Costantini, Antonio, Pala, Maria Immacolata · Journal of alternative and complementary medicine (New York, N.Y.) · 2013 · DOI
This small study tested whether high-dose vitamin B1 (thiamine) could help fatigue in people with inflammatory bowel disease. Twelve patients took large amounts of thiamine for 20 days, and ten of them reported their fatigue almost completely went away. The researchers suggest that fatigue in these patients may come from cells not absorbing thiamine properly, rather than from actual vitamin deficiency in the blood.
ME/CFS shares prominent fatigue as a core symptom with inflammatory bowel disease, and understanding metabolic mechanisms underlying fatigue—particularly cellular energy metabolism—may have relevance for ME/CFS research. The hypothesis that fatigue can stem from impaired cellular thiamine transport despite normal blood levels could inform investigation of similar transport dysfunctions in ME/CFS patients.
This study does not establish that thiamine deficiency causes fatigue in ME/CFS patients, as the research population had inflammatory bowel disease, not ME/CFS. The open-label design and lack of placebo control cannot rule out placebo effect or natural symptom fluctuation. Normal blood thiamine levels do not confirm intracellular deficiency—this remains theoretical without direct cellular measurement.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Costantini, Antonio & Pala, Maria Immacolata (2013). Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study.. Journal of alternative and complementary medicine (New York, N.Y.). https://doi.org/10.1089/acm.2011.0840
BibTeX
@article{mecfsatlas-costantini-2013-thiamine-fatigue,
author = {Costantini, Antonio and Pala, Maria Immacolata},
title = {Thiamine and fatigue in inflammatory bowel diseases: an open-label pilot study.},
journal = {Journal of alternative and complementary medicine (New York, N.Y.)},
year = {2013},
doi = {10.1089/acm.2011.0840},
note = {PubMed: 23379830},
url = {https://www.mecfsatlas.com/evidence/costantini-2013-thiamine-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/costantini-2013-thiamine-fatigue
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