Saturday, March 5, 2011

Thiamine - a breakthrough in stuttering treatment?


Thiamine as seen under a microscope


NB: For an FAQ (Frequently Asked Questions) on the use of thiamine (vitamin B1) and magnesium for stuttering, click HERE.  

URGENT NOTE: PLEASE PLEASE DO NOT POST ANY MORE QUESTIONS OR COMMENTS IN THIS THREAD AS IT HAS BECOME MUCH TOO LONG! NEW COMMENTS SHOULD BE PLACED IN THE SECOND THIAMINE THREAD WHICH CAN BE ACCESSED HERE.    BEFORE COMMENTING OR ASKING, PLEASE STUDY THE FAQ WHICH YOU WILL FIND HERE.

About 30% of adult males who stutter may significantly benefit from taking 300 mg of thiamine (ordinary vitamin B1) per day, according to a recent study at the National Center for Stuttering.

“38 male stutterers between 21 and 37 years of age were randomly divided into two groups. One group received 300 mg of thiamine per day and the other a placebo,” said Dr Martin F Schwartz, executive director of the Center.

The subjects were given standardised tests for stuttering prior to the experiment and again at its conclusion.

“The findings for the vitamin group were highly significant, with a before and after difference of such magnitude that the likelihood of it occurring by chance was less than one in a hundred.” Only 6 of the 19 subjects showed the dramatic effect, however.

“It was decided to follow these six individuals to see if the effect persisted. They continued to take what was now openly acknowledged to be the vitamin. It has been more than seven months and their speech has remained essentially free of stuttering,” said Dr Schwartz.

“If the results of this study are valid (and only replication by independent investigators will establish this), then approximately 30% of adult male stutterers can have their stuttering cured by the simple expedient of taking 300 mg of thiamine daily.”

Note that those with dietary habits that could negate the effect of thiamine, or those with a medical condition that would interfere with thiamine absorption, were excluded from the experiment.

“Fortunately the lack of toxicity for thiamine, even well in excess of the amounts used in this study, has been well documented. As with all supplements, however, those interested in trying thiamine should always first consult their doctor.”

The dosage specified is for adult males, not for children or adult females. Research on these populations is apparently underway.

Dr Schwartz said that the effects, if any, can be seen within two weeks. If no effects are seen after this period, none will occur and you can assume that thiamine will not be of benefit. Click HERE for the actual media release and HERE for the original study.

It is important to note that some conditions, foods and minerals have anti-thiamine properties. Thiamine deficiency can be caused by malnutrition, antacids, barbiturates, diuretics, a diet high in thiaminase-rich foods (raw freshwater fish, raw shellfish, ferns) and/or foods high in anti-thiamine factors (tea, coffee and carbonated beverages), tobacco and by grossly impaired nutritional status associated with chronic diseases, such as alcoholism, gastro-intestinal diseases, HIV-AIDS and persistent vomiting,” according to Dr Schwartz.

My comments:

If you are interested in starting with a daily 300 mg thiamine course for two weeks (the time needed to see if the vitamin benefits your fluency), it would make sense to also stop taking eg. tea, coffee, carbonated drinks, antacids and the other foods mentioned above for that period, as these could neutralise the thiamine taken and negate the experiment.

The study was not very big, and different results might be obtained when using larger groups of people who stutter.

If it is true that some people who stutter benefit from thiamine, it could be due to significant stress reduction. Dr Schwartz has in the past recommended vitamin B Complex (which includes vitamin B1) for lowering stress and muscle tension (so as to ultimately reduce vocal-cord muscle tension), so if he is correct it could be that vitamin B1 (thiamine) is the main stress-reducing factor in B Complex.

Update April 2013: Read THIS POST for Dr Schwartz's latest thinking on the cause of stuttering and how thiamine may help in assisting the basal ganglia in the brain to better coordinate the vocal cords.

Stuttering treatment through medication, drugs, supplements etc. has a long and complex history. Various drugs have throughout the years been tested for their effect, if any, on stuttering – Pagoclone being the latest – and up to now the results have generally been disappointing, with many stutterers complaining of negative side-effects. Others, however, have benefited to some extent. How can this be explained?

It could be that the benefits obtained in this way are simply the results of temporarily reduced stress levels. For instance, I have often found that, when suffering from the flu or a cold, certain painkillers and flu medicines improve my speech as they make me feel somewhat numb and drowsy. They anaesthetise the central nervous system and the so-called ‘mental scanner’ with which we scan for feared words. They can also reduce general tension levels and also, and more specifically, can reduce vocal cord tension. Alcohol can have a similar effect. Regrettably, some stutterers use various illegal and unhealthy drugs in an effort to improve their speech. What really happens is that some of these drugs have the effect of simply reducing stress levels. Far better to stay clear from detrimental drugs, and rather take health-promoting over-the-counter supplements that produce exactly the same effect – by reducing tension levels.     

I have in the past taken stress-reducing supplements and they have definitely been helpful in taking the edge off stuttering. These days, however, B Complex gives me headaches so I’ve stopped this, though I still take magnesium (slow release) and potassium (slow release). The combination of these is usually recommended as a muscle relaxant, and I take them mainly because of another problem - leg muscle cramps which I get at night. They are very effective for muscle cramps, and they also seem to improve my fluency though it's difficult to prove. 

I’m sure that stress-reducing supplements can be highly beneficial for many stutterers, particularly those with high stress levels. I have found that, in combination with using a fluency technique, they are indispensable. They lower tension levels to a point where you can apply your fluency technique with success – these techniques are difficult to apply if stress levels are too high. Try it – you have nothing to lose!   

Postscript - results of my informal 2011 survey on this blog:

The question was: Does 300 mg of vitamin B1 (thiamine) per day improve your fluency? 57 people responded as follows:

"Dramatic improvement!" - 6 people (10%)
"Has helped somewhat" - 8 people (14%)
"Hasn't helped at all" - 8 people (14%)
"Haven't tried it yet" - 29 people (50%)
"Don't believe that it will work" - 6 people (10%).   

Note that, as at the end of 2011, 24% of the respondents indicated that thiamine helped them, either "dramatically" or "somewhat". This is not far from the 30% mentioned in Dr Schwartz's findings - my poll was far from being scientific. Even so it is a further indication that people who stutter should seriously consider trying out thiamine to see if it improves their fluency.

Second postscript, October 2012: A reader (Anonymous - see below) has kindly pointed out that the results above are distorted by the people who didn't think that it would work and who haven't tried it! Anonymous is of course absolutely correct. If these two groups are discounted, the results are as follows:

Dramatic improvement - 27%
Helped somewhat - 36%

If all the people who have been helped are totalled, it means that no less than 64% of those who have tried thiamine have benefited to some extent, with 27% having experienced a dramatic improvement.

Even though relatively few people participated in the poll, these figures are impressive; bearing in mind, however, that suggestion and the placebo effect may also be at work here and that such polls are in no way scientific. The 27% is very close to Dr Schwartz's figure of 30%. It at least indicates that people who stutter should seriously try thiamine to see if it benefits them. I find it amazing why this potential breakthrough is not publicized widely.


Third postscript, December 2012:


Dr Schwartz has sent me the following relevant email:


"I have also just submitted a report on thiamine and stuttering to the

New England Journal of Medicine, our most prestigious medical journal in the US.  In it, as part of the study, I report a follow-up on some individuals who reported success in terms of long-term daily usage. It would appear that as long as they continue to take the vitamin, they remain fluent.  As you may know, several national organizations have reported no upper limit of toxicity for thiamine taken when taken orally and some studies, for example, as a treatment for Alzheimers, have reported subjects taking as much as 9 g daily (that's 9 000 mg) for a year or longer with no observable side effects.  Thus thiamine is one of the vitamins that is generally recognized as safe.  However, it may interact with some medications so it is best to check with a physician first.  Interestingly, it has been shown that the amount  of thiamine in the bloodstream continues to rise up to a certain level and then rises no further.  That level coincides with the ingestion of 1 200 mg per day.  So if one were to ask if there was an upper limit to check if thiamine could produce enhanced fluency, I would peg it at 1 200 mg per day."

And another message from Dr Schwartz on 22 January 2013:

"I have now followed five original subjects that showed a remission of symptoms when taking thiamin - for over 2 years. The follow-up was by telephone on a bi-weekly basis. The results indicate that as long as they continued to take the thiamin, they remained symptom free. This result comes close to a definition of a cure and clearly suggests that for these individuals, at least, stuttering represents a thiamin deficiency disorder. Also, there were no reported side effects
associated with taking 300 mg of thiamin daily over the two-year
period. Even though these observations were not made within the
protocol of a scientific study, nevertheless I feel encouraged by
this finding and will continue to follow these subjects."

Update January 2013: Dr Schwartz has brought to our attention that in 1951 a similar study (the Hale trial) on 30 mg of thiamine given to children produced interesting results. People who stutter are greatly indebted to Dr Schwartz for revisiting the Hale trial and its important results, and making people aware of its implications. Check out this article by Thomas David Kehoe, the owner of Casa Futura which manufactures appliances aimed at improving fluency. Mr Kehoe's fluency has benefited significantly from the thiamine-magnesium regimen.   


Update 31 January 2013: Thiamine hydrochloride is recommended

If you take thiamine for your stutter, thiamine hydrochloride is the recommended type of thiamine, according to Dr Martin Schwartz.

For more information on the safety of this type of thiamine, check out the following link to the American FDA (Food and Drug Administration): CLICK HERE. 
"Combining thiamine hydrochloride with magnesium is a good idea," Dr Schwartz adds. "I prefer magnesium orotate because of its superior bioavailability."

New informal poll started 30 December 2012 - please participate, but remember that the placebo effect (self-suggestion) is also a factor, so before stating that thiamine is helping you, make sure that the effect is permanent, i.e. that the two-week trial period has passed and that you are still benefiting from the thiamine: