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Sulbutiamine is not considered a standard CFS medicine, nor is it often cited (in research, studies, forums etc). It has proven a cure to some and therefore demands consideration (even if it is not helpful to all patients).
Page Synopsis: the only antiasthenic compound known to cross the blood-brain barrier and to be selectively active on specific brain structures directly involved in asthenia
page 11 CFS > SUPPLEMENTS and NUTRITION > NOOTROPICS > SULBUTIAMINE
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Pharmacologic and therapeutic features of sulbutiamine https://pubmed.ncbi.nlm.nih.gov/12973384
Sulbutiamine, a highly lipophilic thiamine derivative, is the only antiasthenic compound known to cross the blood-brain barrier and to be selectively active on specific brain structures directly involved in asthenia
Note: asthenia is defined as abnormal physical weakness or lack of energy
"If you have not yet done so, you could try sulbutiamine" https://forums.phoenixrising.me/threads/if-you-have-not-yet-done-so-you-could-try-sulbutiamine.27043
"I just introduced myself in the members forum and realized that a lot of CFS sufferers have not tried sulbutiamine, which for me is the only thing that has worked, and it works WELL. At 800/mg per day, after a couple days loading period, it completely resolves my CFS. And when I stop taking it, about five days later, my symptoms return. I notice a large effect both in my mind as well as physical energy. Interestingly, thiamine and benfotiamine do nothing for me, and sulbutiamine is the only one shown to cross the BBB.
Here is a little reading that can help add some extra information:
Pharmacologic and therapeutic features of sulbutiamine https://pubmed.ncbi.nlm.nih.gov/12973384
Sulbutiamine, a highly lipophilic thiamine derivative, is the only antiasthenic compound known to cross the blood-brain barrier and to be selectively active on specific brain structures directly involved in asthenia. This article reviews the current knowledge on the effects of sulbutiamine in animal models and in various forms of human asthenia
Adjuvant role of vitamin B analogue (sulbutiamine) with anti-infective treatment in infection associated asthenia
https://pubmed.ncbi.nlm.nih.gov/14710977
Results: The number (%, 95% confidence interval) of patients with complete resolution of all asthenic symptoms was 916 (51.7, 49.4-54). In the remaining patients, severe asthenia was reduced but persisted in 11 (0.6, 0-26); and moderate asthenia in 94 (5.3, 0-17.6). The response was greater in patients with acute infection and symptoms more related to cerebral function. Side effects occurred in 10 (0.6%), patients and well being improved significantly.
Conclusions: Vitamin B analogue (sulbutiamine) may be a useful adjunct to specific anti-infective treatment
Sulbutiamine as a Treatment for Chronic Fatigue Syndrome https://corpina.com/sulbutiamine-treatment-chronic-fatigue-syndrome
In recent years, a thiamine analog called sulbutiamine has attracted the attention of both doctors and patients attempting to treat themselves.
Thiamine, also known as vitamin-B1, is essential for proper nervous system function Sulbutiamine consists of two thiamine molecules bonded by a “disulfide bridge”, which produces a form that more readily crosses into the brain than ordinary thiamine.
Sulbutiamine and Chronic Fatigue Syndrome (CFS)
Besides providing an essential nutrient, sulbutiamine has been shown to affect the dopamine systems of the brain, which contributes to its therapeutic effect on CFS.
More specifically, this is helpful for asthenia, a subtype of CFS that originates from the central nervous system rather than the muscles.
Physical Description
Sulbutiamine normally appears as a yellow powder bearing a scent reminiscent of sulfur. It is usually pressed into tablets or packed into capsules for convenience.
Anecdotally, the taste of the compound is very unpleasant, giving another reason to not to ingest it as powder. One user goes so far as to say, “[sulbutiamine is] the VILEST powder I have ever tasted – like paint, only worse.”
How it Works
Sulbutiamine acts on the body through a number of systems, many of them directly involving the nervous system and deep within the brain.
Chiefly, it is thought it helps CFS sufferers by the upregulation of neurons in reticular activating system, which is the brain’s center of arousal and motivation.
In this area, sulbutiamine increases the number of dopamine receptors and thereby increases cells’ sensitivity to activation by dopamine.
Since a lack of dopamine is associated with lowered energy levels, it seems quite fitting to treat CFS by compensating for this.
Another neurological effect observed with sulbutiamine is the potentiation of glutamatergic activity in the prefrontal cortex (when used with anticholinesterasic drugs), which has a positive effect on memory in patients diagnosed with early stage Alzheimer’s disease.
Off Label Use of Sulbutiamine
While Sulbutiamine can be prescribed for CFS under the brand name Arcalion, it is heavily used by healthy individuals for a purpose as a nootropic or mood enhancer.
Some people self-diagnose themselves as fatigued and seek this drug to help alleviate daily bouts of tiredness.
Others find that they enjoy the temporary boost in energy and motivation that sulbutiamine provides, even if they don’t normally complain of fatigue. The boosts to mood and memory ability are attractive, on a short term basis.
Sulbutiamine has been researched as a possible treatment for depression and erectile dysfunction, with preliminary results being positive.
The latter makes intuitive sense; sulbutiamine works by activating the Reticular Activating System (RAS) in the brain, a region essential for regulating important emotions like arousal, fear and motivation.
Anecdotal benefits
As with many newer nootropics, much of what we know comes from anecdotal user reports. There are a few reports that stand out. Here are their common themes:
As a stimulant sulbutiamine is preferable to caffeine, dextroamphetamine, vinpocetine, DMAE, adrafinil, or modafinil.
Dosing and Safety
A well-trained physician will likely know how to handle a drug such as Sulbutiamine properly, in the case of patients being prescribed Arcalion for CFS.
However in the case of off-label use, it is especially important to be aware of the strength and effects it has on the body.
Excess dopamine can cause psychosis and impaired cognitive function, neither of which are intended effects. Side effects of either group can include foul-smelling urine (due to sulfur content), headaches, irritation, and rarely an allergic reaction as with most drugs.
Dosing in the case of Arcalion is typically a 200mg tablet, whereas people taking a sulbutiamine supplement have more control over the amount they take.
For the safe off-label use of sulbutiamine, it’s recommended to start at around 100mg to assess tolerance and reaction, before slowly increasing upwards at an increment of 50mg to 100mg.
The manufacturer of Arcalion suggests taking no more than 600mg of sulbutiamine per day, as a safety guideline.
For sulbutiamine to reach its fullest potential, take it with food, drink, or perhaps some fish oil capsules.
A combination of the food and drink works best. When taken with a meal, the effects come on in 1 – 1.5 hours, and noticeably last for 6 hours.
Conclusion
Sulbutiamine is a promising treatment to help patients of Chronic Fatigue Syndrome, especially those of the asthenia variety
there are many links regarding asthenia such as https://www.medicalnewstoday.com/articles/asthenia-weakness and https://www.sciencedirect.com/topics/medicine-and-dentistry/asthenia, and a pdf is included below
click here to download the page below
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