Hiding in Plain Sight: Modern Thiamine Deficiency

[Mito]

Abstract​

Thiamine or vitamin B1 is an essential, water-soluble vitamin required for mitochondrial energetics—the production of adenosine triphosphate (ATP). It is a critical and rate-limiting cofactor to multiple enzymes involved in this process, including those at the entry points and at critical junctures for the glucose, fatty acid, and amino acid pathways. It has a very short half-life, limited storage capacity, and is susceptible to degradation and depletion by a number of products that epitomize modern life, including environmental and pharmaceutical chemicals. The RDA for thiamine is 1.1–1.2 mg for adult females and males, respectively. With an average diet, even a poor one, it is not difficult to meet that daily requirement, and yet, measurable thiamine deficiency has been observed across multiple patient populations with incidence rates ranging from 20% to over 90% depending upon the study. This suggests that the RDA requirement may be insufficient to meet the demands of modern living. Inasmuch as thiamine deficiency syndromes pose great risk of chronic morbidity, and if left untreated, mortality, a more comprehensive understanding thiamine chemistry, relative to energy production, modern living, and disease, may prove useful.

Hiding in Plain Sight: Modern Thiamine Deficiency

Thiamine or vitamin B1 is an essential, water-soluble vitamin required for mitochondrial energetics—the production of adenosine triphosphate (ATP). It is a critical and rate-limiting cofactor to multiple enzymes involved in this process, including those at the entry points and at critical...

www.mdpi.com

 

[Creative Nature]

Thanks, @Mito. A great introduction to the subject and a reminder of the many important roles B1 plays. I hope not to interact much with doctors in the future, but if I needed to persuade one to take B1 deficiency seriously, this article would likely be my opening salvo.

 

[osar]

wow @Mito you sure do post a lot of the same studies as uptophate on twitter; https://twitter.com/UpToPhate

 

[Ben.]

7.1. High Carbohydrate Diets
Perhaps the most commonly disregarded factor when considering thiamine status, is
the composition of the individual’s diet. High carbohydrate diets effectively decrease cir‐
culating thiamine concentrations by a number of mechanisms. Metabolizing carbohy‐
drates, regardless of their source or quality, diminishes thiamine stores. One study found,
that when 55% of total caloric intake came from carbohydrates, no matter their source,
thiamine status in otherwise healthy and thiamine sufficient individuals declined. As car‐
bohydrate intake increased, thiamine decreased further [122]. In contrast, a lower carbo‐
hydrate, higher fat diet slows thiamine loss in thiamine‐restricted experimental conditions
[123] while protein seems to preserve thiamine degradation in foods [124]. Intravenous
glucose or dextrose may precipitate WE in traditionally malnourished [125], hyperemetic
[126] and non‐traditionally malnourished, e.g., well‐fed, but under nourished individuals
[127].

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I guess this is one of the reasons why people may feel better initially on low carb/low sugar diets and why going "peaty" can be problematic for some.

 

[Peater Piper]

Is it possible to drink a lot of coffee without experiencing thiamine deficiency?

 

[Jing]

What I have always thought who decides the rda? What if they rda is actually like 50mg?

 

[hei]

What I have always thought who decides the rda? What if they rda is actually like 50mg?

Even getting 5 milligrams from food is tough. What do you think people were eating that they would have been getting 50mg?

 

[Jing]

Even getting 5 milligrams from food is tough. What do you think people were eating that they would have been getting 50mg?

Well 50 obviously seems to high but nutritional yeast has about 9mg in 2 tablespoons but I don't mean hundreds of years ago I mean with modern living all the stress and digestive problems etc..

 

[Perry Staltic]

Is it possible to drink a lot of coffee without experiencing thiamine deficiency?

Sip and spit. Still get the taste with a slight caffeine buzz (absorbed thru the gums).

 

[golder]

Sip and spit. Still get the taste with a slight caffeine buzz (absorbed thru the gums).

What a miserable life.

 

[Blossom]

What a miserable life.

That’s exactly what I thought too.

 

[Perry Staltic]

That’s exactly what I thought too.

Beats going without coffee, so not THAT miserable

 

[Peater Piper]

Beats going without coffee, so not THAT miserable

Truthfully, I feel fine with three cups of coffee a day, but I'm not sure a mild thiamine deficiency would be noticeable. This is like the third time I've told myself I need to give a small supplemental dose of thiamine a try.

 

[Blossom]

Beats going without coffee, so not THAT miserable

Sadly I’m just not there yet. I’m closing in on 40 years of drinking it and I’m down to only one cup most days…

 

[Perry Staltic]

Sadly I’m just not there yet. I’m closing in on 40 years of drinking it and I’m down to only one cup most days…

I can't handle it anymore for some reason. Not drinking it improves my life more than anything.

 

[Blossom]

I can't handle it anymore for some reason. Not drinking it improves my life more than anything.

That’s great! You’re the second person who has told me that and this is the third time in the last year the idea of stopping coffee has come up for me so I may have to try it.

 

[Dr. B]

Well 50 obviously seems to high but nutritional yeast has about 9mg in 2 tablespoons but I don't mean hundreds of years ago I mean with modern living all the stress and digestive problems etc..

i started using 500mg thiamine hcl, not sure of the brand its called dr clarks store on amazon, got it cuz its just gelatin caps no fillers. didnt seem to notice much, not yet
Thiamine in foods can be degraded in a variety of ways. Sulfites, which are added to foods usually as a preservative,[39] will attack thiamine at the methylene bridge in the structure, cleaving the pyrimidine ring from the thiazole ring.[12] The rate of this reaction is increased under acidic conditions. Thiamine is degraded by thermolabile thiaminases (present in raw fish and shellfish).[11] Some thiaminases are produced by bacteria. Bacterial thiaminases are cell surface enzymes that must dissociate from the membrane before being activated; the dissociation can occur in ruminants under acidotic conditions. Rumen bacteria also reduce sulfate to sulfite, therefore high dietary intakes of sulfate can have thiamine-antagonistic activities.

Plant thiamine antagonists are heat-stable and occur as both the ortho- and para-hydroxyphenols. Some examples of these antagonists are caffeic acid, chlorogenic acid, and tannic acid. These compounds interact with the thiamine to oxidize the thiazole ring, thus rendering it unable to be absorbed. Two flavonoids, quercetin and rutin, have also been implicated as thiamine antagonists.

theres vitamin mixes with quercetin which seem to cause me severe issues. based on what the above says it seems even bacteria can create thiaminases, which would include gut bacteria, so hypo people could potentially have thiamine issues and absorption issues?

are caffeic acid and chlorogenic present in caffeine pills or only in actual coffee? i think wikipedia says caffeic acid is in caffeine...
i have caffeine pills, not sure if i should stop using
coffee seems to have all sorts of nonsense in it, even if you get the organic stuff and dont have to worry about pesticides, herbicides etc

does "sulfate" mean sulfur in food, or only sulfate as an additive

 

[Mauritio]

Thiamine enzymes are also blocked by fungi . So living in a moldy apartment (like me for 3 years) can certainly increase your requirements .

https://pubs.acs.org/doi/abs/10.1021/jo950451f

 

[Dr. B]

What I have always thought who decides the rda? What if they rda is actually like 50mg?

the current rdas are mostly attainable from food sources. 50mg would be likely impossible from food sources, even liver, pork, milk, OJ dont have much thiamine. unless theres some alternate forms of it that were not able to properly test for, like how Ray mentioned the vitamin C form present in meat/milk which isnt tested for since its not the same as the fruit/veggie sources

 

[Peatness]

Thiamine enzymes are also blocked by fungi . So living in a moldy apartment (like me for 3 years) can certainly increase your requirements .

https://pubs.acs.org/doi/abs/10.1021/jo950451f

Good to know. Thank you