That is surely A LOT to have survived, and I applaud your finding your way to being able to consider B1 therapy as a solution in light of your complex, but clue-filled, history.

Regarding my BP, I am not sure, at this point, what accounts for my improvement, but in the back of my mind, I suspect I may never really have had essential hypertension, because the scenario that prompted my PCP to put and keep me on two antihypertensive drugs was a series of episodes of very high BP during doctor visits (with measurements at home often being quite normal). I do feel certain that I have dysautonomia, though, and the erratic cardiovascular behavior common to that disorder could by itself have made me look like an essential hypertension case to some doctors. In addition, my BP has mostly normalized, after ceasing BP meds, at a time when I have been taking not only B1, but also supplements like NAC and nattokinase, both of which are well known for their potential benefits on blood pressure and vascular health. Because I feel so unwell in so many ways, these days, I have not had the luxury of experimenting with one supplement at a time, because I am always desperate to get well again and simply don´t have the patience to stay sick for any longer than I need to. But even though I use multiple approaches simultaneously, once I am well again, my plan will be to remain on B1 supplementation for life while tapering off of the enzymes and other remedies that have been palliative (for symptoms, only). Then I will finally learn how much of a role B1 has played in my case. Prediction: It is going to be the missing link, for me, because every single disorder that has ever befallen me has been linked quite convincingly to B1 deficiency (subacute or acute).

Right now, I am pausing all synthetic forms of B1 (mononitrate, HCl, benfotiamine, and synthetic TTFD) and transitioning to allithiamine (naturally occurring TTFD) as my exclusive source. I do this because I have experienced symptom aggravations every time I have increased my B1 dosing using the synthetics, and I am beginning to wonder whether relying only a dietarily-derived product might work better for me. (This is not particularly scientific, but it feels right to me for now because since I got COVID, many OTC remedies I used to rely on are no longer tolerable for me, making me suspect that I am more adversely sensitive to EVERYTHING right now, and that avoiding as many synthetic products of all kinds may help me heal. Again, not terribly scientific.)

Hereś what I want to do, for a while, as my B1 protocol: Dr. Bergś B1 product once daily (contains 50 mg allithiamine and low doses of other B vitamins) together with Mg taurate, potassium bicarbonate, and choline (or citicoline) (good partners for B1 absorption and to offset B1ś tendency, in some, to deplete potassium), and, at another time of day, another dose of potassium bicarbonate (to continue to complement/offset the B1 taken earlier in the day). IN ADDITION (and this is off the beaten track), I will soon begin to apply a topical (OTC dermatological cream) allithiamine product to discrete areas of my face, in hopes that local absorption of B1 through these locations may possibly influence the behavior of the remote peripheral nerves that regulate operation of my nose and paranasal sinuses. (I derive this idea from the use of topical capsaicin by some patients who suffer from chronic obstructed nasal breathing and/or cluster headaches, the latter of which are believed to be triggered by malfunction of the same nerves as regulate the nasal cycle).

Once I am sure I can tolerate Dr. Bergś 50 mg strength of allithiamine (which is much higher than I have ever tolerated, so far, in the way of synthetic TTFD), I will try, if possible, to add minute amounts of allithiamine to my daily dose, gradually, from an allithiamine-only product (50-mg tabs) available from Ecological Farms. I will cut the tablets up, for this purpose, and will go very slowly with the upward push.

IMPORTANTLY, I am going to make peace with staying on a relatively low dose of thiamine permanently, if my pattern of experiencing frequent aggravations (aka paradoxical reactions) continues. In other words, whereas I know that B1 therapy has shown its most dramatic benefits in patients who made it up to very high doses of thiamine, I am starting to believe that some of us, especially if we have been sickly for a long while, may be able to benefit meaningfully only if we stay at a relatively low dose, but stay on some dose of thiamine permanently. I don´t recall either Dr. Lonsdale or Elliot Overton contemplating this possibility, but my gut tells me the possibility exists.