Vitamin B-1 By: Lotje Mulder

Deficiency
 Overview

Background
Causes
Pathophysiology
Symptoms
Effects
 Thiamine

water-soluble vitamin of the B complex

biosynthesis of the neurotransmitter acetylcholine and
gamma-aminobutyric acid (GABA)
detrimental for bodily functions
Not synthesised in the body essential nutrient
yeast & pork
 Thiamine Deficiency
Nervous system: dependence on oxidative metabolism
Causes:
malnutrition:
inadequate intake
alcoholism, gastrointestinal diseases, HIV-AIDS, and
persistent vomiting
a diet high in thiaminase-rich foods: raw shellfish
or anti-thiamine factors: tea, coffee
 Further Causes

Secondary thiamine deficiency:

Increased demand (hyperthyroidism, pregnancy)
Impaired absorption (e.g. prolonged diarrhea)
Impaired metabolism (e.g. hepatic insufficiency)
In alcoholics: decreased intake, impaired absorption and
increased demand
 Pathophysiology

Degeneration peripheral nerves, thalamus,

mammillary bodies, and cerebellum
Cerebral blood flow is reduced
heart becomes dilated
muscle fibers swell & fragment
Vasodilation: edema in feet and legs
Arteriovenous shunt increases (heart failure may
occur)
 Early (non-specific)
Symptoms
Fatigue
Irritability
Poor memory
Sleep disturbances
Precordial pain
Anorexia
Abdominal discomfort
 Beriberi
Dry: peripheral neurologic deficits
Bilateral
Lower extremities
Wet: myocardial disease
Vasodilation, tachycardia,
sweating, lactic acidosis
Heart failure
Wernicke-Korsakoff syndrome

combination of Wernickes encephalopathy and

Korsakoff psychosis
Wernickes: psychomotor slowing (apathy), optic
neuropathy
Korsakoff: mental confusion, dysphonia, impaired
memory, etc.
 Diagnosis & Treatment

Supplemental thiamin - favorable response to vitamin b

Similar lower extremity polyneuropathies do not respond
to thiamine
 Summary

Cause: malnutrition, malabsorption, impaired metabolism

Degeneration: peripheral nerves, thalamus, mammillary
bodies, and cerebellum
Early symptoms: fatigue, irritability, sleeplessness, poor
memory, etc.
Beriberi, Wernickes encephelopathy, Korsakoffs
Treatment: thiamine supplements