B-1 Thiamine
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B-1 (Thiamine)

Thiamine has double-blind studies to support its use in alcohol detox, congestive heart failure, diabetic neuropathy, Dilantin patients, teenage menstrual cramps, elderly with low levels, and possibly depression.  However, in most of these, I have found only a single small- to moderate-sized double-blind study.  In all cases, the amount of research is inadequate to draw any firm conclusions of benefit.  Because of the very low cost and virtual absence of side-effects, it seems reasonable to use thiamine even though the research is inadequate to assure benefit.  

Alcoholic Detox Helped by Thiamine: DB PC of 107 patients receiving various dosages of IM thiamine. Highest dosages proved best for cognition. Thiamin treatment and working memory function of alcohol-dependent people: preliminary findings. Ambrose ML, Bowden SC, Whelan G. Alcohol Clin Exp Res 2001 Jan;25(1):112-6

Alzheimer's Thiamine No Help in Small Study:  In a very small 15-patient 1-year DB PC study of a huge 3 mg/day dose of thiamine, no measurable impact on Alzheimer's was detected. A trial of thiamine in Alzheimer's disease. Nolan KA, Black RS, Sheu KF, Langberg J, Blass JP. Arch Neurol. 1991 Jan;48(1):81-3

Blood Pressure and Weight: Thiamine Helps only in 15% of Elderly Who Have Two Low Thiamine Tests: In a 76-patient DB PC study of thiamine 20 mg/day, 35 of 222 people over 64 had two concentrations of erythrocyte thiamine pyrophosphate (TPP) < 140 nmol/L 3 mo apart and 41 other people had the first, but not the second, TPP concentration below this value. These 76 low thiamine subjects were randomly assigned to receive thiamine showed increases in TPP concentrations compared with control subjects. Only the subjects with persistently low TPP concentrations showed subjective benefits from treatment with improvements in quality of life (measured on a visual analogue scale; P = 0.02) and decreases in systolic blood pressure (P = 0.05) and weight (P < 0.01) when compared with subjects given placebo. There was a trend toward benefits in sleep and energy (P = 0.07). New Zealand. The response to treatment of subclinical thiamine deficiency in the elderly. Wilkinson TJ, Hanger HC, Elmslie J, George PM, Sainsbury R. Am J Clin Nutr. 1997 Oct;66(4):925-8

Congestive Heart Failure: Thiamine High Dose Helps: In a DB PC 1 week study of CHF patients on furosemide diuretic, thiamine 200 mg IM decreased erythrocyte thiamine pyrophosphate effect and increased the left ventricular ejection fraction. In another 6 weeks of open treated of all 30 patients, the LVEF increased 22% with increased diuresis and sodium excretion. Israel. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Shimon I, Almog S, Vered Z, Seligmann H, Shefi M, Peleg E, Rosenthal T, Motro M, Halkin H, Ezra D.  Am J Med. 1995 May;98(5):485-90 

Depression: Says Four DB Thiamine Studies Show Benefit, Iron Decreased in Women: In four double-blind studies an improvement in thiamine status was associated with improved mood. Iron deficiency anemia is common, particularly in women, and is associated with apathy, depression and rapid fatigue when exercising. The effects of nutrients on mood. Benton D, Donohoe RT. Public Health Nutr 1999 Sep;2(3A):403-9

Diabetic Neuropathy: Thiamine Better than Pyridoxine in Tanzania: In a 200-patient DB study of thiamine 25 mg/day vs. pyridoxine 50 mg/day, 88% of thiamine vs. 30% of pyridoxine patients improved at four weeks. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. Abbas ZG, Swai AB. East Afr Med J. 1997 Dec;74(12):803-8; Similar results in a German DB PC with thiamine, B-6, and B-12. Exp Clin Endocrinol Diabetes. 1996;104(4):311-6

Diabetic Neuropathy: B-1 & B-6 Help Diabetes Peripheral Neuropathy: DB PC 200 patient study of thiamine 25mg/d and pyridoxine 50mg/dm vs. placebo found a 49% vs. 11% decrease. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. Abbas ZG, Swai AB. East Afr Med J 1997 Dec;74(12):803-8

Dilantin Patients: Thiamine Helps: DB PC 6 mo for 72 patiants on phenytoin placebo vs. folate 5 mg vs. thiamine 50 mg vs. both. Patients had blood levels 30% below normal in both. No benefit from folate but thiamine group did better on Wechsler both verbal and non-verbal. Botez, Montreal, Epilepsy Res ’93;16:157

Exercise Performance: Three DB PC studies document little or no benefit even at 100 mg/day. Metab Brain Dis. 1996 Mar;11(1):95-106; Eur J Appl Physiol Occup Physiol. 1997;75(6):520-4; Int J Sport Nutr. 1997 Mar;7(1):39-47

Menstrual Pain in Teens: Thiamine Claimed Curative: In a DB PC study of 556 girls 12-21 in Indian with painful periods, those given 100 mg/day (1.6 mg/day = 100% of the Daily Value) for 90 days had dramatic relief in 95% with 87% "completely cured." Two months after stopping thiamine, improvement persisted. Curative treatment of primary (spasmodic) dysmenorrhoea. Gokhale LB. Indian J Med Res. 1996 Apr;103:227-31. Ed: This sounds too good to be true.

Thiamine B-1: Moderate thiamine deficiency was found in 40% of hospitalized elderly with higher with depression, Alzheimer's disease, cardiac failure and falls. Belgium, Pepersack, Gerontology 3/99;45:96

Thiamine Supplement Helped Elderly Irish: 80 healthy elderly Irish women were treated in a DB PC study with 10 mg/day of thiamine for 6 week. Increased appetite, weight, well-being, and decreased fatigue occurred in the thiamine group. Smidt, UC Davis, J Gerontol ’91;46:M16;

Thiamine Claimed to Help Post-ECT Confusion: Three cases of elderly patients getting ECT for depression. Using thiamine to reduce post-ECT confusion. Linton CR, Reynolds MT, Warner NJ. Int J Geriatr Psychiatry 2002 Feb;17(2):189-92

Vitamin B1, B2, B6 DB with Nortriptyline Helpful Trend: In a very small DB PC study of 14 elderly treated with nortriptyline for depression, seven received 10 mg/day of each vitamin and showed trends toward better cognitive functioning and decreased depression as well as higher nortriptyline levels and B-12 levels. Harvard. Brief communication. Vitamin B1, B2, and B6 augmentation of tricyclic antidepressant treatment in geriatric depression with cognitive dysfunction. Bell IR, Edman JS, Morrow FD, Marby DW, Perrone G, Kayne HL, Greenwald M, Cole JO. J Am Coll Nutr 1992 Apr;11(2):159-63. Harvard.