SULBUTIAMINE

What is sulbutiamine?

Sulbutiamine is a manmade version of vitamin B1. It was developed in Japan in the 1960s to treat beriberi, which is vitamin B1 deficiency [^[1]]. It is known mainly for its effects on cognition and fatigue.

What does sulbutiamine do in the body?

Sulbutiamine is widely used in endurance sports for its anti-fatigue, cognitive enhancement, and antioxidant effects. It can also have neuroprotective effects [^[1]]. Sulbutiamine is used in medicine to treat fatigue, thiamine deficiency, and concentration difficulties. The supplement improves brain function regarding memory, concentration, and mood. In rodent studies, sulbutiamine modulates acetylcholine activity in the hippocampus. Sulbutiamine exerts anti-oxidant and anti-apoptotic properties, which can prevent cells from dying due to oxidative damage. Medical applications of sulbutiamine outside of cognitive enhancement and fatigue include depression, diabetes polyneuropathy, and erectile dysfunction. Sulbutiamine may also be an anti-cancer supplement, as its analog, thiamine, is [^[2]].

How can sulbutiamine help alleviate certain Long COVID symptoms and/or pathophysiology? 

Sulbutiamine is known for its anti-fatigue effects in healthy populations and those suffering from various diseases [^[3]]. Sulbutiamine could be used to reduce fatigue in Long COVID alongside other treatments. In patients with multiple sclerosis, sulbutiamine, supplemented alongside disease-modifying treatment, reduced fatigue symptoms [^[4]]. Therefore, sulbutiamine may have particularly restorative and/or regenerative activities relevant to the central nervous system. COVID long-haulers suffer from cognitive issues and debilitating “brain fog” as well as both physical and mental exhaustion, so sulbutiamine could be a way to improve those symptoms via supplementation.

Lastly, as sulbutiamine was developed as a replacement for vitamin B1 or thiamine, the same effects seen for Long COVID with thiamine may generally apply for sulbutiamine, though this hypothesis needs further testing. Thiamine can help reduce inflammation in Long COVID and, in one study, reduced the neurological burden of Long COVID patients [^[5]].