Second in the series on malnutrition syndromes including SAM (severe acute malnutrition), proceeding from a hierarchy of risk factors and high calorie malnutrition caused primarily from poor diet choices or lack of nutrients due to soil depletion. This series also covers kwashiorkor and other forms of malnutrition when even if mild can have profound impact.

Although I began with B12 it would be fitting to begin with B1 also known as the great imitator due to the numerous complications that can arise from this deficiency but in addition it is also known as the gateway vitamin because a deficiency in this vitamin can affect synthesis of all other B vitamins resulting in a cascade of B vitamin deficiencies.

B1 is a cofactor for enzymes involved in carbohydrate metabolism, including transketolase, α-ketoglutarate dehydrogenase, pyruvate dehydrogenase, and branched chain α-keto acid dehydrogenase. These enzymes are involved in the link between glycolysis and the citric acid cycle; the citric acid cycle itself; the pentose-phosphate pathway; that allow for the production of ATP, NADPH, and ribose-5-phosphate which are critical for generating cellular energy and downstream production of amino acids, nucleic acids, and fatty acids. A deficiency in these enzymes can affect B1 status. B1 is also necessary for glutathione production.

Enzymes are bio chemical catalysts. Enzymes are produced in various organs, salivary, pancreatic, small intestine for example. Organisms can also produce enzymes. Foods may also contain enzymes for digestion. Almost all processes in living organisms require some form of enzyme to cause the reactions to occur at a rate sufficient to support life.

Milk is a superfood, time tested and the gold standard for treatment of kwashiorkor, it helps increase levels of B vitamins and absorption and transport of other nutrients. Whole fat mammal milk is one of the best and easiest ways to help combat malnutrition syndromes.

Learn how you can increase B vitamin content in dairy foods with the addition of specific probiotics and by using other fermentation techniques. All of this info can be found throughout the site and in Immune For Life.

Did you know?

LAB and bifidobacteria provide an effective way to increase vitamin levels in milk. Some bacterial strains in the genera Lactobacillus and Bifidobacterium provide an additional source of B vitamins (thiamine, riboflavin, cobalamin, folate, and biotin) during dairy fermentation. Deficiencies in vitamin B2 or vitamin B1 can lead to both liver and skin disorders and alterations in brain glucose metabolism.
All of our B-vitamins (B1, B2, B3, B5, B6, B12, folic acid,and biotin are synthesized in the colon by various strains of Bifidobacteria. Several lactic acid bacteria (LAB) species (e.g., Lactococcus lactis, Lactobacillus gasseri, and Lactobacillus reuteri) and Bifidobacterium (e.g., B. adolescentis) produce B vitamins, often in large quantities and are found in fermented foods. L. reuteri was also found to metabolize glycerol, indicating that a LAB might also be able to make B12. Bifido strains of probiotics have been patented to specifically reduce H2S.

Take 3 FB intro…. nothing ventured, nothing gained. 


Since I could not find current extreme examples of B1 deficiency (beriberi) syndromes for this post I decided to include a general overview and stellar researchers who focus primarily on B1 deficiency, hormones and malnutrition. One is introduced in the first video, Dr. Derrick Lonsdale and the others are from his co-author Dr. Chandler Marrs. While I disagree with calling this deficiency a disease that may have been the choice of the interviewer and Dr. Chandler Marrs is careful to parse distinctions between genetic causes and preventable causes. I think you’ll find all videos helpful. Since I couldn’t find many video featuring Dr. Derrick Lonsdale (age 98) I am including his blog and his book. I also don’t agree with the huge emphasis placed on environment and soil depletion as research has reached a different conclusion regarding dietary only intervention in reversing SAM. Yes, quality nutrient dense food prevents starvation and malnutrition, it does not reverse this core dysfunction, microbiota development. I have fears about the continuation of skirting around the number one risk factor and setting up plausible deniability and I have yet to hear much about microbiota development, colostrum or the utmost importance of breastfeeding. It is hard to distinguish risk factors in this day and age but it is not impossible, it has been done and it very much affects vitamin bio synthesis.

Throughout history vitamin deficiencies are often over looked and in many cases misdiagnosed as other conditions, beri beri is no exception. Malnutrition can’t be alleviated with drugs, can be caused by any chronic drug use and nutrition science isn’t generally taught therefore most remain ignorant of the dangerous effects of malnutrition and consider it to be a thing of the past when in reality malnutrition syndromes are prevalent and present in numerous populations worldwide. These chronic malnutrition syndromes, especially in children have long lasting effects that can be devastating to future health outcomes.

I also think many people are confused about malnutrition symptoms therefore missing the chance to correct them. Most are also not aware of the effects of malnutrition on embryonic development, this includes the effects of birth control induced malnutrition syndromes.

The B-complex vitamins include: 

• B1 (thiamine) breaks down carbohydrates. 

• B2 riboflavin (B2) 

• B3 (niacin and niacinamide) maintains normal cholesterol levels. 

• B6 (pyridoxine) helps calm moods. 

• B12 (cyanocobalamin and hydroxocobalamin) promotes mental sharpness. 

• PABA (biotin, choline, folic acid, pantothenic acid, and para-aminobenzoic acid. B9 (folic acid) helps to maintain healthy gene activity, and it also reduces the risk of cardiovascular diseases. 

• In addition, inositol is often considered a B vitamin.


Vitamin B1 Deficiency

Vitamin B1, also known as thiamine, is an essential micronutrient. It helps the body function by creating energy from food and turning it into fuel for mitochondria. Thiamine is crucial for processing carbohydrates like sugars and starches. A thiamin deficiency can result in several health problems including confusion, seizures, shortness of breath, brain disease, coma, and more.

Food sources of thiamine include whole grains, legumes, and some meats and fish. Grain processing removes much of the thiamine content, so in many countries cereals and flours are enriched with thiamine. Supplements and medications are available to treat and prevent thiamine deficiency and disorders that result from it, including beriberi and Wernicke encephalopathy. Other uses include the treatment of maple syrup urine disease and Leigh syndrome. They are typically taken by mouth, but may also be given by intravenous or intramuscular injection.

Benefits of B1:

  • Thiamin helps prevent complications in the nervous system, brain, muscles, heart, stomach, and intestines.
  • It is also involved in the flow of electrolytes into and out of muscle and nerve cells.
  • It helps prevent beriberi diseases, which involve disorders of the heart, nerves, and digestive system.
  • Thiamine is considered a form of vitamin B that is water-soluble. It helps to convert what you eat and drink into energy or glucose.
  • Thiamine vitamins are necessary for keeping the liver, skin, hair, and eyes healthy. They also play a role in the nervous system and are needed for good brain function.
  • The B vitamins are sometimes called anti-stress vitamins because they boost the body’s immune system during stressful times.


  • Ataxia is a degenerative disease of the nervous system. Many symptoms of Ataxia are similar to those of being drunk, such as slurred speech, stumbling, falling, and poor coordination.
  • Confusion. You may experience the inability to think or reason in a focused, clear manner.
  • Nystagmus. Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements.
  • Irritability. Feelings of frustration or anger, often over seemingly small matters, may occur.
  • Seizure. A seizure is a burst of uncontrolled electrical activity between brain cells (also called neurons or nerve cells) that causes temporary abnormalities in muscle tone or movements (e.g. stiffness, twitching, or limpness).
  • Papilledema. Papilledema is a severe medical condition where the optic nerve at the back of the eye becomes swollen.
  • Tachycardia. This condition results in a rapid heartbeat that may be regular or irregular but is out of proportion to age and exertion or activity level.
  • Mood changes. Mood swings refer to rapid changes in mood. The term may refer to minor or significant mood changes on a daily basis.
  • Edema. More commonly known as swelling, edema is puffiness caused by excess fluid trapped in the body’s tissues.
  • Dyspnea. This condition results in shortness of breath. However, it can have causes that aren’t due to underlying disease.
  • Sensory-Motor Polyneuropathy. This condition is a body-wide (systemic) process that damages nerve cells, nerve fibers, and nerve coverings. Damage to the covering of the nerve cell causes nerve signals to slow or stop.

Well-known disorders caused by thiamine deficiency include beriberi, Wernicke–Korsakoff syndrome, optic neuropathy, Leigh’s disease, African seasonal ataxia (or Nigerian seasonal ataxia), and central pontine myelinolysis.

Who Is at Risk of Vitamin B1 Deficiency?

  • ‌Alcohol intake, use or abuse 
  • Gastric bypass surgery
  • Genetic (inability to absorb thiamine)
  • Kidney disease
  • Poor diet
  • Poor quality food
  • Diabetics
  • Pharmaceutical or drug use (all drugs damage mitochondria and affect B1 status)

Chronic alcoholism is a secondary cause. Also at risk are older adults, persons with HIV/AIDS or diabetes, and persons who have had bariatric surgery. Varying degrees of thiamine deficiency have been associated with the long-term use of high doses of diuretics.


Overall a couple of great videos by Dr. Chandler Marrs that I think viewers will find very informative regarding thiamine. 

This might help you find a Thiamine form that works for you, people react differently and some have a paradoxical reaction. Be aware. As with most nutrition I rely mostly on whole foods and natural supplements like salmon oil for B12, cod liver oil for D etc. to ensure I get all necessary co-factors.

Salmon is an excellent source of B vitamins
Below is the B vitamin content in 3.5 ounces (100 grams) of wild salmon:

• Vitamin B1 (thiamin): 18% of the RDA
• Vitamin B2 (riboflavin): 29% of the
• Vitamin B3 (niacin): 50% of the RDA
Vitamin B5 (pantothenic acid): 19% of
the RDA
• Vitamin B6: 47% of the RDA
• Vitamin B9 (folic acid): 7% of the RDA
• Vitamin B12: 51% of the RDA

Dr. Derrick Lonsdale

Beriberi was a scourge in the East for millennia. It is now known to be due to dietary vitamin B1 (thiamin) deficiency, damaging energy metabolism, chiefly affecting the brain, heart and nervous system. Earlier attempts to find the cause were blocked by a simple observation. Eastern factories were built in blocks with passages between them. In the summer the workers would eat their lunch in the passages. Initially in the shade, the sun would eventually shine on them and several would get their first symptom(s) of beriberi simultaneously, leading to the false conclusion that the disease was caused by an unknown infection. Ultra violet light (UVL) is stressful to the human body, (why tanning is a natural defense). Some of the workers, being “on the dietary edge” of developing beriberi, were stressed by the UVL. Lacking sufficient cellular energy to mount an efficient adaptive response, they were “knocked off their metabolic cliff”, a metaphor for a person succumbing to risk. Both the diet and the exposure to sunlight were risk factors.

A Nutritional Approach to a Revised Model for Medicine: Is Modern Medicine Helping You? 
by Derrick Lonsdale M.D. (Author)

With its expansive empire, boundless wealth, glorious architecture, and advanced military, Rome was the apex of civilization in the ancient world. However during its very height, many of Rome’s leading citizens were inadvertently poisoning themselves with the lead glazing that was widely used in wine containers at the time. Is it possible that today, we are doing the same thing to ourselves with sugar? Could the obesity epidemic, diabetes and the outbreak of a host of other almost completely unrecognized diseases, be the result of our present dietary mayhem? That’s the view expressed in A Nutritional Approach to a Revised Model for Medicine. In this illuminating book, author Derrick Lonsdale M.D. draws attention to the dangers of the prolific ingestion of sugar that is so widespread today. The book cites case reports to illustrate these dangers and to emphasize the ease with which symptoms may be stemmed in the early stages. However the book also makes it clear that if symptoms are left unrecognized and behavior is left unmodified, these same symptoms become less treatable, giving rise to chronic diseases and other serious health problems. About the Author: Derrick Lonsdale M.D. was born in Lancashire, England and earned an MB.BS. at London University. He worked in medical practice for 64 years, eventually retiring at the age of 88. Dr. Lonsdale is a Fellow of the American College for Advancement in Medicine (ACAM), an international professional organization that represents the alternative medicine field. Dr. Lonsdale has written two previous books on the subject of alternative medicine and published over 100 medical papers. Publisher’s website: http://sbpra.com/DerrickLonsdale

Alternavita: All you need to know (critical info in a nutshell)..... by focusing exclusively on these foundational health and immune development issues up to 90% of chronic conditions can be eliminated.

WHO STATEMENTS: 2017 Millennium Goal

  1. Breastfeeding,
  2. food (security)
  3. and water security (sanitation)

are major protective factors against malnutrition and critical factors in the maturation of healthy gut microbiota, characterized by a transient bifidobacterial bloom before a global rise in anaerobes. Early depletion in gut Bifidobacterium longum, a typical maternal probiotic, known to inhibit pathogens, represents the first step in gut microbiota alteration associated with severe acute malnutrition (SAM). Later, the absence of the Healthy Mature Anaerobic Gut Microbiota (HMAGM) leads to deficient energy harvest, vitamin biosynthesis and immune protection, and is associated with diarrhea, malabsorption and systemic invasion by microbial pathogens. A therapeutic diet and infection treatment may be unable to restore bifidobacteria and HMAGM.


Researchers found that malnourished children’s microbiota failed to follow the healthy pattern they identified in healthy children. The microbiota of malnourished children is immature, lagging in development behind that of their healthy peers. Supplementing these children’s meals with widely used therapeutic foods that increase calories and nutrient density reduces deaths from malnutrition, but it does not fix their persistent microbiota immaturity.

“Perhaps more insidious than slowing growth is malnutrition’s effect on less visible aspects of health, including impaired brain development and dysfunctional immunity, which follow these children throughout their lives”.

The Father of The Microbiome

Dr. Jeffrey Gordon


SIBO can cause severe malabsorption, serious malnutrition and immune deficiency syndromes in children (non breastfed) and adults. 

Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.



The WHO recommends that immunization or treatment be orally administered due to economic, logistical and security reasons. Furthermore, this route offers important advantages over systemic administration, such as reducing side effects, as the molecules are administered locally and have the ability to stimulate the GALT immune responses  (Levine and Dougan, 1998Neutra and Kozlowski, 2006Bermúdez-Humarán et al., 2011).



For ANY infectious or parasitic disease to start, it is ALWAYS a requisite that the host suffer IMMUNODEFICIENCY. At the same time, infectious and parasitic diseases themselves cause additional IMMUNE SUPPRESSION and more MALNUTRITION. This immune suppression is SECONDARY to the accumulation of free radicals, especially oxidizing species, that occurs during and after infectious and parasitic diseases.

Clinical Aspects of Immunology and Biochem J.


Current IBD Research 2016

Currently available treatments for IBD, which target the systemic immune system, induce immunosuppression, thereby exposing the patient to the risk of infections and malignancy. The interplay between the gut and the systemic immune system determines the final effect on target organs, including the bowel mucosa. Inflammatory bowel diseases (IBD) are associated with an altered systemic immune response leading to inflammation-mediated damage to the gut and other organs.

Clinical & Translational Immunology (2016)
Gastroenterology and Liver Units, Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel

Most importantly, the immune modulatory agents used today for IBD do not achieve remission in many patients.

Not all IBD patients benefit from currently available drugs. Young people with IBD do not want to be on long-term drug therapy. Oral immune therapy, while not yet studied in large cohorts of patients, may provide an answer to this unmet need.

Clinical & Translational Immunology (2016)
Gastroenterology and Liver Units, Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel


Tolerance is the ability of the immune system to ‘see’ and respond appropriately. Without galactose (a necessary sugar) the immune system can not 'see'. Your immune system would not be able to function without galactose Your body wouldn’t know which cells are “good” and what cells are “bad.” Your body wouldn’t know who the invaders were and which ones should be attacked by antibodies. As you will learn the importance of these ‘sugars’ in gut microbiota health is a rapidly expanding field of research, only recently discovered, including HMO's (human milk oligosaccharides).

Why galactose? Milk sugar aka lactose has been shown to be very beneficial for the human body though unlike sucrose, lactose is made up of glucose and galactose. There is no fructose in lactose. It is a healthy disaccharide sugar. Galactose is known as the “brain sugar” and supports brain development of babies and children. Galactose helps triggers long-term memory formation. Galactose has been shown to inhibit tumor growth and stop its spread, particularly to the liver. This beneficial sugar can also enhance wound healing, decrease inflammation, enhances cellular communication, and increases calcium absorption.
What does immune ‘tolerance’ mean in simple language?
Immune tolerance, or immunological tolerance, or immunotolerance, is a state of unresponsiveness of the immune system to substances or tissue that have the capacity to elicit an immune response in a given organism. The Th1 cytokine profile is vital for clearance of certain organisms and ancillary immune activity, and a limiting effect on this cytokine profile may result in reduced chances for overcoming infections especially intra-cellular organisms residing within macrophages. Effective clearance will depend on appropriate macrophage activation (which occurs through IFN≥ release by Th1 and NK cells) and production of nitric oxide. If this pathway is disrupted IFN≥ secretion is blocked, impairing macrophage activation. Persistent blockade of these inhibitory receptors has lead to the breakdown in immune self tolerance, thereby increasing susceptibility to autoimmune or auto-inflammatory side effects, including rash, colitis, hepatitis and endocrinopathies. Many drugs may cause checkpoint blockade toxicity including pharmaceutical drugs termed ‘immuno therapy’ by pharmaceutical companies, these include Mab drugs and cancer treatments. Checkpoint Inhibitor–Induced Colitis: A New Type of Inflammatory Bowel Disease? Madeline Bertha, MD MS, corresponding author1 Emanuelle Bellaguara, MD, Timothy Kuzel, MD, and Stephen Hanauer, MD ACG Case Rep J. 2017; 4: e112. Published online 2017 Oct 11. doi: 10.14309/crj.2017.112 PMCID: PMC5636906 PMID: 29043290

The Elderly

Mammal milk is required for enhanced phagocytosis as shown by research, especially in the elderly. Whole fat mammal milk can actually restore phagocytosis in senescent cells in the elderly. Phagocytosis, by which immune cells ‘eat’ bacteria or infected cells, is one of the mechanisms that help to resist infections. Lactic acid bacteria strains like acidophilus also increases phagocytosis.