Thiamine supplementation efficacy
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Thiamine Supplementation Efficacy in Disease and Health
Thiamine Supplementation in Critical Illness and ICU Patients
Thiamine supplementation in critically ill patients has shown some benefits, particularly in reducing the incidence of ICU delirium, but has not demonstrated significant effects on overall mortality, mortality in sepsis, or length of ICU stay according to systematic reviews and meta-analyses of randomized controlled trials Sedhai2021Karimi2023. Thiamine supplementation was found to lower serum creatinine levels, especially in patients over 60, suggesting a protective effect on kidney function, but did not significantly affect lactate levels or the need for renal replacement therapy .
Thiamine Supplementation in Heart Failure
In patients with heart failure, thiamine supplementation has not shown significant improvements in key clinical outcomes such as left ventricular ejection fraction, NYHA class, BNP/NT-proBNP levels, symptom changes, or quality of life, based on systematic reviews and meta-analyses . While thiamine is essential for cardiac metabolism and preclinical data suggest potential benefits, current clinical trial evidence remains inconclusive and limited by small sample sizes and short follow-up periods Ritorto2025Xu2022.
Thiamine Supplementation in Diabetes and Cardiometabolic Health
For adults with type 2 diabetes, thiamine supplementation does not significantly improve glycaemic outcomes such as HbA1c, fasting blood glucose, or postprandial blood glucose. However, it may have a positive effect on lipid profiles, including increasing HDL and reducing triglycerides at certain doses . Thiamine supplementation is also noted to counteract oxidative stress and inflammation, which may benefit cardiometabolic health, though clinical evidence is mixed and further research is needed .
Thiamine Supplementation in Genetic Thiamine Metabolism Disorders
In patients with genetic defects affecting thiamine transport and metabolism (such as SLC19A2, SLC19A3, and TPK1 mutations), thiamine supplementation is effective in restoring thiamine levels and improving clinical outcomes. The dosing varies by genetic defect, and early diagnosis is crucial for optimal benefit .
Thiamine Supplementation in Cancer and Tumor Proliferation
Thiamine deficiency is common in advanced cancer, and supplementation is often used for nutritional support. However, correcting thiamine deficiency in tumor-bearing mice significantly increased tumor growth, likely due to enhanced transketolase activity. Interestingly, very high doses of thiamine had an inhibitory effect on tumor growth, though the mechanism is unclear and requires further study .
Thiamine Supplementation in Post-Acute COVID-19 Syndrome
In patients recovering from COVID-19, thiamine supplementation significantly reduced the duration and severity of post-acute symptoms such as fatigue, myalgia, anosmia, and sleep disturbances. Recovery rates were notably higher in the thiamine group compared to controls, suggesting a beneficial role in post-acute COVID-19 management .
Thiamine Supplementation in Animal Health and Growth
In juvenile beluga fish, dietary thiamine supplementation improved growth performance, protein content, digestive enzyme activity, immune responses, and antioxidant capacity. The most beneficial effects were observed at a specific supplementation level, supporting its use for improving health and growth in aquaculture .
Thiamine Supplementation and Obesity
High-dose thiamine supplementation in mice fed a high-fat, high-fructose diet alleviated obesity symptoms, improved intestinal barrier function, and reshaped gut microbiota composition. These changes were associated with reduced endotoxemia and improved metabolic health, indicating a potential mechanism for thiamine’s anti-obesity effects .
Conclusion
Thiamine supplementation shows clear benefits in specific contexts, such as genetic thiamine metabolism disorders, post-acute COVID-19 syndrome, and animal growth. In critical illness, heart failure, and diabetes, the evidence for clinical benefit is limited or mixed, with some improvements in secondary outcomes like kidney function and lipid profiles. In cancer, thiamine supplementation may stimulate tumor growth when correcting deficiency, but very high doses could have inhibitory effects. Further large-scale, well-designed studies are needed to clarify the efficacy and safety of thiamine supplementation across different populations and conditions.
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