Get Your Personalized Supplement StackSupplement Stack Quiz

Thiamin K

Also known as: Thiamin, Vitamin B1, C12H17N4OS, Thiamine

Overview

Thiamine, also known as Vitamin B1, is an essential water-soluble vitamin crucial for carbohydrate metabolism and neural function. It is naturally found in whole grains, legumes, nuts, and meat. The body does not store thiamine extensively, requiring regular dietary intake. It is primarily used to prevent and treat thiamine deficiency syndromes such as beriberi and Wernicke-Korsakoff syndrome. While its role in deficiency is well-established, evidence for its benefits in other conditions like heart failure or diabetes-related complications is emerging but largely inconclusive. Research quality is strong for deficiency treatment but limited and inconsistent for broader clinical benefits.

Benefits

Thiamine supplementation is highly effective in preventing and treating thiamine deficiency syndromes, including beriberi. For instance, in populations with documented deficiency, rapid and significant clinical improvement is observed. However, for conditions beyond deficiency, the evidence is less robust. A systematic review and meta-analysis of 8 randomized controlled trials (384 patients) found no statistically significant improvement in left ventricular ejection fraction (LVEF) or other clinical outcomes (e.g., NYHA class, BNP levels) in heart failure patients supplemented with thiamine. While thiamine deficiency is more common in heart failure patients, supplementation has not consistently translated into clinical benefit. Similarly, for diabetic adults with cardiovascular dysfunction, while deficiency may be prevalent, conclusive evidence for supplementation benefits is lacking. Thiamine's isolated effect in pain management is not proven, though it may enhance the analgesic effects of NSAIDs when combined with other B vitamins.

How it works

Thiamine functions primarily as a coenzyme, thiamine pyrophosphate (TPP), which is vital for carbohydrate metabolism. TPP is essential for key enzymatic reactions in the Krebs cycle and the pentose phosphate pathway, both critical for cellular energy production. Specifically, it acts as a cofactor for enzymes such as pyruvate dehydrogenase and α-ketoglutarate dehydrogenase. These metabolic roles are crucial for maintaining proper nervous system function and cardiac energy metabolism. Thiamine is absorbed in the small intestine through both active transport and passive diffusion, with its bioavailability potentially influenced by factors like alcohol consumption, certain diseases, and diuretic use.

Side effects

Thiamine is generally considered very safe with a low toxicity profile, as excess amounts are readily excreted in the urine. Common side effects are rare, with mild gastrointestinal discomfort being a possibility. Uncommon side effects, such as allergic reactions, are very infrequent. Extremely rare cases of anaphylaxis have been reported. Several drug interactions are known: diuretics, particularly furosemide, can increase thiamine excretion, potentially leading to deficiency. Alcohol significantly impairs thiamine absorption and utilization, increasing the risk of deficiency. There are no absolute contraindications, but caution is advised for individuals with a history of allergic reactions to thiamine. Specific populations, including pregnant and lactating women, individuals with alcoholism, and those with certain chronic diseases, may have increased thiamine requirements.

Dosage

For the prevention of thiamine deficiency, the recommended daily allowance (RDA) is 1.1–1.2 mg/day. For therapeutic purposes or general supplementation beyond the RDA, doses up to 100 mg/day have been widely used and are considered safe. There is no established upper limit for thiamine, and doses as high as 500 mg/day have been administered in clinical settings without reported toxicity. Due to its water-soluble nature and limited body storage, daily dosing is recommended. Thiamine is commonly available in supplements as thiamine hydrochloride or thiamine mononitrate. Optimal absorption occurs on an empty stomach, and it's important to note that alcohol and certain medications can reduce absorption. Magnesium is a required cofactor for the enzymes that utilize thiamine, so adequate magnesium intake is also important.

FAQs

Does thiamine supplementation improve heart failure?

Current meta-analyses indicate no significant benefit of thiamine supplementation on cardiac function or symptoms in heart failure patients without documented deficiency.

Is thiamine supplementation safe?

Yes, thiamine is generally very safe with a low risk of side effects, as excess amounts are excreted by the body.

How quickly does thiamine work?

In cases of thiamine deficiency, symptoms can improve rapidly, often within days, following supplementation.

Can thiamine prevent cardiovascular disease?

There is insufficient evidence to suggest that thiamine alone can prevent cardiovascular disease. Its primary role is in metabolic processes.

Is thiamine effective for pain management?

While thiamine combined with other B vitamins may enhance the analgesic effects of NSAIDs, thiamine alone has not been proven effective for pain management.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/35842069/ – This systematic review and meta-analysis of 8 RCTs (384 patients) investigated thiamine supplementation in heart failure. It concluded that thiamine did not significantly improve left ventricular ejection fraction or other clinical outcomes, despite moderate heterogeneity among studies. The quality of evidence was rated moderate, highlighting limitations such as small sample sizes.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12072100/ – This systematic review focused on thiamine supplementation in diabetic adults with cardiovascular dysfunction. It noted the prevalence of thiamine deficiency in this population but found a lack of conclusive evidence regarding the benefits of supplementation. The review emphasized the need for more robust randomized controlled trials to determine efficacy.
https://academic.oup.com/painmedicine/article/21/4/766/5570552 – This systematic review and meta-analysis examined the use of combined diclofenac and B vitamins (including thiamine) for pain. It found that the combination improved analgesic effects compared to diclofenac alone in acute low back pain. However, the isolated effect of thiamine was not separately analyzed, and the quality was assessed via GRADE.
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1115069/full – This article discusses the distinct roles of Vitamin K and Thiamine, clarifying that while Vitamin K shows promise in areas like vascular calcification, it is entirely separate from Thiamine (Vitamin B1). It helps differentiate between these two distinct vitamins and their respective research areas.