I second your sense that B1 repletion and supplementation can be a very slow-going process, fellow explorer! After I posted yesterday about how terrific my BPs are now after complete discontinuation (under medical supervision) of my BP meds (losartan and carvedilol), and chalking this up to my B1 protocol, I remembered that I also recently started on a beet root supplement that could also be helping with BP . . and have also been taking nattokinase for a while, something that can also help with BP (and other cardiovascular issues).

At the same time, I admitted to myself that my worsening lower respiratory issues (cough, wheezing) have begun only since I got into my higher B1 doses. .

I agree that until you have a more stable set of BP readings, itś hard to assess whether your status is truly improved. . .but this comes with the rule of thumb that when we alter our metabolism (and B1 is THE quintessential metabolism-affecting nutrient, being studied very intensively for its effects on mitochondrial function), we have to be patient, but also hopeful that steady-state improvement will set in.

Todayś ¨wisdom,¨ from me, moreover, is that when my wheezing and coughing got really bad yesterday, I finally admitted to myself that it might be something about my B1 protocol that itself was to blame, and sure enough, I discovered, with just a little research, that thiamine HCl, my primary thiamine source, is associated, in some people, with respiratory effects like the ones Iḿ experiencing. I had been careful to use MOSTLY HCl all these weeks, and only recently added in TTFD and benfotiamine, but as of today, I am going to try to replace my HCl thiamine with increasing strengths of allithiamine, which is naturally-occurring TTFD.

My hope is that I AM, in fact, a good responder to B1 therapy, but that I am also someone who gets side-effects from doses of HCl in the higher range.

The other new thought I have is that IF I cannot easily tolerate my ongoing synthetic TTFD and benfotiamine and/or I also experience some adverse reaction to allithiamine even at lower doses, I am going to try to use thiamine mononitrate (the cheap, most commercially used thiamine) as my upward-dosing protocol component.

None of this tinkering, btw, is at odds with the themes of B1 therapy, because itś well known that different people react very differently to all the various sources of thiamine, and that trial and error is typically necessary before one begins to get stable and improving.

The one objective, though, that I plan not to change is my goal of including at least one source of TTFD (either synthethic TTFD or allithiamine) in my protocol, to ensure relatively easy penetration of the blood-brain barrier.

In a situation like yours, I believe that the B1 gurus like Elliot Overton would probably say that you should look into the phenomenon known as paradoxical reaction, which can happen even with low doses of B1, and try to figure out whether your ups and downs may be associated with this. Overton believes we should tough it out through paradoxical reactions (which are essentially temporary aggravations of the condition being treated) and then resume upping our B1 dose once these have passed, but I now plan to follow the policy used among Parkinsonś patients who rely on B1, which is to reduce total B1 intake for a while any time there is an aggravation of the treated symptoms. (In Parkinsonś, it is apparently possible for some patients to arrest their disease, and even reverse some manifestations of it, at relatively low doses of B1 mononitrate taken sublingually. Wow!) The Parkinsonś community approach is not consistent with the Elliot Overton approach, but I respect it, as the Parkinsonś B1 protocol was developed by a brilliant neurologist in Italy who used the protocol with success before he passed away. His work is a ringing confirmation that even relatively low doses of thiamine mononitrate, famous for not easily crossing the blood-brain barrier, CAN, in fact, cross the barrier if taken in sufficient doses.

Again, itś all about trial and error for each individual.

If you don´t already have the book about thiamine and dysautonomia written Drs. Derrick Lonsdale and Chandler Marrs, and also the pdf produced and sold by practitioner Elliot Overton describing his approach to B1 therapy, maybe consider getting these. (They are pricey, alas.) I have learned, by reading both, that my path is not going to follow any one version of the protocols these materials describe, and that I will hit my stride primarily by careful self-observation and trial and error. I suspect you can achieve this, too

Fortunately, most forms of B1 are surprisingly inexpensive. My top picks so far are ThiActive B (by EO/Elliot Overton), which combines low doses of benfotiamine and synthetic TTFD with a backdrop of other B vitamins and some minerals, sublingual thiamine mononitrate (any brand . . though only one is widely available, at 100 mg/tab), and then either of the two commercially available allithiamine products (50 mg tabs). Again, I am swearing off thiamine HCl for now, and will not use benfotiamine beyond whatś in ThiActive B for the time being (because Dr. Lonsdale did not think very highly of benfotiamine).

My daily byword, in meantime, is to be patient, and to be as objective as possible in assessing whether the various B1s I am taking at any given time are really working for me. These principles should be able to take one to the finish line, I hope.