Thiamine is known as B1 because it was the first of the B vitamins to be identified by scientists. Like all the other Bs, thiamine works better in concert with its cousins than it does by itself. It’s water soluble, which means that you have to take it daily since it is not stored in your cells. A true deficiency of thiamine causes beriberi, a condition that’s rare in the United States except in people with alcoholism or chronic diarrhea. More often, people who develop thiamine deficiency fly under the radar with symptoms chalked up to aging rather than to nutritional deficits.
Thiamine is important to the digestive process of breaking down carbohydrates, fats, and protein, so it plays a role in maintaining weight, lowering blood sugar, and reducing cholesterol. This makes it incredibly important to people of all ages.
Although this vital nutrient can be helpful in preventing and treating a whole host of conditions, let’s start by dispelling a couple of myths. Some people think that thiamine can repel insects. Some thiamine does get excreted through the skin, and insects are apparently put off by this residue. The theory is that if you have a good enough supply on board, you might be less likely to get bitten. Hmm. If I ever travel to the Amazon River Basin, where insects are the size of small VWs, I won’t be counting on thiamine. But I will keep this information in my back pocket, right next to a big flyswatter.
Some misguided people also think that thiamine can prevent motion sickness, for example on a cruise. This reminds me of the last Caribbean cruise I went on. A guest at my table kept saying how dizzy she was from the swaying of the ship (which was not moving one iota). She asked for health advice while I was eating dinner. Finally, over the cheesecake, I suggested that the next night she should skip the 2½ glasses of cabernet sauvignon before dinner and the Frangelico for dessert, as these sorts of things tend to make the boat sway. In her case, thiamine would have been helpful only to replenish what the drug mugger alcohol stole. But it doesn’t relieve motion sickness.
So what does thiamine do? To begin with, a deficiency of thiamine can cause macular degeneration, reduced appetite, fatigue, weakness, poor digestion, chronic constipation, an inability to gain weight, paresthesia (pins and needles or a sensation that someone is poking you with toothpicks all over the place), and mental fatigue. It can also lead to depression, nervousness, mental exhaustion, and insomnia. If the deficiency persists, the muscles become affected, which could cause leg cramps and general muscle weakness.
That last symptom is a big concern because your heart is a muscle and it’s not supposed to be weakened. In a state of thiamine deficiency, the heart muscle gets a tad lazy and stops pumping properly. This leads to hypertrophy (enlargement) of the heart. Then, because circulation slows down, even the scalp loses blood flow, causing the hair to fall out and new hair growth to slow down.
Even though thiamine deficiency is fairly rare, it is getting more common thanks to processed foods and sweets made with refined white sugar, neither of which supplies adequate amounts of the nutrient. Alcohol, though, is the biggest drug mugger of thiamine, so imagine all those people who enjoy wine with dinner. They are more than likely deficient in B1.
People with diabetes can greatly benefit from taking a thiamine supplement because it can help prevent diabetic retinopathy, blurry vision, atherosclerosis, and the plaque buildup that especially affects diabetics. All this gunk is what squeezes off arteries to the heart, limbs, and eyes.
Naturally, people with heart disease could also benefit because thiamine not only helps normalize cholesterol, but also has a mild diuretic effect, both of which are helpful. If you take this supplement, be sure to take it in the morning so you’re not running to the bathroom during the wee hours.
You’ll soon see from my drug mugger list that some heart medications are drug muggers of thiamine. Obviously, anyone who takes a drug mugger is at higher risk for thiamine deficiency. One study found that 98 percent of people with congestive heart failure who took the loop diuretic furosemide (approximately 80 mg daily) were deficient in thiamine. Based on this study, it looks like taking a thiamine supplement is a must for any heart failure patient on a loop diuretic.
All the B vitamins play a role in protecting the nerves and improving nervous system function. Thiamine can help improve numbness and tingling (peripheral neuropathy), burning sensations, painful and tender feelings in the limbs, and headache. If you run low on thiamine, you can develop all of these problems along with fatigue, depression, and memory loss.
If you drink alcohol, you must take a thiamine supplement because alcohol is a huge drug mugger of this nutrient. Longtime alcoholics are prone to malnutrition, causing more pronounced thiamine deficiency. This is the part that sounds crazy: Chronic drinkers frequently develop mental confusion, staggering gait, and visual disturbances. Doesn’t that sound like what happens after a few beers? But they experience all these neurologic disturbances (called Wernicke’s encephalopathy) even while sober. Thiamine can help relieve these symptoms. It’s simple but true. If you are deficient in B1, then your body has a much more difficult time breaking down the alcohol and clearing it out of your body. So B1 deficiency is a risk factor for hellish hangovers.
You are probably wondering if thiamine can be used as a hangover remedy. Sure it can. It is much better than other hangover helpers such as orange juice and raw eggs. The study I’m going to share with you is nothing short of remarkable. Laboratory rats were given enough acetaldehyde to kill them (acetaldehyde is one of the metabolic by-products of alcohol). Then some of them were given the antioxidant nutrients vitamin B1, vitamin C, and L-cysteine. Guess what? The rats that were given the antioxidant cocktail did not die. I have a family member who struggles with alcohol, and it’s challenging for all of us who love him, so I strongly urge you not to drink. Realistically, I know that some people will ignore this advice. If you choose to drink anyway, you can take 200 or 250 mg thiamine before you get the party started, then take 100 mg more before bed along with 1,000 mg vitamin C and 600 mg NAC (cysteine), which scavenges the acetaldehyde. Be aware that acetaldehyde can cause pancreatitis.
Do problems with your memory have you concerned that you might be developing Alzheimer’s disease? Then a thiamine supplement is a good choice for you. Thiamine helps improve memory by mimicking acetylcholine, a crucial memory molecule in your brain cells. It sharpens both memory and focus, and apparently also reduces your risk of developing Alzheimer’s. Thiamine helps make acetylcholine through the production of acetyl coenzyme A, which feeds directly into your Krebs cycle, the metabolic pathway that gives you energy. In other words, thiamine deficiency can cause mitochondrial dysfunction. This all translates into being exhausted all the time!
Thiamine plays a big role in the digestive process, so people with gastrointestinal disease (who don’t absorb the nutrient properly) can often benefit from taking a supplement. Among them are people with poor liver function, irritable bowel syndrome, Crohn’s disease, or celiac disease. People who have had gastric bypass surgery often run out of thiamine because they have poor absorption in their gastrointestinal tracts.
Dieting can also cause an individual to run low on thiamine. A woman who goes on a crash diet and starves herself for several days in order to look thinner at her 10th high school reunion is likely going to that event with a thiamine deficiency. Chronic dieting or simply not eating (if you have chronic pancreatitis pain, for instance, and can’t eat much or anything at all) can also be a problem. Low levels of acetylcholine have been tied to anorexia, so taking thiamine may help people with this condition. (Remember, thiamine mimics acetylcholine in the body.) Thiamine overdose is rare, even in high dosages, but it is possible. You’re getting too much if you develop headaches, tremors, irritability, rapid pulse, or insomnia, or if a blood test shows that your level of thyroid hormone has fallen below normal. By thyroid hormone I mean free T3 specifically, not T4.
Acid Blockers
Cimetidine (Tagamet)
Esomeprazole (Nexium)
Famotidine (Pepcid and Pepcid Complete)
Lansoprazole (Prevacid 24HR)
Nizatidine (Axid)
Omeprazole (Prilosec OTC)
Pantoprazole (Protonix)
Rabeprazole (Aciphex)
Ranitidine (Zantac)
Antacids
Aluminum and magnesium hydroxide (Maalox, Mylanta)
Aluminum carbonate gel (Basaljel)
Aluminum hydroxide (Amphojel, AlternaGEL)
Calcium carbonate (Rolaids, Titralac, Tums)
Magnesium hydroxide (Phillips’ Milk of Magnesia)
Sodium bicarbonate (Alka-Seltzer, baking soda)
Antibiotics (Just a few here, but all of them are drug muggers.)
Aminoglycosides
Amoxicillin (Amoxil)
Azithromycin (Z-pak)
Cefaclor (Ceclor)
Cefdinir (Omnicef)
Cephalexin (Keflex)
Ciprofloxacin (Cipro)
Clarithromycin (Biaxin)
Doxycycline (Doryx)
Erythromycin (E.E.S.)
Levofloxacin (Levaquin)
Minocycline (Minocin)
Penicillin (Pen VK)
Sulfamethoxazole and trimethoprim (Bactrim Septra)
Tetracycline (Sumycin)
Anticonvulsants
Phenytoin (dilantin) (Space supplement at least 4 hours away from the medication.)
Zonisamide (Zonegran)
Antivirals
Delavirdine (Rescriptor)
Lamivudine (Epivir)
Nevirapine (Viramune)
Foscarnet (Foscavir)
Zidovudine, AZT (Retrovir)
Zidovudine and Lamivudine (Combivir)
Cardiac Glycoside
Digoxin (Lanoxin, Lanoxicaps, Digitek)
Blood Pressure Drugs
Diuretics, loop:
Bumetanide (Bumex)
Ethacrynic acid (Edecrin)
Furosemide (Lasix)
Torsemide (Demadex)
Diuretics, potassium-sparing: (possibly, however this is not conclusive)
Indapamide (Lozol)
Diuretics, thiazide:
Any combination drug that contains HCTZ or hydrochlorothiazide (dozens of drugs contain this)
Chlorothiazide (Diuril)
Chlorthalidone (Hygroton)
Hydrochlorothiazide or HCTZ (Hydrodiuril)
Methyclothiazide (Enduron)
Metolazone (Zaroxolyn)
Bronchodilators
Theophylline (Uniphyl, Theo-24, or Theo-Dur)
Hormone Replacement Therapy/Oral Contraceptives
Estradiol (Estrace, Climara, Estraderm, Estring, Activella, Femring, Combipatch, EstroGel, Menostar, and many others)
Estrogen-containing drugs (hormone replacement therapy and birth control)
Estrogens, conjugated (Premphase, Prempro)
Ethinyl estradiol (found in many birth control pills)
Nonsteroidal Aromatase Inhibitors for breast cancer
Anastrozole (Arimidex)
SERMs (Selective Estrogen Receptor Modulators—used for breast cancer)
Raloxifene (Evista)
Tamoxifen (Nolvadex)
Toremifene (Fareston)
Sulfonamides
MISC:
Alcohol
Betel nuts (also called bettlenuts or areca nuts, these are popular in Taiwan)
Coffee
Estrogen dominance
Genetic problems that prevent you from activating B1
Raw shellfish or raw seafood (such as sushi, oysters, or mussels)
Tea (because of the tannins in tea, so even decaf)
Tobacco (nicotine)
Quercetin and rutin (two popular dietary supplements)
Sulfites found in foods as a preservative
Romaine lettuce, asparagus, spinach, sunflower seeds, yellowfin tuna, celery, green peas, tomatoes, eggplant, mustard greens, brussels sprouts, cabbage, watermelon, carrots, squash, broccoli, corn, kale, pineapple, oats, oranges, split peas, peanuts, lentils, and whole wheat.
If you take too much thiamine, you may become deficient in your other B vitamins. Remember that whenever you take a single B vitamin, it is wise to take a B complex, too, so that the other Bs are in your system.
For general health: 5–10 mg per day
Drug mugger dose: 20–50 mg per day
Heart disease, alcoholism, or diabetes: 50–250 mg per day (ask your doctor for his or her input on this)
People who have cancer or are undergoing chemotherapy should stick to very low dosages. Thiamine is sometimes given to combat the B1 deficiency associated with fast-growing cancers like leukemia, but low doses are used because some studies have found that doses of more than 3 mg per day could backfire and increase the growth of the tumor. It’s not completely clear, because chemotherapy itself can cause thiamine deficiency, but supplementing with too much can spark faster tumor growth in certain people. So my advice is to ask your doctor if thiamine is right for you, and if so, stick to what he or she advises.
Also, you will find lots of B1 supplements with something called benfotiamine. This is a patented, fat-soluble, synthetic version of thiamine also called S-benzoylthiamine-O-monophosphate. This molecule is a precursor to thiamine and appears to be very effective in replenishing nutritional deficiencies. There is clinical research suggesting that benfotiamine offers protection against advanced glycation end products, or AGEs, which are typically associated with age-related diseases such as diabetes, Alzheimer’s, cataracts, heart attack, and stroke. Reducing AGEs is one of the best things you can do if you want to reverse diabetes or blood sugar abnormalities. Simply put, thiamine, and more specifically benfotiamine, appear to have antiaging benefits.
The more refined the food, the less thiamine you get. If you eat the typical American diet, you will become thiamine-depleted in about 3 to 4 weeks. It doesn’t take long! Remember, this is a water-soluble vitamin, so it’s not stored in your body. You have to constantly replenish this nutrient. It’s always better to get your nutrients from foods rather than supplements, but I feel that supplementation is necessary for some people.
To install the tightest security system and get the highest content of thiamine from your foods, always choose brown rice (not white rice), whole grain bread (not white bread), and so forth. When supplementing, it’s better to take smaller doses throughout the day than to take one large dose. Your body just takes what it needs and excretes the rest.
Thiamine is also a must for anyone taking high dosages of any other B vitamin since that can cause a relative deficiency of thiamine. Bs exist as a family (called B complex), so if you take one in a high dose, your body is tilted in the direction of the B you’re taking. You won’t even realize a deficiency is in the making because it could take weeks or months to develop, and all the while you think you’re losing your mind, forgetting stuff all the time, and maybe even developing paresthesia, that prickly feeling all over. It’s really not that uncommon, because many people take high doses of methyl B12 for demyelination disorders or fatigue. Other people commonly take high dosages of folic acid (or 5-MTHF, the active form) to improve estrogen metabolism or protect against heart disease. Some people take high dosages of B6 for carpal tunnel. My point is that if you drive up the level of a particular B vitamin, you are very likely going to suffer a relative deficiency of thiamine, and it’s superuncomfortable.
Vitamin B-1 by Solaray: This product contains pure thiamine in a whole food base. Solaray uses natural sweeteners and flavors in all of its products, as well as natural preservatives such as vitamin E and rosemary extract.
Vitamin B-1 by Swanson: These small capsules provide 100 mg thiamine hydrochloride in rice flour, so it’s gluten free. This company also offers the synthetic version of B1 I mentioned that is considered to be more easily absorbed because it’s fat soluble so it gets into the cells faster and easier. It’s called benfotiamine. Contact information: www.swansonvitamins.com.
B-Complex #1 by Thorne Research: I like this brand for people who are in good general health because it contains a full range of all the B vitamins including pantothenic acid, riboflavin, folic acid, niacin, B6, and others. It also has a good amount of B1 (200 mg per capsule). It is yeast free, magnesium stearate free, and free of all diluents, flowing agents, and allergens. It doesn’t get any purer than that!
B1 Caps by Twinlab: These hard gelatin capsules contain 100 mg pure crystalline thiamine that is yeast free and free of other allergens. It does not have any coatings, bindings, or colorings and is gluten free.
B-1 by Nature Made: This product contains 100 mg of thiamine with no artificial colors, flavors, or preservatives. It’s also gluten free.
High Potency B-1 by Source Naturals: This product is strong, offering 500 mg per tablet. The company also produces 100 mg tablets.
Benfotiamine by Nutraceutical Sciences Institute (NSI): This product, sold at www.vitacost.com, is the fat-soluble precursor to thiamine. It is kosher.
Mega Benfotiamine by Life Extension: This is a pure, high-potency product (250 mg) free of all allergens.
Thiamine by injection: This is given by your doctor, particularly holistic MDs, but they will usually test your blood first to see if you’re deficient (since they feel it’s rare). I don’t think blood level is as important as the clinical picture, though. I’ve seen people get remarkably better on thiamine injections or oral supplements despite their so-called normal blood levels.
One of the most effective ways to get thiamine (and other Bs) into your system is with an IV drip in a mixture called a Myers cocktail. I’ve tried this and found it to be just amazing because it created so much energy for me and it lasted for days.