Why must I take thiamine supplements before starting an alcohol detox?
Approximately 80% of people with chronic alcohol use will develop a thiamine deficiency.1 It is essential that you start taking thiamine (vitamin B1) to help prepare and protect your body before starting an alcohol detox. At your initial assessment, our doctor will tell you exactly how much thiamine to take and how often. This is part of the reason there is about a week between your initial assessment and commencing the detox to allow enough time for your body to build up sufficient thiamine stores.
If you regularly drink a lot of alcohol we recommend taking Vitamin B1 (thiamine) to help protect your body, even if you are not planning on stopping or reducing your alcohol consumption. Please speak to your GP who will be able to assess if this is appropriate for you and how much thiamine you should be taking each day.
Signs and symptoms of thiamine deficiency
Thiamine deficiency can develop in as little as three weeks, but can take 3 to 6 months to reverse the damage to the brain and nervous system. Some people may experience permanent brain damage.2 Symptoms of thiamine deficiency can be very serious and range from tiredness to nerve damage, heart failure and sometimes paralysis. Below are the most common symptoms of thiamine deficiency:
- loss of appetite
- fatigue
- irratability
- nerve damage
- tingling arms and legs
- blurry visions
- nausea & vommitting
- delirium3
Associated diseases and disorders
Beriberi. There are two types of beriberi: wet beriberi and dry beri beri. Wet beriberi affect the heart and circulatory system and in extreme cases result in heart failure. Dry beriberi damages the nerves and eventually leads to muscle paralysis. If left untreated, beriberi can be fatal.4
Wernicke-Korsakoff Syndrome is a brain disorder caused by thiamine deficiency. Wernicke encephalopathy (WE) and Korsakoff syndrome (also known as Korsakoff psychosis) are two different conditions that can occur together. WE causes peripheral neuropathy, a type of nerve damage that can cause pain, numbness or tingling in your arms and legs.5 Confusion and loss of mental activity can progress to coma and death. Korsakoff’s Psychosis (KP) is associated with sever short-term memory loss, disorientation, and confabulation (making up stories), hallucinations and inability to form new memories. These two conditions can be difficult to diagnose due to the overlapping symptoms of alcohol intoxication.6
Sources of Vitamin B1 (thiamine)
Most adults should aim to get 1.1–1.2 mg of thiamine per day. As thiamine is soluble in water, you need a regular supply of thiamine because your body cannot store it for long periods of time. Thiamine can be found in the following foods:
- enriched white rice or egg noodles
- wholegrain bread and pasta
- pork
- salmon and trout
- legumes, particularly black beans
- yoghurt
- fortified breads and breakfast cereals
References
- Administration of Thiamine in Chronic Alcohol Abuse Guideline. (n.d.). https://www.wacountry.health.wa.gov.au/~/media/WACHS/Documents/About-us/Policies/Administration-of-Thiamine-in-Chronic-Alcohol-Abuse-Guideline—Albany-Health-Campus.pdf?thn=0 ↩︎
- Hammond N, Wang Y, Dimachkie MM, Barohn RJ. Nutritional neuropathies. Neurol Clin. 2013 May;31(2):477-89. doi: 10.1016/j.ncl.2013.02.002. PMID: 23642720; PMCID: PMC4199287. ↩︎
- Thiamine (Vitamin B1): Deficiency Symptoms and Treatment. (2021, December 17). Healthline. https://www.healthline.com/nutrition/thiamine-deficiency-symptoms#basics ↩︎
- Badii, C. (2012). Beriberi: Overview, Causes, and Symptoms. Healthline. https://www.healthline.com/health/beriberi ↩︎
- Australia, H. (2020, June 26). Peripheral neuropathy. Www.healthdirect.gov.au. https://www.healthdirect.gov.au/peripheral-neuropathy ↩︎
- Administration of Thiamine in Chronic Alcohol Abuse Guideline. (n.d.). https://www.wacountry.health.wa.gov.au/~/media/WACHS/Documents/About-us/Policies/Administration-of-Thiamine-in-Chronic-Alcohol-Abuse-Guideline—Albany-Health-Campus.pdf?thn=0 ↩︎
Published: 29 August 2024
