040: Why You Should Manage Your Thiamin Status and How to Do It

Mastering Nutrition Episode 40

Jan 14, 2018

∙ Paid

Introduction

Thiamin, or vitamin B1, is central to both energy metabolism and antioxidant defense. While its deficiency causes many problems, out of all the B vitamins its deficiency is most neurological in nature, because energy metabolism of the brain becomes severely compromised, and because neurotransmitters derived from protein cannot be produced. In its most severe form, beriberi, it can cause loss of muscle control, twitching, muscles freezing into awkward positions, and seizures.

Carbohydrates require twice as much thiamin as fat. This means, on the one hand, that high-carbohydrate diets increase the need for thiamin, and on the other hand, that people who are deficient in thiamin may have neurological symptoms that resolve when they go on a low-carbohydrate, high-fat diet.

Thiamin is widely distributed in foods. Historically, diets high in refined grain produced beriberi, but now refined grains are enriched in thiamin, so its deficiency is rarely caused by diet. However, certain foods such as raw fish and moths that are eaten in some cultures contain thiamin antagonists, gastrointestinal microbes can degrade thiamin, and there are various environmental causes of thiamin deficiency, such the algae that grow in dead zones. As such, environmental exposure to thiamin antagonists may be a more common cause of thiamin deficiency than poor dietary intake.

Still, some foods are much higher in thiamin than most others, with whole grains, legumes, yeast, and red meat being among the best sources.

Show Notes

0:01:00 Cliff Notes
0:06:27 Thiamin is centrally involved in energy metabolism and is required to metabolize fat, protein, and especially carbohydrate.
0:07:26 Thiamin is critical to the pentose phosphate pathway, which supports antioxidant status, detoxification, the recycling of vitamin K and folate, and the synthesis of fatty acids, cholesterol, neurotransmitters, and nucleotides.
0:08:34 Clinical thiamin deficiency syndromes: beriberi, Wernicke’s encephalopathy, and Korsakoff’s psychosis.
0:11:24 Signs and symptoms of moderate thiamin deficiency: poor glucose tolerance, poor antioxidant status, poor vitamin K or folate status, feeling better on a low-carb diet.
0:12:04 Dietary causes of thiamin deficiency; food sources of thiamin are meat, legumes, whole grains, and enriched, fortified grains.
0:15:18 Other causes of thiamin deficiency: persistent vomiting, alcoholism, GI diseases that cause malabsorption, liver diseases, HIV/AIDS, and diabetes.
0:18:01 Thiamin antagonists can occur in raw fish and shellfish, seasonally in ferns, and in the larvae of the African silkworm Anaphe venata.
0:20:43 Sulfite destroys thiamin in vitro; the metabolism of sulfur amino acids, found primarily in animal protein, generates sulfite; molybdenum is required to detoxify sulfite.
0:22:53 Thiamin-destroying bacteria and fungi have been found in the human gut; infections and indoor toxic molds may cause thiamin antagonism.
0:23:59 Markers of thiamin status: whole blood thiamin pyrophosphate, erythrocyte transketolase activity.
0:28:02 Thiamin’s role in energy metabolism: pyruvate dehydrogenase, alpha-ketoglutarate dehydrogenase, and branched-chain alpha-keto acid dehydrogenase.
0:30:56 Other functional markers of thiamin deficiency: elevated alpha-ketoglutarate, alanine, lactate, and possibly pyruvate on the Genova ION Profile with 40 amino acids or some other combination of plasma amino acids and urine organic acids.
0:34:24 Keep in mind that all of the thiamin-dependent enzymes in energy metabolism also require lipoic acid.
0:35:25 How to address thiamin deficiency: fix the dietary pattern, consider supplementation (thiamin hydrochloride, benfotiamine, or thiamin pyrophosphate), and address any relevant medical conditions.

Lab Tests Related to Thiamin Status

Whole blood thiamin pyrophosphate (LabCorp) and erythrocyte transketolase activity (available from HDRI as “ETKA” on their requisition form) are low in thiamin deficiency.

On the Genova ION Profile + 40 amino acids or an equivalent combination of plasma amino acids and urine organic acids, alanine, alpha-ketoglutarate, lactate, and possibly pyruvate are elevated in thiamin deficiency.