Monday November 24th 2014

Thiamine deficiency, alcohol, and alcoholism

Thiamine is one of the important vitamins for alcohol withdrawal.  But what does thiamine deficiency do in the bodies of chronic drinkers? And why should former drinkers get thiamine levels tested? We explore here, and invite your questions about thiamine deficiency at the end.

Alcohol can cause brain damage

Are you a recovering alcoholic who has difficulty remembering simple things, like what you had for lunch or where you parked your car? Are you able to engage in a detailed discussion about events in your life prior to your alcoholism, but unable to remember ever having had that discussion only a few hours later?  If so, you may suffer from a common type of alcohol-induced brain damage marked by a deficiency in an essential nutrient for healthy brain functioning, known as thiamine.  And after the acute withdrawal symptoms for alcohol pass, thiamine deficiency can persist.  So what is thiamine and how can you get more of it?

What does thiamine do in the body?

Thiamine, also known as vitamin B1, is a “helper” molecule required for the assembly and proper functioning of several enzymes important for the breakdown, or metabolism, of sugar molecules into other types of molecules (i.e., in carbohydrate catabolism). Proper functioning of these thiamine–using enzymes is required for numerous critical biochemical reactions in the body, including the synthesis of certain brain chemicals (i.e., neurotransmitters); production of the molecules making up the cells’ genetic material (i.e., nucleic acids); and production of fatty acids, steroids, and certain complex sugar molecules.

Drinking alcohol interferes with thiamine absorption

The human body itself cannot produce thiamine, which is why people must ingest it with their diet. A daily intake of 1.1 mg thiamine is recommended for adult women and 1.2 mg for adult men. Since alcoholics tend to “drink” most of their meals, they often suffer from malnutrition and, as a result, consume less than 0.3 mg of thiamine per day. Acute alcohol exposure also interferes with the absorption of thiamine from the gastrointestinal tract at low thiamine concentrations. And to make matters worse, magnesium deficiency, also caused by chronic alcohol consumption, contributes to an inadequate functioning of the thiamine–using enzymes and may cause symptoms resembling those of thiamine deficiency. Thus, any thiamine that does reach the cells cannot be used effectively, aggravating an already serious deficiency.

Why get your thiamine levels tested?

Furthermore, since thiamine deficiency can lead to Wernicke–Korsakoff syndrome (WKS) and a number of other alcoholic-induced brain disorders, including cerebellar degeneration, which can develop more than 10 years after heavy drinking, recovering alcoholics are encouraged to get their thiamine levels tested, even if they’ve been sober for a considerable period of time.

The reason alcoholics should get tested is that a lot of the adverse effects associated with thiamine deficiency are not only treatable, but in some cases, even reversible. In fact, prolonged abstinence from alcohol coupled with improved nutrition and thiamine maintenance at the pharmacological level has been shown to reverse some of the impairments associated with thiamine deficiency, including improving brain functioning. One study administered different thiamine doses to a group of alcoholics undergoing detoxification and showed that those who received the highest thiamine doses performed best on tests of working memory.

Wernicke–Korsakoff syndrome and deficiency in thiamine

A prevalent neurological disorder among alcoholics caused by a deficiency in thiamine is known as Wernicke–Korsakoff syndrome (WKS). This disorder is broken up into two distinct components; a short–lived and severe condition called Wernicke’s encephalopathy (WE) and a long–lasting and debilitating condition known as Korsakoff’s psychosis.

The symptoms of WE include mental confusion, paralysis of the nerves that move the eyes and an impaired ability to coordinate movements, particularly of the lower extremities. It is important to note that many WE patients do not exhibit all of three of these symptoms and WE may still be present even if the patient exhibits only one of them.

The second component of WKS, Korsakoff’s psychosis, is a chronic neuropsychiatric syndrome characterized by memory impairments. Although these patients can remember seemingly minute details of their lives prior to their illness, they have difficulty remembering the simplest, “new” information, like what they ate for lunch or where they parked their car. Because of these characteristic memory deficits, Korsakoff’s psychosis is often called alcohol amnestic disorder.

Experts are still unclear whether Korsakoff’s psychosis is always preceded by WE or whether it develops on its own without an overt episode of WE. Thus, a patient who only exhibits symptoms of alcohol amnestic disorder, like memory impairment, without the more acute symptoms of WE, like nerve paralysis, should not be precluded from a WKS diagnosis.

How recovering alcoholics can benefit from thiamine

So, there is definitely hope for alcoholics entering recovery who find themselves having difficulty with motor control, muscle coordination, and the acquisition of “new” information. I, personally, noticed a marked increase in not only my memory, but also my overall coordination and balance after only six months sober and three months of increased thiamine intake. I found myself being able to do things that I never dreamed of doing when I was drinking; things like snowboarding, cycling, swimming, surfing. I can even have conversations with people and still remember what I said to them a few days later. All it took was a few months without alcohol and a strict regimen of thiamine-rich foods including pork, poultry, brown rice, bran, nuts, dried beans, peas, and soybeans.

You can do it too!

Just ask your doctor if a thiamine-rich diet or thiamine supplements are right for you. You may find that you’ve been suffering from a thiamine deficiency without ever having known about it, in which case, a healthier, happier brain is only a few pork chops away. Good luck!

Thiamine deficiency questions

Pills for stop drinking may help you in the short term.  But if long term sobriety is your goal, addressing low thiamine levels can help you feel better over time.  If you have any questions, comments or feedback about thiamine deficiency, please leave them here. We welcome your input and try to respond to all legitimate queries with a personal and prompt response ASAP.

Reference Sources: The Role of Thiamine Deficiency in Alcoholic Brain Disease, Peter R. Martin, M.D., Charles K. Singleton, Ph.D., and Susanne Hiller–Sturmhofel, Ph.D. National Institute of Alcohol Abuse and Alcoholism (NIAAA), Alcoholic Brain Disease, Volume 27, Number 2: 2003.

Photo credit: NIAAA

Leave a Reply

3 Responses to “Thiamine deficiency, alcohol, and alcoholism
jacqueline williams
10:31 am January 8th, 2013

I have been drinking for 30 years and for the last 20 have consumed a litre bottle of medium sherry every night. I recently felt pain on my lower right back and consulted the doctor and asked if i could have a liver test. She sent me for a blood test which confirmed that I had liver damage. I am on only 50 mg of thiamine a day and I have stopped alcohol completely (cold turkey). Some of the articles about memory in your article alarm me as I have experienced this. I cannot remember new faces which is very embarrassing to my granddaughter as it takes me ages to get them into my head. Forget to take pills, forget conversations, cannot recall pieces of general knowledge which i know. Your advice would be helpful.

I first got in touch with a counceller who advised me to take 200mg of thamine a day so the doctors verdict surprises me. Will it do my any harm to double this dose to 100mg a day.

Kindest Regards,

Jackie

3:24 pm January 9th, 2013

Hi Jacqueline. Thanks for your question. I think that you need to first address this with your doctor or pharmacist before increasing dosage. While your counselor may have experience working with people on thiamine, you need a medical OK before changing any prescription dose.

James
7:18 pm August 4th, 2014

Hi,

I am an excessive drinker and am currently on 100mg a day and often take 2.
I am fine and work in finance.
It is all about your mental state and if you ever need comfort just do what you need.
I believe in the following:
-do what makes you happy
-always be happy with yourself and what you need to be happy is simply a smile
-just look at others around you and be happy with them

About Andrew Seaward

Andrew Seaward is the author of Some Are Sicker Than Others. Although he makes his living as a chemical engineer in the Oil & Gas industry, his true passion is telling great stories through both acting and writing. He is a member and contributor of Benjy Dobrin Studios, the Cinematic Arts of Colorado and the Lighthouse Writers Workshop. He has written and acted in several short and feature length films, one of which won an Award of Merit at the 2010 Indie Fest.