Vitamin B1 / Thiamin - Are you getting enough?

March 16, 2015 | Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

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 Vitamin B1 / Thiamin - Are you getting enough?
Thiamin is an essential vitamin needed for energy production, brain health, heart health, muscle function, and mood. Thiamin deficiency is often considered a problem of the past, but today’s society and influences show otherwise. Signs that thiamin is lacking include trouble focusing, coordination difficulties, fatigue, fluid managment, and muscle soreness. Thiamin is depleted by high carbohydrates and sugar, caffeine, alcohol, certain medications, and stress. Thiamin need today is much more prevalent than previously thought.

Thiamin is vitamin B1 and is a powerful anti-stress vitamin. We must get it every day from our foods, but most foods generally contain small amounts. Foods that have higher amounts include pork, organ meats, brewer’s yeast and molasses. Other foods have little to no thiamin present, prompting the food industry to add vitamin B1 to processed foods.

Take a look at your cereal box and you will see thiamine mononitrate added. This is the synthetic form of vitamin B1 and the cheapest, most inactive form. This fortification is intended to prevent the most basic, severe disease state from lack of nourishment as set by the government RDA/RDI. The 1998 RDA recommendations are trivial 1.2 mg of thiamin per day for adults, just enough to prevent the ancient scourge beriberi.

Thiamin function impacts a number of enzyme systems in the body and often works together with other minerals, especially magnesium and other B vitamins. It is heavily involved with the breakdown of carbohydrates and branch chain amino acids turning them into energy. It is essential for blood sugar regulation. Thiamin is essential to the function of mitochondria and the Kreb’s cycle for energy production. These are fundamental processes to all tissues, but especially tissues that have high energy demands, i.e. the heart, brain/nervous system, and mitochondria.

Symptoms of inadequate thiamin are often vague, but there are many clues. Think nervous system (brain, peripheral, and autonomic nervous system) heart, and energy production. Difficulty may occur with fatigue, irritability, poor memory and thinking, sleep problems, problems with appetite, abdominal upset and even some types of chest discomfort. Other symptoms may include problems with muscle aches, weakness, and lactic acid build-up in muscles especially in the calf muscles, trouble focusing with vision, swelling in the legs, and increasing concerns with feeling tipsy, losing your balance, or frequently bumping into things. It may affect heart rate, blood pressure regulation, breathing, and sensation in fingers and toes.

The thiamin deficiency and the elevated blood sugar in the brain. It also leads to glutathione depletion and higher levels of oxidative stress damaging the mitochondria.

Standard American Diet Lacks Thiamin

Inadequate thiamin intake relate to poor dietary intake, but many other factors now found in the 21st century deplete or interfere with thiamin. The Standard American Diet is loaded with high amounts of simple carbohydrates and sugars. Thiamin is especially vital to enzymes that breakdown carbohydrates. Consuming a high carb/high sugar diet is a fast track to creating a high functional need for thiamin. In fact, scientists call it high calorie malnutrition which is commonly associated with thiamin deficiency, i.e. early beriberi. Diets high in processed carbohydrates and sugar are a double problem. The food itself is lacking thiamin and the act of metabolizing the high amount of carbohydrates requires higher amounts of vitamin B1 to complete the job.

Alcohol, Coffee, and Tea

Alcohol, coffee, and tea intake, especially chronic and high amounts of intake interfere with thiamin. Tobacco use, raw seafood and carbonated beverages have also been reported to lead to thiamin deficiency. Chronic alcohol use is the most common recognized factor that leads to thiamin depletion.

Gastric By-Pass/Bariatric Surgery

Research from 30 years ago shows that gastric by-pass surgery or bariatric surgery patients suffer chronic thiamin deficiency and often develop severe neurological problems specifically because of it. It is still just as prevalent of a risk today for those going thru bariatric surgery.


Numerous medications cheat the body of vitamin B1. Some of the classes of medications that steal thiamin are acid blockers and antacids, antibiotics, antivirals, barbituates, cardiac glycosides, blood pressure meds/multiple types of diuretics, bronchodilators, HRT and oral contraceptives, SERMs (Selective Estrogen Receptor Modulators) and Sulfonamides.

Other Factors That Lead to Insufficiency

Problems with eating disorders, extensive fasting, high blood sugar levels, magnesium deficiency, GI disorders with chronic vomiting or diarrhea, and genetic disorders also influence thiamin status of the body. Our gut bacteria can also make thiamin if our digestive tract is healthy. Think about the epidemic levels of digestive disorders associated with inflammation and gut bacteria imbalances that are plaguing young and old alike and the implications with thiamin.

A 1999 study showed that in hospitalized elderly individuals, nearly 40% of the patients had moderate thiamin deficiency and suffered from much poorer health. Many senior citizens who may have limited budgets or reduced appetites, eat packaged foods or stretch their one community supported meal to last the whole day, or nibble on tea and crackers all day are all at risk for thiamin deficiency. How about the daily routine for the busy adult loading up on coffee and a quick bagel or scone for breakfast? Does this sound like you or any one that you know who is complaining of forgetfulness, are now on Gabapentin for some neuropathy pains in their feet, or seems like they lose their balance a little more often than they should?


The adrenal glands need thiamin in order to maintain a balanced circadian rhythm and improve the function of adrenal hormones. This was described back in 1975. Healthy adrenal function and circadian problems are tremendous issues for many in this busy world. Lack of thiamin was even shown to be related with low blood pressure and low body temperature.

Functional Autonomic Nervous System Problems

Problems with sweating, rapid heart rate, pulse pressure, attention and focus, dermographia/skin writing (red lines that appear on the skin after scratching and are intensely itchy), blood pressure regulation, and autonomic dysfunction, associated with the Standard American Diet or high caloric malnutrition has been reported in children and young adults.

These are just a handful of recognized concerns associated with thiamin deficiency. Vitamin B1 as thiamin diphosphate is an activated form of supplemental thiamin and is readily absorbed into the system. Dosages for thiamin can range from a 10 mg per day to as much as 1000 mg or more for those with thiamin dependent genetic defects. Vitamin B1 is a water soluble B vitamin and must be replenished on a daily basis.

If you are an individual taking any one of the medications listed above, especially two or more or have a problematic history of blood sugar, blood pressure, cholesterol, fatigue, lactic acid build-up, nerve pain, balance problems, etc. and consume sugar, caffeine or alcohol, chances are you are functionally challenged with thiamin. Don’t wait until you have full blown problems like those described. Simple daily supplementation with a high quality multiple vitamin or a full co-enzyme B complex can help a person avoid these disastrous consequences. This applies to children, adults, and the elderly of all ages. The government RDA for vitamin B1 is not going to save you in these circumstances. Be proactive today!

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