Thiamin, Vitamin B1 : Part 2

by MedlinePlus

(Page 2 of 4)

Total parenteral nutrition (TPN)

Thiamin should be added to TPN formulations for patients who are unable to receive thiamin through other sources (such as a multivitamin) for more than 7 days. There are documented cases of lactic acidosis occurring in patients receiving TPN without thiamin.

Alzheimer's disease

Because thiamin deficiency can result in a form of dementia (Wernicke-Korsakoff syndrome), its relationship to Alzheimer's disease and other forms of dementia has been investigated. Whether thiamin supplementation is of benefit in Alzheimer's disease remains controversial. Some improvements in cognitive function have been reported in Alzheimer's patients taking thiamin. Further evidence is necessary before a firm conclusion can be reached.

Athletic performance

There is inconclusive scientific evidence in this area.

Cancer

Thiamin deficiency has been observed in some cancer patients, possibly due to increased metabolic needs. It is not clear if lowered levels of thiamin in such patients may actually be adaptive (beneficial). Currently, it remains unclear if thiamin supplementation plays a role in the management of any particular type(s) of cancer. A multivitamin including thiamin is generally considered to be reasonable in such patients, particularly in those with decreased dietary intake or anorexia.

Cataract prevention

Preliminary evidence from a population study suggests that high dietary thiamin intake may be associated with a decreased risk of cataracts (approximately 10mg thiamin daily). Further evidence is necessary before a firm conclusion can be reached.

Coma/hypothermia of unknown origin

Administration of 50-100mg IV or IM of thiamin is often recommended in patients with coma or hypothermia of unknown origin, due to the possible diagnosis of Wernicke's encephalopathy.

Crohn's disease

Decreased serum thiamine levels have been reported in patients with Crohn's disease. It is not clear if routine thiamin supplementation is beneficial in such patients generally.

Didmoad (Wolfram) syndrome

Didmoad (Wolfram) syndrome is a rare autosomal recessive inherited disease which results in diabetes mellitus, optic atrophy, diabetes insipidus, sensorineural deafness, and occasionally megaloblastic anemia. The defect is believed to cause a decrease in the enzyme that converts thiamin to its active form, thiamin pyrophosphate. Thiamin, at doses between 25-100mg, has been reported as effective in reversing anemia associated with Didmoad syndrome, within 2 weeks. Thiamin may also be effective in reducing or eliminating insulin requirements. Thiamin appears to be beneficial principally in patients with Didmoad syndrome with anemia. Management should be under strict medical supervision.

Heart failure (cardiomyopathy)

Chronic severe thiamin deficiency can cause heart failure (wet beriberi), a condition, which merits thiamin supplementation. It is not clear that thiamin supplementation is beneficial in patients with heart failure due to other causes. However, it is reasonable for patients with heart failure to take a daily multivitamin including thiamin, because some of these individuals may be thiamin deficient.Diuretics may lower thiamin levels, particularly high doses of loop diuretics such as furosemide (Lasix) 80 mg/day. Since diuretics are commonly administered to patients with heart failure, patients taking diuretics are at an increased risk of thiamin deficiency. This area remains controversial, and further evidence is necessary before a firm conclusion can be reached.

Pyruvate dehydrogenase deficiency (PDH)

There is preliminary evidence of clinical improvements in children with PDH following thiamin administration. Further evidence is necessary before a firm conclusion can be reached.

Subclinical thiamin deficiency in the elderly

While typically asymptomatic, the elderly have been found to have lower thiamin concentrations than younger people. There is limited evidence that thiamin supplementation may be beneficial in individuals with persistently low thiamin blood levels, yielding improved quality of life, decreased systolic blood pressure and decreased weight compared to placebo. Further study is necessary before a firm conclusion can be formed in this area. Hip Fracture

Fractures of the hip are an important cause of later ill health and mortality in older people. People with hip fractures are often malnourished at the time of fracture, and have poor food intake in hospital. Preliminary evidence shows that supplemental thiamin is not beneficial for hip fractures.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Age-related lens opacification, Bell's palsy, canker sores, chronic diarrhea, circulation enhancement, depression, diabetes, diabetic nephropathy, dysmenorrheal (painful menstruation), epilepsy, erectile dysfunction, fibromyalgia, gastrointestinal disorders, HIV support, high blood pressure, insect repellant, learning, low back pain, memory enhancement, myelodysplasia, optic neuropathy, multiple sclerosis, poor appetite, protection from radiation-induced genetic changes, tissue healing after surgery, ulcerative colitis.

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