Why Do We Give Thiamine to Alcoholics?

What Is Thiamine?

Thiamine is also known as Vitamin B1. It's essential for healthy brain function.

It's needed for the function of dendrites. Dendrites are the parts of your neurons that send and receive information. Without thiamine, dendrites are less able to do this.

Thiamine is available in plants and food, as well as in vitamin supplements. In serious cases, a patient may need intravenous (IV) thiamine injections.

These are the main types of food that have thiamine:

• Whole grains — grains are the leading source of thiamine. 
• Meat — pork is another common food product that has thiamine. 
• Fish — 3 oz. of trout cooked in dry heat can offer approximately 33% of the daily value (DV). 

In the United States, it's common to find bread, cereals, and infant formulas fortified with thiamine. For this reason, thiamine deficiency is rare. 

What are the Benefits of Thiamine?

Thiamine helps the body to use carbohydrates as energy. It also enables the flow of electrolytes to and from muscle and nerve cells.

It can reduce diabetic complications, heart issues, and prevent or delay the onset of Alzheimer’s disease.

Alzheimer's disease is a form of dementia. It's characterized by severe memory loss. According to the NHS, lack of thiamine can kill your neurons, making Alzheimer's more likely.⁴

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Thiamine Deficiency and Alcohol 

As mentioned earlier, thiamine deficiency is often caused by alcohol use disorder (AUD). Roughly 80% of chronic alcoholic patients suffer from thiamine deficiency.³

This is because alcohol reduces the absorption of vitamin B1. Depending on the person, some with AUD absorb no thiamine at all.

This is why those with AUD are often malnourished.

Early symptoms of thiamine deficiency include:

• Fatigue
• Weakness 
• Weight Loss
• Anorexia
• Emotional disturbances

Thiamine deficiency can lead to beriberi, a heart and circulatory disease.

There are two main types of beriberi:

1. Dry (paralytic or nervous) — Symptoms include nerve dysfunction leading to numbness or tingling sensations in the limbs. Reflex problems are also possible.
2. Wet (cardiac) — Besides neurological symptoms, this condition causes heart issues. These include racing heart rate, enlarged heart, trouble breathing, and heart failure. Another symptom is intense swelling of the limbs. Nausea, vomiting, and severe abdominal pain are also possible.

Wernicke-Korsakoff Syndrome

In extreme cases beriberi can lead to Wernicke-Korsakoff Syndrome (WKS), a devastating brain disorder caused by thiamine deficiency.

WKS is actually made up of two separate disorders that often go together: Wernicke's Encephalopathy and Korsakoff Syndrome. 

WKS is sometimes referred to as alcohol-related dementia.

Wernicke's Encephalopathy usually develops first and has three symptoms:

1. Confusion
2. Loss of muscle coordination
3. Uncontrollable or repetitive eye movements

Korsakoff Syndrome is a severe brain disorder that causes severe short-term memory impairment . In rare cases, seizures are possible.

Korsakoff Syndrome develops in 80% of people with untreated Wernicke’s Encephalopathy.⁴

WKS requires immediate administration of high doses of thiamine to mitigate the effects of the disease, such as eye symptoms.

In more severe cases, in which clinical symptoms have been present for an extended period, improvements in motor coordination skills and memory may be minimal. 

Treatment for Thiamine Deficiency: Why Do We Give Thiamine to Alcoholics? 

Clinicians may prescribe oral thiamine to those with AUD suffering from thiamine deficiency.

Thiamine administered through an IV drip is more effective. It can replenish thiamine stores faster and prevent any clinical symptoms or disorders from worsening.

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Alcohol Addiction Treatment Options

If you or a loved one is suffering from alcohol addiction, there is a range of options available that can place you on the path to recovery. You can select from the following:

• Detoxification programs — when you stop drinking you may go through severe alcohol withdrawal symptoms. Detox programs allow a medical professional to monitor your health and progress and prescribe appropriate actions. Medication-assisted treatment (MAT) can also help someone detox from alcohol.
• Inpatient treatment — This treatment will provide professional support as you work through your addiction. In-patient facilities may also offer a host of activities to make the recovery experience more pleasant. 
• Support groups — Support groups provide refuge and encouragement among those who have suffered from a prior alcohol addiction. They may serve as an emotional outlet to ensure you stay clean.