Thiamine deficiency unrelated to alcohol consumption in high‐income countries: a literature review

Gomes, Filomena; Bergeron, Gilles; Bourassa, Megan W.; Fischer, Philip R.

doi:10.1111/nyas.14569

Cited by 27 publications

(29 citation statements)

References 38 publications

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“… 11 Thiamine deficiency has also been reported in intensive care unit settings when patients are critically ill with infections and other illness. 11 …”

Section: Historical Perspectivementioning

confidence: 99%

Thiamine deficiency disorders: a clinical perspective

Smith

Johnson

Koshy³

et al. 2020

Annals of the New York Academy of Sciences

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101

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Thiamine is an essential water‐soluble vitamin that plays an important role in energy metabolism. Thiamine deficiency presents many challenges to clinicians, in part due to the broad clinical spectrum, referred to as thiamine deficiency disorders (TDDs), affecting the metabolic, neurologic, cardiovascular, respiratory, gastrointestinal, and musculoskeletal systems. Concurrent illnesses and overlapping signs and symptoms with other disorders can further complicate this. As such, TDDs are frequently misdiagnosed and treatment opportunities missed, with fatal consequences or permanent neurologic sequelae. In the absence of specific diagnostic tests, a low threshold of clinical suspicion and early therapeutic thiamine is currently the best approach. Even in severe cases, rapid clinical improvement can occur within hours or days, with neurological involvement possibly requiring higher doses and a longer recovery time. Active research aims to help better identify patients with thiamine‐responsive disorders and future research is needed to determine effective dosing regimens for the various clinical presentations of TDDs. Understanding the clinical diagnosis and global burden of thiamine deficiency will help to implement national surveillance and population‐level prevention programs, with education to sensitize clinicians to TDDs. With concerted effort, the morbidity and mortality related to thiamine deficiency can be reduced.

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“… 11 Thiamine deficiency has also been reported in intensive care unit settings when patients are critically ill with infections and other illness. 11 …”

Section: Historical Perspectivementioning

confidence: 99%

Thiamine deficiency disorders: a clinical perspective

Smith

Johnson

Koshy³

et al. 2020

Annals of the New York Academy of Sciences

Self Cite

101

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“…In many countries, mandatory or voluntary fortification of food products with thiamine provides an artificial dietary source of the vitamin, compensating for its often-insufficient intake from foods containing it naturally [ 12 , 23 , 92 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 ]. Fortified foods contribute to about half of the total thiamine consumed in some high-income countries [ 175 , 180 ]. Wheat flour, maize flour, and rice are foods commonly fortified with thiamine [ 61 , 92 , 181 , 182 , 183 , 184 , 185 , 186 ].…”

Section: Thiamine—vitamin Bmentioning

confidence: 99%

Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5

et al. 2022

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This review summarizes the current knowledge on essential vitamins B1, B2, B3, and B5. These B-complex vitamins must be taken from diet, with the exception of vitamin B3, that can also be synthetized from amino acid tryptophan. All of these vitamins are water soluble, which determines their main properties, namely: they are partly lost when food is washed or boiled since they migrate to the water; the requirement of membrane transporters for their permeation into the cells; and their safety since any excess is rapidly eliminated via the kidney. The therapeutic use of B-complex vitamins is mostly limited to hypovitaminoses or similar conditions, but, as they are generally very safe, they have also been examined in other pathological conditions. Nicotinic acid, a form of vitamin B3, is the only exception because it is a known hypolipidemic agent in gram doses. The article also sums up: (i) the current methods for detection of the vitamins of the B-complex in biological fluids; (ii) the food and other sources of these vitamins including the effect of common processing and storage methods on their content; and (iii) their physiological function.

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“…There are no significant stores of thiamine in any human tissue (21), and its concentrations are highest in the skeletal muscles, heart, kidney, liver and brain respectively (24,25). Due to its short half-life of 9.5-18.5 days (24), necessary role in multiple metabolic processes and increased requirements in some pathological states, appropriate dietary intake is crucial for avoiding deficiency states (26,27).…”

Section: Thiamine: Functions and Mechanisms Of Actionmentioning

confidence: 99%

Insights Into Thiamine Supplementation in Patients With Septic Shock

et al. 2022

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Septic shock is associated with unacceptably high mortality rates, mainly in developing countries. New adjunctive therapies have been explored to reduce global mortality related to sepsis. Considering that metabolic changes, mitochondrial dysfunction and increased oxidative stress are specific disorders within the path of septic shock, several micronutrients that could act in cellular homeostasis have been studied in recent decades. Thiamine, also known as vitamin B1, plays critical roles in several biological processes, including the metabolism of glucose, synthesis of nucleic acids and reduction of oxidative stress. Thiamine deficiency could affect up to 70% of critically ill patients, and thiamine supplementation appears to increase lactate clearance and decrease the vasopressor dose. However, there is no evident improvement in the survival of septic patients. Other micronutrients such as vitamin C and D, selenium and zinc have been tested in the same context but have not been shown to improve the outcomes of these patients. Some problems related to the neutrality of these clinical trials are the study design, doses, route, timing, length of intervention and the choice of endpoints. Recently, the concept that multi-micronutrient administration may be better than single-micronutrient administration has gained strength. In general, clinical trials consider the administration of a single micronutrient as a drug. However, the antioxidant defense is a complex system of endogenous agents in which micronutrients act as cofactors, and the physiological interactions between micronutrients are little discussed. In this context, the association of thiamine, vitamin C and corticoids was tested as an adjunctive therapy in septic shock resulting in a significant decrease in mortality. However, after these initial results, no other study conducted with this combination could reproduce those benefits. In addition, the use of low-dose corticosteroids is recommended in patients with septic shock who do not respond to vasopressors, which can affect the action of thiamine. Therefore, given the excellent safety profile, good biologic rationale and promising clinical studies, this review aims to discuss the mechanisms behind and the evidence for single or combined thiamine supplementation improving the prognosis of patients with septic shock.

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Thiamine deficiency unrelated to alcohol consumption in high‐income countries: a literature review

Cited by 27 publications

References 38 publications

Thiamine deficiency disorders: a clinical perspective

Thiamine deficiency disorders: a clinical perspective

Biological Properties of Vitamins of the B-Complex, Part 1: Vitamins B1, B2, B3, and B5

Insights Into Thiamine Supplementation in Patients With Septic Shock

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