Wednesday, 17 July 2013

Vitamin B as a Treatment for Fibromyalgia: What is the evidence?

This past week, I was on the radio again, FM 101.1 in Dallas, Texas, speaking about herbal remedies. Specifically, I was asked to explain what the evidence is for and against using them.

As it turns out, I have been receiving a ton of questions lately about fibromyalgia and especially about how to treat it with herbals. So here I am beginning what I intend will be a series of blogs about herbal and other alternative remedies for fibromyalgia and its associated symptoms (especially pain, fatigue and insomnia). I say this in the context of a recent poll in which 36% of people with fibro felt that some alternative therapy (herbal or otherwise) was THE MOST HELPFUL part of their treatment... more effective than any pharmaceutical drug or conventional treatment.

Let me start with vitamin B1 (thiamine), because I just received an email today asking about it from my good friend Tamara in Windsor. But before I start with that, let me go back even further to remind you what my basic philosophy about treating fibro is, which is... I never treated fibro.

That's right. I don't believe in treating fibro.  Does that sound crazy?  Well let me put that in perspective by saying that I don't believe in treating rheumatoid arthritis or diabetes either. Or, in fact, any disease. I believe in the Patch Adams approach to medicine. Did you see the movie?  You should. In the movie called Patch Adams, Robin Williams plays the young Patch while he's still in medical school. Near the end of the movie, Patch is being threatened with expulsion from the school for setting up a free clinic to offer treatment to those who can't afford to pay the rates necessary to be seen at the hospital. He is specifically asked if he has been, without a license, treating diseases in this clinic. His response is that he never treats disease, and then explains:

"If you treat a disease, sometimes you win, sometimes you lose. But if you treat the person, I guarantee you will win every time."

This is especially true of treating any chronic disease which, by definition, lacks a cure.  And it is ESPECIALLY true of fibromyalgia, which has so many different symptoms.  Let me explain what I mean this way:

UNLESS YOU ARE EXTREMELY LUCKY, THERE IS LIKELY NO ONE TREATMENT THAT WILL RID YOU OF ALL YOUR FIBRO SYMPTOMS

The key, then, is to work to improve those symptoms that are most troubling to you, because effectively managing them will most improve your overall quality of life.

And that brings me back to vitamin B1, which is also called thiamine. I did an extensive search of the medical literature today to find everything I could about vitamin B1 and fibromyalgia. What I found was... not much.

Thiamine deficiency is a known clinical condition that usually is associated with severe malnutrition. In North America and Europe, more wealthy countries, this degree of malnutrition is most commonly seen in alcoholics. Severe thiamine deficiency is associated with major neurological problems, especially affecting the brain. In such cases, death may result.  To begin with, very few with fibromyalgia are likely to have anywhere near this degree of malnutrition (unless they are alcoholic).

Thiamine is critical in the production of energy within cells, however, and low levels could be associated with fatigue, which is a prominent symptom in fibro.  Could undetected thiamine deficiency be causing the severe fatigue so many with fibro face?  The answer to this is that there is only a very small bit of evidence to support this. In a couple of papers from more than 20 years ago, this possibility was raised.  In these papers, the vitamin B1 abnormalities demonstrated in FM were found not to be induced by any nutritional deficiency, but more likely related to reduced activation of thiamine into thiamine pyrophosphate, which is important in energy production.  Sadly, almost no further research has been done on this, until a recent paper was published (in May 2013) in which vitamin B1 was said to help relieve the symptoms of fibromyalgia in three patients who were found to be low in it. The biggest problems with this last paper are (1) that only three patients were tested; and (2) that there was no comparison against placebo, which generally is required to determine if a drug (or herbal) actually works or not.

I'll get into the whys and wherefores of placebo trials in another blog (soon, I promise). But that only three patients were tested and there was no comparison group is a big problem, in terms of me saying that vitamin B works.

So what DO I recommend?  Let me say that, if you have an excellently balanced diet, you probably don't require vitamins of any kind (except perhaps vitamin D if you live in a northern climate, and that's to prevent osteoporosis/thinning of the bones). That being said, very, VERY few of us have well-balanced diets. So taking a daily multivitamin that contains a good dose of thiamine seems perfectly reasonable to me. Make sure you check that your multivitamin has enough thiamine, however, because some preparations may not. The recommended daily allowance of thiamine is 1.4 milligrams. Make sure that whatever vitamin you take has at least that much.

Thiamine is also found in a wide variety of foods at low concentrations. Yeast, yeast extract, and pork are the most highly concentrated sources of thiamine. But in general, cereal grains are where most people get most of their thiamine, with whole grains richer than refined grains. Other foods that are rich in thiamine are oatmeal, flax, sunflower seeds, brown rice, whole grain rye, asparagus, kale, cauliflower, potatoes, oranges, liver (beef, pork, and chicken), and eggs.

So actually treating fibro with thiamine is unproven and likely not necessary, beyond a good diet and a daily multivitamin. Starting your day with an egg on wheat toast and a glass of OJ to wash down your multivitamin might be a good place to start.

(Note: this advice comes from a man who typically eats his first meal of the day late in the afternoon... so do what I say, not what I do.)

In my next blog, I'll talk about a couple of herbal preparations that HAVE been tested and found to be helpful for improving sleep. But first, I need to take a nap.

zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
 

Kevin White, MD, PhD, multiple award-winning researcher, author, teacher & speaker
Multiple award-winning author of Breaking Thru the Fibro Fog: Scientific Proof Fibromyalgia Is Real

5 comments:

  1. (NATURAL CURE FOR FIBROMYALGIA DISEASE)
    October 2015 my mother was diagonised of fibromyalgia at Hanover District Hospital. Fibromyalgia is a horrible condition. My mother suffer from it so therefore I have learnt all about the condition and the nasty symptoms she suffers from, It had lead me to spend countless hours of research & discussion on how to cure it and relieve symptoms.Am so happy to share these testimony on how Health Herbal clinic cured my mother totally from FIBROMYALGIA,December 2015 i purchased FIBROMYALGIA herbal medicine from health herbal clinic,I received the herbal remedy through DHL couriers within 8 days and my mother immediately commenced usage as prescribed, she used the herbal remedy for about 7 weeks, her condition has greatly improved, all her symptoms including Chronic muscle pain, Abdominal pain, nausea, are unbelievably reversed she is fibromyalgia free! contact Health Herbal Clinic via their email healthherbalclinic@gmail.com or visit www.healthherbalclinic.weebly.com..

    ReplyDelete
    Replies
    1. thank to doctor Monday,I am from USA, I was diagnosed of Emphysema
      (COPD) in 2014 and I have tried all possible means to get cured, i even
      visited phonologist but all to no avail, until i saw a post in a health
      forum about a herbal doctor from Africa who prepare herbal medicine to cure
      all kind of diseases including Emphysema, at first i doubted if it was real
      but decided to give it a try, when i contacted this herbal doctor via his
      email he sent me the Emphysema herbal medicine through courier service,
      when i received this herbal medicine, he gave me step by instructions on
      how to apply it, when i applied it as instructed i was totally cured of
      this deadly disease within 12-14 days of usage, if you are suffering of
      this diseases you can as well Contact this great herbal doctor via his
      email nativeherbalclinic@gmail.com or Www.nativeherbalclinic.webs.com

      Delete
  2. My mother have been suffering from fibromyalgia disease for the last 3 years and had constant pain, especially in her neck,During the first year,she had faith in God that she will be healed someday by the Almighty. This disease started circulate all over my moms body and she have been taking treatment from her doctor, few weeks ago i came on search on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from (fibromyalgia) by this man DR Abumere and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so i wrote to DR Abumere telling him about my mothers fibromyalgia disease he told me not to worry that my mom is gonna be okay with his herbal remedies!! actually i never believed it,, well after all the procedures and remedy given to me by this man i went to discuss it with my mom and explain everything to her on what she is about to take in,because Dr Abumere told me my mother must stop other medication just to make sure his own work properly,she agreed because this great doctor gave me assurance about his good work.
    Weeks later after my mother start using this herbal medicine she started experiencing changes all over her as the DR assured me that she will cured,after some time i went to her doctor to confirmed if she has finally healed behold it was TRUE, So dear viewers my advise is if you have such sickness or any other at all you can email DR Abumere on: abumereherbalcentre @ gmail. com or visit his websit: www . abumereherbalcentre . simplesite . com
    thank you doctor i will forever be grateful.

    ReplyDelete
  3. ALL THANKS TO DR WILLIAMS WITH HIS HERBAL PORTION I WAS CURED FROM COPD.
    I found more Courage, Happiness and Faith in me, when I contacted Dr williams over the issue I have on me on ground, But all thanks goes to God Almighty for using the great healer called Dr williams to heal me, and it has been six months from now and I have been free from this diseases. My Names are johnson kate, Living in the u s now, I was diagnosed positive of COPD since Two Years Ago now, and I have tried all my possible best I can to get rid of it, but nothing is working out, I have spend hell, spend all my savings but nothing work out, and I even stop smoking and taking alcohol drinks, I have been directed and advise in different types/aspect of cures still yet no changes, One faithful morning, when I was listening to the news at the TV set, and Later on they switch to COPD discussion, and I was really interested in it, I focus my mind listening and a man came and started sharing a testimony about a particular doctor called Dr. williams, he said this man has helped thousands of people out there and people still do run to him for help and this has make him 30yrs of experienced in curing people from different diseases and God has been helping him, they showed the contact of this great Dr and I quickly copied everything out and contact him immediately, I send all my information's to him and after three days, i received a parcel from him containing the medicine/cure and I was told to use it for Just a month, and I greatly use it and God be all the Glory, I am now negative and I have gone to the hospital many times without numbers, and the Doctor confirmed I am clean and OK, all thanks to Dr. williams for his miraculous Healing.
    I am giving his contact today so that if you also reading this testimony of mine and you are still in the same problem, that you should not have anything to worry about, just contact him today Via his email address drwilliams098765@gmail.com for advice and for his product
    Thanks and Remain Bless

    ReplyDelete
  4. thank to doctor Monday,I am from USA, I was diagnosed of Emphysema
    (COPD) in 2014 and I have tried all possible means to get cured, i even
    visited phonologist but all to no avail, until i saw a post in a health
    forum about a herbal doctor from Africa who prepare herbal medicine to cure
    all kind of diseases including Emphysema, at first i doubted if it was real
    but decided to give it a try, when i contacted this herbal doctor via his
    email he sent me the Emphysema herbal medicine through courier service,
    when i received this herbal medicine, he gave me step by instructions on
    how to apply it, when i applied it as instructed i was totally cured of
    this deadly disease within 12-14 days of usage, if you are suffering of
    this diseases you can as well Contact this great herbal doctor via his
    email nativeherbalclinic@gmail.com or Www.nativeherbalclinic.webs.com

    ReplyDelete