When you begin your Sodium dichloroacetate regimen, it is crucial that you take supplementation which provides protective benefits. This way you minimize the chance for developing reversible peripheral neuropathy as well as other adverse reactions related to the nervous system.
Below you will find a list of supplements which are essential or recommended for a pleasant DCA usage experience with the lowest achievable side effect probability.
Vitamin B1 – Benfotiamine (Necessary)
• Dosage: Take 150 – 600 mg of Benfotiamine in the morning, ideally after breakfast.
The B group vitamin thiamine appears to have a protective effect against peripheral neuropathy. This food supplement can be used not only for DCA induced neuropathy but also for other neuropathies which are caused by diabetes and chronic alcohol abuse. (Ref.)
We recommend using benfotiamine because it can be absorbed over five times better than the ordinary thiamine form.
In addition, the newest research claims that Vitamin B1 can have an antiproliferative effect on malignant cells. (Ref.)
Alpha–Lipoic acid. (Necessary)
• Dosage: Take 600 mg of Alpha-Lipoic Acid once a day in the morning, ideally after breakfast. For the moderate (recommended) or high dose, take 1200 mg.
Alpha-Lipoic Acid is a potent antioxidant that helps avoid neuropathy symptoms, including tingling, burning, pain, and numbness. It can also reduce anxiety and improve memory. (Ref.)
!Don’t take α-Lipoic acid if you’re receiving chemotherapy or radiotherapy.
Alpha-Lipoic Acid has strong antioxidant properties that may interfere with chemotherapy effectiveness. For this reason, it’s recommended to avoid it a few days before, during, and one week after treatment. (Ref.)
Similarly, Alpha-Lipoic Acid may reduce the effectiveness of radiotherapy, so it’s best to avoid it several days before, during, and up to two weeks after treatment.
Acetyl L-Carnitine. (Recommended)
• Dosage: Take 1000 mg of Acetyl L-Carnitine once a day in the morning for the minimal dose. For the recommended or high dose, take 1000 mg in the morning and 1000 mg with dinner.
Acetyl L-Carnitine has been well-supported by scientific research for its ability to help reduce symptoms of peripheral neuropathy. This supplement is safe for long-term use and carries minimal risk of side effects. When combined with Alpha-Lipoic Acid, it provides enhanced benefits for protecting nerve health. (Ref1.), (Ref2.), (Ref3.)
Acetyl L-Carnitine is not essential or mandatory in the DCA protocol, but it is strongly recommended for long-term use if possible and affordable. It complements the efforts of Vitamin B1 (Benfotiamine) and Alpha-Lipoic Acid (ALA) to prevent side effects, particularly peripheral neuropathy.
Recommended Supplements (Summarized):
| Minimal/Optimal Dose | Recommended/Moderate Dose | High/Heavy Dose |
| Vitamin B1 (Benfotiamine) 150 mg (necessary) | Vitamin B1 (Benfotiamine) 300 mg (necessary) | Vitamin B1 (Benfotiamine) 600 mg (necessary) |
| Alpha Lipoic Acid 600 mg (necessary) | Alpha Lipoic Acid 1200 mg (necessary) | Alpha Lipoic Acid 1200 mg (necessary) |
| Acetyl L-Carnitine 1000 mg (optional) | Acetyl L-Carnitine 2000 mg (optional) | Acetyl L-Carnitine 2000 mg (optional) |
On rare occasions, Sodium dichloroacetate administration can result in heartburn or nausea. If this is the case, try taking DCA after you eat a little bit of food and drink some fluids to avoid your stomach becoming irritated.
If that didn’t resolve the problem, you should try taking medications that lower gastric acid secretion – proton pump inhibitors.
Any type of PPI is acceptable provided the fact that they don’t have any major differences.
Pantoprazole (Optional)
• Dosage: Take one 20-40 mg tablet once a day, 30 minutes before breakfast.
For convenience purposes, we recommend using Pantoprazole because it doesn’t seem to have any poor interactions with other medications.
Alternatives:
- Omeprazole: 20–40 mg once daily, 30 minutes before breakfast.
- Esomeprazole: 20–40 mg once daily, 30 minutes before breakfast.
These PPIs are effective alternatives with similar benefits and minimal interactions.
If you began experiencing moderate side effects or develop a stronger form of peripheral polyneuropathy – stop taking DCA until the adverse reactions become acceptable or disappear completely.
All Sodium dichloroacetate side effects are reversible.
When you stop taking DCA, the majority of the side effects disappear in several days. Peripheral neuropathy can take up to a week or, in rare occasions, a couple of weeks to resolve completely. (Ref.)
Additionally, if you have an opportunity – we recommend regularly performing blood tests and checking the blood serum for tumor marker levels.
Ultrasound, Computer tomography scans, Magnetic resonance imaging, Positron emission tomography are imaging tests that can provide more information about the dynamics of your overall health, and most importantly, the size changes of your tumor.
Hello DCAGUIDE,
Regarding thiamine and benfotiamine: is it reasonable to use 600 mg of benfotiamine instead of 300 mg of thiamine?
I came across the study “High-dose vitamin B1 reduces proliferation in cancer cell lines analogous to dichloroacetate” and was wondering whether a higher dose of benfotiamine (e.g., 600 mg) might be preferable to 300 mg of thiamine, particularly with respect to safety and antiproliferative effects.
Any insight would be appreciated.
Dear John,
Thank you for the thoughtful question.
The study you mention is correct in showing that high dose thiamine can influence cancer cell metabolism in a way similar to dichloroacetate by activating pyruvate dehydrogenase and reducing glycolytic behavior in cancer cells.
Benfotiamine is essentially a lipid-soluble precursor of thiamine. It is absorbed significantly better than regular thiamine and produces several-fold higher blood levels after oral dosing, while remaining well tolerated even at higher amounts.
For this reason, a lower milligram amount of benfotiamine can often achieve comparable or greater biological exposure than standard thiamine.
Regarding your specific comparison, 600 mg of benfotiamine is a commonly used dose range in human studies and has been administered safely for months, including neuropathy protocols.
Because of its higher bioavailability, it is reasonable to consider 600 mg benfotiamine as broadly comparable or stronger than 300 mg thiamine from a systemic availability standpoint rather than weaker.
However, the antiproliferative observations with vitamin B1 originate primarily from laboratory models using thiamine itself, and direct clinical equivalence between thiamine and benfotiamine for this specific metabolic effect has not been firmly established. Benfotiamine can be viewed as a practical and often better absorbed delivery form, but not necessarily a proven superior anticancer agent.
In summary, using 600 mg benfotiamine instead of 300 mg thiamine is a reasonable substitution from a safety and exposure perspective, while acknowledging that the mechanistic cancer data still comes mainly from thiamine research rather than clinical outcome studies.
Dear DCAGUIDE,
Thank you for your reply. Much appreciated.
Dear DCAGUIDE,
Thank you for your reply. Actually I am reading Naturopathic Oncology, 4th Edition by Dr. Neil McKinney and notice on page 144 his note regarding thiamine:
“Vitamin B-1 or thiamine, or the fat-soluble benfotiamine 80–160 mg twice daily. Inject 100 mg intramuscular daily. Thiamine at moderate doses intensifies tumour growth through transketolase activation, so do not use thiamine outside the context of this protocol.”
In terms of transketolase activation, I am concerned taking benfotiamine 300 mg twice daily may fall outside the context of the protocol he described.
Any comments? I am looking forward to hearing from you soon.
Dear John,
Thank you for the follow up question.
The caution you found relates to an older metabolic observation that low to moderate thiamine availability can support the pentose phosphate pathway through transketolase activity, which in some laboratory settings may assist cellular proliferation. However, the effect is dose dependent and context dependent. At higher concentrations, thiamine shifts cellular metabolism toward oxidative phosphorylation through pyruvate dehydrogenase activation, which is the same metabolic direction targeted by dichloroacetate.
For this reason, thiamine used together with DCA is generally intended not as nutritional replacement but as a pharmacologic cofactor supporting mitochondrial metabolism and helping reduce neuropathy risk. Benfotiamine functions as a more bioavailable delivery form of thiamine rather than a separate metabolic agent.
A dose such as 300 milligrams twice daily of benfotiamine is typically considered within the range used to ensure sufficient intracellular thiamine availability during DCA use rather than outside the intended context. The concern described in the text mainly applies to isolated low dose supplementation where metabolic direction is not being actively shifted.
As always, gradual introduction and monitoring tolerance remains the most practical approach.
Yes, that should be OK Zaklina.
“Don’t take α-Lipoic acid if you’re receiving chemotherapy or radiotherapy.” My wife had been receiving “Moga” infusions for T cell lymphoma. Those treatment were not effective and stopped 2 weeks ago.
We have DCA and suggested supplements but she may resume with other infusions. Question:: if she can’t take Lipolic acid then she should not take DCA. Correct?
Can you give DCA without food? My sister is on palliative care and she is eating very little . Is it ok to continue giving the DCA with very little food.