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Vitamin B1, Thiamin, Thiamine


Vitamin 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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