This article has been medically reviewed by Dr Robert Lefever, a world-leading addictions specialist.
It is estimated that around 30% to 89% of alcoholics suffer from a degree of thiamine deficiency. Are you worried and scared because you might have a high risk of brain disease? Do you feel you have already started exhibiting the symptoms? Are you wondering if it is even serious at all?
Thiamine deficiency is not one to joke with. If you heavily consume or abuse alcohol, the concern is needed. Contemplating addiction treatment can be hard. We at Help4addiction use evidence-based treatment methods to ensure the complete recovery of our patients. Please feel free to contact us for more information.
What is Thiamine?
Thiamine is an essential vitamin in the body for converting carbohydrates into glucose, fuel for the body. The body uses the glucose produced by thiamine as an energy source which goes a long way to help the growth, development and efficient function of cells.
Thiamin belongs to the family of B vitamins and is popularly known as Vitamin B1. Its functions are essential for the smooth operation of the central and peripheral nervous systems.
A deficiency in it for prolonged periods could lead to severe damage to the nervous system, heart and brain. However, in optimum quantities, it does not just help the body operate smoothly but also reduces health complications such as the reduction of Diabetic complications, the risk of heart failure, and significantly affect the onset of Alzheimer’s disease.
Sources of Thiamine
Thiamine is available in various foods, so much so that it is almost impossible to miss any of the sources as long as you are eating a balanced meal at least once a day. The recommended daily intake (RDI) for men is 1.2 mg and 1.1 mg for women.
Below are some of the primary sources of thiamine:
- Fish – Example: Tuna and Trout
- Meat – Example: Pork and
- Whole grains – Bread and cereals
- Eggs
Dairy products, fruits and vegetables are rich sources of thiamine. However, when taken in large quantities, they can become substantive sources of the vitamin. Therefore, it is recommended that meals have at least 20% of the DV to make them a high nutrient source. As long as individuals consume foods with at least 20% of the DV, they will get all nutrients in suitable proportions.
Thiamine Deficiency
The body stores thiamine in low quantities, so it is essential to keep refuelling through meals. If an individual is not eating much or eating well and is perhaps throwing up the food they eat, the probability of the person suffering a deficiency is very high. This is usually rare, though, considering that thiamine is found in many foods we consume. So as long as the individual is eating, they might not experience the deficiency.
Thiamine deficiency can sometimes lead to more severe illnesses and irreversible health consequences. When the deficiency persists for a long time and is not dealt with, it interferes with the healthy function of the individual’s heart, circulatory system, nervous system, and brain.
In difficult mover situations, the damage is irreversible, and the individual may have to live with it. An example of such a situation is when it leads to alcohol-related brain damage.
So who is at Risk of Thiamine Deficiency?
Not many individuals are at risk of thiamine deficiency in today’s world due to all the advancements that have been made medically, agriculturally and technologically. There are many healthy food sources for individuals in today’s world as compared to centuries ago. Supplements are available to make sure we meet our required nutrient intake. As long as individuals are on a healthy diet, they will be good unless they have certain health conditions.
Some of the health conditions that may put an individual at risk of a thiamine deficiency include:
- Crohn’s Disease
- HIV/AIDS
- Diabetes
- Kidney Disease
- Heart failure which comes with long term diuretic treatment
Thiamine and Alcohol
Aside from health conditions, another factor that might lead to thiamine deficiency and has usually been found to be the underlying cause of thiamine deficiency is alcohol. Alcoholism and alcohol dependency remain significant causes of thiamine deficiency today.
Although illnesses have been shown to affect thiamine in the body by either causing increased excretion of low absorption, alcohol does have similar and, in some cases, more significant effects. Ethanol which is the type of alcohol used for alcoholic beverages significantly affects gastrointestinal absorption of thiamine. When Alcohol is consumed excessively, it causes inflammation of the gastrointestinal tract, which affects the body’s ability to absorb vitamins through the stomach’s lining.
This leads to a deficiency of the vitamin in the body at levels so significant that if nothing is done about it, it could be dangerous for the individual. Approximately 80% of chronic alcohol users have the deficiency since they cannot absorb enough of the vitamin or their bodies are impaired in their utilisation of it for the good of the body.
Some studies investigating thiamine deficiency have discovered that the absorption of thiamine varied among individuals who abuse alcohol, with some not being able to absorb any thiamine at all. In addition, the chronic use and abuse of alcohol have also been linked with the development of the Wernicke-Korsakoff Syndrome.
What are the Symptoms Associated with Thiamine Deficiency
Thiamine deficiency can come with several symptoms. The general symptoms associated with thiamine deficiency are so subtle that they can easily be overlooked. Symptoms include
- Anorexia
- Weight Loss
- Weakness & Fatigue
- Emotional Disturbances
- Mental confusion
- Short-term memory loss
- Tingling sensations in arms and legs
- Blurry Vision
Types of Thiamine Deficiency
Thiamine deficiency is sometimes known as beriberi. Depending on the symptoms present in the individual, it can be grouped into two major types; dry beriberi and wet beriberi.
Dry Beriberi
This type of beriberi is sometimes referred to as paralytic beriberi. Individuals with this type of beriberi suffer from damage or dysfunction to their nervous system, leading to numbness or tingling sensations in the legs and arms and exaggerated reflexes. If these symptoms are not treated, the individual could eventually end up paralysed and die in much more extreme situations. Symptoms that are usually exclusive to dry beriberi include:
- Difficulty walking
- Speech difficulties
- Paralysis of lower legs
- Involuntary eye movements
- Vomiting
Dry beriberi is sometimes referred to as Cerebral Beriberi because of its brain-damaging effects. It is also associated with Wernicke’s Encephalopathy and Korsakoff’s Psychosis. Wernicke’s Encephalopathy is cerebellar dysfunction. When this condition is not treated, it deteriorates further into Korwsakoff’s Psychosis.
An individual experiencing combined symptoms from both conditions is described as having the Wernicke – Korswasakoff Syndrome (WKS). With the Wernicke-Korsakoff Syndrome, the individual has amnesic symptoms, experiences confusion and constantly experiences loss of recent and working memory. In some situations, these symptoms are accompanied by seizures, although this is quite rare. This condition has been significantly associated with alcohol abuse.
Wet Beriberi
This type of beriberi is sometimes called cardia beriberi, as it affects the heart and circulatory system. It can lead to heart failure and cause the weakening of the capillary walls, which can cause pain. It is characterised by
- An enlarged heart
- Increased heart rate
- Dyspnea (shortness of breath)
- Intense swelling (also referred to as oedema)
Gastrointestinal Beriberi
There is potentially a third type of beriberi which is the Gastrointestinal Beriberi. As the name implies, this type of beriberi has to do with the stomach and intestines. It is predominantly characterised by nausea, vomiting, abdominal pain and lactic acidosis and was first prescribed as recently as 2004.
Treatment of Thiamine Deficiency
General treatment of thiamine deficiency or beriberi can be done by simply reintroducing thiamine into the body. Therefore, the treatment is done in these two main ways.
- IV – Thiamine is most effective when introduced into the body intravenously. It is usually the first treatment given depending on the severity of the deficiency, and the effect is felt within 24 hours of administration.
- Oral – This form of treatment is usually done after IV, depending on the severity of the deficiency. An individual may be encouraged by the doctor to take dietary supplements or thiamine capsules/tablets. They can have a sulphuric smell, but that is normal.
Dosage: The usual dose is between 25mg and 100mg for those with mild thiamine deficiency, taken once a day. The usual dose is 100mg taken 2 or 3 times daily for those with more severe deficiency.
Things to Note
- None of these treatments should, however, be taken without a doctor’s prescription.
- Individuals who have a more severe deficiency and may have developed extreme conditions such as peripheral neuropathy might require months of treatment to get better. WKS, for instance, may require high doses of thiamine to mitigate the effects of the disease.
Conclusion
Although thiamine deficiency is not common, it is still hazardous if it does occur. For example, suppose you regularly consume alcohol and experience the symptoms listed. In that case, it might be on the safer side to visit your health practitioner and make sure everything is fine. However, do not downplay it; it’s too risky. It is always better to consult with a medical professional and nutrition expert to ensure you’re not deficient in essential nutrients.
However, if you are not the one but know a significant other in that situation, encourage them to seek help. We at Help4addiction provide evidence-based treatment and counselling for those in need. Feel free to contact us today to assess the alcohol-related health risks.
