

Identification of Early as well as Advanced Symptoms of B1 Deficiency Along With Neurological, Cardiac And Gastro Intestinal Manifestations
Abstract
Thiamine, also termed as thiamin and vitamin B1, is one of the 8 B-complex vitamins and is categorized as a water-soluble B vitamin. Thiamine happens naturally in specific diets, is included in food products, and is available in dietary supplements. Brown rice, whole grains, pork, poultry, soybeans, nuts, peas, dried beans, and fortified or enriched grain products namely bread, cereals, and infant formulas are rich sources of thiamine. Multivitamins supplement an additional 1.5 mg of thiamine to a diet already excess in this essential vitamin.
Wernicke-Korsakoff syndrome can occur in people with persistent or untreated vitamin B1 deficiency if they experience advanced-stage symptoms. Thiamine is approved by the United States Food and Drug Administration (FDA) paricularly for the treatment of Wernicke encephalopathy, infantile beriberi, and cardiovascular disease leading to thiamine deficiency. Vitamin B1 deficiency may present with early or advanced symptoms. Early symptoms mainly arise from neurological, cardiac, and gastrointestinal systems. Due to thiamine's restricted storage duration before rapid excretion, regulating essential blood serum levels needs a consistent and regular dietary intake. The indications, mode of action, methods of administration, major side effects, contraindications, and monitoring protocols—specifically for vitamin B1—are all explained in this activity. Along with increasing patient outcomes, this exercise prepares clinicians to work as part of an interprofessional team with dieticians, pharmacists, and primary care physicians to assist patient therapy in treatment or supplementation settings when thiamine is necessary.
References
Sriram K, Manzanares W, Joseph K. Thiamine in nutrition therapy. Nutr Clin Pract. 2012 Feb;27(1):41-50. [PubMed]
Wooley JA. Characteristics of thiamin and its relevance to the management of heart failure. Nutr Clin Pract. 2008 Oct-Nov;23(5):487-93. [PubMed]
Sharma S, Sheehy T, Kolonel LN. Ethnic differences in grains consumption and their contribution to intake of B-vitamins: results of the Multiethnic Cohort Study. Nutr J. 2013 May 20;12:65. [PMC free article] [PubMed]
Fulgoni VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011 Oct;141(10):1847-54. [PMC free article] [PubMed]
Saldanha LG, Dwyer JT, Bailen RA. Modernization of the National Institutes of Health Dietary Supplement Label Database. J Food Compost Anal. 2021 Sep;102 [PMC free article] [PubMed]
Thomson AD, Baker H, Leevy CM. Patterns of 35S-thiamine hydrochloride absorption in the malnourished alcoholic patient. J Lab Clin Med. 1970 Jul;76(1):34-45. [PubMed]
Thomson AD, Jeyasingham MD, Pratt OE, Shaw GK. Nutrition and alcoholic encephalopathies. Acta Med Scand Suppl. 1987;717:55-65. [PubMed]
Frank LL. Thiamin in Clinical Practice. JPEN J Parenter Enteral Nutr. 2015 Jul;39(5):503-20. [PubMed]
Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2010 Feb;28(1):107-70. [PubMed]
Lonsdale D. Thiamin. Adv Food Nutr Res. 2018;83:1-56. [PubMed]
Agabio R. Thiamine administration in alcohol-dependent patients. Alcohol Alcohol. 2005 Mar-Apr;40(2):155-6. [PubMed]
Thomson AD, Marshall EJ. The natural history and pathophysiology of Wernicke's Encephalopathy and Korsakoff's Psychosis. Alcohol Alcohol. 2006 Mar-Apr;41(2):151-8. [PubMed]
Thomson AD, Guerrini I, Marshall EJ. The evolution and treatment of Korsakoff's syndrome: out of sight, out of mind? Neuropsychol Rev. 2012 Jun;22(2):81-92. [PMC free article] [PubMed]
Hemachudha P, Rattanawong W, Pongpitakmetha T, Phuenpathom W. Fluorouracil-induced leukoencephalopathy mimicking neuroleptic malignant syndrome: a case report. J Med Case Rep. 2023 Mar 08;17(1):86. [PMC free article] [PubMed]
Falder S, Silla R, Phillips M, Rea S, Gurfinkel R, Baur E, Bartley A, Wood FM, Fear MW. Thiamine supplementation increases serum thiamine and reduces pyruvate and lactate levels in burn patients. Burns. 2010 Mar;36(2):261-9. [PubMed]
Lonsdale D. A review of the biochemistry, metabolism and clinical benefits of thiamin(e) and its derivatives. Evid Based Complement Alternat Med. 2006 Mar;3(1):49-59. [PMC free article] [PubMed]
Whitfield KC, Bourassa MW, Adamolekun B, Bergeron G, Bettendorff L, Brown KH, Cox L, Fattal-Valevski A, Fischer PR, Frank EL, Hiffler L, Hlaing LM, Jefferds ME, Kapner H, Kounnavong S, Mousavi MPS, Roth DE, Tsaloglou MN, Wieringa F, Combs GF. Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs. Ann N Y Acad Sci. 2018 Oct;1430(1):3-43. [PMC free article] [PubMed]
Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academies Press (US); Washington (DC): 2001. [PubMed]
The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management. J Addict Med. 2020 May/Jun;14(3S Suppl 1):1-72. [PubMed]
Heinz J, Domröse U, Westphal S, Luley C, Neumann KH, Dierkes J. Washout of water-soluble vitamins and of homocysteine during haemodialysis: effect of high-flux and low-flux dialyser membranes. Nephrology (Carlton). 2008 Oct;13(5):384-9. [PubMed]
Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: Nausea And Vomiting Of Pregnancy. Obstet Gynecol. 2018 Jan;131(1):e15-e30. [PubMed]
Barennes H, Sengkhamyong K, René JP, Phimmasane M. Beriberi (thiamine deficiency) and high infant mortality in northern Laos. PLoS Negl Trop Dis. 2015 Mar;9(3):e0003581. [PMC free article] [PubMed]
Fattal- Valevski A, Kesler A, Sela BA, Nitzan-Kaluski D, Rotstein M, Mesterman R, Toledano-Alhadef H, Stolovitch C, Hoffmann C, Globus O, Eshel G. Outbreak of life-threatening thiamine deficiency in infants in Israel caused by a defective soy-based formula. Pediatrics. 2005 Feb;115(2):e233-8. [PubMed]
Panigrahy N, Chirla DK, Shetty R, Shaikh FAR, Kumar PP, Madappa R, Lingan A, Lakshminrusimha S. Thiamine-Responsive Acute Pulmonary Hypertension of Early Infancy (TRAPHEI)-A Case Series and Clinical Review. Children (Basel). 2020 Oct 28;7(11) [PMC free article] [PubMed]
Ito Y, Yamanaka K, Susaki H, Igata A. A cross-investigation between thiamin deficiency and the physical condition of elderly people who require nursing care. J Nutr Sci Vitaminol (Tokyo). 2012;58(3):210-6. [PubMed]
Vognar L, Stoukides J. The role of low plasma thiamin levels in cognitively impaired elderly patients presenting with acute behavioral disturbances. J Am Geriatr Soc. 2009 Nov;57(11):2166-8. [PubMed]
Wilkinson TJ, Hanger HC, George PM, Sainsbury R. Is thiamine deficiency in elderly people related to age or co-morbidity? Age Ageing. 2000 Mar;29(2):111-6. [PubMed]
Wrenn KD, Murphy F, Slovis CM. A toxicity study of parenteral thiamine hydrochloride. Ann Emerg Med. 1989 Aug;18(8):867-70. [PubMed]
Katta N, Balla S, Alpert MA. Does Long-Term Furosemide Therapy Cause Thiamine Deficiency in Patients with Heart Failure? A Focused Review. Am J Med. 2016 Jul;129(7):753.e7-753.e11. [PubMed]
D'Alessandro C, Benedetti A, Di Paolo A, Giannese D, Cupisti A. Interactions between Food and Drugs, and Nutritional Status in Renal Patients: A Narrative Review. Nutrients. 2022 Jan 04;14(1) [PMC free article] [PubMed]
Enogieru OJ, Koleske ML, Vora B, Ngo H, Yee SW, Chatad D, Sirota M, Giacomini KM. The Effects of Genetic Mutations and Drugs on the Activity of the Thiamine Transporter, SLC19A2. AAPS J. 2021 Mar 01;23(2):35. [PMC free article] [PubMed]
Rosano GMC, Spoletini I, Agewall S. Pharmacology of new treatments for hyperkalaemia: patiromer and sodium zirconium cyclosilicate. Eur Heart J Suppl. 2019 Feb;21(Suppl A):A28-A33. [PMC free article] [PubMed]
Refbacks
- There are currently no refbacks.