Parkinson’s disease (PD) is a progressive neurological disease. Although it may start out with something as simple as a tremor in a single finger, it can progress over the years to complete disability. Its hallmark is the dying off of brain cells that make the neurotransmitter dopamine. Without sufficient dopamine, movement becomes increasingly difficult and finally almost impossible. PD’s non-motor symptoms include anxiety, depression, fatigue, insomnia and other sleep disorders, hallucinations, cognitive impairment and dementia.
Although dopamine replacement and enhancement drugs can control motor symptoms for a while, they don’t reverse or stop the underlying disease process. When these medications lose their effectiveness, a surgery may be done to control symptoms. But again, because the surgery doesn’t address the underlying disease process, it too becomes less effective with time.
However, a novel therapy addresses both symptoms and the disease process.
Italian neurologist Antonio Costantini published several small clinical trials before his unfortunate passing from COVID in 2020 showing that intramuscular injections of megadoses of thiamine (vitamin B1) led to remarkable reversals in Parkinson’s symptoms. In some newly diagnosed PD patients with mild symptoms, Dr. Costantini was able to completely reverse the disease! In patients who had had PD for years, he was able to reverse many long-standing symptoms, allowing them to reduce their medications and lead a much fuller life.
Dr. Costantini, who was a professor at Catholic University in Rome, hypothesized that in PD there is a “focal deficiency” of thiamine in the part of the brain where dopamine-producing brain cells reside. This means that although the patient isn’t deficient in thiamine, a malfunction in the way thiamine is processed in these brain centers creates a local deficiency.
Although he didn't claim that high-dose thiamine (HDT) was a cure—patients must continue it for the rest of their lives—he did claim that it protected the dopamine-producing neurons from further damage so the disease didn’t progress. Most of his patients combine HDT with levodopa (a dopamine replacement drug) to manage motor symptoms; most non-motor symptoms are alleviated with the HDT. Costantini also claimed that HDT prevented the dyskinesias (erratic, uncontrollable movements) associated with levodopa. There are many interesting videos, interviews with patients telling the story of their treatment with Dr. Costantini, available here on U-tube.
His website says the longest he'd had a patient on HDT is 5-1/2 years, but he hadn't observed any significant side effects in that time period. Of the more than 2,500 patients he treated with HDT for PD and other neurological diseases, only one could not tolerate the thiamine—she became too nauseated to continue.
It’s possible to replace injections with oral thiamine supplements, however finding the right dose can be tricky, as this article indicates. There is extensive information on his website about using HDT.
A note on his website about his passing says that colleagues are hoping to raise money for a large-scale clinical trial on HDT through GoFundMe.
- Costantini A. An open-label pilot study with high-dose thiamine in Parkinson’s disease. Neural Regeneration Research. March 2016;11(3): 406-407.
- Costantini A. Long-term treatment with high-dose thiamine in Parkinson disease: An Open-Label Pilot Study. Journal of Alternative and Complementary Medicine. December 2015;21(12): 740-747.
- Costantini A. (2013) High-dose thiamine as initial treatment for Parkinson’s disease. British Medical Journal: Case Reports. August 2013.
- Costantini A. Effects of overdose of high-dose thiamine treatment. Gerontology & Geriatrics Studies. December 2018;4(1):389-390.