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Why Do We Give Thiamine to Alcoholics?

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Alcohol use disorder (AUD) can often cause thiamine deficiency. Thiamine deficiency occurs when you don’t get enough thiamine. Your body may not absorb thiamine, or it loses too much.

Roughly 80% of chronic alcoholic patients suffer from this condition.3 Clinicians may prescribe thiamine to those suffering from AUD-induced thiamine deficiency.

Why Does AUD Cause Thiamine Deficiency?

Alcohol reduces the absorption of vitamin B1. Heavy drinking can damage the stomach lining, reducing vitamin absorption. Depending on the person, some with AUD absorb no thiamine at all.

An alcoholic’s diet is also low in thiamine. Alcoholics are more likely to drink alcoholic beverages as part of their daily energy intake. They’re also more likely to skip meals or binge on unhealthy food. 

Alcoholics have nutrient-deficient food and beverage choices. This increases the risk of thiamine deficiency. 

If a person continues to experience thiamine deficiency, they can end up with serious health conditions.

Symptoms of Thiamine Deficiency in Alcoholics

The most common reason for thiamine deficiency is inadequate dietary intake. However, in Western countries, thiamine deficiency is more prevalent in individuals suffering from alcoholism or chronic illness.

The symptoms of thiamine deficiency are non-specific. Many people may not even notice that they’re suffering from this condition.  

Symptoms of thiamine deficiency include:

Fatigue and Weakness

Thiamine converts food to energy. So, people with thiamine deficiency get tired easily. 

When you don't have enough thiamine, your body won't produce enough energy for day-to-day function. This leads to fatigue and weakness.

Some studies have also linked fatigue to thiamine deficiency. For instance, one study showed that post-stroke patients with chronic fatigue have benefited from high-dose thiamine.7 

Weight Loss and Anorexia

Although weight loss can be linked with alcohol dependence, it can also signify thiamine deficiency. Thiamine deficiency can reduce appetite. 

In one study, researchers observed the effects of thiamine deficiency in mice. They fed mice a thiamine-deficient diet for 16 weeks. As a result, the mice displayed a significant amount of weight loss.8

According to the researchers, thiamine deficiency inhibited hypothalamic adenosine monophosphate-activated protein kinase (AMPK) activity. AMPK regulates food intake. 

When the researchers treated the mice with thiamine, their appetite returned, and their body weights increased.

Nausea and Vomiting

Thiamine deficiency can cause nausea and vomiting. These symptoms are often associated with infections or gastrointestinal problems.

Although nausea and vomiting are non-specific symptoms, they're more prevalent in those with thiamine deficiency.

In addition, alcoholics are more prone to these gastrointestinal problems. Excessive alcohol consumption damages the lining of the stomach. The damage causes ulcers and bleeding.

Emotional Disturbances

People with thiamine deficiency also experience emotional disturbances. These may include confusion, short-term memory loss, and irritability.

Thiamine deficiency can also affect your mood. The vitamin affects neurotransmitters that regulate emotions.

What is Thiamine?

Thiamine is also known as Vitamin B1. It's essential for a healthy brain and dendrite function. Dendrites are the parts of your neurons that send and receive information. Without thiamine, dendrites are less able to do this.

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

It can reduce diabetic complications and heart issues. Thiamine also prevents or delays the onset of Alzheimer’s disease. According to the NHS, a lack of thiamine can kill your neurons, making Alzheimer's more likely.4

Thiamine is available in plants, food, and vitamin supplements. It’s usually found in whole grains, meat, and fish. 

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Risks of Thiamine Deficiency in Alcoholics

Alcoholics are more prone to thiamine deficiency. Continuous thiamine deficiency can cause serious health conditions, such as: 

Beriberi

Thiamine deficiency can lead to beriberi, a heart and nerve issue.

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). This condition is a devastating brain disorder caused by thiamine deficiency.

WKS comprises two separate disorders: 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.

Treating Thiamine Deficiency in Heavy Drinkers

Heavy drinkers are at risk of developing a thiamine deficiency. Once the symptoms appear, you must know how to get your thiamine levels back up.

Here are some tips on how to treat thiamine deficiency in heavy drinkers:

  • Get adequate amounts of thiamine through your diet: Choose food high in thiamine, such as whole grains, meat, yogurt, and fish.
  • Cut back on alcohol intake: Consuming alcohol will affect your body's ability to absorb thiamine. It's best to avoid drinking altogether. If you must drink, limit yourself to two drinks per day.
  • Take supplements containing thiamine: There are many ways to supplement your daily thiamine needs. For example, you can take oral capsules. People with nutrient absorption problems may receive thiamine through an IV drip.

If you think you may have low levels of thiamine, talk to your doctor about the best treatment options.

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Alcohol Addiction Treatment Options

Several treatment options are available for alcohol addiction. 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. Professionals can also 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 various activities for a better recovery experience. 
  • Support groups: Support groups provide refuge to those who have suffered from prior alcohol addiction. They may serve as an emotional outlet to ensure you stay clean. 
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Updated on September 29, 2022
8 sources cited
  1. Agabio, Roberta. “Thiamine administration in alcohol-dependent patients.” OUP Academic, Oxford University Press, 2004.
  2. Higdon, Jane. “Thiamin.” Linus Pauling Institute, Oregon State University, 2000.
  3. Office of Dietary Supplements - Thiamin.” NIH Office of Dietary Supplements, U.S. Department of Health and Human Services.
  4. Thomson, Allan D. “Mechanisms of Vitamin Deficiency in Chronic Alcohol Misusers and the Development of the Wernicke-Korsakoff Syndrome.” OUP Academic, Oxford University Press, 2000.
  5. Vitamin B1 (Thiamine).” Mount Sinai Health System.
  6. Thiamin.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2020.
  7. Costantini, A., et al. "High-dose thiamine improves fatigue after stroke: a report of three cases." Journal of alternative and complementary medicine, 2014.
  8. Liu, M., et al. "Thiamine deficiency induces anorexia by inhibiting hypothalamic AMPK." Neuroscience, 2014.

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