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Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study.
J Altern Complement Med. 2013 Aug; 19(8):704-8.JA

Abstract

OBJECTIVES

To demonstrate that fatigue and other disorders related to ulcerative colitis and Crohn's disease are the manifestation of an intracellular mild thiamine deficiency and not due to malabsorbtion, augmented requirements, or nutritional factors, and that this dysfunction is curable with high doses of thiamine administered orally or parenterally.

DESIGN

In this pilot study, we treated fatigue in eight patients with ulcerative colitis and four patients affected by Crohn's disease from January to April 2011. The patients were recruited through general practitioners' surveys and among personnel and affiliated personnel of the clinic Villa Immacolata. Fatigue was measured using the chronic fatigue syndrome scale, and the determination of thiamine and thiamine pyrophosphate levels in the blood was carried out through blood tests. The levels of thiamine and thiamine pyrophosphate in the blood were normal. All patients were assigned to receive high doses of thiamine orally. Depending upon the body weight of each patient, dosage ranged from 600 mg/day (60 kg) to 1,500 mg/day (90 kg). The chronic fatigue syndrome scale as well as thiamine and thiamine pyrophosphate levels in the blood were measured 20 days after the beginning of the therapy.

RESULTS

Ten patients out of twelve showed complete regression of fatigue, while the remaining two patients showed nearly complete regression of fatigue compared to the chronic fatigue syndrome scale scores before therapy.

CONCLUSIONS

The absence of blood thiamine deficiency and the efficacy of high-dose thiamine in our patients suggest that fatigue is the manifestation of a thiamine deficiency, likely due to a dysfunction of the active transport of thiamine inside the cells, or due to structural enzymatic abnormalities. The administration of large quantities of thiamine increases the concentration in the blood to levels in which the passive transport restores the normal glucose metabolism in all cells and leads to a complete regression of fatigue.

Authors+Show Affiliations

Department of Neurological Rehabilitation, Villa Immacolata, Viterbo, Italy. carapetata@libero.itNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23379830

Citation

Costantini, Antonio, and Maria Immacolata Pala. "Thiamine and Fatigue in Inflammatory Bowel Diseases: an Open-label Pilot Study." Journal of Alternative and Complementary Medicine (New York, N.Y.), vol. 19, no. 8, 2013, pp. 704-8.
Costantini A, Pala MI. Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study. J Altern Complement Med. 2013;19(8):704-8.
Costantini, A., & Pala, M. I. (2013). Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study. Journal of Alternative and Complementary Medicine (New York, N.Y.), 19(8), 704-8. https://doi.org/10.1089/acm.2011.0840
Costantini A, Pala MI. Thiamine and Fatigue in Inflammatory Bowel Diseases: an Open-label Pilot Study. J Altern Complement Med. 2013;19(8):704-8. PubMed PMID: 23379830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study. AU - Costantini,Antonio, AU - Pala,Maria Immacolata, Y1 - 2013/02/04/ PY - 2013/2/6/entrez PY - 2013/2/6/pubmed PY - 2013/11/1/medline SP - 704 EP - 8 JF - Journal of alternative and complementary medicine (New York, N.Y.) JO - J Altern Complement Med VL - 19 IS - 8 N2 - OBJECTIVES: To demonstrate that fatigue and other disorders related to ulcerative colitis and Crohn's disease are the manifestation of an intracellular mild thiamine deficiency and not due to malabsorbtion, augmented requirements, or nutritional factors, and that this dysfunction is curable with high doses of thiamine administered orally or parenterally. DESIGN: In this pilot study, we treated fatigue in eight patients with ulcerative colitis and four patients affected by Crohn's disease from January to April 2011. The patients were recruited through general practitioners' surveys and among personnel and affiliated personnel of the clinic Villa Immacolata. Fatigue was measured using the chronic fatigue syndrome scale, and the determination of thiamine and thiamine pyrophosphate levels in the blood was carried out through blood tests. The levels of thiamine and thiamine pyrophosphate in the blood were normal. All patients were assigned to receive high doses of thiamine orally. Depending upon the body weight of each patient, dosage ranged from 600 mg/day (60 kg) to 1,500 mg/day (90 kg). The chronic fatigue syndrome scale as well as thiamine and thiamine pyrophosphate levels in the blood were measured 20 days after the beginning of the therapy. RESULTS: Ten patients out of twelve showed complete regression of fatigue, while the remaining two patients showed nearly complete regression of fatigue compared to the chronic fatigue syndrome scale scores before therapy. CONCLUSIONS: The absence of blood thiamine deficiency and the efficacy of high-dose thiamine in our patients suggest that fatigue is the manifestation of a thiamine deficiency, likely due to a dysfunction of the active transport of thiamine inside the cells, or due to structural enzymatic abnormalities. The administration of large quantities of thiamine increases the concentration in the blood to levels in which the passive transport restores the normal glucose metabolism in all cells and leads to a complete regression of fatigue. SN - 1557-7708 UR - https://www.unboundmedicine.com/medline/citation/23379830/Thiamine_and_fatigue_in_inflammatory_bowel_diseases:_an_open_label_pilot_study_ L2 - https://www.liebertpub.com/doi/10.1089/acm.2011.0840?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -