Thiamine (Vitamin B1)


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Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Metabolic disorders (subacute necrotizing encephalopathy, maple syrup urine disease, pyruvate carboxylase deficiency, hyperalaninemia)
Taking thiamine by mouth helps to temporarily correct some complications of metabolic disorders associated with genetic diseases, including subacute necrotizing encephalopathy (SNE, Leigh's disease), maple syrup urine disease (branched-chain aminoacidopathy), and lactic acidosis associated with pyruvate carboxylase deficiency and hyperalaninemia. Long-term management should be under strict medical supervision. 		A
Thiamin deficiency (beriberi, Wernicke's encephalopathy, Korsakoff's psychosis, Wernicke-Korsakoff syndrome)
Humans are dependent on dietary intake to fulfill their thiamine requirements. Because there is very little thiamine stored in the body, depletion can occur quickly, within 14 days. Severe chronic thiamine deficiency can result in potentially serious complications involving the nervous system, brain, muscles, heart, and gastrointestinal system. Patients with thiamine deficiency or related conditions should receive supplemental thiamine under medical supervision. 		A
Alcoholism
Patients with chronic alcoholism or those experiencing alcohol withdrawal are at risk of thiamine deficiency and its associated complications and should be administered thiamine. 		B
Total parenteral nutrition (TPN)
It has been suggested that thiamine should be added to total parenteral nutrition (TPN) formulations for patients who are unable to receive thiamine through other sources (such as an oral multivitamin) for more than seven days. The use of thiamine in parenteral nutrition has been mentioned in several reviews. 		B
Alzheimer's disease
Because thiamine deficiency can result in a form of dementia (Wernicke-Korsakoff syndrome), its relationship to Alzheimer's disease and other forms of dementia has been investigated. Whether thiamine supplementation is of benefit in Alzheimer's disease remains controversial. Further evidence is necessary before a firm conclusion can be reached. 		C
Anemia (thiamine-responsive megaloblastic anemia syndrome)
Thiamine-responsive megablastic anemia (TRMA) is a genetic disorder affecting thiamine transport in the body or the conversion of thiamine into its active form. DIDMOAD (Wolfram) syndrome is a rare autosomal recessive inherited disease that results in diabetes mellitus, optic atrophy, diabetes insipidus, sensorineural deafness, and occasionally thiamine-responsive megaloblastic anemia. Management, including thiamine supplementation, should be under strict medical supervision. 		C
Atherosclerosis (prevention in patients with acute hyperglycemia, impaired glucose tolerance (IGT), and diabetes mellitus)
Patients with diabetes are at risk of developing hardened arteries (called atherosclerosis). This happens when cholesterol and other substances build up and clog the arteries. Thiamine has been studied as a way to help widen arteries that are too narrow. Regular intake of thiamine might help slow the progression of atherosclerosis. However, additional research is needed. 		C
Athletic performance
Active individuals who reduce intake of food might be at greater risk of vitamin deficiency, including thiamine deficiency. There is inconclusive scientific evidence for supplementation in this area. 		C
Cancer
Thiamine deficiency has been observed in some cancer patients, possibly due to increased metabolic needs, medication use, or malnutrition. It is not clear if lowered levels of thiamine in such patients may actually be adaptive (beneficial). Currently, it remains unclear if thiamine supplementation plays a role in the management of any particular types of cancer. 		C
Cataract prevention
Preliminary evidence suggests that high dietary thiamine intake may be associated with a decreased risk of cataracts. Further evidence is necessary before a firm conclusion can be reached. 		C
Cerebellar ataxia
Preliminary research suggests thiamine supplementation has benefit for acute cerebellar ataxia following febrile illness. Further research is needed. 		C
Coma/hypothermia of unknown origin
Administration of thiamine is often recommended in patients with coma or hypothermia of unknown origin, due to the possible diagnosis of Wernicke's encephalopathy. 		C
Crohn's disease
Decreased serum thiamine levels have been reported in patients with Crohn's disease. It is not clear if routine thiamine supplementation is beneficial in such patients generally. 		C
Diabetic complications
Thiamine may prevent diabetic complications, including complications of the nervous system, eyes, blood vessels, and kidneys. Other diabetic complications that may benefit from thiamine supplementation include increased urination, high levels of glucose in the urine, and high blood cholesterol levels. Additional research is needed in this field. 		C
Dysmenorrhea
Based on preliminary evidence, thiamine may be effective for dysmenorrhea. Further research is needed to confirm these results. 		C
Epilepsy
Preliminary research suggests that thiamine may improve attention and motor function in patients with epilepsy. However, data are limited, and further research is needed. 		C
Heart failure (cardiomyopathy)
Chronic severe thiamine deficiency can cause heart failure (wet beriberi), a condition that merits thiamine supplementation. It is not clear that thiamine supplementation is beneficial in patients with heart failure due to other causes. However, it is reasonable for patients with heart failure to take a daily multivitamin including thiamine, because some of these individuals may be thiamine deficient. Diuretics may lower thiamine levels. Since diuretics are commonly administered to patients with heart failure, patients taking diuretics are at an increased risk of thiamine deficiency. This area remains controversial, and further evidence is necessary before a firm conclusion can be reached. 		C
Leg cramps (during pregnancy)
Vitamin B supplements have been used to treat leg cramps during pregnancy. However, additional studies are needed to determine if it is effective. 		C
Mitochondrial disorders
Mitochondrial disorders are genetic defects in mitochondrial energy production and can lead to various types of diseases. There is some evidence to suggest that thiamine may be used as part of a treatment regimen for these disorders. Well-designed research is needed before conclusions can be drawn. 		C
Pyruvate dehydrogenase deficiency (PDH)
There is preliminary evidence of clinical improvements in children with PDH following thiamine administration. Further evidence is necessary before a firm conclusion can be reached. 		C
Renal impairment (kidney dysfunction)
Vitamin deficiency, including thiamine deficiency, is associated with chronic renal insufficiency. Multivitamin supplementation is often recommended. However, some researchers believe individualization may be necessary. Research is needed in this field. 		C
Rheumatic diseases
Preliminary evidence suggests that B vitamins might aid in pain reduction. However, clinical data are lacking for B vitamins and rheumatic diseases. Further research is needed. 		C
Subclinical thiamin deficiency in the elderly
While typically asymptomatic, the elderly have been found to have lower thiamine concentrations than younger people. There is limited evidence that thiamine supplementation may be beneficial in individuals with persistently low thiamine blood levels. Further research is necessary before a firm conclusion can be formed in this area. 		C
Temporomandibular joint disorder (TMJ)
A combination of indomethacin and thiamine were found to be less effective than classical acupuncture for temporomandibular disorders. Further research is needed in this field. 		C
Fractures (hip)
Preliminary evidence shows that supplemental thiamine is not beneficial for hip fractures. 		D

Key to grades
A Strong scientific evidence for this use
B Good scientific evidence for this use
C Unclear scientific evidence for this use
D Fair scientific evidence against this use (it may not work)
F Strong scientific evidence against this use (it likely does not work)

Grading rationale

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Aging, AIDS/HIV, amnesia, antioxidant, arrhythmia, arthritis, bedwetting, Bell's palsy, blood disorders (myelodysplastic syndrome), brain damage (hepatic encephalopathy, ifosfamide-induced encephalopathy), canker sores, chronic diarrhea, circulation improvement, death and dying (sudden unexplained death syndrome), delirium, depression, Down syndrome, drug withdrawal, erectile dysfunction, fibromyalgia, filariasis, gastrointestinal disorders, Guillain-Barre syndrome, hair loss, high blood pressure, HIV support, insect repellant, kidney failure, lactic acidosis, learning, liver damage from drugs or toxins, liver disease, loss of appetite, low back pain, lung disease, malaria, memory enhancement, menstrual problems, migraine, mitochondrial diseases, mood, motion sickness, multiple sclerosis, muscle weakness (fine motor control), neuritis (associated with pregnancy), neurologic disorders, obesity (bariatric surgery), ophthalmologic disorders, optic nerve dysfunction (optic neuropathy), pain, pancreatic disorders (encephalopathy), peripheral neuropathy (associated with pellagra), poisoning, pyruvate carboxylase deficiency, pyruvate dehydrogenase deficiency, radiation-induced damage (protection from genetic changes), refeeding syndrome prevention, respiratory disorders (scleroma), stress, sudden infant death syndrome (SIDS), tetanus, tissue healing after surgery, tuberculosis, ulcerative colitis, vitamin and nutrient deficiency (dependency syndrome).

Dosing Related terms
NS_patient-thiamin Portions of this document last updated: Sept. 1, 2012

THIS EVIDENCE-BASED MONOGRAPH WAS PREPARED BY
THE NATURAL STANDARD RESEARCH COLLABORATION
(www.naturalstandard.com)

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