READER RESOURCES: THE APOCALYPSE ALMANAC: Hidden cures in our dystopian age. Check out the “Cure Cancer in Your Kitchen” chapter. FULLSCRIPT SUPPLEMENTS: top quality and economical.
Introduction
I managed to snatch my dear wife Judy from the jaws of certain death from AL amyloidosis several years ago with a lot of reading, networking, and then a trip to Europe for a comprehensive cleanout of her mouth abscesses and root canal removals. (Read about that in Judas Dentistry.) At about that time, I was diagnosed with Parkinson’s, but had confidence I could find a treatment that worked.
Everyone seemed against me. Even Dr. Perlmutter, the celebrity neurologist, said that he had never seen a case of Parkinson’s that was reversed or cured. I listen to his podcasts, and he is a brilliant dude who seems to be in the alternative camp, but I guess he just can’t get his head out of the pharmaceutical propaganda.
I reviewed thiamine treatment for Parkinson’s two years ago, but when a reader was kind enough to contact me about it recently, I reconsidered. I initially made the mistake of using pills instead of the pure thiamine powder from BulkSupplements.com, which is easier to handle in the required doses of a gram or more. I also learned that injecting a low dose of thiamine once or twice a week works as well and is easier compared to swallowing many grams of thiamine daily.
My dear reader had fairly severe Parkinsonian symptoms that he had more or less relieved with oral thiamine. It took him four months to get the dosing straight for optimal benefit, but once he did, it changed his life. His tremors went away, his coordination nearly normalized, and he felt great with excellent sleep and no constipation. All of these things troubled him for years before that.
This treatment works for other neurological diseases besides Parkinson’s, and I am going to tell you enough about it here so you can try it yourself. Use the resources I show you to confirm and aid your decision-making. Try to find a doctor who can help you, but good luck with that. As you read this, don’t forget that I do not give medical advice.
Summary
• Italian neurologist Antonio Costantini developed high-dose thiamine therapy for Parkinson’s disease in 2011 and treated more than 2,500 patients with reported improvements of 50 to 90 percent on motor and non-motor symptoms.
• Oral protocol: 2 to 3 grams per day of thiamine hydrochloride, split before and after lunch, water only, no acidic carriers.
• Oral equivalence with intramuscular or subcutaneous: 2 grams oral daily equals 100 mg IM or SQ weekly; 3 grams oral equals 75 mg twice weekly; 4 grams oral equals 100 mg twice weekly.
• Vitamin B6 sabotages thiamine treatment in patients on L-dopa because B6 activates peripheral decarboxylase and blocks L-dopa from reaching the brain, so stop supplementing it.
• Costantini died of COVID-19 in May 2020. The B1 Parkinson’s Foundation, supported by Daphne Bryan PhD and others, now continues the work and is planning a randomized controlled trial.
• Injectable thiamine in the US now requires a prescription. A 503A compounding pharmacy is the cleanest sourcing route. A sublingual thiamine mononitrate formulation offers a third option backed by anecdote rather than trial data.
The Italian neurologist who reversed Parkinson’s
In 2011, Antonio Costantini, a neurologist at the Villa Immacolata Clinic in Viterbo, treated a 47-year-old man with spinocerebellar ataxia type 2 and watched his motor symptoms improve on injectable thiamine. That one case led to a decade of work involving more than 2,500 patients with Parkinson’s, multiple sclerosis, Friedreich’s ataxia, Huntington’s disease, and other neurodegenerative conditions.
Costantini’s first published series documented improvements on the Unified Parkinson’s Disease Rating Scale (UPDRS) ranging from 31 to 77 percent in drug-naive Parkinson’s patients given intramuscular thiamine twice a week (BMJ Case Reports, 2013). His 50-patient pilot study, published in the Journal of Alternative and Complementary Medicine in 2015, showed stable clinical improvement over years of follow-up with no adverse effects on blood chemistry and no worsening on standard metrics.
He observed something no levodopa regimen had ever produced: a normalized pull test. In that test, a clinician pushes a Parkinson’s patient backward to assess postural reflexes. A healthy person takes one compensatory step. A Parkinson’s patient takes two or three and often needs support to avoid falling. Within a month of starting high-dose thiamine (HDT), Costantini saw that tests normalized in most patients. Nothing else he had used produced this effect.
Focal, not systemic, thiamine deficiency
Plasma thiamine in Costantini’s Parkinson’s patients was measured as normal before therapy. He argued the deficiency is local and functional, confined to neurons in the substantia nigra whose thiamine transporters or thiamine-dependent enzymes are broken. Saturating the brain with pharmacologic doses of thiamine allows passive diffusion to carry it into failing neurons, where active transport has stalled. The energy machinery restarts. Surviving cells work again.
This mechanism also explains why thiamine alone does not replace neurons that have been destroyed. By the time a patient develops tremor, around 70 percent of substantia nigra neurons on one side are dead. Thiamine protects what is left. L-dopa replaces the dopamine that the dead cells used to produce. Costantini reported that HDT plus L-dopa yielded 50 to 80, or even 90 percent improvement in motor symptoms and prevented the dyskinesias that L-dopa normally causes over the years of use.
The oral protocol
For a patient weighing 50 to 65 kilograms with recent-onset disease, Costantini started at 2 grams of oral thiamine hydrochloride per day, split before and after lunch. Heavier patients started at 3 grams per day, also split.
It is consumed in water only. No juices. No sour drinks. Thiamine breaks down in acidic media, and any dose taken with orange juice, kefir, or a low-pH beverage is partly lost. The pills or powder are taken around a meal. An empty stomach is not required; the acidic carrier is the problem, not food itself (highdosethiamine.org protocol).
Costantini warned that dosing too high produces a paradoxical pattern: initial improvement for a few days, then worsening. When that happens, he stops thiamine for a week and restarts at half the previous dose. A correct dose produces benefit without side effects.
He cautioned against multivitamins containing vitamin B6 (pyridoxine). B6 facilitates peripheral decarboxylase, which chews up L-dopa before it crosses the blood-brain barrier. Standard L-dopa preparations include decarboxylase inhibitors such as carbidopa, but the interaction still muddies the picture, and Costantini would not start HDT in the presence of a B6-containing multivitamin. Small amounts of other B vitamins including folate are fine. Extended-release magnesium 375 mg twice a week is acceptable, but combined magnesium-thiamine products are not, because the cumulative magnesium load across hundreds of daily thiamine doses becomes excessive.
Jonathan Rickert’s comment: Restricting B6 makes sense, but restricting magnesium in this context is wrong. The whole point of high dose thiamine (HDT) is to help the mitochondria make ATP and restore energy production. You cannot use the ATP you just made without magnesium. Mg-ATP is the active form that the enzymes use.
Also, thiamine has to be converted to a biologically active form, and that reaction is Mg‑ and ATP‑dependent.
Costantini was trying to prove HDT helped Parkinson’s. Magnesium became a variable to eliminate. It was his study design and not intended for maximizing the real world clinical results.
Costantini also observed that North American and African patients tended to require lower doses than his Italian patients and developed overdose symptoms within the first day of therapy more often. The dose is individual, and the response is the only reliable guide.
A useful note for anyone dosing the powder by volume: a half teaspoon of thiamine hydrochloride weighs roughly 1.2 to 1.7 grams, depending on the packing, because the bulk density ranges from 0.5 to 0.7 grams per milliliter. A jeweler’s scale ($20 from Amazon), used once, resolves the question. After that the volume measurement is reliable.
Intramuscular and subcutaneous alternatives
The 2013 through 2016 studies used 100 milligrams of thiamine intramuscularly twice a week, on Mondays and Thursdays. That dose produced the 31 to 77 percent UPDRS improvements in drug-naive patients and the stable multi-year results in the 50-patient series. The Monday and Thursday schedule was chosen so that elderly patients had fixed weekly days rather than a rolling 3-to-4-day interval.
After years of clinical experience with 2,500-plus patients, Costantini published a refined oral-to-intramuscular equivalence table on his website. Three tiers:
• 2 grams per day oral equals 100 milligrams intramuscular once per week.
• 3 grams per day oral equals 75 milligrams intramuscular twice per week.
• 4 grams per day oral equals 100 milligrams intramuscular twice per week.
The original research dose at 100 mg intramuscular twice weekly is at the top of the dosing range, corresponding to roughly 4 grams of oral thiamine per day. Most patients in the mature protocol did not need that much. The ratio of oral to the injectable dose is about 140 to 1, reflecting first-pass metabolism and limited gut absorption of water-soluble thiamine at high oral concentrations.
All Costantini’s published data used intramuscular injection into the gluteus or deltoid. He never published subcutaneous data outside the hospital clinic setting. Pharmacologically, thiamine hydrochloride is a small water-soluble molecule with hydrophilic distribution kinetics, and subcutaneous absorption of such molecules is near-complete with a slower time to peak concentration than intramuscular. For weekly or twice-weekly dosing, the peak-timing difference is clinically irrelevant.
Practical factors favor subcutaneous for home use. A 28-gauge insulin syringe injected into abdominal or thigh subcutaneous tissue is painless, takes seconds, and has no hematoma risk for patients on anticoagulants. Intramuscular injection with a 22 or 23-gauge needle into the gluteus maximus requires help for proper placement, hurts more, and bruises if technique is sloppy. Intravenous push is reserved for inpatient or clinic use, and Costantini rarely used it.
One caution on the intramuscular route: Costantini warned against using it in patients on anticoagulants like Coumadin (warfarin) or Sintrom (acenocoumarol), because needle-track bleeding can produce a large gluteal hematoma. For anticoagulated patients, the subcutaneous route eliminates the problem.
Sublingual thiamine mononitrate
A sublingual formulation has been used over the past several years as a third route. It has been championed by patient communities rather than by Costantini. The product is thiamine mononitrate dissolved under the tongue, typically at 100 mg per dose. Like the shots, less is needed because the absorption bypasses the first-pass liver metabolism. Adherents claim that the sublingual 100 mg is roughly equivalent to a 100 mg intramuscular injection, but no clinical study confirms this. Anecdotal reports collected by the B1 Parkinson’s Foundation describe symptom improvement comparable to oral and Intramuscular.
Daphne Bryan PhD, whose Parkinson’s response to high-dose thiamine led her to write the most accessible patient guide on the protocol, has discussed the sublingual route in multiple YouTube interviews. Her position is that sublingual mononitrate offers a practical compromise for patients who find the oral powder unmanageable and cannot get an injectable prescription.
The unresolved concern with sublingual thiamine mononitrate is renal toxicity at high cumulative doses. Derrick Lonsdale, the American thiamine pioneer who lived to 99, argued that 100 mg sublingual is too small a dose to pose a threat to the kidneys. Whether his confidence holds up for long-term users is an open question. A second sublingual product based on cocarboxylase, the active phosphorylated form of thiamine, also exists, again without trial data.
My reader is using the sublingual type.
Here is what she says:
I am using a sublingual. It is not an oral. It gets absorbed under the tongue. You don’t swallow it.
HERE is where to buy it. This is the thiamine that Daphne Bryan uses and recommends. Here’s a video:
I took a single sublingual dose per day for 2 days. The second day, it made me loopy. So on days 3 and 4, I’ve been crushing the tablet and taking half of it per day sublingually. This seems to work well for me. I’m doing better. My digestive tract is better, and I am sleeping better. My energy level is better.
My oligoscan showed that my sulfur pathway is blocked. 2 grams of thiamine HCl daily is more sulfur than I can handle. So I stopped taking thiamine HCl orally, and I am now taking thiamine mononitrate sublingual (1/2 tablet per day).
The patient videos
Costantini recorded every patient before treatment and at intervals afterward, capturing facial expression, speech, gait, and pull test. His archive at ultimaedizione.eu includes six case studies (Giosuè, Maurizio, Alberto, Andrea, Bruno, and his first patient from 2011), each showing before-and-after footage plus interviews.
The before clips show classic parkinsonian signs: masked face, shuffling steps, tremor, freezing, flexed posture. The after clips show the same patients walking with fluid gait, swinging arms, smiling, and speaking without the flat monotone. One man walks backward smoothly on the pull test. Another does a heel-to-toe line without wobbling. The English-captioned interviews describe months of progressive improvement and patients staying stable years into treatment.
Comment: This is a huge series of well-documented case reports. They are the most convincing photographic and video record of Parkinson’s response to any single intervention. Paul Marik said that enough anecdotes are data. I call it proof.
What happened to Dr. Costantini?
A post-surgical stroke in late 2019 forced Costantini to suspend consultations. He was recovering at home in mid-May 2020 when he contracted COVID-19 and died. The steady flow of before-and-after footage ended with him.
No academic neurologist replicated his clinic at the same scale. Italian neurology did not build his protocol into a national program. American academic neurology ignored it. Pharma had no reason to fund a phase 3 trial of a vitamin that costs pennies per dose.
Comment: A treatment with a 50 to 90 percent response rate across 2,500 patients, zero serious adverse effects, and a cost under a dollar a day should have destroyed conventional Parkinson’s treatments. Instead it died with Costantini. The incentive structure of clinical research does not reward the development of cheap, off-patent, widely available treatments that are so effective. Pharma will not fund what it does not own, and patients who are effectively cured are no longer prospects for future billing.
The work that survived him
Costantini’s website at highdosethiamine.org is still up, maintained by his collaborators. A separate organization, the B1 Parkinson’s Foundation, is now the central hub for the protocol. The site collects scientific literature on high-dose thiamine, offers patient-facing materials in multiple languages, runs a Facebook group of users sharing dose-titration experience, and publishes video presentations covering the protocol, magnesium cofactor strategy, and B12 screening.
The most important new development is a planned randomized controlled trial. A foundation-led study to formally test Costantini’s protocol against placebo is in design and fundraising. If funded and completed, it will be the first RCT of high-dose thiamine in Parkinson’s disease, and the result will either rescue Costantini’s legacy from open-label oblivion or settle the question against him.
Comment: Placebo controls are unethical in view of the evidence already existing.
Daphne Bryan PhD, a Parkinson’s patient and B1 protocol responder, wrote Parkinson’s and the B1 Therapy, the most readable patient-facing guide to the regimen. The book is available in 14 languages including English, German, French, Spanish, Italian, Russian, Korean, Chinese, Polish, and Ukrainian, with an audiobook edition narrated by Anna Crowe. Bryan’s writing has done more to spread the protocol among patients than any clinician’s work since Costantini’s death.
Dr. Lonsdale and Dr. Marrs
Derrick Lonsdale MD, a retired Cleveland Clinic pediatrician, spent more than five decades studying thiamine deficiency. He showed that modern American diets produce widespread subclinical thiamine insufficiency, with symptoms including fatigue, brain fog, gut dysfunction, and tachycardia. The deficiency responds to therapeutic doses rather than to RDA-level supplementation. His article archive is at hormonesmatter.com.
His co-author, Chandler Marrs PhD, a neuroendocrinologist based near Las Vegas, founded and edits Hormones Matter, an online journal with more than 1,400 articles covering thiamine, mitochondrial medicine, medication adverse events, and women’s health. Their 2017 textbook, Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition, is the reference in the field.
Marrs argues that most modern chronic illness involves some degree of thiamine insufficiency. Diabetics, women on birth control, patients on diuretics, heavy drinkers, and anyone eating predominantly refined carbohydrates are at risk. Thiamine is the rate-limiting cofactor in glucose metabolism. When it is depleted, every downstream enzyme in energy production slows. She calls this pattern “modern Beriberi” and shows that this deficiency presents as fatigue and many neurological syndromes that other physicians misdiagnose as psychiatric.
How to take thiamine
Costantini’s protocol answers most of the questions.
Twice a day, not once. Thiamine hydrochloride has a short plasma half-life, around 96 minutes after oral dosing. Splitting the daily dose before and after lunch keeps blood levels higher over a longer window. A single morning bolus wastes the afternoon hours.
Water only. No kefir, no orange juice, no lemon water, no apple cider vinegar chaser. Acidic carriers degrade thiamine in the digestive tract. Plain water, room temperature, around a meal is what the protocol calls for. An empty stomach is not required.
If I were to use oral dosing, I would start at 1 gram twice daily, for a total of 2 grams per day. I weigh 80 kilograms, and I am (reasonably) fit, so 2 grams per day is the lower end of Costantini’s range for me. If my motor symptoms did not improve within a month, I would increase to 3 grams per day (1.5 grams twice daily). If I saw worsening, I would follow Costantini’s advice and stop for a week, then restart at half the dose.
However, because of my strenuous oral chlorine dioxide program, DMSO (dimethyl sulfoxide), and methylene blue regimen, I have ordered the injectable form. Costantini’s equivalence table translates my starting dose of 2 grams per day orally into 100 milligrams intramuscularly or subcutaneously once per week. I will increase to 75 mg twice a week if I don’t have a good response, and then, after another month, perhaps 100 mg twice a week.
To track my progress, the pull test is the best measurement, and it responds only to HDT. I will film myself doing this before I start and weekly afterward. Gait, facial expression, and handwriting are also worth filming at the same intervals.
How this fits my current regimen
I am already treating my Lyme disease with a MMS1 (activated sodium chlorite) chlorine dioxide protocol, methylene blue, DMSO, and I am about to add Alinia (nitazoxanide).
Chlorine dioxide oxidizes thiamine in a test tube. I drink it for six to seven hours every morning when I get up. I always wait two hours before taking any other supplements.
Alinia has no documented thiamine interactions. Methylcobalamin (B12) is synergistic. Marrs warns that starting thiamine without adequate riboflavin produces air hunger, a sense of poor oxygenation, so I will add riboflavin 100 mg daily alongside the thiamine, and consider a B6-free B complex multivitamin.
Marrs says magnesium is dangerous for anyone starting thiamine. High-dose magnesium without adequate thiamine depletes ATP and deepens functional thiamine deficiency. Costantini allowed 375 mg extended-release magnesium twice a week.
Most B-complex products contain B6. Any supplement of mine that includes B6 gets dropped for the duration of the thiamine trial, to rule out central interference with dopaminergic signaling.
Sourcing injectable thiamine
Around 2022, the FDA tightened prescription requirements on injectable veterinary products, supposedly driven by concerns about ketamine diversion and compounded peptide sales, and thiamine was swept up in the same policy. VetOne 500 mg/mL thiamine hydrochloride, once available at any Tractor Supply, now requires a veterinarian’s prescription at all major US distributors including Tractor Supply Rx, Heartland Vet, Valley Vet, PBS Animal Health, Allivet, Penn Vet, and Leedstone. Three sources survive:
1) US 503A compounding pharmacies
These produce thiamine hydrochloride injection to order, typically 100 to 200 milligrams per milliliter in a 30 mL multi-dose vial with benzyl alcohol preservative. No B6, no B-complex filler, no veterinary adjuvants. The prescription comes from a licensed physician, the pharmacy fills and ships under federal regulation, and public FDA inspection records exist for every major operation. Empower Pharmacy in Houston is the largest name with the most-visible inspection history. Strive, Olympia, Belmar, and Tailor Made are other well-known 503A operations serving longevity and peptide medicine.
Compounders should have:
Accreditation by the Pharmacy Compounding Accreditation Board (PCAB)
State board licensure in every state the pharmacy ships to
No FDA warning letters or recall history in the last five years.
Bigger is not automatically better in compounding. Some of the worst compounding-pharmacy disasters of the last 20 years came from large operations cutting corners on sterile technique. The 2012 New England Compounding Center meningitis outbreak killed 64 people. What matters is the specific pharmacy’s inspection record and its adherence to United States Pharmacopeia (USP) 797 sterile compounding standards, not size or brand recognition.
Comment: Compounding pharmacies’ products are more reliable overall than Pharma products from Walgreens or Rite Aid.
2) Mexican pharmacy
Mexican pharmacies sell injectable B vitamins without a prescription. Bedoyecta Tri, the most heavily marketed product, contains 50 milligrams of pyridoxine per 2-milliliter ampule alongside 100 milligrams of thiamine and 10,000 micrograms of B12. That B6 load is exactly what Costantini forbade. Skip Bedoyecta.
Straight thiamine hydrochloride injection sold under the generic names Tiamina or Benerva is available over the counter at most Mexican pharmacies, though quality and availability vary by location. A border run to Nogales, Tijuana, or Ciudad Juárez lets a buyer inspect the product and the expiration date. Mail-order from online Mexican pharmacies is riskier.
Foreign injectable products sometimes have contaminants or other problems. Endotoxin contamination, particulate matter, concentration fraud, and counterfeit labeling all appear in Mexican and Indian injectable supply chains at higher rates than in US 503A products. Products for oral use are more problematic than injectables, but sterile injectable products are also vulnerable, and the consequences of a contaminated intramuscular shot are worse than a contaminated pill. For something going into muscle weekly for years, the additional cost of a PCAB-accredited US compounder is worth the reduced contamination risk.
3) Veterinary supply
VetOne 500 mg/mL thiamine hydrochloride injection costs about 28 dollars per 100-milliliter bottle through Heartland or Valley Vet with a veterinarian’s prescription. Rural feed stores serving ranchers sometimes still move the 200 mg/mL polio-injection formulation marketed for cattle polioencephalomalacia without asking. Jeffers Livestock and regional ag suppliers are looser than the big Rx portals. A veterinarian willing to write a script for livestock use generates a legal supply at veterinary pricing.
The veterinary product is pharmacologically identical to the human compounded product: thiamine hydrochloride in aqueous solution with a preservative. The concentration is higher (500 mg/mL vs. 100 to 200 mg/mL for human compounded), so at 100 mg per dose the draw volume is 0.2 mL, which requires a standard insulin syringe or a 1 cc syringe. The human compounded product at 100 to 200 mg/mL is slightly easier for some people.
Why this got buried
Thiamine is off-patent. Injectable thiamine costs about 50 cents a dose in Italy. The oral powder costs pennies per gram. No company with a Parkinson’s medication has any incentive to run a phase 3 trial that would render its 30-thousand-dollar-per-year dopamine agonist obsolete.
Academic medicine and Pharma’s love affair with randomized controlled trials gives rise to dismissal of data like Dr. Costantini’s. Their claim that anything without a randomized control trial is nonsense is itself nonsensical. Despite all this, the B1 Parkinson’s Foundation is now organizing a large study.
American neurology claims Parkinson’s is a one-way degeneration. Accepting that dopaminergic neurons recover function once a metabolic block is removed threatens a body of literature and a training curriculum built on lies. Conceding that a 30-dollar-a-month vitamin reverses 50 to 90 percent of symptoms across thousands of cases would force neurologists to explain why they did not sign on to what was right in front of them.
Comment: The globalists who fund institutional medicine have no motive to develop cheap off-patent therapies and a strong motive to bury them. Thiamine fits the pattern, and so do ivermectin, mebendazole, methylene blue, and most of all, chlorine dioxide. In thiamine’s case, there are no documents, no leaked memos, no coordinated academic attack. But it has been neglected on purpose: no sponsor, no RCT funded for 13 years, no curriculum inclusion, and now a closed supply route as collateral damage from a veterinary crackdown aimed at ketamine.
Any neurologist who wanted to replicate Costantini’s work could do so over a few months. The reason none have is the absence of sponsors, the demand for RCT data no one has been willing to fund, and a clinical culture that claims a huge open-label series from an Italian provincial clinic is not worth attention.
And finally
Neurologists have diagnostic skills that are far higher than most doctors’, for they spot their patients’ diagnoses as they walk across the room towards them. Chronic neurological disorders like stroke, Parkinson’s, Alzheimer’s, and amyotrophic lateral sclerosis (ALS) are obvious to them. They carefully document the patient’s stage of illness and make it all into a neat record.
Their ability to treat, however, is at best limited and often non-existent. For example, as far as I can tell, the patented Pharma drugs used for Alzheimer’s are useless, toxic, and we are being robbed blind to pay for them. Thiamine treatment for Parkinson’s is an example of the problem with the system and neurologists. I don’t think any of them use it because if they did, they might be run out of practice by their local medical board.
High-dose thiamine is the most important Parkinson’s intervention of the last 40 years. Not only is it safe and there is proof positive that it works, but thiamine gives us a way to treat Parkinson’s with Sinemet (carbidopa/levodopa) and not risk untreatable dyskinesias that are the nearly inevitable consequence of long-term use. In most cases, these are as bad as the original disease.
Thiamine-responsive conditions include dysautonomia, chronic fatigue, postural orthostatic tachycardia syndrome, gastroparesis, some depressions, and the early stages of other neurodegenerative diseases. If a third of the American population is functionally thiamine-insufficient, as Marrs and Lonsdale argue, the public-health consequences are enormous and the cure is a bottle of powder.
Selected references
• Costantini A, Pala MI, Compagnoni L, Colangeli M. “High-dose thiamine as initial treatment for Parkinson’s disease.” BMJ Case Reports, 2013.
• Costantini A, et al. “Long-term treatment with high-dose thiamine in Parkinson disease: an open-label pilot study.”Journal of Alternative and Complementary Medicine, 2015.
• Costantini A, Fancellu R. “Effects of overdose of high-dose thiamine treatment.” Gerontology & Geriatrics Studies, 2018.
• “High-Dose Thiamine (HDT) Therapy for Parkinson’s Disease.” Dr. Costantini’s HDT website.
• B1 Parkinson’s Foundation patient and clinician resources.
• Marrs C, Lonsdale D. “Hiding in plain sight: modern thiamine deficiency.” Cells, 2021.
• Bryan D. Parkinson’s and the B1 Therapy. 2021.
• Lonsdale D. “Vitamin therapy paradox: getting worse before getting better.” Hormones Matter, 2015.
• Empower Pharmacy, compounded thiamine HCl injection.
• Pharmacy Compounding Accreditation Board (PCAB).
Editing credit: Jim Arnold of Liar’s World Substack.
Affiliate store: I will never use paywalls, but if you want to help me, I offer competitively priced affiliate products HERE that I have personally tested and used.
Appendix: Getting Help
The cupboard is mostly bare for HDT clinical practice. Costantini left no clinical successor to do virtual consultations. Here is who remains:
Roberto Fancellu, MD (the closest thing to a true successor), Neurologist at IRCCS San Martino University Hospital, Genoa. Co-author on the 2015 pilot study and the 2018 overdose paper. Worked with Costantini from 2011. Speaks English. 22+ years in neurology, 20+ in Parkinson’s.
Phone: +39 010 5554580 (Fridays 2–4 pm only, ask for an English speaker)
Will support the protocol by email only after an in-person consultation in Genoa. No virtual-first option. Last reported fee was 125 euros, circa 2019.
Daphne Bryan, PhD (patient advocate, the public face) PhD in music psychology, Parkinson’s patient, author of Parkinson’s and the B1 Therapy. Lives in Stirlingshire, Scotland. Not a clinician, cannot prescribe. Runs the educational hub.
b1parkinsons.org and the Facebook group “Parkinson’s B1 Therapy”
YouTube: @B1Therapy
Sergio Pièche is President of the B1 Parkinson’s nonprofit and answers questions online with Bryan. Not a clinician. Marco Colangeli was Costantini’s assistant in environmental science and ran the RCT fundraising. Maria Immacolata Pala was the clinic nurse. None of these three prescribes.
Elliot Overton, DipCNM, CFMP (UK/France nutritionist, modern thiamine authority) Considered the leading living voice on clinical thiamine application. Explicitly states on his website that he no longer takes personal consultations. Sells written protocols, including a Parkinson’s one.
eonutrition.co.uk, thiamineprotocols.com, office@eonutrition.co.uk
Chandler Marrs, MS, MA, PhD (Lonsdale’s co-author, near Las Vegas) PhD in experimental psychology/neuroendocrinology. Editor of Hormones Matter. Not a licensed clinician, no consultations.
hormonesmatter.com
Derrick Lonsdale, MD, died May 2, 2024, at age 100.
Recommendation
Nobody is providing virtual HDT consultation in the way you would want. The practical path for someone in your position:
Use Bryan’s book and b1parkinsons.org as your dosing reference. Bryan answers questions via the Facebook group.
Have one of your existing prescribers write the compounded thiamine HCl injection script. Empower or Tailor Made will fill it.
If you want a physician with direct Costantini lineage to review your case, Fancellu in Genoa is the only option, and he requires you to fly to Italy first. He will then support you by email.
Buy the EONutrition Parkinson’s protocol document if you want Overton’s written guidance, since he will not consult.
Most patients in this protocol are self-managing with the b1parkinsons.org resources.
Blue’s Clues for podcasters
The audio for this episode was generated with an AI. HERE is how to start using this same system yourself.
To prepare this app for its task of transcribing my text into voice, I uploaded two hours of samples from my best recordings. These were mostly from my book dictations, where I used a basic sound studio in my closet and then had a sound engineer delete mistakes. When I use this service, I cannot tell the AI voice from mine.
The program costs about $20 a month for 3- or 4-hour-long podcast episodes, so I use it for only about half of my work. The rest I still do manually, and you can distinguish these by the occasional coughs and errors I make.
I am also using Wispr Flow, a dictating AI
I use it all day, every day, and this must save me half my editing time. I was struggling with one of its competitors, but when I started Wispr, I liked it so much that I bought a year’s membership for $144, which was a bit more expensive. It’s been a lifesaver since my Parkinson’s tremor has rendered typing more difficult.
The backstory is that these programs, with their modest monthly charges, work as well as DragonDictate, the former gold standard. This used to cost about $800.
I have an affiliate link HERE for you to use when you buy—and if you do much writing, you have to get it. Your price is the same as if you searched for the website and bought without using it. You are going to love this thing.
