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Sulbutiamine is a nootropic, man-made supplement that provides thiamine, also known as vitamin B1, to the body. Thiamine is an important part of how our bodies regulate metabolism and nerve function. Although we can get thiamine from our diets, and it is available as a supplement on its own, sulbutiamine is considered superior a superior version because it is able to cross the blood-brain barrier and benefit the brain directly.
Sulbutiamine calms anxiety and improves memory formation and mood. It is often used alone or as a part of stacks geared towards boosting motivation, improving alertness and memory during learning and studying, and reducing fatigue (particularly nervous system fatigue.) Researchers are studying it as a potentially untapped resource for treating Alzheimers, chronic fatigue syndrome, depression, and anxiety.
Benefits and Effects
Sulbutiamine raises the thiamine levels in the brain, which provides benefits to memory and energy, and boosts feelings of mood and motivation. Some of these benefits include:
Sulbutiamine is very effective at treating asthenia – a general fatigue or weakness of the body and mind that can occur after a bout of illness, or as a symptom of chronic diseases. Asthenia can be incredibly debilitating and, because it is a nerve-based weakness, it does not respond to rest in the same way that muscle-based exhaustion and fatigue do.
Sulbutiamine helps alleviate asthenia and is often prescribed as a part of anti-infection procedures during hospitalizations, where both infection and post-illness or surgery weakness is common. [1, 2, 3]
Multiple sclerosis, an autoimmune disease, also causes asthenia, and sulbutiamine has shown promise in treating it. 
In studies with mice and rats, treatment with sulbutiamine helped them better remember how to run a maze. Although they did not do better at running the maze at first, they remembered how to do it while their un-treated counterparts did not. This means that, although sulbutiamine did not help them memorize the maze better, it did help them remember it for a longer period of time. [5, 6, 7]
Although no studies on humans have been recorded yet, this strongly implies that sulbutiamine improves the retention of memories – how well memories stick in the mind. Anecdotal evidence from people taking sulbutiamine in stacks with alertness or attention boosting supplements supports this. It is thought to do this by upping the activity and effectiveness of choline, a neurotransmitter, in the hippocampus, the part of the brain responsible for memory. 
Sulbutiamine might do more than keep memories from fading, but this is still being studied and the evidence is not yet out.
Thiamine affects energy levels and mood, boosting your motivation to keep working at a task and giving you the energy to match. When sulbutiamine is used pre-workout, and stacked with caffeine, it can help boost alertness and promote feelings of energy and focus. Thiamine also boosts appetite and the metabolism of glucose, which helps the body and brain find the fuel for its new energy needs.  While sulbutiamine is not used for weight loss on its own, it can encourage higher levels of exercise and physical activity.
Thiamine is a stimulant, and sulbutiamine provides a lot of it directly to the brain. By encouraging neurons to take in more glutiamine and produce more energy, sulbutiamine turns up the power on your thoughts and senses.  As with many stimulants, it is a good idea to eat something along with it, so that you don’t run out of energy and crash.
Protect Neurons from Damage
Sulbutiamine helps protect neurons in the hippocampus, the region of the brain responsible for memory, and in the retina, the part of the eye responsible for sight. In studies in rats, sulbutiamine prevented these neurons from dying from oxygen and glucose deprivation, commonly caused by heart attacks and strokes. [10, 11] It may do this through antioxidant activity, by stimulating the cell to use its available energy more efficiently, or a mixture of both. 
Because of its effects on the mind and the body, sulbutiamine also has a lot of potential as a part of the treatment plans of several diseases and disorders:
While sulbutiamine and thiamine are not antidepressants, they can help even out moods by helping the brain use choline and dopamine better. Studies with subutiamine in people with depression show good behavioral outcomes without serious side effects. 
Sulbutiamine may also boost the effectiveness of antidepressant drugs, allowing lower doses (with a lower risk of side effects) to be used.
There is some limited evidence that sulbutiamine can help with diabetes and with glucose balance.  More promising, though, is its ability to protect nerves from diabetes-related damage and reduce fatigue and pain. Though trials in mice did not show improvement, their nerves did, implying that taking sulbutiamine long term could be the way to go when treating diabetes. [15, 16]
Sulbutiamine is a useful nootropic to add to an anti-anxiety stack, as it makes the other nootropics more effective.
Thiamine stimulates the release of GABA, a neurotransmitter that is involved with mood, sleep, and alertness. GABA also regulates anxiety, helping to calm down the brain.  Thiamine supplementation through sulbutiamine also encourages the production of dopamine, another important neurochemical.
Thiamine also encourages cells in the brain to bind to dopamine and GABA more easily, leading to a greater effect on mood.
The common treatment for memory loss in Alzheimer’s is acetylcholinesterase, but it is not always effective. Studies on sulbutiamine indicate that it can be an alternative to acetylcholinesterase and improve memory retention and mood in early-stage Alzheimer’s patients, which may slow the progression of the disease. [8, 18]
This is supported by the fact that older people have trouble absorbing thiamine, which makes an easily absorbable thiamine supplement like sulbutiamine very important. Thiamine supplementation is also associated with reduced plaque formation in the brain and boosted glucose metabolism, which are linked to Alzheimer’s symptoms. [19, 20]
This means that sulbutiamine is a possible way to help patients with early-stage Alzheimers disease maintain memory, mood, and proper brain functions. 
Chronic Fatigue Syndrome
The cause of chronic fatigue syndrome is still, as yet, unclear. However, the origin of the fatigue itself is well known – it is a type of asthenia, a nerve-based fatigue originating in the brain and nervous system. This kind of fatigue is very debilitating but extremely difficult to treat. Thiamine supplementation with sulbutiamine is known to be helpful with asthenia and has been studied in people with chronic fatigue syndrome. The effects are promising. [2, 22]
Subutiamine may help erectile dysfunction. Thiamine deficiencies can contribute to erectile dysfunction. In studies, men given thiamine supplements (not sulbutiamine specifically in this case) experienced better blood flow to their penis, and more energy for sexual activities. 
How Sulbutiamine Works
Sulbutiamine’s mechanism of action involves it being transformed into thiamine in the body, a brain chemical that regulates metabolism and mood. Because sulbutiamine passes through the blood-brain barrier and is fat-soluable, it is easier for the brain to pick up thiamine when it comes into the body as sulbutiamine.
Sulbutiamine also encourages the brain to use more choline and dopamine, important neurotransmitters responsible for mood regulation and memory. It also affects the receptors in the brain that are triggered by choline and dopamine, encouraging the brain to use – and reuse – these chemicals more efficiently.  This improves the effects of the neurotransmitters, and boosts mood and memory.
It also affects glutamine receptors, which are involved in the body’s production and use of energy.  This means that thiamine and sulbutiamine act as a stimulant, turning the energy production in the brain up, and giving the neurons more energy to function.
Because of this, it interacts well with drugs and supplements that use these neurotransmitters, making the drugs more effective. However, sometimes it can interact poorly. If you are taking any prescribed drugs for depression, anxiety, or mood disorders, you should consult your doctor before and during use so that they can tailor it to your needs.
Benfotiamine vs Sulbutiamine
Benfotiamine and sulbutiamine are very similar – both act as thiamine supplements. However, they are absorbed into different parts of the body: sulbutiamine is better absorbed into brain, while benfotiamine can be absorbed into the liver and bloodstream. If you are looking for a nootropic, sulbutiamine is the better choice. 
The usual sulbutiamine dosage is about 400mg daily. A sulbutiamine high-dose would be up to 600mg daily. Though there is some evidence that higher doses have bigger effects, this is fairly slim.
Sulbutiamine is available as both a capsule and a powder, which can be made into customized capsules. It is not recommended to mix the powder with water and drink sulbutiamine, or to inject it (though this is done in the mouse and rat experiments.)
Sulbutiamine affects concentration and memory almost immediately, so you should take it when you really need to focus. For diseases such as diabetes it’s best to take it in the long term, over the course of several months, to see the benefits in some of the diseases. 
However, due to the addictive nature of sulbutiamine, you should be careful when taking it long term, keep your doctor in the loop, and be mindful about whether you are building a tolerance to the supplement, whether it is interacting with medications, or whether you are experiencing sudden mood swings. If so, you may want to taper off or stop using sulbutiamine for a while.
Silbutiamine side effects are generally mild. Physical side effects don’t go far beyond nausea or a skin rash. Because the stimulant effects may raise blood pressure, sulbutiamine headaches can occur as well. These are not generally life-threatening.
The mental side effects, however, can be more problematic. Because thiamine stimulates the brain, using sulbutiamine can overstimulate the brain and result in agitation and mood swings. You can also build up a tolerance to sulbutiamine, and even become addicted to it.
In a case study in a person with bipolar disorder who was taking sulbutiamine, the combination of mood swings and addiction caused many problems for them. They behaved erratically, going off of their prescribed medications and missing doctors’ appointments. The root cause appears to be the tolerance and resulting addiction to sulbutiamine, which distracted the patient from their own health. 
Sulbutiamine interactions include many drugs for mood disorders, as it affects the release and uptake of dopamine and choline. Usually, this interaction is positive – Sulbutiamine makes the medications more more effective. However, for some people, and possibly for the bipolar patient in the case study, it can interact poorly with their medications and their current mental state.
It is a good idea to let a medical professional know if you are starting sulbutiamine, and to keep an eye out for tolerance or any problematic mood symptoms. They can help you regulate the dosages of sulbutiamine or your medications to match your needs. If you get tested for thiamine levels, normal or high levels may mean that you shouldn’t start sulbutiamine at all.
For the most part, however, sulbutiamine is safe: aside from the issue of tolerance, the side effects are mild even at high doses, and in healthy people there does not appear to be a dosage at which sulbutiamine becomes dangerous.
Sulbutiamine and Phenibut
Sulbutiamine and phenibut are sometimes taken together for extra effects on mental clarity and focus. Anecdotally, they work well together and boost performance. However, both are addictive and can be habit forming.
Unlike sulbutiamine, building up to higher dosages of phenibut can lead to severe adverse effects, including intoxication, and can interact with alcohol, narcotics, and prescription drugs. It also has serious known withdrawal symptoms. 
So use sulbutiamine and phenibut together with caution, and taper off if you don’t react well – don’t stop any long term use “cold-turkey.”
Sulbutiamine and Choline
Because thiamine improves the body’s use of choline and its neurotransmitter form acetylcholine, taking choline with sulbutiamine can improve the effectiveness of both for improving memory. 
Sulbutiamine and Piracetam
Piracetam and sulbutiamine have been used together with success to improve motivation and alertness and sharpen focus. It’s considered a great combination for studying but be careful about tolerance!
Sulbutiamine and Aniracetam
Aniracetam and sulbutiamine are used together to add a creativity boost to sulbutiamine’s memory and fatigue effects. This combination also helps to calm the brain down, reducing some anxiety and depression symptoms.
Sulbutiamine and Noopept
Noopept’s focusing, brain boosting, and clarifying powers work well with sulbutiamine’s focus boosting and memory enhancing affects. Noopept and sulbutiamine stacks are common, and people claim great success by them.
Sulbutiamine and Caffeine
Thiamine is a stimulant, but it can be taken with fellow stimulant caffeine, if alertness is what you are after. Just be sure to keep an eye on your mood – if you are feeling agitated or anxious, you may be stimulating your mind too much.
Huperzine A and Alpha GPC
Huperzine A and Alpha GPC work well with sulbutiamine for memory improvement and learning. Alpha GPC also becomes acetylcholine in the brain, which sulbutamine makes more effective.
Both are also Alzheimers-fighters (though Alpha CPC is not approved for use as a drug in the US) so a combination of Huperzine A, Alpha GPC, and sulbutamine could be a powerful addition to an Alzheimers treatment regimen.