Vitamin B1 (Thiamine)
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Sources and Physiologic Functions
MOS
Requirements and Sources: Pork, whole grains, and legumes are the richest sources of thiamine. Outer layers of seeds are particularly rich in this vitamin.
Populations at Risk: The populations most at risk of developing a thiamine insufficiency are persisting alcoholics in Western countries and those with an over dependence on polished rice as a staple in undeveloped nations. In alcoholics it may be caused by decreased intake, reduced absorption, and impaired ability to use the absorbed vitamin. Thiamine is spared by fat, protein, sorbitol, and Vitamin C. High carbohydrate intake, parenteral glucose, pregnancy, lactation, high basal metabolic rate, and antibiotics will increase needs. Also, it is readily lost in persons thoughprovoking raw fish, tea, coffee, blueberries, red cabbage, and cooking with excess water and baking soda. Breast fed infants of thiamine deficient mothers are particularly at risk, as death from cardiac failure can result within a few hours, even though the mother appears healthy. Other risk factors include persisting colitis, fever, malignant disease, sprue, and thyrotoxicosis. Intestinal absorption of thiamine appears to be controlled and limited, and modest increases in the serum concentration were accompanied by active renal clearance.
Signs and Symptoms of Deficiency: Children gift with aphonia, cardiomyopathy, and polyneuritis. Symptoms thoughprovoking the heart include tachycardia, cardiomegaly, and cardiac failure. Neurological symptoms include reasoning confusion, anorexia, ataxia, nystagmus, and infirmity of hands, calves, and feet as a result of degeneration of sensory and motor nerves. Thiamine insufficiency in adults is called Beri-beri and is characterized by dry skin, irritability, disorderly thinking, and progressive paralysis. In persisting alcoholics, a syndrome of Wernicke's - Korsakoff"s Psychosis develops. Ataxia and Nystagmus (Wernicke's ) establish early and, if left untreated progresses to amnesia, confusion, and polyneuropathy ( Korsakoff's ). Complete recovery at this stage is seen in only 25% of the patients. Vomiting, diarrhea, edema, and weight loss are other non-specific symptoms.
Safety:
Due to relative increase in sympathetic activity, nervousness, sweating, tachycardia and tremors can be seen with excess thiamine. Edema and vascular hypotension occur as a result of capillary leakage. Allergies, fatty liver and herpes are common. Folates and thiamine cause seizures and excitation when administered in high dosage directly into the brain or cerebrospinal fluid (Csf) of experimental animals, but have rarely been reported to cause human neurotoxicity, although fatal reactions to i.v. Thiamine are well known.
Biochemistry: The biologically active form of thiamine is Tpp (thiamine pyrophosphate). It acts as a coenzyme in the oxidative decarboxylation at the pyruvate and the alfa-ketoglutarate steps in the power producing Kreb's cycle and is particularly prominent in the tissues of the nervous system. It also acts as a coenzyme in the oxidative decarboxylation ( of alfa-keto acids and in the formation or degeneration of ketols ) by transketolase in the Pentose phosphate pathway, the intermediary products of which are used in the synthesis of ribonucleotides such as Atp & Gtp, deoxyribonucleotides such as dAtp & dGtp, and nucleic acids Dna & Rna. Thiamine is also essential for protein catabolism, acetyl choline synthesis, normal muscle tone in cardiac and Gi tissues, and for normal increase and appetite.
In human the storage of thiamine is is in most concentrations in skeletal muscle, heart, brain, liver, and kidneys. The human shop about 25 to 30mg of thiamine. ThMp and free (unphosphorylated) thiamine is gift in plasma, milk, cerebrospinal fluid, and just about all extracellular fluids. Unlike the extremely phosphorylated forms of thiamine, ThMp and free thiamine are capable of crossing cell membranes.
Recommendations: Rda in mg
Infants birth to 6 mos - 0.3mg
Infants 6 mos to 1 yr - 0.4mg
Children 1 yr to 3 yr - 0.7mg
Children 4 yr to 6 yr - 0.9mg
Children 7 yr to 10 yr - 1mg
Adolescent males 11yr to 14 yr - 1.3mg
Adolescent females 11 yr to 14 yr - 1.1mg
Adolescent males 15 yr to 18 yr - 1.5mg
Adolescent females 15 yr to 18 yr - 1.1mg
Adult males 19 yr to 50 yr - 1.5mg
Adult females 19 yr to 50 yr - 1.1mg
Adult males 51 yr plus - 1.2mg
Adult females 51 yr plus - 1.0mg
Pregnant Women - 1.5mg
Lactating Mothers - 1.6mg
Thiamine hydrochloride is the common supplemental form. Thiamine therapy for alcoholics may involve a singular injection of 10-mg thiamine or 50 mg of oral fat-soluble thiamine propyl disulfide that permits productive absorption in alcoholics. Erythrocyte transketolase operation is carefully the most reliable index of the functional state of thiamine.
Thiamine B1
Food Source - Serving Size - whole of milligrams per serving
Pork (lean arm braised) - 3.5 oz - 0.60mg
Pork (bacon cured/pan fried) - 4.48oz - 0.88mg
Navy beans (canned) - 1 cup - 0.37mg
Pinto beans (canned) - 1 cup - 0.24mg
Pinto beans (boiled) - 1 cup - 0.32mg
Literature:
A cross-sectional investigation of patients with congestive heart failure being treated with loop diuretic therapy showed that thiamine insufficiency may occur in a enormous proportion of patients with congestive heart failure (Chf) and dietary inadequacy may contribute to increased risk. Men and nonwhite patients with Chf appeared most likely to have evidence of thiamine deficiency, although this reflects, in part, the gender combination of the patients recruited for the study. Patients with more severe Chf (as indicated by lower percentages of left ventricular ejection fractions) had greater biochemical evidence of thiamine deficiency. Someone else study found left ventricular ejection fraction to be adversely affected by thiamine insufficiency and described that, when these patients were supplemented with thiamine intravenously, the ejection fraction improved significantly. Thus, nutritional estimate of thiamine status, including dietary intake, may be an prominent component of care for patients with Chf who are being treated with loop diuretic therapy.
Cognitive functioning
A study by Benton et. Al demonstrated the association in the middle of improved thiamine status and improved execution on a range of measures of cognitive functioning in females. No such association was found in males. Although it was not inherent to establish the calculate for a useful response in females rather than males, there is evidence that females rejoinder differently to dietary factors.
Alzheimer's disease:
Results of one study suggest that probable Alzheimer's Disease (pAd) is connected with a decrease in plasma thiamine levels. In Someone else study, a 40-50% decrease of thiamine diphosphate (Tdp) was found in patients with frontal lobe degeneration of the non-Alzheimer's type (Fnad). As Tdp is an essential co-factor for oxidative metabolism and neurotransmitter synthesis, and because low thiamine status (compared with other species) is a constant feature in humans, a nearly 50% decrease in cortical Tdp content may contribute significantly to the clinical symptoms observed in Fnad. This study also provides a basis for a trial of thiamine to improve the cognitive status of the patients. A mild useful result in patients with Alzheimer's disease was observed on supplementation with Fursultiamine (Ttfd), a derivative of thiamine, at an oral dose of 100 mg/day in a 12-week open trial. Similar benefits were observed in Someone else trial with high dose thiamine (3-8 g/d), while a 12 month study with 3 g/d of thiamine showed no apparent advantage in slowing the progression of dementia of the Alzheimer's type. Thus, weak and contradictory evidence suggests that vitamin B1 may be helpful for Alzheimer's disease.
Assessment of thiamine status
In any human studies while the past 10 years, thiamine status was assessed whether by measuring thiamine pyrophosphate response alone or by using Tpp response measures in conjunction of calculated estimates of thiamine intake from diet histories. Some investigators have combined estimates of thiamine intake with measures of thiamine status other than Tpp response, such as erythrocyte Tpp [18] or plasma Tpp In any of these reports, poor thiamine status, as defined by Tpp response, could not be connected to less-than-adequate thiamine intake. any authors have noted that valid Tpp response measures depend on a kinetically normal enzyme. Hence, disease states, such as alcoholic encephalopathy, may influence enzyme-cofactor binding, and thus, Tpp response. Particular statistical determination of association in the middle of urinary thiamine urination and Tpp response seems to be lacking in the report commonly cited as evidence of the validity of Tpp response measures. In the Icnnd report, categories of thiamine status appear to tell superficially to urinary thiamine excretion, but when there is no clear break-point in the curve for thiamine intake plotted against urinary excretion, it is difficult, in distinction to the case with urinary riboflavin excretion, to define deficiency. One author has demonstrated that in non-human species, pyruvate dehydrogenase appears to be a more sensitive indicator of tissue thiamine insufficiency than is transketolase. A study by Gans et. Al. Raises questions about the usefulness of the Tpp response as the sole indicator of marginal thiamine status. Thiamine status was measured in 137 incarcerated and 42 nonincarcerated immature males by use of both dietary intake data and a standard biochemical assay, thiamin pyrophosphate (Tpp) response. Although average daily thiamine intake of nonincarcerated subjects was significantly higher than that of incarcerated subjects, both groups appeared to be at minimal risk for marginal thiamine status. Comparison of Tpp response values indicated that there was no essential distinction in the middle of groups. However, practically 24% of the total people appeared to have less than adequate Rbc thiamine on the basis of current standards for Tpp response. Neither dietary intake nor reported former alcohol intake was correlated with Tpp response. Thus, clinical standards of thiamine insufficiency seem to lack firm definition. Maybe a better, more valid metabolic measure, such as thiamine or Tpp in plasma, should be investigated and adopted. Also, intake data as well as some standard measure of enzyme operation or function may be prominent values to compare to tell the thiamine status of a group more correctly.
Summary:
Thiamine is essential in the metabolism of proteins, carbohydrates, and fats. It is also needed in the synthesis of Atp and Gtp and nucleic acids Dna and Rna. It acts as a coenzyme in the power producing Kreb's cycle and is particularly prominent in the tissues of the nervous system. Thiamine is also essential for acetylcholine synthesis, maintenance of normal tone of muscle in cardiac and Gi tissues, and for normal increase and appetite.
A whole of claims have been made about the useful effects of thiamine on numerous conditions. (Fibromyalgia, Hiv Support, gravidity and postpartum support, Canker sores - mouth ulcers, and Minor injuries)
Evidence strongly suggests that patients with Chf may advantage from thiamine supplementation. Patients with Chf who are on loop diuretics are shown to have thiamine insufficiency and patients with more severe Chf showed greater biochemical evidence of thiamine deficiency. Thiamine supplementation is shown to improve the left ventricular ejection fraction significantly.
Thiamine supplementation may improve cognitive functioning and has been shown to improve execution on a range of cognitive tests in females.
Populations who are prone to be deficient in this vitamin, like persisting alcoholics, patients with malabsorption syndromes, and those who consume high carbohydrates should receive supplementation. Pregnancy, lactation, high basal metabolic rate, and parenteral glucose therapy will increase the requirements of thiamine. Breast-fed infants of thiamine deficient mothers should receive adequate supplementation, as death from cardiac failure can result within hours, even though the mother appears normal.
Our recommendation for adults is 25 mg/d. This whole can be obtained from practically 41 servings of Pork (lean arm braised), 28 servings of Pork (bacon cured/pan fried), and 80 servings of Pinto Beans (boiled). The Rda for adults is 1.5 mg/d, although a range of doses from 1-25 mg/d is usually consumed. Thiamine therapy for alcoholics may involve a singular injection of 10-mg thiamine or 50 mg of oral fat-soluble thiamine propyl disulfide that permits productive absorption in alcoholics. Wernicke's syndrome, which involves ataxia and nystagmus, develops early and, if left untreated, may progresses to Korsakoff's psychosis, the neurological manifestations of which are irreversible in 75% of the patients. Fatal reactions to high doses of I.V. Thiamine have been reported.
Thiamine (Vitamin B1) How, Why and When to Supplement
MOS
