Skye Schulte, MS, MPH
Thiamine, also called vitamin B1, is a water-soluble vitamin found in virtually every cell in the body. Water-soluble vitamins are stored in the body in limited amounts. They leave the body through the urine. For this reason, it is a good idea to have them in your daily diet. Thiamine is also available as a supplement and by prescription as an injection.
Thiamine helps to process carbohydrates, fats, and proteins. It is needed to make adenosine triphosphate (ATP), which is the body’s main energy-carrying molecule. Thiamin is also necessary for memory and other brain functions.
There have been no adverse effects reported with taking too much dietary thiamine. The body excretes any excess amount that is consumed. In rare instances,
hives, itching, swelling, and breathing difficulties have occurred from thiamine injections given by doctors.
Thiamine is mostly found in whole-grain and enriched grain products like bread, pasta, rice, and fortified cereals. These foods are enriched with thiamine because the vitamin is often lost during the refining process. Pork, liver, and other organ meats are naturally high in thiamine. This table lists good food sources of thiamine.
Thiamine deficiencies are rare in the United States because thiamine is added to refined grains. However, deficiencies do sometimes occur.
A severe thiamine deficiency can cause the disease beriberi. Beriberi can damage the heart and the nervous system.
Symptoms of thiamine deficiency include:
Beriberi is still seen in people with alcohol use disorder (AUD), in people whose ability to absorb thiamine is impaired, some people with kidney failure that eliminate thiamine, and in developing countries where foods are not fortified. Treating beriberi with vitamin B1 cures most cases, though severe deficiency can cause irreversible damage.
A deficiency of thiamine can cause Wernicke encephalopathy (WE), which affects mental status and vision. It is also more commonly seen in people with AUD. WE is treated with thiamane.
WE can develop into Korsakoff’s syndrome. Symptoms of Korsakoff’s syndrome include memory problems, confusion, and emotional changes. Other causes may include brain damage, such as with tumors,
head injury, or
stroke. If AUD is the cause, avoiding alcohol is an effective treatment. Treatment with thiamine may also be used.
In people with
heart failure, the heart's ability to pump weakens, and fluid begins to build up in the lungs and legs. Loop diuretics are often prescribed to treat heart failure. However, these drugs can deplete the body of thiamine. Since thiamine is required for normal heart function, this can cause problems. Thiamine supplements may be prescribed in these cases.
While thiamine deficiency in a healthy person is uncommon, there are conditions that can increase the need for thiamine, making a deficiency possible. If you have any of the following conditions, talk with your doctor about your thiamine needs:
To help increase your intake of thiamin, add some of these to your diet:
Eat Right—Academy of Nutrition and Dietetics
US Department of Agriculture
Dietitians of Canada
Korsakoff syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900713/Korsakoff-syndrome. Updated January 16, 2012. Accessed April 10, 2017.
Alternative Med Rev. 2003;8(1):59-62.
Thiamine. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T233207/Thiamine. Updated March 6, 2017. Accessed April 10, 2017.
Thiamin. Linus Pauling Institute website. Available at: http://lpi.oregonstate.edu/infocenter/vitamins/thiamin. Accessed April 10, 2017.
Thiamine deficiency. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116008. Updated June 28, 2010. Accessed April 10, 2017.
Wernicke encephalopathy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115007/Wernicke-encephalopathy. Updated December 19, 2014. Accessed April 10, 2017.
Last reviewed April 2017 by Michael Woods, MD, FAAP
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