-Danlos Syndrome? — A Call for Research. Medium, Jan. 10, 2021.

Lubell, Jeffrey. Could High-Dose Thiamine (B-1) Help with ME/CFS, Fibromyalgia, and the Neurological Complications of Ehlers-Danlos Syndrome? Health Rising, April 15, 2021.

Lubell, Jeffrey. Nearly 2/3rds of Survey Respondents Report Large Benefits from High-Dose Thiamine (B-1). Health Rising, June 2, 2021.