Thiamine in Nutrition Therapy

Department of Surgery, Room 3350, Stroger Hospital, 1901 West Harrison St, Chicago, IL 60612, USA.
Nutrition in Clinical Practice (Impact Factor: 2.4). 02/2012; 27(1):41-50. DOI: 10.1177/0884533611426149
Source: PubMed


Clinicians involved with nutrition therapy traditionally concentrated on macronutrients and have generally neglected the importance of micronutrients, both vitamins and trace elements. Micronutrients, which work in unison, are important for fundamental biological processes and enzymatic reactions, and deficiencies may lead to disastrous consequences. This review concentrates on vitamin B(1), or thiamine. Alcoholism is not the only risk factor for thiamine deficiency, and thiamine deficiency is often not suspected in seemingly well-nourished or even overnourished patients. Deficiency of thiamine has historically been described as beriberi but may often be seen in current-day practice, manifesting as neurologic abnormalities, mental changes, congestive heart failure, unexplained metabolic acidosis, and so on. This review explains the importance of thiamine in nutrition therapy and offers practical tips on prevention and management of deficiency states.

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    • "Despite this relatively simple structure, thiamine can be synthesised only by plants and microorganisms whereas human and animals depend entirely on its nutritional intake (Camiener & Brown, 1960; Kowalska & Kozik, 2008). Failing to meet the recommended dose of vitamin B 1 can result in some mild ailments such as stomach problems or muscle contractions; however, a prolonged deficiency leads to severe dysfunctions, affecting mainly the nervous and circulatory systems (Sriram et al., 2012). "
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    ABSTRACT: Numerous recent studies have established a hypothesis that thiamine (vitamin B1) is involved in the responses of different organisms against stress, also suggesting that underlying mechanisms are not limited to the universal role of thiamine diphosphate (TDP) in the central cellular metabolism. The current work aimed at characterizing the effect of exogenously added thiamine on the response of baker's yeast Saccharomyces cerevisiae to the oxidative (1 mM H2O2), osmotic (1 M sorbitol) and thermal (42°C) stress. As compared to the yeast culture in thiamine-free medium, in the presence of 1.4 μM external thiamine: (i) the relative mRNA levels of major TDP-dependent enzymes under stress conditions versus unstressed control (the “stress/control ratio”) was moderately lower, (ii) the stress/control ratio was strongly decreased for the transcript levels of several stress markers localized to the cytoplasm, peroxisomes, the cell wall and (with the strongest effect observed) the mitochondria (e.g., Mn-superoxide dismutase), (iii) the production of reactive oxygen and nitrogen species under stress conditions was markedly decreased, with the significant alleviation of concomitant protein oxidation. The results obtained suggest the involvement of thiamine in the maintenance of redox balance in yeast cells under oxidative stress conditions, partly independent of the functions of TDP-dependent enzymes.This article is protected by copyright. All rights reserved.
    Full-text · Article · Oct 2014 · FEMS Yeast Research
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    • "The major causes of TD are dietary imbalance, chronic alcoholism, and a history of gastrectomy [2, 3]. Other causes include poor oral intake; inadequate provision of thiamine in enteral or parenteral nutrition therapy; malignancies; AIDS; pregnancy and lactation; hyperthyroidism; renal failure, particularly in those receiving hemodialysis; loop diuretic use; systemic infections; advanced age; diabetes mellitus; and bariatric surgery [7]. "
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    ABSTRACT: Cardiovascular beriberi presents as either the fulminant (Shoshin beriberi) or chronic form. Shoshin beriberi is a rare disease that may lead to a fatal outcome if the patient does not receive appropriate treatment. In the present report, we describe the case of a 66-year-old man presenting with leg edema and dyspnea at rest. Clinical presentations were nonalcoholic Shoshin beriberi and lactate accumulation; however, clinical improvement was observed after the administration of thiamine. His pretherapy thiamine level (2.1 μ g/dL) was consistent with a diagnosis of beriberi. Based on the findings of the present case, we believe that a diagnosis can be made in patients with a clinical history that is consistent with that of Shoshin beriberi, combined with low thiamine levels, lactate accumulation, and colliquative myocytolysis. Learning Objective. Shoshin beriberi is often misdiagnosed because of its rarity; a detailed clinical history and characteristic myocardial histopathology changes may be useful for making a definite diagnosis.
    Full-text · Article · May 2014
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    • "The prevalence of TD in critically ill patients has been described [14-16] and was associated with increased morbidity and mortality [16]. Recent studies have demonstrated that additional attention is needed in the identification of thiamine deficiency (TD) and that thiamine supplementation is necessary not only in intensive care unit patients but also in patients with heart failure [15,17,18]. "
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    ABSTRACT: Sepsis is a prevalent condition in critically ill patients and may be associated with thiamine deficiency (TD). The aim of this study was to evaluate the effect of TD on inflammation, oxidative stress and cellular recruitment in a sepsis model. The experimental sepsis model, cecal ligation and puncture (CLP), was utilized on mice in comparison with a sham procedure. The following four groups were compared against each other: SHAM with AIN93G complete chow, SHAM with thiamine deficient (TD) chow, CLP with AIN93G complete chow, and CLP with TD chow. Thiamine pyrophosphate (TPP) blood concentrations were determined, and blood and peritoneal fluid were evaluated for differences in TNF-alpha, IL-1, IL-6, KC and MCP-1/CCL2 levels. In addition, the levels of 4-HNE adducts in liver proteins were evaluated by Western Blot. The mean TPP blood concentration from the mice fed with the complete chow was 303.3 ± 42.6 nmol/L, and TD occurred within 10 days. TNF-α and MCP-1 concentrations in the peritoneal fluid were significantly greater in the CLP with TD chow group when compared with the other groups. The blood IL-1β level, however, was lower in the CLP with TD chow group. Liver 4-HNE levels were highest in the TD chow groups. Blood mononuclear cell numbers, as well as peritoneal total leukocyte, mononuclear cell and neutrophil numbers were greater in the CLP with TD chow group. Peritoneal bacterial colony forming units (CFU) were significantly lower in the CLP with TD chow group. TD was associated with greater bacterial clearance, oxidative stress and inflammatory response changes.
    Full-text · Article · Apr 2014 · Journal of Inflammation
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