Thiamine supplement
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The Benefits and Effects of Thiamine Supplementation
Thiamine Supplementation in Critically Ill Patients
Thiamine, also known as vitamin B1, has been studied extensively for its potential benefits in critically ill patients. A systematic review and meta-analysis of 18 studies, including both randomized controlled trials (RCTs) and cohort studies, found that thiamine supplementation significantly reduced the odds of developing ICU delirium by 42% among critically ill patients1. However, the analysis did not show a significant reduction in overall mortality or mortality in patients with sepsis1. These findings suggest that while thiamine may help in reducing certain complications like ICU delirium, its impact on survival rates remains inconclusive.
Thiamine and Glycaemic Control in Type 2 Diabetes
Patients with type 2 diabetes mellitus (T2DM) often exhibit thiamine deficiency, prompting investigations into whether thiamine supplementation could improve glycaemic outcomes. A systematic review and meta-analysis of six trials involving 364 participants found no significant beneficial effects of thiamine or benfotiamine (a thiamine derivative) on HbA1c, fasting blood glucose (FBG), or postprandial blood glucose (PPG) levels2. However, the supplementation did result in a significant increase in high-density lipoprotein (HDL) and a reduction in triglyceride levels at specific doses2. These results indicate that while thiamine may not directly improve blood glucose control, it could have favorable effects on lipid profiles in T2DM patients.
Thiamine's Impact on Blood Pressure and Lipid Profiles
In individuals with hyperglycemia, thiamine supplementation has shown potential benefits in managing blood pressure. A randomized, double-blind cross-over trial involving 12 hyperglycemic subjects found that high-dose thiamine significantly decreased diastolic blood pressure (DBP) and mean arterial pressure (MAP) after six weeks of supplementation3. However, no significant changes were observed in lipid profiles or C-reactive protein (hs-CRP) levels3. These findings suggest that thiamine may help in lowering blood pressure in hyperglycemic individuals, potentially reducing the risk of vascular complications.
Thiamine and Inflammation in Dairy Cows
Thiamine supplementation has also been studied in the context of animal health, particularly in dairy cows. Research has shown that thiamine can attenuate inflammation induced by high-grain diets in low-yielding dairy cows. Thiamine supplementation increased the expression of thiamine transporters in the rumen epithelium and reduced inflammatory markers such as lipopolysaccharide (LPS) and pro-inflammatory cytokines4. These findings suggest that thiamine could play a protective role against diet-induced inflammation in dairy cows, potentially improving their overall health and productivity.
Thiamine in Heart Failure Patients
Thiamine deficiency is a concern in patients with chronic heart failure, especially those on diuretic treatment. A randomized, double-blind, placebo-controlled cross-over pilot study involving nine heart failure patients found that high-dose thiamine supplementation significantly improved left ventricular ejection fraction (LVEF) after 28 days5. This improvement in cardiac function highlights the potential of thiamine supplementation in managing heart failure, particularly in patients at risk of thiamine deficiency due to diuretic use.
Thiamine and Tumor Proliferation
While thiamine supplementation is generally considered beneficial, it may have unintended effects in certain conditions, such as cancer. A study on mice with Ehrlich's ascites tumor found that thiamine supplementation significantly increased tumor growth by activating the transketolase enzyme, which is involved in cell replication8. This suggests that while thiamine is essential for overall health, its supplementation in cancer patients should be approached with caution due to the potential risk of promoting tumor proliferation.
Conclusion
Thiamine supplementation offers various health benefits, including reducing ICU delirium in critically ill patients, improving lipid profiles in T2DM patients, and lowering blood pressure in hyperglycemic individuals. It also shows promise in managing heart failure and reducing inflammation in dairy cows. However, its effects on tumor proliferation warrant careful consideration. Further research is needed to fully understand the diverse impacts of thiamine supplementation across different health conditions.
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Most relevant research papers on this topic
Effect of thiamine supplementation in critically ill patients: A systematic review and meta-analysis.
Thiamine supplementation in critically ill patients reduces ICU delirium but shows no significant benefit in overall mortality or sepsis mortality.
Meta-AnalysisEffect of thiamine supplementation on glycaemic outcomes in adults with type 2 diabetes: a systematic review and meta-analysis
Thiamine supplementation does not significantly affect glycemic outcomes in adults with type 2 diabetes, but reduces triglycerides and increases HDL levels.
Meta-Analysis
Rigorous JournalThe impact of thiamine supplementation on blood pressure, serum lipids and C-reactive protein in individuals with hyperglycemia: a randomised, double-blind cross-over trial.
High dose thiamine supplementation may have beneficial effects on blood pressure in individuals with early-stage hyperglycemia, potentially preventing further vascular complications.
RCTThiamine supplementation facilitates thiamine transporter expression in the rumen epithelium and attenuates high-grain-induced inflammation in low-yielding dairy cows.
Thiamine supplementation in dairy cows can reverse depressions in ruminal pH, milk fat, and protein, and reduce high-grain-induced inflammation.
RCT
Animal StudyRigorous JournalThiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study
Thiamine supplementation improves cardiac function in patients with diuretic drugs for symptomatic chronic heart failure, potentially addressing subclinical thiamine deficiency.
RCTRigorous Journal
Highly CitedThiamine ameliorates metabolic disorders induced by a long-term high-concentrate diet and promotes rumen epithelial development in goats.
Dietary thiamine supplementation can alleviate metabolic disorders and promote rumen epithelial growth in goats fed a long-term high-concentrate diet.
RCTRigorous JournalThiamine supplementation in the critically ill
Thiamine supplementation is crucial in critically ill patients to prevent potential neurological damage and increase survival rates.
Literature ReviewHighly CitedThe effect of thiamine supplementation on tumour proliferation. A metabolic control analysis study.
Thiamine supplementation sufficient to correct thiamine deficiency stimulates tumor growth, but high doses may inhibit tumor growth.
Non-RCTAnimal StudyHighly CitedThiamine ameliorates inflammation of the ruminal epithelium of Saanen goats suffering from subacute ruminal acidosis.
Thiamine supplementation in Saanen goats mitigates high-concentrate diet-induced local inflammation and improves ruminal pH, suggesting its potential as a dietary supplement for ruminal health.
RCTRigorous JournalThiamine supplementation mood and cognitive functioning
Thiamine supplementation improves mood and reaction times in young adult females, without affecting memory, but does not affect memory.
RCTHighly Cited