@
Cumbrianjudith. Some notes on B1 that you or others may find interesting or useful. Some from experience, some from links below.
'Normal' B1/Thiamine is water soluble and I have been told people can take quite high doses without issue as it just washes out if too much.
Benfotamine is a fat soluable form of B1- So it is very important to follow dosing instructions of this in order to not overdose.
B1 is interesting in that it it used in its own absorption/processing/storage process, and how much you have determines which absorption/processing pathway is used.
If you are taking B1 its worth making sure you have enough other vitamins/minerals on board to enable its safe absorption and storage.
I agree that researching the deficiency is very difficult especially when wet and dry beriberi are mentioned! I also saw a really intersting article - can't remember where sorry- that mentioned that even those distinctions are not relevant to todays situation as most of those deficient would have had other deficiencies at the same time and who knows which was which back then.
I think the most useful distinctions are:
Thiamine is involved in the process of getting energy into muscles, and affects the function of the muscles. ( this includes everything from the heart, to your legs and your bladder)
Thiamine is involved in nerve function - sending messages - sensory and functional
Thiamine is involved in helping your brain function- thinking, talking and listening, movement and problem solving
Thiamine is involved in metabolic processes including blood glucose aspects, and in my experience a defiency can result in limb swelling( also poss related to heart function), and generally retaining water.
Thiamine is rarely tested by GP's and usually has to be asked for and fought for.
Thiamine deficiency can cause brain damage, so it is worth fighting for a test. (Wernicke-Korsakoff is the endpoint)
NB there is controversy about thiamine testing. The emergency hospital protocols I have seen say test, and then treat before the result comes back because of the potential negative outcomes. There are questions about the blood test accurately reflecting an accurate level of thiamine past the blood brain barrier.
Some have a policy of if in doubt treat, and if there is a benefit/positive outcome, keep taking it rather than relying on the test result.
The Brain and the Pancreas are very high users of Thiamine in the body - compared to other organs and systems. There is also a link between Thiamine and pancreas inflammation which I am further researching.
Low thiamine is usually caused by (in no particular order)
Alcoholism
Gastric bypass type surgery
Excessive loss from eg Kidney issues, long term diarrohea
Anti-Thiamine factors/thiaminases eg a loooot of coffee or tea, betel leaves/nuts, some shelfish, - there are others but they are rare, apart from Cassava which can be made into chips and seen in your local chip aisle.
Aging - as we age we absorb less
Family tendency. It is rare but I know from experience that there can be a tendency for lack of / reduced absorption in some families - this is suggested to be genetic and from a genetic change probably affecting one of the thiamine transporter genes but is very rare.
Medications
- This is a very new field with research out in 2020, and 2024.
Essentially early research shows that there are medications that block the Main Thiamine transporter ThTR2 and more are expected to be confirmed.
'Drug-nutrient interactions: discovering prescription drug inhibitors of the thiamine transporter ThTR-2 (SLC19A3)'
Our comprehensive analysis of prescription drugs suggests that several marketed drugs inhibit ThTR-2, which may contribute to thiamine deficiency, especially in at-risk populations.
pubmed.ncbi.nlm.nih.gov
( this is the 2020 research, there is subsequent)
Metformin is on their list of medications to research further, as are medications from other groups including antidepressants.
One of the articles outlines the issue that the inhibition of of the gene, not only affects the initial absorption, but also the processing/conversion/storage, the 'getting it into the cell to be used' , the ability of the Kidney to filter and retain the thiamine and also restorage/reuse. A nightmare. This also illustrates that although yor blood level may be OK, you may not have the enzyme function to get it used where it is needed.
So in short, worth talking to your GP about testing and or supplementation and seeing if it helps.
https://lpi.oregonstate.edu/mic/vitamins/thiamin is a useful resource with more than just 'beri beri' info.
