Saturday, August 17, 2013

FAQ about thiamine (vitamin B1) and magnesium for stuttering



There have been many queries on this blog about taking thiamine (vitamin B1) and magnesium to reduce stuttering. Based on these queries, anecdotal feedback and the responses from Dr. Martin Schwartz I have written the following Frequently Asked Questions (FAQ) and answers. The original article and discussion threads can be found HERE (also see the informal, non-scientific poll results) and HERE. Please note that the information in this post is in no way intended to be medical, professional or therapeutic advice. The use of thiamine and magnesium for stuttering is still at a very early and unconfirmed experimental stage, and any such use is entirely at the user's own risk.

It is very important to first get the approval of your doctor before taking any supplement, including vitamin B1 and magnesium, as some health conditions or medicines which you might be taking can interact with the new supplement and result in adverse consequences. Note that I am not a pharmaceutical or medical expert nor a speech therapist/pathologist and can only relay this information. It is very important that you read the WHOLE of this FAQ, especially the section "What side effects are possible?", before taking any supplement for stuttering.

If you find that thiamine with magnesium is helping your fluency, please provide feedback by reading THIS POST and leaving a comment below that post. Your feedback may assist in furthering more research in order to improve stuttering treatment. 

Do thiamine pills help in reducing stuttering?

Two studies have found that thiamine (another name for vitamin B1) seems to reduce, sometimes dramatically so, stuttering in some individuals. The reason for this effect could be reduced stress or tension levels resulting from the thiamine - it is well known that stress or tension can significantly increase stuttering. Or else the thiamine may address a neurotransmitter deficiency. Note that this is not a drug nor a medicine - it is a nutritional supplement.

About a third of adults who take 300 mg per day seem to benefit to a more or lesser extent, while others do not benefit at all. Anecdotally, a few people even report increased stuttering when on thiamine. This could be due to an allergy to an additive within that particular product brand, or to the thiamine itself - in this case you may want to change brands and try another brand of thiamine, or else discontinue the thiamine altogether.

If you are interested in trying out thiamine, note that this approach is still in an early experimental stage. However the risks are minimal, provided that you observe the guidelines below, and you owe it to yourself to at least try this out for about three weeks and see if you are one of the lucky ones who seem to benefit from thiamine, or thiamine together with magnesium. Regard it as an experiment in which you have little to lose, but don't get your hopes up prematurely as it may not work for you.

It is important to first get the approval of your doctor before taking any supplement, including vitamin B1 and magnesium, as some health conditions or medicines which you might be taking can interact with the new supplement and result in adverse consequences.

Note that a pro-thiamine diet should be followed during the test period - no sense in taking thiamine pills if your current diet contains anti-thiamine substances - tea and coffee (tannins and caffeine), sugars and sweets, raw fish and alcohol among other things - that reduce the amount of thiamine in your body. Also take note that some medicines which you may be taking, such as certain hypertension, antibiotic and antacid pills, can reduce the thiamine in your body - read this list of factors that can affect thiamine levels. Obviously, if your health depends on such medicines, they take precedence and should not be discarded. 

Does it work for all people who stutter?

Unfortunately not. Approximately only one-third of all adults seem to benefit to some extent. The 1951 Hale study indicated that some children may also benefit, though the dosage needs to be adjusted for age, weight etc. Though females have not been the subject of any trials, some would probably also benefit. Apart from the approximately three out of ten people who seem to benefit, others find it helps them though not significantly. For some it has no effect whatsoever on their fluency.

How much thiamine should be taken for an adult?

For adults (20 years and older), Dr. Martin F. Schwartz recommends 300 mg of thiamine hydrochloride (not thiamine mononitrate) per day, taken in dosages of 100 mg right after breakfast, 100 mg right after lunch and 100 mg right after dinner. So it is important to get a container of 100 mg pills.

At the same time, however, you should ensure that you do not lose thiamine through eating and drinking substances that neutralise thiamine levels in your body. For more on this, see the comments below under "Are there other things I should do or not do during the trial period of two weeks?"

Can I take the daily thiamine hydrochloride all in one go? I can't take pills three times a day due to my work.

The reason why the intake must be spread throughout the day is because only a small amount of thiamine hydrochloride is absorbed by the body at a time. If you take 300 mg of thiamine all at the same time, it will serve little purpose and you will waste most of it.

Where can I get these pills?
It varies from country to country. In many countries it is sold over-the-counter by pharmacies and / or health shops. If it is not available in your country, you should be able to order it via the internet. As it is a vitamin, no prescription from a doctor is usually needed to purchase it. However you should first get the OK from your doctor before starting to take 300 mg of thiamine hydrochloride per day, as certain health conditions or medicines which you may be taking may interact with the thiamine and lead to adverse results.

Do I need a doctor's prescription to buy it?

Thiamine is a nutritional supplement usually sold over-the-counter. It is not a medicine, and therefore no doctor's prescription is usually necessary. However you should first get the OK from your doctor before starting to take 300 mg of thiamine hydrochloride per day, as certain health conditions or medicines which you may be taking may interact with the thiamine and lead to adverse results.

For how long should I take these pills?

The recommended test period is for two weeks (though anecdotally some have found that the effect kicks in later). Try the pills for two weeks. If at the end of the two weeks there is no change in your fluency, add magnesium (see the comments below regarding magnesium) after consulting with your doctor. If the combination of thiamine and magnesium still does not improve your speech, you can conclude that unfortunately you are not one of the lucky few who benefit from this regimen.

If thiamine, with or without magnesium, does make a difference to your fluency and if you decide to continue taking them, take note that, in order to maintain your improved fluency, you will have to take them for the rest of your life.

Anecdotally, some people have said that the thiamine effect only lasts for a number of hours after taking it, after which their fluency again deteriorates until they again take thiamine.

If the thiamine on its own improves your fluency (i.e. without any magnesium) and you decide to continue taking thiamine long-term, you will need to add magnesium in order to avoid a magnesium deficiency. The reason is that increased levels of thiamine require increased amounts of magnesium to convert thiamine to its usable form. If there is not sufficient magnesium in the body to do this, the body will withdraw magnesium from other parts of the body. This is not desirable.

Are there any risks connected to taking thiamine hydrochloride pills?

Thiamine is another name for vitamin B1. It is not a drug or a medicine; it is a vitamin supplement. Natural vitamin B1 is part of a normal healthy diet and is found in various foods. Excess vitamin B1 is excreted in the urine, and the US Food and Drug Administration has FOUND that even large overdoses of thiamine HCL are not detrimental to health. Even so you should first consult your doctor before taking 300 mg of thiamine hydrochloride per day, or any supplement for that matter, as some health conditions or medicines that you may be taking can interact with the supplement and result in adverse consequences.

In 1998, researchers at the Ohio State University in the US cautioned that vitamin B1, which is usually given in excess to many cancer patients, should be carefully regulated for people undergoing cancer therapy. They FOUND that too much thiamine could actually help tumours grow. In the US, the government-recommended daily intake of thiamine for males is only 1.4 mg, while for females it is as little as 1.0 mg., and these amounts are easily reached through a normal Western diet. 300 mg substantially exceeds this recommendation, which is one reason why you should, in consultation with your doctor, balance the potential benefits with the potential risks of taking additional thiamine pills.

Keep in mind that not everybody responds in the same way to supplements or medicines. If you do find that thiamine pills cause negative side effects for you, reduce the dosage or discontinue the pills immediately - check out the section "What side effects are possible?" further down this post. Paradoxically there have been a few anecdotal reports of people whose stutter has increased when taking B1, which could be due to an allergic reaction to B1, or to additives within that particular brand of thiamine, resulting in increased stress and more stuttering. Such persons should decide to either change brands, or else reduce the dosage or discontinue taking thiamine.

There are various forms of thiamine available in shops. What type of thiamine is recommended?

Dr. Martin Schwartz recommends thiamine hydrochloride (HCL), which is water soluble, so that the body can get rid of excess thiamine through the urine. He does not recommend thiamine mononitrate as this is fat soluble, with the result that in the long term it can accumulate in the body and result in overdosing.

Should I also take magnesium for stuttering, and how much?

First try the thiamine HCL on its own for two weeks. If that doesn't do anything for your fluency, add 400 mg per day (if an adult; for children it would be the RDA - Recommended Daily Allowance - appropriate for age, weight and sex) of magnesium glycinate, taken with the thiamine with meals, and try for another two weeks. If there is still no change, you can safely conclude that unfortunately this regimen does not work for you, and you can stop the test (and save yourself some money).

If you find that the thiamine, with or without the magnesium, does improve your speech, you will need to decide whether to continue with the supplement(s). If you find that the thiamine works well for you without magnesium, and you decide to take thiamine long-term, you will still need to supplement it with magnesium in order to avoid a magnesium deficiency. The reason for this is that increased levels of thiamine require increased amounts of magnesium to convert thiamine to its usable form. This increased demand for magnesium, occasioned by the increased presence of thiamine, but in the absence of sufficient magnesium, causes the body to withdraw magnesium from other parts of the body. This would not be desirable, therefore your magnesium intake should also be increased.

If you do see some improvement in fluency after adding the magnesium to the thiamine, Dr. Schwartz says that you can then try increasing the thiamine dosage to 600 mg per day (spread over three intakes of 200 mg after breakfast, lunch and dinner). In other words, you will then be taking a daily maximum of 600 mg of thiamine together with the magnesium. Do keep your doctor in the picture when you take these steps.

Why is the magnesium necessary?
The problem with thiamine is that it is not easily absorbed by the body; only small amounts of it are absorbed at a time. Magnesium, however, assists in this absorption process.

Note that your doctor should give the green light for taking magnesium, as magnesium supplements could interfere with certain health conditions or medicines you may be taking. For instance, people with kidney impairments should not take magnesium supplements. Also read the paragraph further down below on possible side effects of magnesium.

Long-term use of thiamine also requires additional intake of magnesium. Dr Schwartz explains:
"There is a distinct possibility that a magnesium deficiency of significant proportions might occur after some months if a person only uses thiamine to address their stuttering. Increased levels of thiamine require increased amounts of magnesium to convert thiamine to its usable form. This increased demand for magnesium, occasioned by the increased presence of thiamine, but in the absence of sufficient magnesium, causes the body to withdraw magnesium from other parts of the body. This is not desirable. So to prevent this I would always suggest that a person using 300 mg of thiamine daily also always take the RDA (recommended daily allowance) for magnesium - just as a precaution."

Note that magnesium also has a muscle-relaxing effect, so should help in reducing tension in the speech muscles as well as have a generally anti-stress effect.

The dosage for a typical adult, with the OK of your doctor, would be, according to Dr Schwartz, 400 mg of magnesium glycinate per day, spread throughout the day together with the thiamine; for children it would be the RDA (Recommended Daily Allowance) for magnesium appropriate to age, weight and sex. Too much magnesium usually results in a runny tummy, so if this happens you know that you should reduce your magnesium intake.

Dr. Schwartz says that an alkaline diet enhances supplement uptake, and he recommends going on a vegetarian diet during the test period of two weeks.

What type of magnesium should I take?

Dr Schwartz responds as follows: "Magnesium compounds vary a great deal in their ability to be absorbed. The most absorbable forms are, among others, magnesium citrate, taurate, aspartate, orotate and glycinate. I recommend magnesium glycinate because of its relatively high absorbability. Magnesium oxide has low absorbability, but is better than nothing. As always, get the OK from your physician first before taking any supplement."

Can I take thiamine as part of B Complex pills? 

Dr. Schwartz has said that a single B Complex pill (B50 on the label) per day has helped some people.

He says: "Since thiamine sometimes works better in the company of certain other B vitamins, I think it may be a good idea, once a day, along with a thiamine pill and magnesium, to take a 25mg B Complex pill. It certainly wouldn't hurt and it might help - especially if the pill also contains choline and inositol." Choline is used in the production of acetylcholine, which is a neurotransmitter in the brain. Dr Schwartz has speculated that stuttering could be linked to a deficiency of acetylcholine - read his thoughts on this here. 

Anecdotally, however, some people who stutter have reported that vitamin B2 (which is usually part of a B Complex pill) has an adverse effect upon their speech. So one has to experiment a bit to see what is most effective for the individual.

Can I also take calcium with the magnesium? Dolomite is a combination of calcium and magnesium.

Dr. Schwartz has advised against calcium, as this would work against what we are trying to achieve.

I am from India and thiamine HCL is not available in my country, but benfotiamin is. Would that have the same effect?

According to Dr. Schwartz, benfotiamin is a fat-soluble form of thiamine and its behaviour is not the same as that of ordinary thiamine. Some individuals have tried it, but there is not enough evidence to conclude that it is efficient, and therefore it is not recommended.

Are there other things I should do or not do during the trial period of two weeks (and thereafter if I decide to take thiamine and magnesium on a permanent basis)?

Some foods, drinks, health conditions and lifestyles are not conducive to thiamine absorption, and it makes sense to refrain from these so that the thiamine HCL effect is not negated. Dr. Schwartz has stated that the following should be avoided when taking thiamine HCL. Note that this includes smoking, drinks containing caffeine and tannins such as ordinary tea and coffee, sugar and sweetened drinks such as colas and "power" drinks. Also, unfortunately, chocolate :-( (as this may also contain caffeine) (yes, that's life, I know, all the nice things are bad for you lol):

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.”

For an exhaustive list of factors and medicines that reduce thiamine levels in the body, click here. If you intend to undergo the two-week test, it makes sense to scrutinise this list and, if medically possible and advisable, avoid these factors - unless, of course, your health depends on such thiamine-reducing medicines! - so that thiamine loss can be limited wherever possible. Consult your doctor if unsure - for instance, if you're taking medicines for hypertension (high blood pressure), you should naturally continue taking them even though hypertension medicines reduce thiamine in the body. Better to have a stutter than suffering from hypertension, which could affect your health very negatively indeed!  

There is some evidence that an alkaline diet improves the absorption of supplements, so with your doctor's OK, Dr. Schwartz recommends going on an alkaline diet for the 2-week trial period. To go on such a diet, google "alkaline foods" and choose from the alkaline or high-alkaline list. 

Dr. Schwartz's study concerns adult males only. Will some females and children also benefit from thiamine?

Though Dr. Schwartz's findings only involve adult males, the same principles should also apply to females. The 1951 trial involved children only. With children, the dosage needs to be reduced according to age, weight and height; but the permission of a pediatrician should definitely be obtained before putting a child on thiamine.

"Children respond quickly to thiamine, particularly in the age range 2 - 5," Dr. Schwartz writes. "Usually 30 mg  of thiamine (10 mg - 10 mg - 10 mg) plus some magnesium (30 mg - 30 mg - 30 mg) will do it. Also, they must lay off refined sugar and refined sugar products while the test is being conducted and use only the forms of thiamine and magnesium I specify. It is not uncommon for fluency to be generated in less than a week for more than 2/3 of the children. Again, parents should try this only with the OK of their pediatrician - this is most important."

For a 5-year-old of average height and weight, Dr. Schwartz has recommended 60 mg of thiamine HCL per day, spread out in two 30 mg amounts taken with food and magnesium, to be tried for two weeks, and to be discontinued should his/her stuttering not improve. How much magnesium to be taken? Well, for a kid aged 4 - 8 years, the magnesium RDA (recommended daily allowance) is 130 mg., so with breakfast it would be about 65 mg of magnesium and the same amount with lunch.

And for a 12-year-old? Dr Schwartz replies as follows: "There are 12-year-olds who weigh 78 lbs and those who weigh 120 lbs; those that are 4' 7" tall and those who are 5'6". It is more about these numbers than age. If I were forced to make a blanket statement, however, I would say that it would be better to err on the side of a conservative amount and specify about 40% of the adult amount for both supplements at age 12, gradually increasing a certain amount each year and reaching the full amount at around age 20."

Anecdotally, one boy aged 3 years 6 months, who had been stuttering for ten months, only began to benefit significantly from 50 mg of thiamine HCL per day (in two intakes of 25 mg each) when given the added magnesium dosage in the form of capsules (100 mg per day, in two doses of 50 mg) after the first two weeks of thiamine intake. The mother has stated that as her son is too young to swallow the capsules, she cuts them and pours the contents in a drink or in yoghurt. (Interestingly the stutter increased at one stage after they put the tablets in a drink - they later found that the tablets did not dissolve and that the boy wasn't getting them into his system. They then got the capsules and poured the contents in yoghurt, and again noted an immediate and dramatic improvement in fluency.)

Some children may prefer thiamine and magnesium in liquid or powder form which can be given as part of their favourite drink. For thiamine in liquid form, a parent has recommended this product. The medium-sized bottle is recommended. For magnesium in orange-flavoured powder form, which can be dissolved in water as a drink, check out this link.

With young children it is usually very difficult to prove decisively that a particular treatment has been effective, firstly because their fluency can vary considerably anyway, with periods of fluency followed by periods of stuttering; and secondly because they are at a life stage when most stuttering children outgrow their stuttering naturally anyway. The anecdotal improvement mentioned in the previous paragraph, however, provisionally indicates that the thiamine-magnesium regimen may indeed help some children.

The absorption of vitamins and minerals slows with age, so it can be expected that the thiamine-magnesium regimen will also be less effective as the individual gets older, though this could perhaps be counteracted by increasing the dosage.

How reliable and scientific were the thiamine trials?

This approach to stuttering treatment is still in an early experimental, preliminary stage. Both the 1951 Hale and the Schwartz trials were performed according to various criteria, both being double-blind trials. The 1951 Hale trial was published and peer-reviewed. It has been criticised as being of limited value as, inter alia, the children who benefited would perhaps anyway have improved through naturally outgrowing their stutter. A subsequent study did not find any relationship between thiamine and fluency.

For interesting comments on the Hale study and thiamine for stuttering, read this review by Mr Thomas David Kehoe, the owner of Casa Futura which manufactures anti-stuttering devices. By his own account, Mr Kehoe's own fluency has benefited significantly from taking thiamine.

The Schwartz trial has not yet been journal-published and peer-reviewed.

One could argue that more participating subjects would have improved the accuracy of the trials.
Additional independent trials should be conducted to further verify the results.

For an interesting and critical discussion on both these trials, listen to the relevant April 2014 StutterTalk podcast here in which Dr Paul Brocklehurst, a UK researcher and director of the Stammering Self-Empowerment Programme, talks about thiamine and its possible effect on stuttering.

Two non-scientific, informal polls in the relevant THREAD on this blog reflecting the experiences of this blog's readers seem to mirror the Schwartz trial results, with roughly a third of poll participants experiencing a significant improvement in fluency, though of course the placebo effect may have influenced the results.  

Why does thiamine have this effect on the stuttering of some people?

We don't know, but Dr. Schwartz has speculated that it improves the functioning of the basal ganglia in the brain. The basal ganglia is responsible for coordination of the vocal cords. It could be that stuttering is conditioned struggle behavior in response to an uncoordinated, tension-related "locking" of the vocal cords, and this vocal-cord discoordination could happen because the basal ganglia are not functioning 100%. This, again, could be because of an insufficiency of the GABA neurotransmitter in the basal ganglia. The production of GABA depends on sufficient vitamin B1. If there is an insufficiency of vitamin B1, it may lead to a lack of GABA.

So if we increase the intake of vitamin B1, it could result in an increase of GABA so that the basal ganglia can do a better job of coordinating the vocal cords. Check out Dr Schwartz's latest (2015) free online and downloadable book (only 87 pages short), The Thiamin Protocol, for more details: click HERE to read or download it.

Another possibility is that thiamine and magnesium simply reduce stress and/or vocal-cord muscle tension, so leading to more fluency. Vitamin B generally as well as magnesium are known for their anti-stress and muscle relaxing properties. Update March 2014: I have received a report from France from a lady who is on 900 mg of thiamine daily and says that it results in fluency in her home language, French, but not when speaking other languages. This could indicate that her base-level tension has dropped to the extent that she is fluent in her home language, but not dropped to the extent that it induced fluency in the languages in which she feels less comfortable. It often happens that people stutter more in a foreign language because such a language can result in more stress (uncertainty about pronunciation, unfamiliarity with grammar et cet.). So this lady's experience may indicate that the supplements reduce stress and tension, resulting in improved fluency.

Within two days of taking thiamine I noticed a marked improvement. But the side effects make it unviable. I experienced dizziness, a sense of being 'drugged up' and little mild sensations of panic.

"It is very rare to have the kind of reaction you are experiencing," says Dr. Schwartz. "Sometimes certain brands contain additives which cause allergic reactions, so consider switching brands. If you have any illness or are taking any medications or supplements, consult your doctor because there could be an interaction with some of these."

"Regarding the mild sensations of panic - these could be psychological responses to your fluency improvement, and not to the thiamine as such," says Peter Louw. "Sudden fluency can cause feelings of panic. One must keep in mind that a person who has stuttered for some years has a 'stutterer's subconscious', and the mind may need lots of time to adjust to improved fluency. Many relapses are the result of this subconscious backlash. Therefore any improvement in fluency should be managed very carefully and gently and with patience. One should gradually get used to better fluency. It takes time to assuage the 'subconscious stutterer', to assure the inner stutterer that 'all is well'. At the time when I made big improvements in my speech thanks to the Passive Airflow technique I also experienced feelings of panic, but they eventually passed. I wrote about this in my book Coping with Stuttering, in particular in the following chapter: click here.

"Regarding the feeling of being 'drugged up' - that could be your experience of being more relaxed generally, and initially it may not be a pleasant feeling because you may not be used to feeling relaxed. High stress levels can become a way of life, and a lowering of this stress level could feel unfamiliar. Of course, if it is unpleasant or makes you drowsy you should reduce the dosage or stop taking the supplement."

What side effects are possible?

Generally, people do not react exactly the same to supplements and medicines. Though most people do not get side effects from thiamine and magnesium it could happen - perhaps because of an allergy to the supplement - and should these occur you should obviously either reduce the intake or cease it altogether. Dr. Schwartz says that should these occur, it could also help to switch brands, as some products contain additives that may cause allergic reactions.

In rare cases a severe allergic reaction to thiamine requiring emergency medical help may include difficulty in breathing or a tight feeling in the throat, swelling of the face, lips, tongue or throat, chest pain, blue-coloured lips, black / bloody / tarry stools, coughing up blood or vomit that looks like coffee grounds. Less serious side effects may include dizziness, nausea, sweating or feeling warm, a mild rash, hives or itching, chapped lips, dry mouth or restlessness. This is not a complete list of side effects.

If the daily 300 mg of thiamine HCL results in minor side effects, Dr. Schwartz recommends reducing the dosage to 100 mg per day (50 mg with breakfast and 50 mg after dinner) and then reviewing the situation.

In 1998, researchers at the Ohio State University in the US cautioned that vitamin B1, which is usually given in excess to many cancer patients, should be carefully regulated for people undergoing cancer therapy. They FOUND that too much thiamine could actually help tumours grow. In the US, the government-recommended daily intake of thiamine for males is only 1.4 mg, while for females it is as little as 1.0 mg., and these amounts are easily reached through a normal Western diet. 300 mg substantially exceeds this recommendation, which is one reason why you should, in consultation with your doctor, balance the potential benefits with the potential risks of taking additional thiamine pills.

Possible side effects from thiamine hydrochloride (HCL): some readers of this blog have reported hives / itchy skin; dizziness; panic; slight depression; lethargy; drowsiness; loss of appetite; increased appetite; increased stuttering (which could be due to an allergy to thiamine HCL or to an additive within the thiamine tablet / capsule); and acidity. For more information you can google "thiamine HCL side effects", then select a reputable website for details.

Possible side effects from magnesium: some readers of this blog have reported diarrhea and tiredness. For more information you can google "magnesium side effects", then select a reputable website for details. For a list of medicines that may interact with magnesium, please read this.

Isn't 300 mg per day of thiamine HCL too much? On the thiamine container which I bought, it says that the therapeutic dosage is 25 mg to 100 mg daily.

300 mg is certainly much higher than the recommended daily allowance (RDA) for thiamine in the US, which is only 1.4 mg for males, and 1.0 mg for females - and these small amounts are easily reached through a normal Western diet. But keep in mind that people who stutter, or at least some of them, may have a particular thiamine deficiency which feeds the disorder. It may be that people who stutter may have a greater need for thiamine than the rest of the population. Also keep in mind that thiamine HCL is water soluble, which means that any surplus is excreted through the urine so that it cannot cause harm.

25 to 100 mg of thiamine daily is sometimes prescribed by doctors where the patient suffers from beri-beri, or lacks sufficient thiamine.

Thiamine HCL is not available in my country. What should I do?

You can order it from the internet. Use a reputable, reliable, well-known dealer such as Amazon.

What brand of supplements should I choose?

Normally I don't allow advertising or the mentioning of specific brands on this blog, but Dr. Schwartz has stated that he likes the Solgar brand of thiamine HCL in the 100 mg format, as the Solgar brand is known for the purity and lack of additives of its products.

300 mg of thiamine per day has not improved my speech. Will it benefit my fluency if I increase the dosage? Would such a higher dosage be dangerous?

Dr Martin F. Schwartz is currently conducting a trial with subjects who have not benefited from 300 mg of thiamine and who are now taking a higher dosage. The results of this test will be announced when available. One person - Thomas D. Kehoe, a well-known expert on stuttering - reported in June 2013 that, after being made aware by Dr Schwartz of the 1951 Hale trial, he has achieved excellent fluency himself after taking 900 mg of thiamine daily together with the recommended dosage of magnesium orotate. Read the relevant blog here. 

Risks: Though the body gets rid of excess thiamine HCL in the urine and though the US Food and Drug Administration has found that even very large dosages of thiamine HCL are normally not detrimental, you should definitely first consult your doctor before experimenting with thiamine HCL, expecially when exceeding the recommended 300 mg per day, because people with certain medical conditions should not take certain supplements or vitamins, also because these may interact with medications which you may already be taking.

A reader of this blog who took 2 000 mg of thiamine HCL per day - far above the recommended dosage of 300 mg - has reported noticeably improved fluency, but also hives (red and sore skin ailment), swollen hands and fingers, and itching. These are well-known, though rare, thiamine side effects, probably caused by a thiamine allergy. 

The thiamine and magnesium only worked for a while, after which the effect wore off. Why?

It could be that unfortunately you are not one of those lucky few for whom it works, and that your initial improvement was due to self-suggestion (self-suggestion and optimism can result in lower base-level tension, so improving speech temporarily).

However it could also be that the sudden fluency caused a psychological relapse. According to Dr Schwartz, sudden fluency is sometimes followed by a subconscious backlash and relapse. This can happen if a person has a strong "stutterer's self-concept". Subconsciously, many people who stutter have a stutterer's self-concept, and sudden fluency "threatens" this self-concept. The self-concept is not accustomed to fluency, and can "rebel" against it. The result is psychological conflict, which is manifested as stress and increased stuttering.

There are no easy answers to this psychological phenomenon. It's a major cause of relapse in stuttering treatment; however, if you suspect that this is the cause of your relapse, note that it takes time for the mind to become used to fluency. "When travelling on the road to improved fluency, take your subconscious mind with you." Counselling and other forms of psychotherapy could help you adjust to improved fluency, and so can stress management. Progress may be a zigzag pattern of two steps forward followed by one step backward, so don't lose hope.

It is important to keep in mind that years or decades of stuttering may have left their psychological mark, even if and when fluency is obtained through the use of supplements. A person who suddenly stops stuttering may have to face psychological challenges resulting from this sudden fluency. There may, for instance, be a remaining fear that the stutter will reappear. If you are in this position, please do not hesitate to contact a relevant expert such as a speech therapist/pathologist or clinical psychologist.

I have definitely found that thiamine and magnesium is helping my fluency.

If the thiamine-magnesium regimen is helping you, PLEASE provide feedback - your comments could help others and could help lay the basis for more research and improved stuttering treatment. So it would be very helpful if you could give relevant information such as your age, how it is helping you and the details of the supplement(s) you are taking. Therefore PLEASE read THIS POST and then provide your feedback below that post as a comment. Thanking you in anticipation!



  1. Vitamin B1 for stuttering was also mentioned in an old healtfood book Eating Right For you that I think was published around 1970. But in that book no mention was made of taking B1 3 times a day and using magnesium with it. And taking it 3 times a day is VERRY inportant.

    Back in 1982 I did try taking it once a day and it realy didn't do much perhaps a 10 to 20 % reduction in blocks for a couple of hours but hardly worth bothering with. But taking it 3 times a week seemed to reduce my blocks about 40% after 2 weeks then I started taking magnesium and after about 6 weeks I was at about a 70% reduction now after about 10 weeks my blocks are reduced about 80% perhaps more I just don't stuter much now.



  2. Yes, that book may have used the findings from the earlier 1951 and rather limited thiamine experiment. I am so glad that thiamine is working for you! Thank you for provided these details, they may help others who are still experimenting with this. Interesting that in your case it took quite some time to kick in fully. It shows that people should give it some time to work, perhaps longer than the current trial period of two weeks. Again, it could be that you are benefiting from a "virtuous circle" where the initial benefits from thiamine are also reducing base-level tension (stress), further improving speech. I have myself found that success in stuttering treatment tends to create new successes, so resulting in a "virtuous circle" (the opposite of a "vicious circle"). Kind regards.

  3. I have stuttered, often times very severely, for all of my life. I am 35 and just discovered the B1 "thing" and started it last week. It may be psychological, but I have noticed a little improvement already. Others who are close to me have said they have noticed a little improvement, too. So I will keep on it and see!

    I am taking a brand of B-1 that contains the following: Thiamin Mononitrate, Calcium Carbonate, Croscarmellose Sodium, Magnesium Stearate.

    I worry about taking things like this. Are any of these dangerous in larger doses? I saw the mention of Thiamin Mononitrate (I wish I had read this blog before going to the pharmacy!) and Magnesium orotate...does magnesium stearate work?

    Thank you so much for posting this! Best wishes!

  4. Dear Anonymous, I am glad that there are initial benefits for you, and I truly hope that it's not the psychological and temporary placebo effect - you will find out soon enough. Do read the rest of the FAQ, particularly the recommended diet, as some foods can negate the thiamine effect. Particularly stop taking any caffeine-containing drinks such as ordinary tea and coffee during the trial period. I am not a pharmacist, but I don't think you should worry too much about the exact type of thiamine or magnesium, though if the current things you are taking don't work, you could try other versions such as thiamine HCL and magnesium orotate. Remember that these are not medicines, they are dietary food supplements. If the risk factor was high, a doctor's prescription would have been necessary - these are over-the-counter supplements. All this is still very experimental and much is still unclear, but it does seem that some people are helped much by thiamine. Best of luck!


  5. Hi,
    I'm looking forward to give this a try.
    Can you just confirm to me that we need to take 100 mg thiamine HCL three times a day?

    I'm having hard times tryng to find such an high dosage pill.
    Could you give me some trademarks names ?


  6. Oops, please delete my previous reply. Yes, 100 mg of thiamine three times a day, so a total of 300 mg per day. Please read the WHOLE of the FAQ, as it contains more important info - for some people it's best to combine it with magnesium, for increased absorption. You also have to go on a pro-thiamine diet during the test period of two weeks. Though thiamine HCL is the recommended version, one person I know uses thiamine mononitrate with a lot of success. I don't like to advertise specific brands on this site, but Dr Martin Schwartz who did the research has recommended Solgar thiamine HCL 100 mg pills, and for magnesium orotate he likes the Advanced Research product consisting of 500 mg pills.

  7. Thanks for your help.
    I ordered it online I hope it is shipped soon.
    I' will try only thiamine for the moment to see if it has any effects on me.

    One more question I would like you to answer if I'm not abusing your patience.

    Last week I've just started trying st john wort-valerian root combo with little or no succes at all, do you think I should stop this combo while on thiamine supplements ?


  8. I hope that you are one of the lucky ones who are helped significantly by thiamine. Regarding the st. John's wart - I am not really qualified to answer your question, but my common sense tells me that it would be better to stop the st. John's wart and the valerian, in order to give the thiamine a chance to do its thing without any possible interaction from other substances. The trial period is two weeks in which to try the thiamine. Best of luck.

  9. Hi, i stutter, my father does and my grandfather did. I have a six years old child and he stutters a lot. I want to try thiamine with my son.
    My stuttering is so slight that I would not find a difference. I´m from Argentina but i have been in USA last week and i bought thiamine by Douglas Laboratories. I´m worried because it´s not Solgar brand that Dr. Schwartz recommends. Do you know that laboratory? Yesterday, i had the OK from his pediatrician to start with b1 and magnesium for two weeks.
    I have several son weights 44 pounds. Is 50 mg of b1 the correct dosis?
    Do i start with only b1 for two weeks and then add magnesium ? (Magnesium glycinate) or do i start with both?
    I really have a hope with this. Thank you.

    1. Hi Silvana, actually your guess is as good as mine. But the Douglas Labs product seems to be OK, as long as it is not the benfotiamine version which they also sell and which is not what we want; I see that they do sell the B1 HCL in the 100 mg per tablet version so if that's the one you bought then you can try it. (I also use B1 which is not the Solgar version and it does make me more relaxed.) Only about a third of people seem to be helped to some extent by the B1 but I hope that your son is one of the lucky ones. 50 or 60 mg per day for your son is in line with Dr Schwartz's recommendation of 60 mg for a 5-year-old of average weight and height. You can break the tablet up in halves so that he gets 30 mg after breakfast and 30 mg after lunch. Actually some people are saying that these dosages are too small to make any difference, and that a larger dose is effective, but that would exceed Dr Schwartz's recommendation. There's some uncertainty on whether we should start with them both, or add the magnesium later. In Dr Schwartz's latest writing on this he mentioned that the two should be taken together, so maybe it's best to take them together from the start. Also remember to try and keep to the recommended diet during the test period - minimize the intake of sweets, sugars, raw seafood such as sushy as these all reduce B1 uptake in the body. Best of luck and I do hope that it helps your son. The effect, if any, is probably just soothing the nervous system and relaxing, but even so that could also improve fluency.

  10. Gracias Peter por tu respuesta. Efectivamente es tiamina hcl en pastillas de 100 mg. Espero que mi hijo pueda ser de los beneficiados. Si esto llegara a funcionar prometo publicarlo en todos lados para ayudar a otros.
    Aqui en Argentina conozco a un hombre que ha intentado con suplemento vitaminico y calcio con su hijo y le ha dado excelentes resultados.
    Muchas gracias !

  11. Thank you Peter for your response. Indeed it is thiamine hcl in tablets of 100 mg. I hope my son can be the beneficiaries. If this were to work I promise to publish it everywhere to help others.
    Here in Argentina I know a man who has tried with vitamin supplement and calcium with his son and has given him excellent results.
    Thank you very much !

    1. Silvana, don't get your hopes up. It seems only a minority of people are helped by this. Just regard it as an experiment. But I hope it will help! However if the B1 and magnesium don't make a difference, don't lose hope. Stuttering is stress-related, and there are ways to reduce speech-related stress for children. Have a look at my short summary of a great book on how to deal with children who stutter:

  12. My son is 6 years old, a very severe stuttering. We started with 50 mg of thiamine in two daily doses and 50 mg of magnesium. There was a slight improvement but no significant changes. Suspending the treatment and the blockages increase a lot. We resumed treatment with 100 mg of thiamine in two daily doses (50 before lunch and 50 before dinner) and 50 mg of magnesium (25mg and 25mg).
    While the repetitions continue, the blockages decreased a lot
    There is a noticeable improvement. Now we are trying to contact in Argentina doctors willing to control my son in his levels of vitamin. As a mother I am afraid to give her such high doses of vitamins but at the same time I notice her more leisurely in her speech and can communicate more comfortably. Almost two months of b1 have passed. The change is not dramatic but it is an important change. He can now say complete sentences without stuttering.

  13. Hi Silvana, I am very pleased that it is helping! Yes, stopping the treatment does seem to make it worse for some - I have myself stopped the B1 several times, and each time my fluency deteriorated markedly. As you say, one has to balance the risks of a high dose of B1 with the risks of stuttering. But as B1 is water-soluble, the risks apparently are minimal or non-existent as any surplus is excreted through the urine. I do hope that the improvement will continue! Keep in mind that as your son gets older, the dosage can be increased. Actually I see that the magnesium RDA for children aged 4 - 8 is 130 mg per day, so you can consider increasing the magnesium dosage now. Also, maybe it's better to give the supplements AFTER lunch and dinner, and not BEFORE? Medicines and supplements are usually taken after or during a meal, as this makes digestion easier. Best of luck and keep us posted on how he is doing!

  14. Do you do periodic analysis to control vitamin levels? I read that too much b1 can lower b6 levels and cause anemia. What dose are you taking?
    I have spoken with stuttering associations to share my experience and completely dismiss this. But I've talked to several doctors and they take it seriously.
    I share something interesting. My son got steroids and your stuttering got really bad. I looked at google the relationship of corticosteroids with stuttering and I came across an article by an Argentinean person, a veterinarian, who has his 22 year old son today and takes vitamin supplements from the age of 6 years. Your stuttering has greatly diminished and if you stop taking them it gets worse. I got in touch with this person, I met him personally, his theory is that with vitamins recomposes myelin sheaths. Here the treatments with speech therapists in children do not see them useful, once a week they play to something slow, it is impossible to see changes with once a week. The associations are very closed to medical discoveries. A pity ... I'll tell you if there is more progress. Thank you!

  15. Silvana, I am not a pharmaceutical expert, but too much of anything can be harmful. But you can have a look at the US Food and Drug Administration's note on overdosing on B1 here: It is not easy to overdose on B1 HCL as any excess is excreted in the urine. Be aware that information on the internet is not foolproof and one should be careful about what and who to believe. I take 300 mg of B1 daily which is what Dr Martin Schwartz recommended. I have known him personally, so I am happy to follow his recommendations - I would not follow any advice on the internet unless I am sure that the source is reputable. I also got the green light from my own doctor before going on the B1 regimen. Please read the FAQ above for more information on the risks of overdosing on B1.

    Most stuttering associations and speech therapists are unaware about the benefits, if any, of B1 and magnesium. They are behind the times, as some people do find these supplements helpful - check out the opinion polls and comments on this website (there is a special post on this site which collects positive results - see the comments under the post titled "Please give feedback on thiamine treatment"). Personally, however, I would not rely on supplements alone. I also use fluency techniques; the B1 and magnesium just make it easier to use such techniques.

    I have anecdotally heard that some people benefit from other vitamin regimens, but the information and evidence is scarce.

    I do hope that your son will continue to improve. If this is unfortunately not the case, he should stop taking the supplements unless they have other benefits as recommended by your doctor. Best of luck!

  16. Wow is just the simple word that may explain that how much I liked it. It was nicely stuffed with the material I was looking for. It is great to be here though by chance.

  17. Hi Peter. There is a newly published journal stating that Baclofen, treatment for alcohol withdrawal and muscle spasm, can greatly reduce or even eliminate stuttering. What are your comments about this?

    1. Hi Martin - I am not a medical person nor a pharmaceutical expert, but I do know that many, many drugs / medicines can reduce stuttering. Anything that anesthetizes the central nervous system will reduce stress and therefore will also reduce stuttering. People have told me that even some over-the-counter painkillers and flu medicines improve their fluency as these medicines make one drowsy. It's the drowsiness that results in improved fluency for some people because it anesthetizes the "mental scanner" with which people anticipate feared words or sounds. These medicines have the effect that people just "don't care" anymore, so that stress and tension drop. The problem with such drugs is that they usually have unwanted side effects that can impact negatively on overall health. It's no use if one takes such a drug for stuttering which then causes other health problems. Also it can be a drawback to feel drowsy due to the drug. Also such drugs only "work" as long as the drug is in the body, meaning that they can lead to addiction (whether physiologically or psychologically). The history of chemical treatment for stuttering is a long one, and many drugs have been tried, only to be found wanting. I don't know much about Baclofen but one will have to look carefully for any side effects, particularly long-term side effects. Personally I don't think that chemical treatment for stuttering is the solution because of the downsides mentioned above. IMO stuttering is a "mindbody" (psycho-physical) issue and requires a mindbody solution consisting of both psychotherapy and fluency techniques. In my recent posts you will find more details about my most recent thinking about stuttering treatment. All the best!

  18. Hey thanks for these information, I wanted to ask few questions regarding this regimen.
    Before I ask you, I've read the entire faq and understood the Role of every supplements you mention, my question is essentially silly but I need to clear it off.

    I bought vitamin b1 off Amazon (imported but Amazon saved me alot because it was on offer price), but I can't import magnesium tablet as it is too costly to import while brands in my country are not reputable nor do I trust them.

    So arriving at the actual question, can I take vitamin b1 tablets but consume magnesium from natural whole foods instead? Like for example, 4 tbsp of peanut butter carries around 200mg of magnesium. I can totally manage to get around 400 with whole foods. That should be same as taking a magnesium tablet right?

    I really hope you answer this question, as it'll help me loads.

    Thanks in advance.

    1. Hello Anonymous, I am not a dietician but logically it should be OK to get the 400 mg from a natural diet. Keep in mind that the function of the magnesium is primarily to support the absorbing of the B1, though magnesium generally is also a muscle relaxant. But ... don't get your hopes up too much, as this is not a miracle cure, and the temporary placebo effect is also a big factor. Personally I think that the B1, and the magnesium, help to relax and soothe the nervous system, so indirectly it may improve fluency for some people. But best wishes and I hope you find it helpful!

    2. Yeah. I can see the possible correlation as well.
      But for me, ever since I started taking magnesium headaches started irk me. Like you said in one of the above comments, it maybe down to the brand of magnesium I'm taking. I have a Hobson's choice when it comes to magnesium brands, so only way for me is to resorting to seek magnesium through regular diet. Thanks for clearing my doubt, and yes magnesium did calm me down but price I had to pay was expensive in the form of irksome headaches.

  19. Good day, I have been on the B1 and Magnesium for a few months now, started taking them early in 2019. My stuttering has improved so much, by 70%, that I do not even think about stuttering anymore. There was once a time where I forgot to renew the pills and I was not on them for a few weeks, then I noticed I stuttered badly again. Then I went on them again and the stuttering got better like before. Currently I am taking B1 200mg three times with the magnesium only once a day. I am planning on reducing it to 100mg three times a day and will see if there is big difference in my speech. Thank you for providing this information as it has really changed my life, to be able to say what I want to say and how I want to say it.

    1. Hey Anonymous, this is great! I am glad that it is helping you! Quite a hefty dose of B1 you are taking; did you get your doctor's OK for it? You might also be interested in reading Thomas David Kehoe's article on the Casa Futura website here: Mr Kehoe now takes 600 mg of B1 daily and 700 mg of magnesium daily. Could you do me a favor? If B1 is helping you, would you mind placing your message in the following section of this blog, or else answer the questions asked there. It would help others!

  20. can I give L-theanine 25mg + Magnesium 50mg + 25mg B1 all together in a single dosage to my 9years old kid, 2 times a day ?

    1. This is a question you should really ask your doctor or pharmacist.

  21. did anybody notice high dosage DHA e.g. 2000- 5000mg per day work on stuttering ?

    1. I am not sure what you mean by "DHA" but if you refer to thiamine you should ask this question in the Casa Futura website of Thomas David Kehoe, as he has experimented with large dosages of B1. His website is at But note that it is a health principle that anything taken in huge amounts can be detrimental to health. Theoretically the excess B1 will be excreted (if it is B1 HCL) but even so it can stress the body to excrete such large amounts. You should definitely ask a doctor or pharmacist before using such large dosages.

  22. This is interesting! My son, 9 years old stutters since he was 4. We did a lot of things that helped for a while, like homeopathy and Bach remedies but the stutter remains and gets worse from time to time. We used to think it was phycological. But a friend suggested to me to give him magnesium and it really helped a lot and almost immediately! Just one capsule per day! I was amazed and started to read about the connection and I found this article. So I ordered B1 to see if it os going to help even more. Thanks for all this information!

    1. Hi Veronica, these days I suspect that stuttering is psychosomatic (mind-body) - engendered in the mind and tension-related but manifesting in the body such as the speech organs. I just wrote a new book about it as you will see in my latest post. Anyway, I'm glad that magnesium helps your son! Magnesium is a well-known anti-stress agent and is a muscle relaxant. Doctors prescribe it for muscle cramps. In the context of the Thiamin Protocol, magnesium has a double positive effect: it not only relaxes, but also stimulates the absorption of the B1, as B1 normally is not easily absorbed by the body. I hope that the B1 will bring even better results for your son! Best wishes.

    2. Thank you! I 'll let you know how it will go.

  23. Does thiamine really get rid of stuttering?

    1. I would not say that it gets rid of stuttering, but some people have found it quite helpful and even dramatically helpful. Definitely NOT everybody benefits, unfortunately. It probably reduces stress somewhat or has some other positive effect for some. The B vitamins are generally supposed to boost the nervous system, so it might counter stress to some extent and thereby also improve fluency.

  24. Magnesium is too costly for me, but I've found a solution.
    How about I try 200 mg of thiamine and 250mg of magnesium? That way I can order the tablet that has high count and try to reduce the overall cost.
    Note: from November I've tried just the vitamin b1 and I think it really has helped me. Atleast a little.
    Oh and I also take one B-complex tablet daily which has 35mg elemental magnesium.
    I'd really appreciate it if you replied.

    1. Hey Anonymous, I'm not a pharmaceutical expert, I'm just a blogger but from what I know your plan seems like a good idea. I hope it helps you. B1 seems to have a relaxing effect and therefore may improve fluency. Personally I have switched over to a mind-body strategy (see the latest of my posts) combined with the Passive Airflow Technique, and this combination works very well for me. Anyway, best of luck!

    2. Okay, I'll check out.
      Appreciate the reply.

  25. Dear Mr.Louw:
    I am from China and my English is not good, so I can only communicate with you through Google Translate. I am very sorry for that! Hope you can understand what I said.

    I watched your and Dr.Schwartz's teaching videos on your blog, It was very helpful to me, Thank you very much! But there is a problem that has been bothering me, I have never understood the characteristics of "fluttering". I repeatedly listened to the sound of correct and wrong airflow in your third lesson, but still did not recognize the "fluttering".

    So when I was practicing, I couldn't judge whether my airflow was correct. Could you please explain the following "fluttering" again?

    Thank you very much!

    1. Hello WangSY, the "flutter" is just the characteristic sound picked up by a cheap microphone when passive air hits the microphone. You will sometimes hear the same sound effect on the radio when a speaker's mouth is too close to the microphone. Most modern microphones have filters so that this noise is cancelled out, but for our purposes it is useful. I have recorded the flutter at other places; I made a podcast where it can also be heard - you will also find it in this blog under the title "Listen to my podcast!" I hope that this will help! You may also want to buy the type of microphone which works well for this purpose. Mine is a Foxxray Echo USB Gaming Microphone With Stand, manufactured in China. I recently also made another video demonstrating it in Facebook. If you have trouble, let me know and I will give you details of this later video. The main point to remember is that this passive airflow has to be VERY faint and slight and short, not long and pushed. The air has to "drift" out of the lips, like a sigh. Best wishes!

    2. Oops, it seems that that link to my podcast has disappeared. But if you have access to Facebook, you will find a later video from me in which I also demonstrated the "flutter" with the airflow. It is in the Facebook page titled "The Passive Airflow Approach to Stuttering". Here is the link:

    3. And now the link to the podcast has miraculously appeared again! Sometimes the internet doesn't make sense ...