Vitamin B1 (Thiamine) Deficiency

Thiamine was the first vitamin identified (vitamin B1) many years ago. It functions as a catalyst in the generation of energy through decarboxylation of branched-chain amino acids and alpha-ketoacids and acts as a coenzyme for transketolase reactions in the form of thiamine pyrophosphate. Thiamine also plays an unidentified role in propagating nerve impulses and taking part in myelin sheath maintenance. This water-soluble vitamin is present in meat, beef, pork, legumes, whole grains, and nuts; however, milled rice and grains have small amounts of thiamine as the processing involved in creating these food products removes thiamine. Additionally, certain food products such as tea, coffee, raw fish, and shellfish contain thiaminases - enzymes that destroy thiamine. Thiamine deficiency can affect the cardiovascular, nervous, and immune systems, as commonly seen in wet beriberi, dry beriberi, or Wernicke-Korsakoff syndrome. Worldwide it is most widely reported in populations where polished rice and milled cereals are the primary food source and in patients with chronic alcohol use disorder. Dry beriberi presents as symmetrical peripheral neuropathy, while wet beriberi presents with high-output heart failure. Wernicke-Korsakoff syndrome (WKS) can manifest with CNS symptoms such as gait changes, altered mental status, and ocular abnormalities.