interesting list
"All the patients also showed the other clinical manifestations of mild thiamine deficiency, such as sleep disorders, depression, anxiety, mood fragility, memory loss, attention disorders, lack of tolerance to stress, frequent lack of appetite, episodes of tachycardia and extrasistolia, generalised muscular weakness, muscular cramps, calf and feet sole pain, temperature-variation intolerance and dry skin.
High-dose thiamine therapy consisted of 600–1 500 mg/day orally or 100 mg/mL once a week parenterally. The oral reference doses were retrieved from our previous study on inflammatory bowel diseases.1 We used a dosage calibration according to the weight of the patients in this way:
Patients less than 60 kg → 10 mg/kg/day of thiamine;
60–65 kg → 14 mg/kg/day of thiamine;
65–70 kg → 17 mg/kg/day of thiamine;
70–75 kg → 20 mg/kg/day of thiamine;
75–80 kg → 23 mg/kg/day of thiamine.
In patients more than 80 kg, parenteral administration was performed due to the patient's reluctance to take large amount of pills. "
Thiamine (n.v. 2.1–4.3 µg/L)*
.........................................Before........ After
average subject serum thiamine: 8.7±3.9....... 121.3±346.6
no controls? hmm.
what a wide variation from patient to patient.. eg
Before.......After
7.0.............8.4
10.8........1414.9
"A detailed observation revealed that improvement of fatigue was obtained within hours from the first parenteral administration or within 2–3 days after the beginning of the oral therapy. ... The patients moreover reported an almost complete disappearance of fatigue-related symptoms such as an improvement of the intolerance to heat variations, sleep disorders, depression, anxiety, irritability, dry skin, lower leg swelling and tachycardia. Motor and other neurological symptoms did not show an appreciable clinical improvement.
During this study, we have never recorded any side effect.8 A recent check-up (after 18 months of treatment) did not show any decrease of the efficacy of the therapy."
the key to my mind is how long relief from symptoms would be maintained after stopping therapy and returning to healthy diet.
my opinion: thiamine should not be considered the one and only go to for fatigue in ms.
re essential nutrients associated with fatigue, iron is the most common issue for all, not just those with ms.
ms patients supplementing zinc need to watch iron status and associated risk of fatigue.
important: 18 months is the current max duration of this study's thiamine treatment during which no side effects were observed. any longer is untested.
from personal xp, klenner benefits kick in on the third day. consistent with the thiamine study's observations above. i don't know if there's any real justification for keeping it up over 18 months.
i don't recall how long i kept it up in 2006, but probably only as long as the first bottle of each separate b vit held up. i would have run out of the thiamine first.
after that, i was done with the klenner approach (my version thereof at least) for good. no temptation or need to revisit during the ensuing decade. the lasting changes are all associated with my ongoing dietary habits. b vits come mostly from natural food sources, with a multi and a sprinkling of b50 complex in the mix. these have done the trick since.
at long last, to your question. study quoted here does not specify timing at any finer grain than 'daily'.
as above, klenner does. think it's your choice, but to my mind divided doses gives you the best shot at absorption.
for context, healthy whole foods deliver thiamine in doses approaching 1 mg per serving.
http://www.whfoods.com/genpage.php?tnam ... #foodchart
nature will have its reasons. in general, we should listen.