Vitamin B1 deficiency

Dr. Anurag Shahi (AIIMS)MBBS,MD

November 28, 2018

March 06, 2020

Vitamin B1 deficiency
Vitamin B1 deficiency

What is vitamin B1 deficiency?

Vitamin B1, also called thiamine, is one of the essential vitamins that our body needs for proper functioning. Vitamin B1 deficiency can cause several conditions, some of which are fatal.

What are its main signs and symptoms?

Common symptoms

  • Thiamine deficiency primarily leads to a disease called beriberi. There are two forms of beriberi – dry and wet beriberi.
  • In dry beriberi, the nerves are affected, and the patient feels numbness and tingling in the hands and feet, along with pain and fatigue.
  • Wet beriberi is characterised by enlargement of the heart, shortness of breath, swollen legs and a fast heart rate.

Other symptoms

  • A patient can become anorexic and lose weight rapidly.
  • The psychological health of a person is affected, and one may experience mental confusion and loss of memory.
  • In alcoholics, thiamine deficiency causes Wernicke-Korsakoff syndrome, where the person has poor coordination, muscle weakness, double vision and loss of balance.

Complications of B1 deficiency include permanent nerve damage, coma and heart failure.

What are its main causes?

  • Deficiency of any nutrient is primarily caused by insufficient dietary intake or impaired absorption.

There are certain risk factors which make an individual more prone to thiamine deficiency.

  • Alcoholism is a major risk factor because it decreases the absorption of thiamine.
  • Patients with chronic kidney disease and those taking diuretics are at higher risk of developing thiamine deficiency.
  • Dietary factors also contribute to the risk, for example, a diet consisting mainly of white rice, which is a poor source of thiamine.
  • Patients with cancer and HIV are at a high risk of vitamin B1 deficiency.

How is it diagnosed and treated?

The diagnosis of B1 deficiency is based on symptoms, medical history and investigations.

  • Special tests are done to assess the level of thiamine pyrophosphate in the blood cells.
  • Diagnosis also includes tests to check the levels of enzymes that help in thiamine absorption and thyroid function.

The primary treatment consists of oral or intravenous thiamine. The symptoms begin to resolve almost immediately.

  • Nerve problems may need longer to resolve. The treatment mainly consisting of exercise and a few months of thiamine administration.
  • Consuming a nutrient-rich, well-balanced diet and taking thiamine supplements improves the condition. Foods such as whole grains, meat, beans and nuts are rich sources of thiamine.



References

  1. Gibson GE, Hirsch JA, Fonzetti P, Jordan BD, Cirio RT, Elder J. Vitamin B1 (thiamine) and dementia. Ann N Y Acad Sci. 2016 Mar;1367(1):21-30. PMID: 26971083
  2. Chandrakumar A, Bhardwaj A, Jong GW. Review of thiamine deficiency disorders: Wernicke encephalopathy and Korsakoff psychosis. J Basic Clin Physiol Pharmacol. 2018 Oct 2;30(2):153-162. PMID: 30281514
  3. National institute of health. Thiamin. Office of dietary supplements; U.S. Department of Health & Human Services
  4. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Thiamine
  5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Vitamin B

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