Thiamine deficiency
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Thiamine Deficiency: An Overview
Introduction to Thiamine Deficiency
Thiamine, also known as vitamin B1, is a crucial water-soluble vitamin that plays a significant role in energy metabolism and the functioning of various enzymes. Thiamine deficiency can lead to a broad spectrum of health issues, affecting multiple organ systems, and is often underdiagnosed due to its varied clinical presentations3 4.
Cardiovascular Implications of Thiamine Deficiency
Thiamine and Cardiovascular Diseases
Thiamine deficiency has been linked to numerous cardiovascular diseases (CVDs) and associated risk factors, including type 1 and type 2 diabetes, obesity, chronic vascular inflammation, dyslipidemia, heart failure, myocardial infarction, and conduction defects1. The deficiency may contribute to the development and progression of these conditions, and thiamine supplementation has shown potential in reversing some of these effects1.
Non-Alcoholic Causes in High-Income Countries
While traditionally associated with alcoholism, thiamine deficiency is also prevalent in high-income countries among non-alcoholic individuals. Factors such as disease-related malnutrition, bariatric surgery, chronic use of diuretics, repeated vomiting, and restrictive diets can lead to thiamine deficiency. Treatment with intravenous thiamine often results in partial or complete recovery from symptoms, including cardiac, neurological, and metabolic disorders2.
Neurological and Psychiatric Aspects
Impact on the Nervous System
The brain is particularly vulnerable to thiamine deficiency due to its reliance on mitochondrial ATP production. Deficiency can lead to a range of neurological and psychiatric symptoms, from mild issues like confusion and memory loss to severe conditions such as encephalopathy and ataxia5. In children, thiamine deficiency is often linked to malnutrition or genetic defects, and it can have severe consequences if not promptly treated5.
Wernicke-Korsakoff Syndrome
One of the most severe neurological disorders caused by thiamine deficiency is Wernicke-Korsakoff syndrome, which can be fatal if untreated. This condition is often difficult to diagnose, leading to many undiagnosed cases. However, treatment with thiamine generally results in significant clinical improvement10.
Global Prevalence and Public Health Strategies
Prevalence and Risk Factors
Thiamine deficiency is a global issue, affecting various populations due to factors like famine, reliance on low-thiamine staple crops, and certain food preparation practices. The lack of a widely agreed-upon biomarker for thiamine status complicates diagnosis and prevalence assessment4. In high-income countries, pediatric thiamine deficiency is still observed, often linked to genetic causes, lifestyle factors, and critical illnesses9.
Prevention and Control
Public health strategies such as food fortification and maternal/infant thiamine supplementation have proven effective in raising thiamine status and reducing the incidence of related disorders. These measures are particularly important in regions where thiamine deficiency is prevalent4. Additionally, increasing awareness among clinicians about the signs and symptoms of thiamine deficiency can help reduce morbidity and mortality associated with this condition3.
Conclusion
Thiamine deficiency is a serious but treatable condition that affects multiple organ systems. It is not limited to low-income countries or alcoholic populations but is also prevalent in high-income settings due to various medical and dietary factors. Early diagnosis and treatment with thiamine supplementation can lead to significant clinical improvements, highlighting the importance of awareness and preventive measures in managing this global health issue.
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Most relevant research papers on this topic
Thiamine deficiency and cardiovascular disorders.
Thiamine deficiency may contribute to the development of cardiovascular diseases, and future studies should focus on the impact of thiamine supplementation on reversing these conditions.
Systematic ReviewThiamine deficiency unrelated to alcohol consumption in high‐income countries: a literature review
Thiamine deficiency is a serious but treatable condition in adults in developed countries, not just in low- and middle-income countries, and is not exclusive to alcoholic patients.
Systematic Review
Rigorous JournalThiamine deficiency disorders: a clinical perspective
Early therapeutic thiamine treatment is the best approach for thiamine deficiency disorders, which affect various systems, and can lead to rapid clinical improvement.
Rigorous Journal
Highly CitedThiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs
Thiamine deficiency disorders are prevalent worldwide, contributing to infant mortality and neurodevelopmental consequences, and require urgent public health responses.
Rigorous JournalHighly CitedNeurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults
Thiamine deficiency contributes to various neurological and psychiatric disorders, with potential benefits from supplementation in autism spectrum disorder and other neurological conditions.
Highly CitedThiamine deficiency
Thiamine deficiency decreases serotonin uptake in the cerebellum, potentially contributing to neurologic manifestations, and restoring serotonin uptake can significantly improve clinical outcomes.
In Vitro StudyHighly CitedThiamine Deficiency
Thiamine deficiency is a common dietary-related illness, particularly in Southeast Asian refugees, and requires a more comprehensive approach for diagnosis and treatment.
Case ReportHiding in Plain Sight: Modern Thiamine Deficiency
Modern thiamine deficiency rates range from 20% to over 90%, suggesting the RDA may be insufficient to meet modern living demands.
Pediatric thiamine deficiency disorders in high‐income countries between 2000 and 2020: a clinical reappraisal
Pediatric thiamine deficiency is present in high-income countries, with genetic causes, lifestyle, eating disorders, cancer, gastrointestinal disorders, and artificial nutrition as predisposing factors.
Systematic ReviewRigorous JournalThiamine (vitamin B1) deficiency and associated brain damage is still common throughout the world and prevention is simple and safe!
Thiamine supplementation in stable food products like flour is an effective, simple, and safe public health measure that can improve thiamine status in all population groups.
Highly Cited