Not enough vitamin B1 can cause brain damage
Key points
- A deficiency of a single vitamin, B1 (thiamine), can cause a potentially fatal brain disorder called Wernicke encephalopathy.
- Vitamin B1, also called thiamine or thiamin, is one of 8 B vitamins.
- The most important use of thiamine is to treat beriberi, which is caused by not getting enough thiamine in your diet.
- Wernicke-Korsakoff syndrome is a brain disorder caused by thiamine deficiency.
A deficiency of a single vitamin, B1 (thiamine), can cause a potentially fatal brain disorder called Wernicke encephalopathy.
Symptoms can include confusion, hallucinations, coma, loss of muscle coordination and vision problems such as double vision and involuntary eye movements. Untreated, the condition can lead to irreversible brain damage and death, according to neurologists at Loyola University Medical Center.
In the developed world, Wernicke encephalopathy typically occurs in people who have disorders such as alcoholism and anorexia that lead to malnourishment.
Wernicke encephalopathy is an example of the wide range of brain diseases, called encephalopathies, that are caused by metabolic disorders and toxic substances, according to a report by Loyola neurologists Matthew McCoyd, MD, Sean Ruland, DO and Jose Biller, MD in the journal Scientific American Medicine.
Acute encephalopathy has a rapid onset of between hours and days. It is commonly due to toxic and metabolic factors.
"Toxic and metabolic encephalopathies may range in severity from the acute confusional state to frank coma," McCoyd, Ruland and Biller write. "As permanent injury may occur, an organized approach is needed to make an accurate and rapid diagnosis."
Thiamin (also spelled "thiamine") is a water-soluble B-complex vitamin, previously known as vitamin B1 or aneurine. Thiamin was isolated and characterized in the 1920s, and thus was one of the first organic compounds to be recognized as a vitamin.
Thiamin is involved in numerous body functions, including: nervous system and muscle functioning; flow of electrolytes in and out of nerve and muscle cells (through ion channels); multiple enzyme processes (via the coenzyme thiamin pyrophosphate); carbohydrate metabolism; and production of hydrochloric acid (which is necessary for proper digestion). Because there is very little thiamin stored in the body, depletion can occur as quickly as within 14 days.
Severe chronic thiamin deficiency (beriberi) can result in potentially serious complications involving the nervous system/brain, muscles, heart, and gastrointestinal system.
Dietary sources of thiamin include beef, brewer's yeast, legumes (beans, lentils), milk, nuts, oats, oranges, pork, rice, seeds, wheat, whole grain cereals, and yeast. In industrialized countries, foods made with white rice or white flour are often fortified with thiamin (because most of the naturally occurring thiamin is lost during the refinement process).
The hallmark of toxic and metabolic encephalopathies is altered sensorium. This can range from mild attention impairment, such as difficulty spelling a word backwards, to coma.
Toxic encephalopathy can be caused by illegal drugs, environmental toxins and reactions to prescription drugs.
Written and revised by
Gerald Hurowitz, M.D.
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