A Family Doctor's Tale - VITAMIN B1 DEFICIENCY

DOC I HAVE Vitamin B1 Deficiency

Vitamin B1(thiamine) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B1 as a result of inadequate dietary intake or impaired absorption.

Vitamin B1 is present in all living human tissues as an important enzyme in the metabolism of carbohydrates.

Functions of Vitamin B1:
1.It is also required for metabolism of alpha-ketoacids and pyruvates in its carbohydrate form,

2.It is also a co-enzyme of pyruvate dehydrogenase and alpha-ketoglutarate both essential in carbohydrate metabolism.

3.It is also essential in production of acetylcholine.

4.It also play a part in energy metabolism for neurons and cardiac muscles.

Vitamin B1 is found primarily in
1.animal sources - liver. egg yolks
2.vegetable sources: Vitamin B1 is found in fresh green and yellow vegetables, cereals, whole grains and potatoes.

Unfortunately most of the active ingredients of Vitamin B1 is lost in cooking.

Optimal requirements of Vitamin B1 are:
1.adults and children above puberty: 1 mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 0.5 mg daily

Causes:
Vitamin B1 Deficiency occurs
1.when there is Vitamin B1 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B1
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis

2.Severity of Vitamin B1 deficiency is inversely related to age.
It is more common in elderly people.

Symptoms:
1.Vitamin B1 Deficiency is a silent disease in the early stages.
People with Vitamin B1 Deficiency often do not know that they have the condition.

2.Vitamin B1 deficiency can result in 2 major illnesses:
A.Beri Beri
1.peripheral neuropathy affective all the peripheral nerves
2.muscle weakness
3.anorexia
4.heart failure
5.aphonia and absent tendon reflexes in infants

B.Wernicke's Syndrome
1.Occurs in severe Vitamin B1 deficiency
2.brain hemorrhage
3.mental confusion
3.aphonia
4.weakness of sixth nerve
5.total opthalomoplegia (blindness)
6.coma and death

Diagnosis:
1.Blood Vitamin B1 levels are low

Treatment:
The goal of Vitamin B1 Deficiency treatment is the prevention of peripheral neuropathy and heart failure.

Therefore, prevention of Vitamin B1 Deficiency is as important as treatment. Vitamin B1 Deficiency treatment and prevention measures are:

Medications:
Vitamin B1 supplements
1.Vitamin B1 is given at 5 mg to 30 mg per day orally until the response is adequate.

Side effects are:
1.Vitamin B1 may cause anaphylactic reactions when given intravenously.

Prognosis:
1.good response to treatment in Vitamin B1 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B1 Deficiency.

3.Heart failure in beri beri may not respond to digoxin

4.Cardiac beri beri and Wernicke's disease may be fatal if left untreated.

Prevention:
take more liver, egg yolks, cereals and fresh green vegetables.