Thiamine deficiency and alcoholism: a lethal mix?
Although alcohol abuse can have damaging effects on just about every organ in the body, the damage to the brain can be significant, especially if the alcoholic also has acquired a thiamine deficiency. Thiamine, or vitamin B1, deficiency targets the cells of the nervous system and heart, causing deficits in motor coordination and cognition, as well as heart disease and even heart failure. When thiamine deficiency is seen in affluent versus impoverished countries, alcoholism, rather than dietary inadequacies, is usually the culprit.
Nutritionists call thiamine a “helper” molecule, or a cofactor, which is utilized by three different enzymes involved in metabolizing carbohydrates. Because the body does not produce thiamine on its own, this vitamin must be ingested through diet. Most healthy people consume .4 to 2.0 milligrams of thiamine daily via meat, poultry, whole grain cereals, rice, nuts, dried beans, peas and soybeans. In addition, many U.S. foods are fortified with thiamine, including breads and cereals.
Thiamine reduction resulting from alcoholism can interfere with a multitude of cellular functions, leading to serious brain disorders. Three main mechanisms contribute to thiamine deficiency: inadequate nutritional intake, decreased thiamine absorption from the gastrointestinal tract and subsequent reduced uptake into cells, and impaired thiamine utilization within the cells.
Approximately 80 percent of alcoholics are deficient in thiamine, and some of them can develop serious disorders. Two such disorders found primarily in alcoholics are Wernicke’s encephalopathy (WE) and Korsakoff psychosis, which often combine as Wernicke-Korsakoff syndrome (WKS), ultimately leading to dementia.
A 2006 study co-authored by Philip J. Langlais, Ph.D., neurosciences professor at the University of California, San Diego, sought to identify the interaction between alcohol (ethanol) consumption and thiamine deficiency.
“We wanted to see if you took thiamine deficiency and combined it with chronic alcohol intake, would you then create a situation that would produce a more severe impairment of cognition and memory than you would with either thiamine deficiency alone, or exposure to chronic alcohol ingestion alone,” stated Langlais in describing the premise of the study.
The prolonged and heavy consumption of ethanol has been associated with thiamine deficiency, and cognitive and memory impairments. Langlais undertook this study to test the hypothesis that ethanol consumption and thiamine deficiency act synergistically, producing more severe clinical neurological disturbances and cognitive and memory impairments than either thiamine deficiency or chronic ethanol ingestion alone.
Twelve-week-old male rats were studied for acute neurological and long-term behavioral consequences. For 32 weeks, researchers compared the impact of chronic ethanol consumption and three separate four-week-long episodes of dietary thiamine deficiency with ethanol consumption or thiamine deficiency alone.
The results indicate that the interaction between chronic ethanol consumption and thiamine deficiency bouts is both-domain specific but not always synergistic. It appears that learning and memory are sensitive to a synergistic interaction between alcohol consumption and thiamine deficiency, whereas short-term working memory disturbances are most affected by alcohol consumption and neurological symptoms are most associated with thiamine deficiency. Neither the presence of neurological symptoms nor blood ethanol concentrations appear to be good predictors of learning and memory deficits.
Because thiamine deficiency can be attributed to poor diet or to poor gastrointestinal absorption in alcoholics, some sort of thiamine supplementation is indicated. Because thiamine injections given to alcoholics are usually so strong that they themselves can be problematic, a steady diet of thiamine-rich or fortified foods can be more helpful. The gut and liver can absorb and process low doses of thiamine, while an abundance can lead to magnesium deficiency. In the case of supplementation, more is not always better.
Sovereign Health Group is a residential treatment program for substance addiction and mental health disorders, with facilities across the nation. For more information about the treatment of alcoholism, please call (866) 524-5504.
Written by Eileen Spatz, Sovereign Health Group writer