VITAMIN B1: THIAMINE

WHAT IS VITAMIN B1?

This is one of the water soluble vitamins found in a variety of foods. It is one of the vitamins in the vitamin B group. The technical name for it is thiamine. The vitamin and the others in the group play a major role in the conversion of carbohydrates into glucose which the body needs to produce energy. They are also needed for the metabolism of proteins and fats. The others are:

• Vitamin B2 (Riboflavin)
• Vitamin B3 (Niacin)
• Pantothenic acid (vitamin B5)
• Vitamin B6 (Pyridoxine)
• Biotin (vitamin B7)
• Folate (vitamin B9)
• Vitamin B12 (Cobalamin)

As a group, they are collectively referred to as vitamin B complex. The members of this group are not chemically the same but they are grouped together because they usually occur together in the same types of foods. All the members of this group play a major role in the metabolism and energy production in the body.

SOURCES OF VITAMIN B1

There are two main sources of vitamin B1. These are from the food we eat and from commercial dietary supplements. As much as it is possible, it is advisable to get all your vitamins need from the diet. However, there are many reasons that necessitate use of supplements. It is important to read the sources of the thiamine in a supplement because thiamine can be found in both animal and plant sources. This is especially important for vegans. Some of the plant sources include:

• Yeast
• Seeds
• Oranges
• Blackstrap molasses
• Oats
• Wheat germ
• Different nuts
• Legumes such as the different types of beans and peas

Many processed foods have their natural thiamin content stripped. To overcome this deficiency and reduce the risk of vitamin B1 deficiency, many authorities have forced food manufacturers to fortify such foods with thiamin. Commonly fortified foods include bread, flour and rice.

WHAT HAPPENS WHEN YOU HAVE VITAMIN B1 DEFICIENCY?

Vitamin B1 deficiency is rare. Many people in the U.S, for example meet the recommended thiamin intake requirement with just 6%  not achieving this. This was established through research data published in the Journal of Nutrition of August 24 2011 (Online edition). Early general symptoms of thiamin deficiency include:

• Mood changes that may include irritability and depression
• Headache
• Nausea with or without vomiting
• Abdominal symptoms such as indigestion and diarrhea
• Generalized and unexplained tiredness
• Heart disorder symptoms

ADVANCED SYMPTOMS OF VITAMIN B1 DEFICIENCY

At this level there are specifically identifiable health conditions. The general health status of a patient at this point is bad. Health disorders caused by this status include:

1. Beriberi

Beriberi leads to pronounced confusion, depression, respiratory distress due to fluid accumulation in the lungs, eye-focusing problems and an enlarged heart. If not treated in time death can occur from heart failure.

1. Wernicke-Korsakoff syndrome - WKS

WKS is a serious syndrome that involves brain and peripheral nerves damage. There is memory loss and uncoordinated movements. This problem can lead to irreversible memory loss even with effective treatment.

WHO IS AT RISK OF DEVELOPING VITAMIN B1 DEFICIENCY

Lifestyle and or disease conditions can lead to thiamin deficiency. Common risk factors include:

• Alcoholism
• Immunosuppressive diseases such as HIV/AIDS
• Medications interaction. Antacids, Lasix diuretics (water pills), digoxin, barbiturates and hydrochlorothiazide are among the drugs that affect thiamine availability in the body even where adequate amounts are taken. If such medications are taken for long, then deficiency symptoms may set in.
• Certain gut surgery including bariatric surgery. This is due to poor absorption of the thiamin and other important nutrients. Encephalopathy associated with thiamin deficiency following bariatric surgery is much higher than previously thought. A study published in the Annals of Surgery of November 2008 elaborated on these findings. In the study, about 94% of those followed after the surgery developed Wernicke Encephalopathy within six months of the surgery.
• The elderly
• Various studies have shown that many patients with either type 1 or type 2 diabetes have some thiamin deficiency. The study findings have shown a varying incidence of the deficiency that ranged from about 10% to almost 80% of the diabetics studied.
• As part of prolonged starvation

When adequate amounts of vitamin B1 are taken and there are no risk factors that hinder its availability to the body, many health benefits are realized.

HEALTH BENEFITS OF VITAMIN B1 – THIAMINE

1. Eye health. Vitamin B1 in conjunction with other vitamin B complex appears to reduce the risk of developing cataracts. The risk is further reduced where adequate proteins are consumed.
2. Helps in the management of diabetes. Studies suggest that thiamine on its own can lower blood sugar. Another studyconcluded that thiamine can help to protect the kidneys against early diabetes-related damage.
3. Supports heart health. There appears to be an association between heart failure and vitamin B1 deficiency. Studies show that 21-98% of patients with heart failure also have thiamine deficiency. Patients with heart problems are also more likely to have other risk factors (see above) for thiamine deficiency. This is why the authors of this studyrecommend concomitant use of thiamine during the treatment of heart failure.
4. May prevent or improve cognitive ability. This has been indicated by studies targeting Alzheimer’s disease patients. The vitamin is necessary for the overall functions of the brain.
5. Supports liver health
6. Promotes healthy skin and hair

VITAMIN B1 SAFETY

There is no data suggesting thiamine toxicity even at high doses. Excess amounts are excreted in urine. However, it is recommended that you stick to the dose recommended by the manufacturer of your thiamine or by your doctor. Vitamin B1 supplements are available. Always read the label carefully to determine the source and inclusion of other ingredients and their possible effects on your body. If you are concerned about whether your thiamine supplement is natural or synthetic, then look out for Benfotiamine in the list of ingredients or on the label. This is a form of synthetic thiamine that has to go through certain processes in the body for it to become water soluble and available to your body.

REFERENCES

Fulgoni VL, 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr 2011;141:1847-54 Bemeur C, Butterworth RF. Thiamin. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2014:317-24. Jermendy G. Evaluating thiamine deficiency in patients with diabetes. Diab Vasc Dis Res 2006;3:120-1 Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery. Pediatr Clin North Am 2009;56:1105-21 Rabbani, N., Alam, S.S., Riaz, S. et al. Diabetologia (2009) 52: 208. doi:10.1007/s00125-008-1224-4 Wooley JA. Characteristics of thiamin and its relevance to the management of heart failure. Nutr Clin Pract 2008;23:487-93 Sarma S, Gheorghiade M. Nutritional assessment and support of the patient with acute heart failure. Curr Opin Crit Care. 2010 Oct;16(5):413-18. Lu'o'ng K, Nguyen LT. Role of thiamine in Alzheimer's disease. Am J Alzheimers Dis Other Demen. 2011;26(8):588-98.