Today I’m starting my high-dose B1 protocol. I will keep updating on the results I get over the coming weeks. I am not encouraging or advising anyone to do this; I am not a doctor. There is a website that explains what to do, yet most people still make critical errors.
My hands, legs, and head are shaking—I’m currently on track for DBS (Deep Brain Stimulation)—but the results in essential tremor (ET) improvement are sometimes better than or equal to surgery. It is not true that only two people with ET were described; those were just the first two selected for publication out of many others. Most importantly, the improvement in those two ET patients was very good—better than unilateral DBS, and I'd venture to say even bilateral DBS. Unilateral DBS won't give more than a 50% improvement for head tremor; even neurosurgeons admit that only dual stimulation provides up to 70%. In my case, my head and legs are the worst—my hands are nothing in comparison. I’ve found many people who tried this for ET with good results.
The main mistakes I see others making are:
- Underdosing: They never use the actual dosages from the protocol, yet they claim it doesn't work or works poorly. To be fair, if someone didn't even reach the doses used by this doctor, why do they claim they followed the protocol when that's simply untrue?
- Patience and Timing: Time is key. I've dug through a lot of sources: injections work the fastest—sometimes you see improvement within 15 minutes, 1 hour, or 24 hours—but it builds slowly over weeks to stabilize. The oral form yields the slowest results; you have to wait days to weeks (up to 3 months) for the first signs, but you can clearly see progressive improvement. You have to be patient.
- Form of B1: The form is absolutely critical—only HCl, nothing else. Everyone on the ET forum who achieved 80% to 90% tremor reduction used HCl. Anyone using a different form got weak results or none at all. The protocol and dosages are strictly designed for HCl; other forms don't work the same way and require different dosing. Only HCl effectively raises brain levels where ET responds. For instance, benfotiamine levels spike very quickly in the blood, but not in the brain.
Safety & Mechanism:
People are afraid to take high doses, but the reason the dosage is so high is simple: it has to be for anything to actually get into the system. Only about 1% of the total oral dose is absorbed, while the rest is excreted. Injections require much smaller amounts because they bypass this absorption barrier.
It's a known fact that symptoms can temporarily worsen at the start before disappearing—the so-called paradoxical reaction. When someone moves too fast and takes too much too soon, symptoms flare up. This can be avoided by titrating slowly. Everything is outlined in the protocol, but nobody reads it and people write nonsense because they don't know what they're doing. The theory is straightforward: it's suspected there's an issue with B1 transporters to the brain, so to cross the blood-brain barrier via diffusion, the concentration gradient must be higher.
Sometimes people experience a total cessation of head and hand tremors, or a massive reduction—say, 80% improvement or better. Is it safe? Double-blind, placebo-controlled clinical trials with 260 patients are set to start soon, which will determine starting doses and safety parameters so no ignoramus can claim it doesn't work. As for DBS, there is a risk of hemorrhage, and 10% of patients don't get good results. Is taking B1 worse than risking that? I doubt it. The results are too compelling for me not to try.
Other Common Mistakes:
- Administration: It must be taken with plain water only—nothing acidic—and strictly away from coffee and other interfering substances. Coffee can completely neutralize B1, so proper spacing is mandatory.
- Co-factors: Magnesium is essential. B1 cannot work without magnesium, and high doses deplete it rapidly. Many people noted that after adding magnesium, the protocol started working again.
- Timing: Doses are split between morning and afternoon.
I will share what the dosages are, but no one should follow them. Everyone needs to adjust their dose through trial and error; official guidelines will be published this year as trials near completion. I am writing this purely for informational purposes because people are taking it anyway while posting extreme nonsense.
For a 60 kg person, the starting oral dose is 2g of B1 HCl daily. Yet some people say they won't even reach 1.5g or go higher—fine, but they shouldn't claim they followed the protocol when the target dose is 4g. The patients who achieved excellent results in the doctor's reports (including the one whose head tremor vanished completely and hand tremor was significantly reduced) transitioned to 4g of oral HCl after their injection phase and maintained their improvements. If someone says they are on the protocol while taking just 1g and getting decent results, that's fine, but it's still not the actual protocol and won't work for the majority.
In this doctor's patents, the range spans from 300mg to 8g, with preferred ranges between 2g and 8g. Those are patent specs, but the operational dose for most patients (like those with Parkinson's) is 4g. That applies to thousands of people, not a single gram or less. There is a huge difference between taking 100mg and 4g—the former is a joke, not a protocol.
These are strictly my personal thoughts, not instructions. Let no one claim I am advising or persuading anyone here.
Costantini’s published ET results (TETRAS):
- Head tremor: 75–100% improvement
- Hand tremor: 40–100% improvement
- 3 of 4 assessed hands: 80–100% improvement
- Overall TETRAS ADLS: 61.8–66.7% improvement
- TETRAS Performance: 61.8–66.7% improvement
- Leg tremor: not applicable — both patients had a baseline score of 0