The alternative title would be “Neurological issues and sublingual”. I got an email this morning from a ME/CFS person which reminded me of what I do often and I thought that I should share/remind others.
Reporting back. I tried B1 benfotiamine again. I was feeling tired for no reason so gave it a shot. I just wanted a low dose and so I opened the cap and sprinkled a quarter in my mouth. I usually take 1 cap. Huge effect. Felt like my muscle and brain came alive. In the past when I’ve taken b1 for a while it usually wears off or causes issues though so my question is how would I used Dr. AI to see if I have a deficiency of b1 and if need be what items to shift the microbiome. I’ve tried it prior to crashing / PEM before and it didn’t stop it but I will do it again since it’s been a while.For other experiences of ME/CFS with benfotiamine (a special form of Vitamin B1), see my earlier post from 2015
I have done many things sublingual, including heparin (much cheaper and appears just as effective than Low-molecular-weight heparin to deal with coagulation issues, and no injections!). My personal favorite is Piracetam which works far far better to get a tired brain working than strong coffee (at least for me).
The logic is simple, the amount that gets to the brain (which is close by) is much more than being processed through stomach acid and slowly working it way to the brain via the blood.
There is considerable literature supporting this, a few examples:
- At-home, sublingual ketamine telehealth is a safe and effective treatment for moderate to severe anxiety and depression: Findings from a large, prospective, open-label effectiveness trial 
- Sublingual Sufentanil in Pain Management After Pulmonary Resection: A Randomized Prospective Study 
- Vascular headache: its treatment with sublingual ergotamine tartrate 
- A new (sublingual) method for controlling the pain of migraine and other headaches; preliminary report 
Note that the instructions for Symbioflor-1 probiotics, ” Take the drops, hold them in the mouth for a while and gargle with them before swallowing.” could be described as sublingual. Taking probiotics sublingual is not common practice…
There is no easy answer. Often taste can be a factor for tolerance of this approach. It may be a good exercise to try many of your supplements (one at a time) via this route and seen what has significant impact.
REMINDER: Rotate, rotate, rotate. A common complaint is that “a supplement benefit wears off”. In terms of the microbiome, this is expected from almost everything. The bacteria population adapts.