Do You Have Enough Thiamin?

Thiamin, vitamin B1, is an essential nutrient. Our bodies need thiamin to digest carbohydrates, to regulate blood sugar and blood pressure, and to produce hydrochloric acid in our stomachs that is needed to digest food. Deficiencies are linked to PMS, anxiety, and peripheral nerve disease. Prolonged deficiency can lead to labored breathing and cardiac damage. Although important, thiamin deficiency unfortunately is often under diagnosed.

Early symptoms of deficiency may include:

• easy fatigue
• loss of appetite
• irritability and emotional instability
• confusion, loss of memory

Later signs of deficiency may include:

• burning feet (especially at night)
• calf muscle cramps
• difficulty rising from a squatting position
• atrophy of the calf and thigh muscles
• foot drop

Some other common signs to look for include:

• loss of muscle tone or heaviness in the arms/legs
• a pulse below 65 bpm in a non-exercising individual
• numbness, tingling or itching in the extremities
• can hear heart beat on pillow at night
• fragile skin, easily chaffed when shaving
• cracks at the corners of your mouth (cheilosis)
• wake up without remembering your dreams

Other than checking signs and symptoms, what laboratory tests are used to detect thiamin deficiency?

The most specific test for thiamin deficiency is called RBC transketolase. Transketolase is an enzyme that cannot be produced without sufficient thiamin. Unfortunately, it is an expensive test and the following tests are often performed first:

• CO2 – below 25
• Anion gap > 12
• Low normal or decreased hematocrit (HCT) – less than 37 or 0.37 in women, less than 40 or 0.40 in men
• Low normal or decreased hemoglobin – less than 135 or 13.5 in women, less than 140 or 14.0 in men
• LDH levels may be decreased
• Glucose levels may be normal or increased (over 5.55 mmol/L or 100)

If you display any of the symptoms listed above I recommend checking for these patterns in your lab test results. These lab result patterns combined with matching symptoms provide sufficient evidence to confirm a possible thiamin deficiency with the RBC transketolase test.

So if you experience any of the symptoms listed above, I recommend working with your naturopathic doctor to rule out a possible thiamin deficiency. Digestive support may be needed to ensure you are producing sufficient hydrochloric acid and a high quality, naturally sourced thiamin supplement may be needed to replenish the deficiency.

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