I read the response of Dr. Nibber to my original letter (Townsend Letter August/September 2004) with interest. Both my letter and the response raise some important issues that go beyond the mere fact of whether blood concentrations are increased by any one of the many thiamine derivatives. The most important of these issues is which one of these derivatives has the best therapeutic record. Readers that may not be familiar with the obscure literature on this subject should be aware that the original biochemical research was carried out in Japan in mid-20th century. These investigators performed detailed biochemical studies and tested the clinical effects of many thiamine derivatives in animal and human subjects. This resulted finally in the choice of thiamine tetrahydrofurfuryl disulfide (TTFD) as the best one for clinical use and it has been marketed for years as Alinamin F (Odorless). It is made by Takeda Chemical Industries in Osaka, Japan. Its patent expired years ago but it has never been picked up for manufacture in the USA because it is generally regarded as a way of administering thiamine for vitamin deficiency rather than considering its use as an extremely valuable therapeutic agent. It is an orphan drug "looking for a disease to treat." Much of the original work was performed with thiamine propyl disulfide (TPD) that has the same properties as TTFD, but is associated with a powerful garlic odor when metabolized. It was for this reason that TTFD was synthesized since the odor was not associated with its use.
There was a hiatus in research news on the subject until the recent papers from Germany appeared on the superiority of benfotiamine. This derivative, whose chemical name is S-benzoyl thiamine monophosphate (BTMP) is produced commercially as "Ankermann" by Worwag Pharma in Germany who provided financial support for at least one research paper that compared benfotiamine with fursultiamin (TTFD). (1) This work was performed on "seven healthy volunteers between 25 and 49 years" and it should be clear to discerning readers that a statistical analysis for differences in transketolase (the test for intracellular thiamine activity), which the authors claimed, are irrelevant with such numbers, added to the fact that the subjects...
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