Getting Started with High-Dose Thiamine Therapy: A Brief Guide

In this video, Alia from EO Nutrition explains the basic principles of high-dose thiamine therapy, also known as Vitamin B1. She discusses the different forms of thiamine available and their qualities, emphasizing that the choice of form doesn’t matter as all forms can be beneficial. Alia advises starting at a low dosage and gradually increasing it based on individual response. She also discusses the paradoxical reaction, where symptoms may worsen before improvement occurs. Alia recommends taking supportive nutrients such as a B complex, magnesium, and potentially more potassium. She provides additional resources, including a clinical document and a Facebook group for further support. Ultimately, she highlights that high-dose thiamine therapy may not work for everyone but can be beneficial for those it does help.

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Key Insights:

  • There are four main forms of thiamine available: thiamin salts, benfotiamine, TTFD, and SobeTamin.
  • All forms of thiamine can be beneficial and help get thiamine into the body if dosed correctly.
  • Different people respond differently to different forms of thiamine, so it is important to try different forms and see which one works for you.
  • When starting high-dose thiamine therapy, it is recommended to start at a low dosage between 10 and 50 milligrams per day and gradually increase from there.
  • The average effective dose of thiamine varies depending on the form, ranging from 500-2,000 milligrams per day for thiamine hydrochloride or mononitrate, 300-1,200 milligrams per day for benfotiamine, and 200-500 milligrams per day for TTFD or SobeTamin.
  • The timing of thiamine intake does not matter; it can be taken all at once or spread out throughout the day.
  • A paradoxical reaction may occur where symptoms worsen before improvement. This is normal and subsides within a week.
  • Supplementing with other B vitamins and minerals, such as a B complex, magnesium, and potassium, alongside thiamine may support thiamine therapy.
  • Different brands of thiamine supplements can be used interchangeably, as long as they contain the desired form of thiamine.
  • Combining different forms of thiamine is possible and may be beneficial for some individuals.
  • Thiamine therapy may not work for everyone, but for those it works for, it can have significant benefits.


Hi guys, this is Alia from EO nutrition, and in today’s video, you will learn the basic principles behind how you can start high-dose thiamine therapy, otherwise known as Vitamin B1. If you’ve come across any of my work in the past, then you’ll know that I’ve spoken about this extensively. You might be interested in using high doses of B1 for different conditions; it could be fibromyalgia, neuropathy, chronic fatigue syndrome, Parkinson’s disease, or practically anything else.

So, first up, there are several different forms of thiamine available, so which one should you take? There are four main different forms, and each of them has different qualities. We’ll go over the basics here. So, you have thiamine salts. These are the cheapest, they’re the most widely available, but they are not very well absorbed, and they don’t have any specific special qualities. So, you generally need to take these in higher doses.

Next, you have benfotiamine, which is also quite widely available. It’s got a much better absorption profile, and it’s particularly useful for certain conditions, including diabetes, diabetic peripheral neuropathy, etc. Finally, you also have the disulfide forms, one being TTFD, which you know that if you follow my work, you’ll know that I’ve spoken about this extensively in the past, and you also have sulbutiamine. Both of these seem to be particularly useful for getting into the brain and central nervous system, and they both have excellent absorption as well.

So, if you’re about to start and you want to know which form to choose, the answer is, it doesn’t really matter. All of them can be beneficial, and in fact, all of them can help get thiamine into the body if they’re dosed in the right way. What I can say is that different people respond in different ways. There is no superior form per se. So, for instance, you can read a study that one form has a really high absorption, but someone can take it and they don’t feel very well on it, yet they try another form and they feel better. So ultimately, there is no right answer to this question. The best way to go about it is to try different forms, try a couple of different forms, and see which one works for you.

The next question that I get asked a lot is which dosage to use. Well, the answer to that question is everyone who’s starting this therapy needs to start at a low dosage. You would want to start anywhere between 10 and 50 milligrams per day, and if that’s well tolerated, then you would gradually build up from there. The key is to start low and go very slowly and gradually incrementally build your way up. Okay, so this might mean that you have to open up a capsule and just take a quarter or one half of a capsule, that’s okay. The ultimate goal of this therapy is to reach a point where you see a major improvement in your symptoms. The average effective dose is going to differ from person to person, but it’s also going to differ between the different forms.

So, for instance, with thiamine hydrochloride or mononitrate, you generally need much higher levels. The average effective dose that I’ve personally found is between 500 and 2,000 milligrams per day. On the other hand, for benfotiamine, you tend to need less because it’s better absorbed. The average effective dose is going to be between 300 and 1,200 milligrams, maybe sometimes higher. Whereas with TTFD or sulbutiamine, generally you need much less, so the average effective dose is going to be in the realm of 200 to 500 milligrams per day. Keep in mind, these are just averages. Someone might need higher amounts, someone might need lower amounts. It’s something that people really need to experiment with themselves.

Something that I also get asked very frequently is when to take them. So, it really doesn’t matter when you take them. Some people might take it all at once, other people might find that it’s good to bump up every couple of hours. They might spread out their dose and take it every three hours of their waking day.

This brings us to the next point, which is really important for people to understand. This is known as the paradoxical reaction. What is the paradoxical reaction? It’s basically referring to the fact that most people notice a worsening of their symptoms before they see improvement. This is especially pronounced in anyone with an underlying thiamine deficiency or someone with a long-standing thiamine deficiency. So, what you’ll usually know is the original symptoms that you have might get worse after you start taking B1 for the first time, and as you gradually begin to increase the dose, very common symptoms can be headache, a change in blood pressure, it might be an increase in fatigue, restlessness, anxiety, could also just be a general feeling of unwellness. This is perfectly normal, and oftentimes, it subsides within a week. So, the key is that after you start on a dose, you don’t increase it until those symptoms return back to baseline. Only when your symptoms return back to baseline do you begin to gradually increase the dose once more.

One thing that can help the paradoxical reaction and reduce the symptoms is getting enough of the supportive nutrients into the system. And this brings us to the next point, are you giving your body enough nutritional support in the form of other B vitamins and minerals when you’re using thiamine? So, when you take thiamine, especially in high doses, it seems to increase the demand for other B vitamins and minerals. So oftentimes, just the baseline, the least amount recommended for anyone starting this therapy is to take a B complex and magnesium behind it. What I’ve personally found is that many people tend to need a lot more potassium as well. Now, these three baseline supplements should be enough for most people. However, this situation can get somewhat tricky to navigate under certain circumstances. In that case, many go to my clinical document here at, which I made for this purpose. This has all of the nitty-gritty details on exactly which form to use, the dosage, the supportive nutrients, the symptoms which could indicate a higher need for different nutrients, along with how to test for each of those. It also contains protocols for specific health conditions which relate to the gut, the brain, the nervous system, and the heart, with different supplements which could also be useful. Again, this isn’t needed per se, but some people like the extra support and the extra information when navigating this situation.

Another thing which people might want to do is go to my Facebook group called „Addressing Thiamine Deficiency and Paradoxical Reactions“ where members discuss these kind of reactions and how to potentially deal with them.

So, another question that I get asked a lot is, can you combine different forms? The answer to this is yes, you can, and in fact, many people benefit from doing that. Some people like to get the benefits of benfotiamine while also taking some thiamine HCL, while also taking some sulbutiamine or some TTFD. There’s lots of ways to mix and match this, and actually, it generally tends to work pretty well. This is exactly the reason why I formulated the product „Thiamega.“ It contains all four different forms, and some people seem to find it helps really well compared to just using one specific form. But ultimately, it doesn’t really matter which company you buy from.

And that brings us to the next question I’m often asked, which brand to use. There are numerous brands which provide most of these forms of B1, and it doesn’t really matter which one you use because most of them will do the same thing. If you only use thiamine hydrochloride, for instance, it might be a better idea to use powder because it saves in costs rather than taking lots of capsules. Likewise, if you choose to use benfotiamine or sulbutiamine, the brands are probably irrelevant. Now, if you choose to take TTFD, there are only two brands that make it. There’s Allithiamine or lipothiamium, which is basically the same company, or there’s my brand, Objective Nutrients, which makes Thymax. Both of them contain the same chemical, both of them will work, they both do the same thing. The only difference is that Thymax doesn’t contain any excipients or fillers. We also have a higher dose, that’s about it. So, if you can only get hold of Allithiamine or you choose to do that, it’s still going to work.

So, to round up, just choose a form that you want to try, maybe choose multiple forms, start low, and go very slowly and gradually build up based on how you respond. Make sure that you are paying attention and listening to your body. Also, don’t become disheartened if you notice a worsening of symptoms because this is perfectly normal. And the best thing is to just hold in there, remain at the current dose until those symptoms subside. Understand this is not the therapy for everyone. It doesn’t work for everyone, but for those it does work for, it can work wonders. And for most people, this is really all that you need to start taking high doses of thiamine or working your way up to that. Like I said, some might want to go to the thiamine protocols document to get the extra information and detailed guidance. However, it’s worth understanding that many people can do this independently. Okay, it’s really quite simple.

So, if you like this video or found it helpful, please like and subscribe, share far and wide. And if that’s everything, see you next time.