Could High-Dose Thiamine Improve Fibromyalgia Symptoms?

by Karen Lee Richards Patient Advocate

A small study recently published in BMJ Case Reports reported some rather remarkable results using high doses of thiamine (vitamin B1) to treat fibromyalgia.

The Story Behind the Study

In June 2010, a group of Italian researchers noticed that the fatigue and related disorders in patients with ulcerative colitis improved after therapy with high doses of thiamine. From that they formulated an hypothesis: "Chronic fatigue that accompanies inflammatory and autoimmune diseases could be the clinical manifestation of a mild thiamine deficiency, probably due to a dysfunction of the intracellular transport or due to enzymatic abnormalities, and responds favourably to high doses of thiamine."

The study authors stated, "From that moment, we systematically searched for and treated with high doses of thiamine chronic fatigue, when present, in any type of disease." Not surprisingly, one of the diseases they decided to test this therapy on was fibromyalgia, since fatigue is a major symptom for most people with FM.

While researching the scientific literature on thiamine and FM, they came across a 1998 study that stated, "A number of similarities exist between Fibromyalgia and thiamine deficiency. They include irritability, frequent headaches, unusual fatigue, muscle tenderness upon pressure palpitation, muscular weakness, irritable bowel syndrome and sleep disturbance. Studies published in JACN [_Journal of the American College of Nutrition_] have demonstrated abnormalities of thiamine metabolism in FM."

Study Design and Results

This was a very small study, with just three female fibromyalgia patients. Although the researchers were mainly interested in how thiamine therapy affected their fatigue levels, pain levels were also monitored since chronic widespread pain is the most prominent symptom of FM.

The therapeutic doses of thiamine ranged from 600 mg to 1800 mg per day. Patient 1 reported improvement at 600 mg. The doses for patients 2 and 3 were increased by 300 mg. every three days. (It generally takes 48 hrs. to see the effects from an increased dose of thiamine.) Neither reported any improvement until they reached a dosage of 1500 mg. The final therapeutic dose for both was 1800 mg., at which time they reported an abrupt improvement.

Following are the results after 20 days of high-dose thiamine therapy:

  • Patient 1: 71.3% reduction in fatigue; 80% reduction in pain.

  • Patient 2: 37% reduction in fatigue; 50% reduction in pain.

  • Patient 3: 60.7% reduction in fatigue; 60% reduction in pain.

None of the patients in this study experienced any side effects. The authors did note, however, that in some studies using high-dose thiamine for other illnesses, a few patients experienced side effects like tachycardia and insomnia.

My Thoughts...

Although this was a very small study and there was not a healthy control group for comparison, the results are nevertheless noteworthy and affirm the need for additional larger studies to confirm these results.

Often I don't even report on studies this small, but this one has really captured my interest. Part of the reason is that in addition to FM, I also have type 2 diabetes and studies have shown that people with diabetes are usually deficient in thiamine. Could it be possible that taking something as simple as thiamine could significantly improve both my diabetes and my FM? I'm certainly going to look into it.

Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.