It is becoming evident that some people get more benefit from thiamine than others. One possible reason may be that Dr. Costantini recommends that the thiamine should be taken on an empty stomach before you eat breakfast and again on an empty stomach before lunch. The uptake potential may be reduced if taken with food or after eating.
Another possible reason for this discrepancy may be the severity or duration of the PD. Two of the best responders here are Kia17 and GioCas and both started using thiamine relatively early in the disease process and have been fairly steady in their thiamine dosing. Persons of longer duration or severity, may require more time to achieve maximum benefit.
I was reading a new ( June / 2018 ) study abstract not related to PD, but it was discussing thiamine and it may offer another potential reason why you may not get the full benefit of thiamine even if you are taking what is the perfect dose for you! In this abstract it is stated that thiamine is converted into an active form called thiamine diphosphate, (TDP) and TDP interacts with magnesium to achieve activation of TDP dependent enzymes, including transketolase (TK), pyruvate dehydrogenase (PDH) and alpha-keto glutaric acid dehydrogenase (AKGDH), during metabolism of glucose. This may be the reason that Dr. Costantini has recommended magnesium or magnesium blends for some of his PWPs. Please note that Kia17 has made it clear that magnesium is definitely on the list of everyday supplements and GioCas, please chime in if magnesium is on your daily supplement schedule. RoyProp has also been a very good responder and if you review his regimen, you will see he is using two types of magnesium! Add in the fact that magnesium is healthful in general and very helpful for PWPs and it makes you wonder!
Here is a post that explains some of the value of magnesium for PWPs :
healthunlocked.com/parkinso...
Add in the synergy of magnesium with vitamin D and.........
Here is the abstract from PubMed that explains how magnesium is needed for thiamine to be more effective :
Art
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Clin Nutr ESPEN. 2018 Jun;25:8-17. doi: 10.1016/j.clnesp.2018.02.007. Epub 2018 Mar 15.
The role of thiamine dependent enzymes in obesity and obesity related chronic disease states: A systematic review.
Maguire D1, Talwar D2, Shiels PG3, McMillan D4.
Author information
Abstract
The WHO 2016 report indicates that worldwide obesity is rising, with over 600 million people in the obese range (BMI>30). The recommended daily calorie intake for adults is 2000 kcal and 2500 kcal for women and men respectively. The average American consumes 3770 kcal/day and the average person in the UK consumes 3400 kcal/day. With such increased caloric intake, there is an increased load on metabolic pathways, in particular glucose metabolism. Such metabolism requires micronutrients as enzyme co-factors. The recommended daily allowance (RDA) for thiamine is 1.3 mg/day and 0.5 mg thiamine is required to process 1000 kilocalories (kcal). Therefore, despite the appearance of being overfed, there is now increasing evidence that the obese population may nutritionally depleted of essential micronutrients. Thiamine deficiency has been reported to be in the region of 16-47% among patients undergoing bariatric surgery for obesity. Thiamine, in turn, requires magnesium to be in its active form thiamine diphosphate, (TDP). TDP also requires magnesium to achieve activation of TDP dependent enzymes, including transketolase (TK), pyruvate dehydrogenase (PDH) and alpha-keto glutaric acid dehydrogenase (AKGDH), during metabolism of glucose. Thiamine and magnesium therefore play a critical role in glucose metabolism and their deficiency may result in the accumulation of anaerobic metabolites including lactate due to a mismatch between caloric burden and function of thiamine dependent enzymes. It may therefore be postulated that thiamine and magnesium deficiency are under-recognized in obesity and may be important in the progress of obesity and obesity related chronic disease states. The aim of the present systematic review was to examine the role of thiamine dependent enzymes in obesity and obesity related chronic disease states.
PMID: 29779823 DOI: 10.1016/j.clnesp.2018.02.007