The cost of treating Sepsis and COVID symptoms is immense when you add in the factors.
There is initially the cost of antibiotics which could be lowered if there was a quicker recovery, often there may be a need for infusion of antibiotics which adds to equipment cost.
The intensive care involves staff and equipment.
Oxygen therapy involves the use of oxygen and all the equipment, some of which is plastic tubing and masks which are all single use to prevent infection.
Surgery cost is expensive and requires more time in hospital to heal.
From the NHS….
‘You should get antibiotics within 1 hour of arriving at hospital… treatment in an intensive care unit…. a machine to help you breathe (ventilator)… surgery to remove areas of infection.’
In this article I will address the need for Thiamine or Vitamin B1 to prevent lactic acidosis and hypoxia, and Nicotinamide or Vitamin B3 to prevent hypoxia and immune failure in sepsis.
Both Vitamins B1 and B3 have remarkable properties to help breathing.
I discovered myself that B1 prevents asthma and psoriasis, and B3 stops asthma.
After decades of asthma about 5 years ago I started using 2 x 500mg tablets of B3 with food taken in the morning and evening to completely stop all asthma symptoms.
B3 at those doses can be too much of an upper but works well on breathing.
Later I tried B1 for psoriasis and found around 300mg of B1 twice a day worked for psoriasis but also helped breathing, so the dose of I take of B3 now is down to 300mg in the morning.
300mg of B1 and 300mg of B3 are not overly high doses and anyone trying this themselves may be surprised at the breathing effects within an hour of ingestion.
Always take them with meals.
Vitamin B6 should also be added in a dose of 100mg a day to absorb iron into our red blood cells and prevent pathogens from using our iron to replicate, this applies to infections and sepsis.
Vitamin B6 therefore should be a mainstay of antibiotic treatment to make antibiotics work.
That needs an entire article on iron and infections which I will do elsewhere.
From these studies below treating Sepsis and COVID could be resolved or symptoms vastly improved with doses of around 300mg of B1 and 300mg of B3 twice a day.
Sepsis and Acidosis/Hypoxia
Lactic acidosis is often accompanied by hypoxia but not always, the main thing to note is that thiamine can be used in adequate doses to lower lactic acid and improve oxygen levels.
Presently the use of thiamine for reducing acidosis in a hospital setting seems to be ignored and overlooked.
‘Metabolic acidosis is frequently found in patients with severe sepsis.’
‘Fall in lactate levels over the first 5 days of admission is a good prognostic marker of survival. Evolution of the blood gas profile over time suggests that a fall in lactate levels and a rise in bicarbonate levels correlate with a better outcome.’
A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting
We see this acidosis and hypoxia relationship in COVID patients as well.
‘Hypoxia and acidosis mutually reinforce each other according to the principle of a vicious cycle (that is, they are involved in a system of positive feedbacks). Elevated blood lactate (lactic acid) levels are associated with poor clinical outcomes in COVID patients.’
The Role of Acidosis in the Pathogenesis of Severe Forms of COVID-19
‘The Use of Sodium Bicarbonate in the Treatment of Acidosis in Sepsis’ is one way to lower acidosis but raising sodium levels can be problematic in patients with high blood pressure.
‘‘hypernatremia or hypervolemia commonly associated with bicarbonate infusion’
Sodium bicarbonate also involves infusion which requires the equipment, inserting cannulas, tubes, drip machines and time taken to set it all up and monitor the outcomes.
From these case studies a guide to dosage is indicated.
This is why I suggest 2 to 3 doses of 300mg of thiamine or B1 orally as it works and does not require IV use.
‘She was started on IV thiamine supplementation 200 mg every eight hours’
Treatment of Refractory Lactic Acidosis With Thiamine Administration in a Non-alcoholic Patient
‘After administration of 300 mg of intravenous thiamine, hyperlactatemia normalized rapidly’ Severe lactic acidosis reversed by thiamine within 24 hours
‘While the patient was treated with a standard dose of thiamine 100 mg on admission, this proved insufficient to fulfill this patient’s metabolic needs. High-dose thiamine, while not indicated in every patient with chronic alcohol use, should be considered as a treatment for persistent hyperlactatemia. After a 500-mg dose of thiamine, the patient’s lactate began to trend downward, with the hyperlactatemia eventually resolving.’
‘Bottom line
Thiamine deficiency can cause production of lactate by shunting glycolysis away from aerobic metabolism. In some situations, high-dose thiamine replacement is necessary to normalize lactate levels.’
How Does Thiamine Deficiency Result in an Elevated Lactate?
Thiamine may not resolve problems with septic shock but the cost is so small to put into use that thiamine should be part of mainstay co-therapy.
The cost of one ‘over the counter’ 100mg B1 tablet is 5 pence.
If there were 3 daily doses of 300mg B1 with meals that becomes 45 pence a day to treat Sepsis, Hypoxia and COVID, 600mg of B1 daily is 30 pence.
‘Finally, early thiamine supplementation in doses from 100 to 300 mg/day for 3 days was safe for critical patients and at low risk of adverse events. Therefore, at this time, we suggest that it might be interesting to broadly supplement thiamine for all patients with septic shock. ‘
Thiamine as a metabolic resuscitator in septic shock: one size does not fit all
The dose of B1 in this study to improve oxygen intake was 200mg.
A good case study here.
‘Here, we describe the case of a young patient admitted to a West African hospital where Thiamine Deficiency is not well documented and diagnosed with severe pneumonia who responded dramatically to thiamine injection.’
Acute respiratory failure in an infant and thiamine deficiency in West Africa: a case report
Thiamine loss has an effect on inducing hypoxia and causing neurotoxicity as well.
It was this study below that made me try Vitamin B1 to see if it stopped psoriasis?
The main reasoning for me was anything that reduces Th17 t-cells is going to stop the same immune reaction that happens with psoriasis.
I can say without a doubt taking 300mg of B1 two to three times a day has amazing effects on preventing psoriasis, this could also help ‘arthritis, multiple sclerosis, inflammatory bowel disease and asthma’ by lowering Th17.
And again this study found using Thiamine stopped the COVID cytokine storm and neurological problems at the same time. I love the title.
‘Thiamine, a very safe drug even at very high doses, could be repurposed for treating the Th17 mediated IL-17 immune storm, and the subsequent neurological symptoms observed in COVID-19.’
The dosage mentioned is here. ‘In humans, a range of 79–474 mg daily of thiamine was estimated to be effective and safe as an intervention for the COVID-19 cytokine storm.’
This study says it all…
Do not forget to give thiamine to your septic shock patient!
Vitamin B3 or Nicotinamide and Prevention of Sepsis and Hypoxia.
Again I cannot emphasise how much Vitamin B3/Nicotinamide can help breathing and is even more effective with Vitamin B1/Thiamine.
If you have suffered asthma for years experiment with low doses first and see if it works.
I will leave the COVID studies at the end.
A swathe of studies show Nicotinamide Riboside and Nicotinamide Mononucleotide may be better forms of Vitamin B3 to use for sepsis.
I would like to see any of this put into use so will summarise Nicotinamide by itself.
The dose of 300mg of B3 twice a day is effective and not likely to cause side effects.
‘Nicotinamide has a wide range of cytoprotective effects. A large number of studies have shown that nicotinamide can play an important role in infection and sepsis by repairing mitochondrial function to restore adenosine triphosphate (ATP) level, inhibiting poly (ADP-ribose) polymerase (PARP) activation, inhibiting proinflammatory mediators and antioxidant damage.’
Progress of nicotinamide in preventing infection and sepsis
One of the possible problems in sepsis is a failure of our white blood cells or macrophages to respond to infection.
In patients who have low Nicotinamide, or low Tryptophan to make Nicotinamide for their NAD+ energy needs, an enzyme called IDO rises to convert Tryptophan to Nicotinamide.
The effect of indoleamine 2,3‐dioxygenase on macrophages (white blood cells) dealing with infection leads to immune failure.
Enhanced Indoleamine 2,3-Dioxygenase Activity in Patients with Severe Sepsis and Septic Shock
Summarised well here…
‘A key enzyme upregulated in alternatively activated macrophages is indoleamine 2,3‐dioxygenase, which converts tryptophan to kynurenine for de novo synthesis of nicotinamide. Nicotinamide can be used to replenish cellular NAD+ supplies. We hypothesize that an insufficient cellular NAD+ supply is the root cause of metabolic shifts in macrophages. We assert that manipulation of nicotinamide pathways may correct deleterious immune responses. We propose evaluation of nicotinamide (Vitamin B3) and analogues, including isoniazid, nicotinamide mononucleotide and nicotinamide riboside, as potential therapy for infectious causes of sepsis, including COVID‐19.’
Low protein diets and low Tryptophan can also be a problem as that will lower Nicotinamide levels.
‘Compared with the healthy controls, the patients with septic shock had 2-fold to 3-fold lower total tryptophan levels throughout the 14-day study period. Platelet serotonin was substantially lower…’
‘Platelet serotonin was substantially lower’ is why I think adding 100mg of Vitamin B6 is needed as well as B6 is like a cheap and effective SSRI which raises serotonin levels.
‘Vitamin B6 (Pyridoxine) has a significant and selective modulatory impact on central serotonin and GABA production ‘
Vitamin B6: A new approach to lowering anxiety, and depression?
I will also write the need for Vitamin B6 to divert iron from pathogens in another article on Iron and Infections.
100mg of B6 is the safe dose, you never take more than 200mg a day of B6.
I have an article here that goes into the mechanisms of IDO enzymes especially with cancer.
Macrophage Polarization and IDO Enzymes, Immunity, Cancer and Depression
Nicotinamide or Vitamin B3 for COVID.
I have been mumbling about using vitamin B3 for COVID even before lockdowns were introduced because of course I was already using Vitamin B3 for asthma.
For years I worked in Woolworths supermarkets in Australia where they sold Vitamin B3 in a massive dose of 500mg tablets, these were impossible to break unless you had iron hands and they had you snorting air an hour later like a strong cup of coffee can do.
But I did what I called ‘30 second consults’ with customers when I noticed them breathing heavily and invariably if they tried my suggestion of taking vitamin B3 they came back for more from the medicine aisle.
So here are a few mentions of Nicotinamide that the ‘pandemic response’ failed to notice and still fail to notice.
These are shown in date order, I was first talking about using B3 in March 2020 and generally got abused for trying to help.
“It is important to mention that various studies have shown that in animal models with bleomycin-induced lung injury, vitamin B3 (niacin or nicotinamide) is highly effective in preventing lung tissue damage. It might be a wise approach to supply this food supplement to the COVID-19 patients.” Mar 2020
COVID-19 infection: the perspectives on immune responses.
This is stating the similar loss of NAD+ that occurs in sepsis.
“CoV infection also induces a severe attack on host cell NAD. Overexpression of one induced enzyme, PARP10, is sufficient to depress host NAD. Gene expression and pharmacological data suggest that boosting NAD through the nicotinamide and nicotinamide riboside kinase pathways may restore antiviral PARP functions to support innate immunity to CoVs…”
Niacin is another form of Vitamin B3…
‘Definitive antiviral properties are evidenced for niacin, i.e., nicotinic acid (NA), as coronavirus disease 2019 (COVID-19) therapy for both health restoration and prevention, to the level that progression of COVID-19 pathology may follow as an intrinsic function of NA supply. This detailed investigation proposes thorough disentanglement of how the downstream inflammatory propagation of ensuing severe acute respiratory virus 2 (SARS-CoV-2) infection can either be prohibited or reversed upstream out the body to expeditiously restore health with well-tolerated dynamic supplementation of sufficient NA (i.e., ~1-3 grams per day). Culmination of this research leads to realization of the potentially ubiquitous therapeutic and preventive powers of NA against inflammatory disease, in general.’
Sufficient Niacin Supply: The Missing Puzzle Piece to COVID-19, and beyond?Jan 2021
COVID-19: Are We Facing Secondary Pellagra Which Cannot Simply Be Cured by Vitamin B3? Apr 2022
‘FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, September 20, 2022
NIACIN for COVID
How niacin, niacinamide, and NAD can help with Long COVID-19
The cost of using Nicotinamide or Vitamin B3 in a daily dose of 2 x 300mg is very low.
The ‘over the counter’ cost for 600mg of B3 tablets is 20 pence.
NAD+ loss is also part of long COVID and now has passed into mainstream therapy.
The cost of using NAD+ described below is running into hundreds of pounds though, when the cheap and easily available addition of Vitamin B3 could be part of home treatment well before getting sick or reaching hospital.
‘The NAD+ intravenous drip
Speaking of quick fixes… One of the biggest things that helped me was the NAD+ IV drip. NAD, which stands for ‘Nicotinamide Adenine Dinucleotide’, is a coenzyme that influences key cellular functions, including metabolic pathways, DNA repair, chromatin remodelling and immune cell function.
“NAD+ is thought to give cells the energy to successfully metabolically function, thus hopefully making long Covid patients feel better. This drip has proved popular with those struggling with brain fog, low energy, poor concentration, mood disorders, and more,” explains Dr Matthew Calcasola, Chief Medical Officer a Get A Drip.
I first forayed into NAD+ with Dr Vali, whose clinic is in a futuristic looking egg on the second floor of Selfridges. Her team of nurses brings you in for consultation, then intravenously administer 1500mgs of NAD+ in stages, incrementally increasing the dosage over three days. It’s a strange sensation and, if rushed, can cause nausea and dizziness, but the team at Dr Vali are pros.
Within the first day I felt energy come back to me. I went from being able to walk no more than 15 minutes at a time to strolling for two hours. I felt happier, my brain fog completely lifted, and I felt the urge to exercise (something chronic fatigue sufferers will know is rarely appealing). This feeling lasted around three months, dwindling as time went on.
Prices for this full dose at Dr Vali’s costs £1,688. There are more affordable and convenient options on the market – Get A Drip, which offers a standard dose of 500mg for £400, can be found in London shopping centres and offer home visits – but I have found smaller doses to be less effective.’
If you’re suffering from long Covid, these six things could help you healDec 2023
NAD loss in COVID patients was noticed at the end of 2020 and could have been prevented with 20 pence of spending on Vitamin B3 a day.
This is a good reason below to also use Vitamin B1.
‘Diabetes
For individuals with Type 1 or Type 2 diabetes, plasma thiamine was estimated to be ~76% lower than in non-diabetic controls in one study. In another, frank deficiency was found in 98% of the study population using plasma and urine samples’
Hiding in Plain Sight: Modern Thiamine Deficiency
3 daily doses of 300mg of B1 with meals is 45 pence
2 Daily doses of 300mg of B3 with food is 20 pence.
One response to “Vitamins B1 and B3 Would Save Millions Spent on Sepsis, Hypoxia and COVID”
Thanks for the article Cal. This is a good mix of personal experience with research and the application to long Covid shows promise.