Could a thiamine deficiency be what’s causing your anxiety?
The answer is YES.
In today’s article we’re going to take a look at why thiamine a.k.a vitamin B1 is so awesome and how it can help to relieve stress and anxiety.
Let’s do it!
1. Thiamine supplementation can be REALLY effective for reducing anxiety levels (and improving stress resilience).
2. Always start low and slow, begin with no more than 10-20 mg thiamine HCL per day and increase dose if needed.
3. Make sure to take thiamine with all the other B-vitamins + adequate magnesium. The B-vitamins work together as a group and you can create imbalances by taking high doses of isolated nutrients.
- What Is Thiamine?
- 7 Scientific Studies On Thiamine Fighting Anxiety
- How Thiamine Helps You Produce Energy
- How a Thiamine Deficiency Causes Anxiety And Depression
- When You Don’t Get Enough Vitamin B1 (Beri-Beri)
- What Are The Causes of Thiamine Deficiency?
- Thiamine – An Effective Treatment for Anxiety & Depression?
- How Much Thiamine Should You Take For Anxiety?
What Is Thiamine?
Thiamine, also known as vitamin B1, is this molecule right here:
Thiamine was actually the first vitamin to be discovered way back in the late 19th century… hence the name B1.
“Right so what’s it good for?!”
Glad you asked!
Thiamine is one of the eight essential B vitamins. Your body doesn’t make it which means you have to get it through foods.
Sometimes it’s referred to as the “anti-stress vitamin”.
And it’s for a good reason!
Thiamine has many important functions in the body which help us deal with the stress of everyday life:
• Vitamin B1 plays a critically important role in energy metabolism. Without thiamine you will not be able to produce any energy a.k.a ATP (ATP being the energy currency of the cells), and without energy your body is not going to work. Quite literally!
• You need it for proper nervous system function so that impulses can be transmitted from one neuron to another. Thiamine is also needed for synthesis of brain chemicals such as acetylcholine (acetylcholine being an essential part of the parasympathetic or ‘rest-and-digest‘ nervous system).
• Thiamine acts as a co-factor for the enzyme transketolase in the pentose phosphate pathway which supports biosynthesis of steroids & nucleic acids, glutathione status a.k.a the master anti-oxidant in the body, maintanence of nerve sheaths, and more.
7 Scientific Studies On Thiamine Fighting Anxiety
Here are a few studies I dug up showing how thiamine can give you relief from anxiety:
1. This study done on 9 older patients with generalized anxiety disorder (GAD) found that they all had low blood thiamine levels.
Daily injections of 100 mg thiamine improved anxiety and overall well-being, improved appetite and reduced fatigue…
Furthermore, after treatment with thiamine ALL patients could go off their anxiolytics and beta-blockers.
Which is pretty awesome!
2. In this double-blinded placebo controlled study, 120 young females took either placebo (i.e a sugar pill) or 50 mg thiamine per day for 2 months.
After these 2 months the group that got the vitamin B1 treatment reported feeling “clearheaded, composed, energetic and having a generally better mood”, even when vitamin B1 status was already adequate.
3. Several other double-blinded studies show that improving thiamine status is associated with improved mood in humans.
4. 80 Irish women with thiamine insufficiency were assigned either to 10 mg thiamine per day or placebo. Compared to placebo, the women supplementing vitamin B1 saw an increase in appetite and bodyweight, improved sleep, improved well-being and decrease in fatigue.
5. This double-blinded RCT study showed that using thiamine together with a standard depression treatment alleviated depression faster!
6. Giving rats thiamine enhances cellular respiration, decreases oxidative stress and increases testosterone. In other words, vitamin B1 has potent anti-inflammatory effects which helps restore levels of protective steroids in the body.
7. Another study done on mice rats where administration of thiamine showed antidepressant/anti-stress effects!
…how does thiamine actually help reduce anxiety?
The main thing that we’re going to look at is vitamin B1’s critical role in energy production, and how a thiamine deficiency may give rise to unpleasant symptoms like anxiety and panic attacks.
And I promise I won’t make this into a boring biochemistry lesson!
How Thiamine Helps You Produce Energy
Your body needs energy for everything it does.
The foods you eat (proteins, fats and carbohydrates) is where you get this energy from!
Food is converted by your mitochondria into a chemical form of energy that the cells can use – this high-energy molecule is called adenosine triphosphate (ATP).
You can think of energy production in the mitochondria as a complex machine with lots of different cogs (enzymatic reactions), and these enzymatic reactions are dependent upon vitamins and minerals.
Vitamin B1 is one such vitamin!
Vitamin B1 = The Spark Needed For Energy Production
Thiamine is a very important cog in the mitochondrial ATP production factory.
Thiamine turns energy production either ON or OFF.
You can think of thiamine as being the spark needed to ignite the fuel (food) you eat.
When there is no spark to ignite the fuel (food) → no flame/combustion in your engines (mitochondria) → no energy.
This is how a thiamine deficiency can really mess with cellular respiration and ATP production. Doesn’t matter how much fuel you “put into the car”, so to speak, if there’s no thiamine to burn the fuel.
When thiamine is low, everything downstream also stops working and you end up with a reduction in energy production and ↓ATP.
Vitamin B1 – Why You Need it to Burn Glucose (Carbohydrates)!
Remember the pyruvate dehydrogenase (PDH) enzyme we talked about?
Ok… maybe not.
All the carbohydrates you eat (glucose and fructose in the form of fruits, rice, bread, honey, etc, etc) has to be shuttled through this pyruvate dehydrogenase enzyme.
When the PDH enzyme isn’t working efficiently due to a lack of vitamin B1 this can “bottleneck” carbohydrate metabolism, where glucose takes another metabolic path and ends up as lactate/lactic acid instead.
This is a bad thing for a number of reasons which we won’t get into now.
But I’ll just mention that for anxious individuals this is particularly bad seeing as patients with panic attacks are more sensitive to lactate and it can easily trigger a panic attack.
How a Thiamine Deficiency Causes Anxiety And Depression
As you now know, thiamine is essential for energy metabolism!
Not having enough of this nutrient leads to a thiamine deficient state with low levels of cellular energy (ATP) → a biological energy deficit which can cause a wide variety of health issues.
Yup, that includes anxiety and depression too!
What I’ve come to learn is that, at its core, anxiety is a (mal)adaptive disease caused by chronic stress.
*Stress = any event that demands a physical or mental response from the body.
When your body is exposed to any stressor (e.g emotional stress and trauma, undereating, overexercising, infections, disease, and so on), energetic resources are used up to deal that stress, for example by pumping out cortisol and adrenaline from the adrenal glands.
Like you would do here:
Chronic stress is what gets us into problem.
When stress (energy demand) is much greater than resources to deal with stress (available energy) for extended periods of time, you’ll eventually run into a chronic energy deficit.
Inescapable, chronic stress depletes your body of your ‘adaptive energy’ or stress buffer…
…and your body is forced to reduce ATP production to conserve energetic resources which makes you more susceptible to unpleasant symptoms like anxiety and depression.
This would be the exhaustion stage of Hans Selye’s general adaptation syndrome where you literally have ZERO resources left to cope with stress.
Thiamine to the rescue!
Thiamine is really one of the most basic anti-stress factors – it allows you to generate the energy needed to meet the demands of everyday stressors and challenges.
So it’s not all that surprising that a thiamine deficiency makes you more vulnerable to all sorts of diseases.
When You Don’t Get Enough Vitamin B1 (Beri-Beri)
Prolonged, severe thiamine deficiency can lead to a condition called beriberi.
Beriberi translates to: “I can’t, I can’t.“
Which is a very fitting name indeed seeing as you literally can’t do anything in a thiamine (energy) deficient state.
It’s like trying to run a car without gasoline in the tank!
A thiamine deficiency affects every single cell, organ and tissue in the body and hence the clinical signs and symptoms vary quite a bit.
Depending on which system in the body is affected, beriberi is typically categorized into:
- Dry beriberi – energetic deficiency in brain and nervous system with neurological symptoms such as neuropathy, impaired reflexes, tingling/numb sensations, difficult walking, pain, brain fog/confusion, loss of muscle function (extreme cases of dry beriberi is called Wernicke-Korsakoff syndrome).
- Wet beriberi – energetic deficiency in cardiovascular system with symptoms such as heart failure with ensuing edema/fluid retention.
- Gastrointestinal beriberi – affecting digestive tract with gastroparesis, nausesa, vomiting and abdominal pain.
Beriberi can also be systemic where you have a mix of all of the aforementioned symptoms.
This disease is typically seen with chronic alcoholism, fasting/starvation and severe malnutrition, malabsorption issues, etc. Here are some of the most common causes of thiamine deficiency:
Developing full-blown beriberi is not so common in Western countries where food supply is ample…
…although it does happen occassionally.
Here’s one case where just 1 night of heavy drinking was enough to cause a severe case of gastrointestinal beriberi/wernicke’s encephalopathy which only resolved upon 1,000 mg thiamine given intravenously.
A State of Thiamine Insufficiency A.k.a “Not Quite Enough”?
A more common condition is thiamine insufficiency.
Not quite fullblown beriberi…
…but somewhere on the spectrum of “sub-optimal thiamine status”.
You may suffer from the symptoms of early thiamine deficiency even if you’re not clinically diagnosed with beriberi. Blood tests for vitamin B1 (plasma/RBC transketolase) do not necessarily need to be low either.
Dr. Derrick Lonsdale is a paediatrician that has successfully treated many so-called “medical mysteries” with high dose thiamine.
He has written many insightful articles on how thiamine insufficiency from “high-calorie malnutrition” can cause all sorts of vague/strange symptoms not typically recognized as a result of thiamine deficiency.
Here are just a few of them:
- Mood swings
- Frequent infections
- Weight loss/poor appetite
- Chronic fatigue
- Brain fog
- Neurological issues similar to dry beriberi
- Digestive issues e.g constipation, low stomach acid and SIBO
- Various forms of autonomic dysfunction, POTS
- Hormonal issues, thyroid problems
- Low metabolism, cold hands and feet
In my estimation, anxiety is one such manifestation of “not enough thiamine” which we’ll explore more in just a second.
What Are The Causes of Thiamine Deficiency?
When discussing the causes of thiamine deficiency, there are 2 main culprits:
- Poor diet and malnourishment – which cuts off the thiamine supply.
- Stress and inflammation – which means increased demands for thiamine.
Let’s look at each of these:
1. How a Poor Diet (Malnourishment) Can Lead to Beri-Beri
Who is this guy?
It’s Admiral Takaki!
Around 1880 is when the Japanese naval physician Admiral Takaki proved that thiamine deficiency was a nutritional disease (and not an infectious disease), and that you could treat this condition with a diet rich in thiamine.
At the time beriberi was a serious problem for the Japanese fleet with lots of the seamen getting seriously ill or dying.
Takai observed that the ordinary crewmen eating mainly white rice got ill, but not the naval officers eating a more nutritionally sound diet of meat and vegetables.
And so he conducted an experiment where he switched the low thiamine all-rice diet to a more varied high thiamine diet including wheat, vegetables, milk and meat.
As a result of this intervention the disease was completely eliminated from the fleet!
High Calorie Malnutrition → Thiamine Deficiency
High calorie malnutrition = eating tons of calories from foods that are lacking in essential nutrients.
An example is the Standard American Diet (SAD) with way too much processed foods, refined sugar and fats and seed oils – and not nearly enough nutritious whole foods.
This way of eating WILL cause thiamine starvation.
1. As I mentioned before, burning carbohydrates requires vitamin B1.
2. Processed junk foods have been stripped of most nutrients, including vitamin B1.
It doesn’t take a rocket scientist to see the problem here!
This is how a high calorie/thiamine ratio, over a long enough period, will inevitably lead to depletion of thiamine stores in the body.
As a side note, this is one of the reasons why I think some people report doing much better on a keto/low-carb diet. It’s not that all carbohydrates are bad – it’s that reducing “empty carbohydrate calories” can spare thiamine needs and make you feel better.
2. How Stress & Inflammation Can Deplete Vitamin B1 Stores
Being mindful about not eating too much processed junk food, and making an effort to eat a more healthy and nutrient-dense diet, are certainly good ideas!
However it does not guarantee protection from gradual thiamine insufficiency sneaking up on you.
Stress and inflammation deplete thiamine stores and/or inactivates thiamine-dependent enzymes.
So while getting the daily 1 mg RDA from food sources may be adequate to stave off acute beriberi…
Here are just few things in our environment that can empty your thiamine stores:
- Medications causing damage to mitochondria and infections
- Environmental toxins e.g tetrafluoroethylene (a.k.a the stuff coating your cookware)
- Inflammatory factors produced by our own immune cells
- Heavy metals e.g arsenic
- Products of lipid peroxidation (from polyunsaturated fats).
Add on top of that a stressful life without adequate time for rest and relaxation, a junk food diet, drinking buckets of coffee or tea with polyphenols that block thiamine absorption, alcohol, lactation/pregnancy or physical activity which increase requirements…
…well you’re on your way beriberi land (where you don’t want to be, trust me!)
Thiamine – An Effective Treatment for Anxiety & Depression?
Let’s briefly recap:
- Stress, inflammation and poor nutrition ↓lowers thiamine levels in the body.
- Thiamine deficiency → low ATP levels → reduced stress resilience and symptoms such as anxiety, panic, worrying, agitation, irritability, restlessness, feeling on edge all the time, physical and mental exhaustion, OCD, depression, ruminating thoughts, dread and despair... I think you get the point.
- This state in itself is obviously very stressful, causing inflammation and oxidative stress, and thus will further accelerate vitamin B1 depletion – a truly vicious circle!
At this point you’re probably wondering…
…can supplementing extra thiamine help improve your anxiety?
Absolutely, yes it can.
In my estimation many cases of chronic anxiety, panic attacks, depression and similar issues can be traced back to a “simple” deficiency of thiamine and/or magnesium (or other factors needed for energy production like thyroid hormones).
Vitamin B1 works to restore energy production in cells – switching the body from a catabolic to an anabolic state, increasing stress resilience and ability to “deal with shit”.
During his practicing years Dr. Lonsdale treated many, many patients with vitamin B1.
Here’s his observation with giving thiamine to anxious and depressed patients:
“During many years of medical practice, I found that a mild degree of thiamine deficiency was responsible for symptoms that are often regarded as psychological. Chronic anxiety and depression were regularly alleviated by getting people to understand the importance of appropriate diet, together with the administration of supplementary vitamins, the most important of which were thiamine and magnesium.”
This has been my experience as well.
Since supplementing with thiamine (and magnesium) I notice I am much more calmer throughout the day, I rarely get anxious ever and OCD tendencies has also reduced significantly!
More Awesome Vitamin B1 Things
As I mentioned before, thiamine helps to lower lactate levels which is a good thing seeing as lactate can trigger panic attacks in susceptible individuals!
Thiamine, being a potent stimulator of oxidative metabolism, also results in higher CO2 levels which has a nice calming effect and oxygenate the brain through the “Bohr effect”.
How Much Thiamine Should You Take For Anxiety?
Using high doses of thiamine (100-1000x daily recommended intake) restores energy production by stimulating the activity of the thiamine-dependent enzymes.
By taking these large doses of thiamine you can reverse the damage done by a hostile environment (toxins, stress etc) and reactivate these “broken enzymes” again.
Used this way, thiamine works more as a medicine in the body and has some truly awesome healing properties.
Here’s how I would go about it:
1. Start With 10-20 mg Thiamine HCL Per Day
Buy some plain 100% thiamine hydrochloride (HCL).
Always start with a SMALL amount, maybe 10-20 mg, and see how you feel.
Though any 100% thiamine HCL supplement will work just as well!
In a severe state of thiamine deficiency you can benefit from much larger doses. An Italian doctor called Antonio Costantini treated neurodegenerative diseases such as Parkinson’s with high-dose thiamine therapy, using up to 1800 mg thiamine per day.
There is really no risk for toxicity since vitamin B1 is water-soluble and you will pee out any excess.
2. Get a Good Quality B-Complex
Vitamin B1 works in synergy together with all of the other essential B vitamins.
For that reason, if you plan on taking high doses of thiamine for longer periods of time, I’d recommend pairing it together with a high quality B-complex so that you are not missing out on any of the other cofactors required for ATP production.
Ideally you would want a clean B-complex without unnecessary fillers – here’s a good quality, broad spectrum B-complex.
(If you want it is perfectly fine to just take the B-complex on its own – unless you need super high doses of thiamine for some reason.)
*Make sure to avoid vitamin B6 in the form of pyridoxine HCL, instead opt for the active form pyridoxal 5′-phosphate (P5P). Same goes for folate; avoid folic acid and opt for 5-MTHF or folinic acid. See the product linked above for a good, balanced B-complex.
3. Get Your Magnesium!
Make sure to eat lots of magnesium-rich foods and/or take a magnesium supplement!
A good starting point would be about 200-400 mg extra magnesium daily, either from magnesium bicarbonate, -taurate or -oxide.
Here is a good magnesium taurate supplement (Amazon).
Why is magnesium so important?
Magnesium is required for thiamine to become activated in the body; it acts as a cofactor both for converting thiamine to its active form thiamine pyrophosphate, as well as in the enzyme pyruvate dehydrogenase.
Thus a magnesium deficiency can mimic a thiamine deficiency, which is why it’s super important to load up on magnesium.
(4. *Try TTFD/Allithiamine)
Tetrahydrofurfuryl disulfide (TTFD) a.k.a allithiamine is a fat-soluble derivative of thiamine.
(Benfotiamine is another form of fat-soluble thiamine.)
Using TTFD has an advantage over thiamine HCL, namely:
Fat-soluble forms of thiamine can passively diffuse across cell membranes without the need for thiamine transporters, which translates into a MUCH, MUCH higher bioavailability in the body…
…thus making them way more efficacious at shuttling thiamine into the cells where it’s needed in order to restore energy metabolism (particularly the brain).
How Much Should You Take Per Day?
I would recommend going with allithiamine a.k.a TTFD a.k.a lipothiamine as it’s what Dr Lonsdale recommends, and it’s also the one I have personal experience with.
Allithiamine is more bioavailable, thus lower doses are used compared to regular therapeutic doses of thiamine salts. I would be careful not to start with more than maybe 5-20 mg.
Magnesium is absolutely essential when taking TTFD, and be prepared to eat lots of food as you will burn through calories fast.
As for product recommendations, I’d go with Thiamax (Amazon.)
Because allithiamine is so potent it can sometimes cause “refeeding syndrome” where symptoms paradoxically get worse for a few weeks. This is temporary and tend to go away after continued usage. You can read more about it here.
And again, vitamin B1 works as a team with the other essential B vitamins, so you would want to stack Allithiamine with a B-complex.
For more information on allithiamine, and what to do if you get strange symptoms, I refer to this video from Elliot Overton:
…And I Think That Is Enough For Today
I really think vitamin B1 can be a game changer for some individuals struggling with anxiety.
Again it’s not a magic pill…
…and anxiety can be caused by many other factors as explained in this article.
But if you haven’t tried thiamine yet I would definitely recommend giving it a go. I think the combo of thiamine with carbohydrate and salt can be very effective for lowering stress hormones and reducing anxiety!
Let me know what your experience has been with using thiamine below in the comments 🙂
And definitely share this article with people who might need it!