One of the key features of fibromyalgia is extreme fatigue, thought to be a consequence (at least in part) of the failure of the energy producing organelles in our cells called mitochondria (1). The mitochondria convert food energy from glucose into cellular energy in the form of a molecule called ATP (adenosine triphosphate) through a series of linked metabolic pathways. Thiamine is involved in these metabolic activities and has long been suspected of playing a role in the mitochondrial dysfunction (2).
More recently, a very small study found that some fibromyalgia patients had mild deficiencies of thiamine due to a problem transporting it from the blood to the mitochondria or an enzyme deficiency. Treatment with high doses of thiamine brought about a significant improvement in their symptoms (3).
As thiamine deficiency and mitochondrial dysfunction are implicated in a number of diseases, especially neurological ones, research is continuing to further elucidate the physiology of thiamine's various activities in the body (4).
Given that thiamine may have a beneficial impact on illnesses such as fibromyalgia for which mitochondrial dysfunction is presumed to be part of the pathology, and given that the risks associated with its use are minimal, people with fibromyalgia should explore its treatment value with their primary caregivers.
1. Eisinger, J., A. Plantamura, and T. Ayavou. "Glycolysis abnormalities in fibromyalgia." Journal of the American College of Nutrition 13.2 (1994): 144-148.
2. Sato, Yoshihiro, et al. "Mitochondrial myopathy and familial thiamine deficiency." Muscle & nerve 23.7 (2000): 1069-1075.
3. Costantini, Antonio, et al. "High-dose thiamine improves the symptoms of fibromyalgia." BMJ case reports 2013 (2013): bcr2013009019.
4. Abdou, Eman, and Alan S. Hazell. "Thiamine Deficiency: An Update of Pathophysiologic Mechanisms and Future Therapeutic Considerations."Neurochemical research (2014): 1-9.