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Vitamin B1, Thiamin, ThiamineVitamin B1, Thiamin Metabolism The active form is thyamin pyrophosphate, Thpp Thaimin is best absorbed in an acid medium Allicin (garlic) combines with thiamin and renders it more absorbable Biochemistry Thpp is a cofactor for: 2-Keto Glutarate -> succinyl CoA (note: forms Heme) pyruvate -> acetyl CoA ribose 5P -> glyceraldehyde 3P Functions oxydative decarboxylation - pyruvate to acetyl CoA, alpha-keto acids transketolase - pentose monophosphate shunt pathway metabolism of carbohydrates, fat and protein Neurology Thiamin may have a specific role in neurons. Thiamine and its esters are present in axonal membranes, and electrical stimulation of nerves effects the hydrolysis and release of thiamine diphosphate and triphosphate. Requirements RDA - 1.0-1.4 mg, Optimal - 15-30 mg Requirement increased by pregnancy, lactation, thyrotoxicosis, fever. Accelerated loss may occur with diuretic therapy, hemodialysis, peritoneal dialysis, and diarrhea. Defective absorption can occur in malabsorption states, alcoholism, chronic malnutrition, and folate deficiency. Sources Brewer's yeast, sunflower seeds, brown rice substantial loss takes place during cooking above 100°C. Toxicity little evidence of toxicity anaphylactic reactions may occur when given by IM or IV Interactions destroyed by anti-thiamine factor in black tea destroyed by chlorinated water, and chlorogenic acid in coffee Deficiency Types Wet beriberi cardiovascular disease characterized by edema 1. peripheral vasodilatation leading to a high-output state 2. retention of sodium and water leading to edema 3. biventricular myocardial failure Dry beriberi - neurologic disease characterized by ÒburningÓ feet 1. peripheral neuropathy 2. Wernicke's encephalopathy (cerebral beriberi) 3. Korsakoff psychosis Histologic lesion is a non-inflammatory degeneration of myelin sheaths Wernicke's encephalopathy vomiting, fever, ataxia nystagmus (horizontal more commonly than vertical) oculomotor muscle palsies - unilateral or bilateral ophthalmoplegia mental deterioration progresses into global confusion, coma and death Korsakoff's psychosis, frequently persistent; the residual mental state is characterized by gaps in memory, confabulation, and disordered temporal sequencing. Deficiency Symptoms Musculoskeletal muscle weakness, calf tenderness, ataxia Cardiac tachycardia, palpitations Neurological mental confusion Gastrointestinal indigestion, constipation, anorexia Obstetrics infant symptoms appear suddenly, involving cardiac failure and cyanosis Therapeutics Neurology depression, insomnia, neurosis, anxiety Hematology anemia - cofactor for Heme synthesis Eyes sensory neuropathy, glaucoma Musculoskeletal sciatica, trigeminal neuralgia
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