Thiamine

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Also called Vitamin B1.

Thiamine deficiency is rare, but can occur in malnourished patients due to chronic alcoholism or cancer chemotherapy with poor dietary intake. Populations and cultures that rely heavily upon rice based diets are at increased risk of thiamine deficiency.

Deficiency of Thiamine

Classic thiamine deficiency causes the symptom complex known as beriberi (“weak, weak”), marked by variable degrees of weight loss, nausea and vomiting, diarrhea, irritability, apathy, muscle weakness and painful peripheral neuropathy. Cardiac dysfunction with right sided heart failure and peripheral edema can also occur and is called “wet” beriberi.

Thiamine deficiency can also present with prominent central nervous system symptoms (Wernicke-Korsakoff syndrome), particularly in malnourished patients with chronic alcoholism or on cancer chemotherapy. Wernicke’s encephalopathy is characterized by mental deterioration, nystagmus, ophthalmoplegia and ataxia; Korsakoff’s syndrome by memory loss, confabulation and psychosis. Acute thiamine deficiency can also cause lactic acidosis. Thiamine is highly water soluble and body stores are not great, for which reason deficiencies can develop rapidly (within weeks to months).

RDA intake of Thiamine

The recommended dietary allowance is 1.2 mg in adult men and 1.1 mg in adult women, amounts that are provided in the average American diet.

Dosage and administration for Thiamine

Thiamine is available generically in many over-the-counter forms and is included in virtually all multivitamin preparations (typically in concentrations of 0.3 to 1.5 mg). Parenteral thiamine is available (100 mg/mL) and used in parenteral nutrition and to treat suspect thiamine deficiencies, often given routinely to hospitalized patients admitted with complications of chronic alcoholism.

Side effects of Thiamine

Oral forms of thiamine have not been associated with adverse events, ALT elevations or liver injury even when given in high doses. Parenteral administration of thiamine can be associated with immediate hypersensitivity reactions including anaphylaxis, but these are extremely rare.


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