Thiamine contributes to the health of the nerves in many ways. A deficiency may cause paresthesia. Short-term, temporary muscle weakness happens to almost everyone at some point. However, persistent, long-standing muscle weakness without a clear cause or reason may be a sign of thiamine deficiency. In multiple cases, patients with thiamine deficiency have experienced muscle weakness 16 , 19 , Severe thiamine deficiency can cause swelling of the optic nerve, inducing optic neuropathy.
This can result in blurry, or even loss of, vision. Multiple documented cases have linked blurry vision and vision loss to severe thiamine deficiency. Thiamine deficiency can cause damage to the optic nerve, which may result in blurry or loss of vision. Vomiting may be more common in infants with deficiency, as it was found to be a common symptom in infants who consumed a thiamine-deficient, soy-based formula On rare occasions, gastrointestinal symptoms like nausea, vomiting or abdominal pain may be symptoms of thiamine deficiency.
Interestingly, it can be affected by your thiamine levels. Not enough thiamine could result in a slower than normal heartbeat. Marked decreases in heart rate have been documented in studies involving thiamine-deficient rats 26 , An abnormally slow heart rate as result of thiamine deficiency may cause increased fatigue, dizziness and a greater risk of fainting.
A thiamine deficiency may cause a decrease in heart rate, resulting in increased fatigue and dizziness. Given that thiamine deficiency can affect heart function, shortness of breath may occur, especially with exertion. This is because thiamine deficiency can sometimes lead to heart failure, which occurs when the heart becomes less efficient at pumping blood.
This can ultimately result in fluid accumulation in the lungs, making it difficult to breathe It is important to note that shortness of breath can have many causes, so this symptom alone is not usually a sign of thiamine deficiency.
Heart failure caused by thiamine deficiency can cause breathlessness. This can occur when fluid accumulates in the lungs. Delirium is a serious condition that results in confusion, reduced awareness and the inability to think clearly. In severe cases, thiamine deficiency can cause Wernicke-Korsakoff syndrome, which involves two types of closely related brain damage 1 , 29 , Wernicke-Korsakoff syndrome is often associated with thiamine deficiency caused by alcohol abuse.
However, thiamine deficiency is also common in elderly patients and may contribute to the occurrence of delirium Some people with thiamine deficiency may show signs of delirium and develop Wernicke-Korsakoff syndrome, especially if thiamine deficiency is a result of chronic alcoholism. Eating a healthy, balanced diet that includes thiamine-rich foods can help prevent a thiamine deficiency.
The recommended daily intake RDI is 1. Below is a list of good sources of thiamine, as well as the RDI found in grams 32 :. Many foods contain small amounts of thiamin, including fish, meat, nuts and seeds.
Most people are able to meet their thiamine requirement without supplementation. Thiamine is found in a variety of whole foods, such as fortified breakfast cereals, macadamia nuts, pork, beans and lentils.
The recommended daily intake for thiamine is 1. Although thiamine deficiency is fairly uncommon in developed countries, various factors or conditions, such as alcoholism or advanced age, can increase your risk. Thiamine deficiency can present itself in various ways, and symptoms are often nonspecific, which makes it difficult to identify. For optimal health, it's a good idea to choose the foods that contain the most nutrients. Here are the 11 most nutrient-dense foods on earth.
There are nine water-soluble vitamins in the human diet. Speak to your doctor if you've been prescribed thiamine and you want to stop taking it for any reason. Thiamine is generally a very safe medicine. Taking too much is unlikely to harm you or your child. Like all medicines, thiamine can cause side effects in some people.
But most people have no side effects or only minor ones. In rare cases, thiamine can cause a serious allergic reaction anaphylaxis.
These are not the full side effects of thiamine. For a full list, see the leaflet inside your medicines packet. You can report any suspected side effect to the UK safety scheme. Thiamine is generally safe to take during pregnancy. However, only take it if your doctor has recommended or prescribed it for you. Thiamine is usually safe to take while you're breastfeeding. It passes into your breast milk, but it's not harmful to your baby. However, if your baby is premature or has health problems, check with a doctor before taking thiamine if you want to breastfeed.
Tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding. However, check with a doctor before starting on thiamine if you're on fluorouracil, a medicine used to treat some types of cancer. Fluorouracil can interfere with the way thiamine works. The doctor may need to adjust your dose of thiamine. Talk to a pharmacist or doctor before taking any herbal remedies or supplements together with thiamine.
Some vitamin and mineral supplements may already contain thiamine. Always check the labels carefully. For safety, tell a doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
If you do not have enough vitamin B1 this process cannot work properly. You may have symptoms such as tiredness, loss of appetite and muscle weakness. Taking man-made thiamine helps restore normal levels of vitamin B1 in your body. This allows your cells to work properly again and your symptoms should improve. However, if you're taking it to treat vitamin B1 deficiency, it may take a few weeks before you start to feel better.
If a doctor has prescribed thiamine to treat a vitamin B1 deficiency, you need to keep taking it until your body is working properly again and your symptoms are better. Many people who become deficient in vitamin B1 cannot absorb enough of the vitamin from their normal diet.
They may need to continue taking a low dose of thiamine for a long time to prevent them from becoming deficient again. You will not notice much difference in the short term but over a few weeks you should graduallly notice that your symptoms improve and you should begin to have more energy again. Your body absorbs the amount of thiamine or vitamin B1 that it needs.
The rest is passed out of your body through your pee. If you are taking thiamine for vitamin B1 deficiency, it's best to avoid drinking alcohol as this will make your symptoms worse. If you are taking thiamine as a vitamin supplement, avoid drinking too much.
Try to keep to the recommended guidelines of no more than 14 units of alcohol a week. A standard glass of wine ml is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol. Thiamine will not stop any contraception from working. This includes the combined pill and emergency contraception. Page last reviewed: 28 November Next review due: 28 November Thiamine vitamin B1 On this page About thiamine Key facts Who can and can't take thiamine How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.
In many patients, Wernicke-Korsakoff syndrome has two phases. At this chronic state of the disorder, parenteral thiamin treatment does not lead to recovery in about one-quarter of patients [ 22 ]. In highly industrialized countries, chronic alcohol use disorders appear to be the most common cause of thiamin deficiency [ 1 ]. Also, people with alcoholism tend to have inadequate intakes of essential nutrients, including thiamin. Possible reasons include low dietary intakes, a combination of chronic diseases, concomitant use of multiple medications, and low absorption of thiamin as a natural result of aging [ 24 , 25 ].
Some small studies have found that the risk of deficiency is particularly high in elderly people who reside in an institution [ 26 , 27 ]. People with HIV infection have an increased risk of thiamin deficiency and its sequelae, including beriberi and Wernicke-Korsakoff syndrome [ 1 , 28 ].
These lower thiamin levels might be due to increases in clearance of thiamin by the kidneys. The relevance of these effects to clinical prognosis or outcomes is not known. About half of these patients experienced long-lasting neurologic impairments.
Micronutrient supplements that include thiamin are almost always recommended for patients following bariatric surgery to avoid deficiencies [ 36 ]. Wernicke-Korsakoff syndrome is one of the most severe neuropsychiatric sequelae of alcohol abuse [ 37 ]. The authors of a Cochrane review of thiamin to treat or prevent Wernicke-Korsakoff syndrome found only two studies that met their inclusion criteria, and one of these studies has not been published [ 37 ].
The Cochrane review authors concluded that the evidence from randomized clinical trials is insufficient to guide healthcare providers in selecting the appropriate dose, frequency, duration, or route of thiamin supplementation to treat or prevent Wernicke-Korsakoff syndrome in patients with alcohol abuse.
However, the authors recommend parenteral thiamin supplementation for patients at high risk, such as those with ataxia, confusion, and a history of chronic alcohol misuse, because oral supplementation is unlikely to produce adequate blood levels. However, the authors of these studies did not assess the potential clinical significance of these findings.
A few small randomized studies have assessed the effects of benfotiamine supplements on diabetic neuropathy. Well-designed studies with larger sample sizes and longer durations are required to determine whether thiamin supplements can reduce glucose levels in patients with diabetes or decrease diabetic compications. Explanations for this association include older age, comorbidities, insufficient dietary intake, treatment with diuretics, and frequent hospitalizations [ 48 ]. Rates of deficiency were even higher when the investigators excluded those who used thiamin supplements.
The different rates of thiamin deficiency in patients with heart failure in these and other studies are probably due to differences in nutrition status, comorbidities, medications and dietary supplements used, and techniques used to measure thiamin status [ 48 ]. The authors of a systematic literature review and meta-analysis found two randomized, double-blind, placebo-controlled trials of thiamin supplementation in people with heart failure that met their eligibility criteria [ 50 ].
In these trials, thiamin supplements significantly improved net change in left ventricular ejection fraction.
The authors did not assess the clinical significance of this finding, however. More research is needed to determine whether thiamin supplements might benefit people with heart failure, even if they have normal thiamin status. The three studies randomly assigned fewer than 20 patients each, and the two crossover studies did not include a washout period [ ].
The review authors stated that it was not possible to draw any conclusions from these three studies because they were small and the publications describing them did not provide enough detail to combine these data in a meta-analysis.
The body excretes excess amounts of thiamin in the urine [ 2 ]. They hypothesize that the apparent lack of toxicity may be explained by the rapid decline in absorption of thiamin at intakes above 5 mg. However, the FNB noted that in spite of the lack of reported adverse events, excessive intakes of thiamin could have adverse effects. Although thiamin is not known to interact with any medications, certain medications can have an adverse effect on thiamin levels.
Some examples are provided below. Individuals taking these and other medications on a regular basis should discuss their thiamin status with their healthcare providers.
Research has linked the use of furosemide to decreases in thiamin concentrations, possibly to deficient levels, as a result of urinary thiamin loss [ 49 , 58 , 59 ]. Whether thiamin supplements are effective for preventing thiamin deficiency in patients taking loop diuretics needs to be determined in clinical studies.
Thiamin supplements might reverse some of these effects. The federal government's — Dietary Guidelines for Americans notes that "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods.
In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients e. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U. Department of Agriculture's MyPlate. This fact sheet by the Office of Dietary Supplements ODS provides information that should not take the place of medical advice.
We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.
Updated: March 26, History of changes to this fact sheet. Find ODS on:. Strengthening Knowledge and Understanding of Dietary Supplements. Health Information Health Information. Thiamin Fact Sheet for Health Professionals.
References Said HM. Encyclopedia of Dietary Supplements. London and New York: Informa Healthcare; Bettendorff L. Present Knowledge in Nutrition. Washington, DC: Wiley-Blackwell; Bemeur C, Butterworth RF. Modern Nutrition in Health and Disease. A high-affinity and specific carrier-mediated mechanism for uptake of thiamine pyrophosphate by human colonic epithelial cells. Thiamine-dependent processes and treatment strategies in neurodegeneration.
Antioxid Redox Signal ; Food and Nutrition Board. Ethnic differences in grains consumption and their contribution to intake of B-vitamins: results of the Multiethnic Cohort Study. Nutr J ; Foods, fortificants, and supplements: Where do Americans get their nutrients?
J Nutr ; Department of Agriculture, Agricultural Research Service. FoodData Central , Food and Drug Administration. National Institutes of Health. Dietary Supplement Label Database. Benfotiamine, thiamine monophosphate chloride and thiamine pyrophosphate chloride, as sources of vitamin B1 added for nutritional purposes to food supplements: Scientific Opinion of the Panel on Food Additives and Nutrient Sources added to Food ANS.
EFSA J ; What We Eat in America, Beriberi disease: is it still present in the United States?
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