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High-Dose Thiamine Improves Fibromyalgia Symptoms

  [ 36 votes ]   [ Discuss This Article ] • May 31, 2013

High-dose thiamine improves the symptoms of fibromyalgia.

By Antonio Costantini, et al.


Living with fibromyalgia means living with chronic pain, fatigue, sleep disorders and other associated key symptoms. To date, pharmacotherapy generally produces modest benefits.

Some observations indicate that the large majority of symptoms of fibromyalgia could be the clinical manifestation of a mild thiamine deficiency due to a dysfunction of the active transport of thiamine from the blood to the mitochondria or to enzymatic abnormalities.

Between June and July 2011, we recruited three female patients affected by fibromyalgia. We proceeded with the study of the patients' history, a physical examination, an evaluation of chronic widespread pain using the Visual Numeric Scale and an evaluation of the fatigue using the Fatigue Severity Scale were also performed. The levels of thiamine and thiamine pyrophosphate in the blood were determined.

After the therapy with high doses of thiamine, in the patients, there was an appreciable improvement of the symptoms.

Source: BMJ Case Reports, May 20, 2013. By Antonio Costantini, Maria Immacolata Pala, Silvia Tundo, and Pietro Matteucci. Department of Neurological Rehabilitation of the Clinic, Villa Immacolata, Viterbo, Italy.

Editor's comment:  Although this was a very small study and there was not a healthy control group for comparison, the results are nevertheless noteworthy. 

  • 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.

The therapeutic doses of thiamine ranged from 600 mg to 1800 mg per day.  One patient reported improvement at 600 mg.  The doses for the other two patients were increased by 300 mg. every three days.  Neither reported any improvement until they reached a dosage of 1500 mg.  The final therapeutic dose for both was 1800 mg.  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.  Additional and larger studies are needed to confirm these results.

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