Thiamin: The Underrated B Vitamin

Thiamin, or vitamin B1, enables the body to use carbohydrates as energy. This critical vitamin is essential for glucose metabolism and plays a crucial role in heart, nerve, and muscle function. Because of its importance and the human body’s inability to store adequate amounts of it within the liver, it’s paramount that you receive your recommended daily allowance of thiamin through a well-balanced diet. Keep reading to learn why thiamin is vital to the human body and how to avoid deficiency in this crucial vitamin.  

Thiamin Deficiency

Because the human body doesn’t store thiamin in levels greater than 30mg, and the half-life of thiamin is only nine to 18 days, we must receive our thiamin through daily ingestion. However, even in developed countries, this can be a struggle.  

In developed countries, industrial food processing often reduces the thiamin content, along with other vital vitamins and minerals, within a product. Common thiamin-containing foods include cereals, bread, meat (pork), and fish. Milk and other dairy products contain thiamin, but only in small amounts as pasteurization reduces thiamin content.  

Common symptoms of early thiamin deficiency include loss of appetite, nausea, apathy, fatigue, irritation, sleep disturbances, anorexia, and abdominal discomfort. Risk factors for thiamin deficiency in the developed world include a poor diet, cancer, morning sickness during pregnancy, bariatric surgery, alcoholism, and HIV. These risk factors affect how well your body absorbs nutrients from your food. Thiamin deficiency is easy enough to treat with thiamin therapy if found early enough. However, thiamin deficiency can cause long-lasting or even permanent effects if left undetected.

Beriberi

Beriberi is one condition thiamin deficiency can cause. There are two types of beriberi, (1) wet beriberi and (2) dry beriberi. Wet beriberi affects the heart and circulatory system, and in extreme cases, can cause heart failure. Dry beriberi damages the peripheral nerves. This damage eventually leads to decreased muscle strength or paralysis.

Wet beriberi symptoms include:

• Rapid heart rate
• Shortness of breath during physical activity
• Swollen lower legs
• Waking up short of breath

Dry beriberi symptoms include:

• Decreased muscle function in the lower legs
• Tingling or loss of feeling in feet and hands on both sides
• Mental confusion
• Vomiting
• Difficulty speaking
• Paralysis
• Involuntary eye movement

In extreme cases, beriberi can lead to Wernicke-Korsakoff Syndrome.

Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff Syndrome is a combination of two conditions. The first is Wernicke encephalopathy (WE), which damages the thalamus and hypothalamus regions of the brain. Many doctors associate this condition with alcohol abuse because the ethanol reduces gastrointestinal absorption of thiamin and thiamin stores in the liver. The reduced gastrointestinal absorption of thiamin partnered with inadequate intakes of essential nutrients as often seen in alcohol dependence, is a recipe for disaster. Failure to diagnose WE promptly results in the death of 17% of those diagnosed with the disease.  

In comparison, 84% of those diagnosed will experience permanent damage, including severe short-term memory loss and hallucinations (Korsakoff’s syndrome). The second condition, Korsakoff syndrome, results from permanent damage to the region of the brain that forms memories. Current research suggests that only about 16% of all WE cases fully recover after thiamin supplementation.

Depression and Thiamin  

With research delving into the effects thiamin has on cognitive function, as seen with WE, doctors seem to have found a connection between depression and thiamin levels within the human body. A study on 1,500 Chinese citizens, ages 50-70, presented findings that suggested those with lower thiamin levels displayed more severe symptoms of depression. However, it is noted that factors like diabetes, altered hormone profiles, and increased alcohol consumption in some of the observed individuals with depressive symptoms may play a role in the bioavailability (rate at which a drug is absorbed and can be used by the body) of thiamin.  

However, another study, which conducted its research on a population with a history of malnutrition, also found a connection between thiamin deficiency and symptoms of major depressive disorder (MDD). Ghaleiha and colleagues tested the effect of thiamin supplementation on those with MDD in a 12-week clinical trial. This trial concluded that symptoms of depression improve significantly following at least six weeks of thiamin supplementation compared to a placebo.

Side Effects and Dosage

There is no evidence to suggest any harm in taking too much thiamin.

For mild cases of thiamin deficiency, the World Health Organization (WHO) recommends a daily oral dose of 10mg thiamin for a week, followed by 3-5mg/daily for at least six weeks.

The WHO recommends 50-100mg in adults, then 10mg/daily administered intramuscularly for about seven days for a severe deficiency. Follow this up with 3-5mg/daily of oral thiamin for at least another six weeks.

For those of us who aren’t thiamin deficient but are looking to get enough thiamin in our day-to-day life, men over the age of 18 should consume 1.2mg/daily, and women over the age of 18 should consume 1.1mg/daily. Those who are pregnant or breastfeeding should consume 1.4mg/daily.

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