Positives

• One individual with Long COVID and EDS noted that taking 200mg of sulbutiamine daily provided a slight improvement in their energy levels and brain fog Reddit.
  
  
• A patient with Long COVID, ME/CFS, and POTS found that gradually increasing their sulbutiamine dose to around 50mg helped them “feel better” over time Reddit.
  
  

Negatives

• Patients on sulbutiamine for MS-related fatigue commonly see modest reductions, but no Long COVID-specific evidence supports its use, and many patients comparing supplements pick more direct fatigue interventions instead. ScienceDirect.
• A published case report documented that sulbutiamine, marketed as an over-the-counter compound, interfered with therapeutic outcomes in bipolar disorder, and patients on forums report that sulbutiamine can produce mood swings, irritability, anxiety, insomnia, or euphoric mania, especially at doses of 1000 to 2000 mg. PubMed.
• Patients commonly describe rapid tolerance build-up to sulbutiamine, prompting concerns about dependency and the need for cycling, which makes it ill-suited as an open-ended daily strategy for chronic Long COVID fatigue. Nootropics Expert.

Hurdles & Side Effects

• One person suggested that sulbutiamine might be an unfamiliar option for some, urging others to discuss with their healthcare provider before starting Reddit.