Can alcohol cause thiamine deficiency?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Thiamine, also known as vitamin B1, is crucial for synthesizing energy and keeping your brain, heart, muscles, and other vital organs and tissues working smoothly. Unfortunately, alcohol interferes with thiamine levels, which can cause deficiencies and lead to a variety of complications.

According to the Australian Alcohol and Drug Foundation, “approximately 80% of people with chronic alcohol abuse will develop thiamine deficiency, which can lead to life-threatening consequences.”

Alcohol suppresses the absorption of thiamine, impairs its activation, and interferes with its distribution to tissues and organs. Your nervous system suffers from the effects of alcohol consumption, and long-term damage to your cells and overall function can be permanent.

Vitamin B1 deficiency isn’t the only complication that boozing can create. In case you’ve been living under a rock, chronic alcohol consumption affects many aspects of your health.

If you’re struggling with alcohol abuse, our alcohol addiction treatment center can provide the support and guidance you need to achieve lasting recovery.

I recently had the good fortune to receive treatment at Ardu, and am so grateful for everyone there… I received the very latest in medical treatment, along with in-depth counseling and behavioral therapy, that allowed me to begin my recovery in a loving and supportive environment… thanks to Ardu Recovery Center!

—Susan H

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What does thiamine do?

Thiamine, or vitamin B1, is a water-soluble vitamin that allows your cells to convert nutrients from carbohydrates, proteins, and fat into energy. Thiamine aids in the production of adenosine triphosphate (ATP), the “energy” molecule that powers every function in the body.

Here’s why vitamin B1 is so important:

It’s vital for proper cell growth, development, and signaling. Every organ in the human body depends on cellular energy production from thiamine.
It’s critical for muscle contractions.
It’s critical for connective tissue formation.
It’s important for conducting nerve signals throughout the body.
It helps synthesize important neurotransmitters that regulate mood, sleep, memory, and focus.
It’s essential for digestive health.
It supports immune function and response.
It helps maintain a stable heart rhythm.

Every cell in your body relies on thiamine to create usable energy from nutrients. Thiamine is what keeps the body’s machinery running properly. Without enough of it, cells lose the ability to generate energy, resulting in a wide range of symptoms such as:

Fatigue and weakness
Loss of appetite and weight loss
Nausea and abdominal discomfort
Muscle cramps and nerve pain
Tingling or numbness in hands and feet
Cognitive impairments (e.g., confusion, memory loss, and brain fog)
Depression, irritability, and anxiety
Vision changes and eye twitching
Cardiovascular effects such as irregular heartbeat
Coordination problems (e.g., tremors, ataxia, or unsteady gait)

Thiamine deficiency can arise from either inadequate dietary intake or impaired utilization. Thiamine-deficient people often have poor-quality diets with lots of calorie-dense foods and refined grains that lack nutrients. Other issues such as eating disorders, gastric surgical procedures, dialysis, diabetes, and thyroid problems can also compromise the nutritional absorption and metabolism of thiamine.

One of the most common and direct causes of clinically significant thiamine deficiency is excessive alcohol consumption.

What are the symptoms of thiamine deficiency in alcoholics?

A 2015 study found that beyond the usual symptoms, alcoholism paves the way for accelerated degradation of the critical nervous system structures that rely on vitamin B1 to function properly.

These are the alcohol-related symptoms of thiamine deficiency:

Confusion and impaired memory. Alcoholics often develop poor short-term memory, confusion, and disorientation, due to a lack of thiamine which aids brain cell metabolism and neurotransmitter production. If left untreated, this can progress and develop into amnesia.
Ataxia and muscle weakness. Lack of thiamine causes nerve damage and muscle weakness. Alcoholics display loss of coordination, shaking hands, and an unsteady gait from cerebellar damage.
Cardiovascular effects. Deficiency contributes to an enlarged heart, high blood pressure, and congestive heart failure in alcoholics. Heavy drinking is bad for the heart.
Nystagmus and eye movement changes. Alcohol-related thiamine deficiency starves ocular nerve cells of energy, impairing neurotransmitter production and disrupting smooth communication along visual pathways. This abnormal eye movement is clinically known as nystagmus.
Metabolic disorders. Thiamine helps metabolize glucose, amino acids, and lipids. Deficiency in alcoholics can lead to low magnesium, metabolic acidosis, and ketoacidosis—imbalanced metabolic byproducts that acidify tissues and further tax the body’s detoxification capacity.

These are tell-tale symptoms of alcohol-induced thiamine deficiency and are among the physical symptoms of alcoholism you can’t miss. Certain behaviors, traits, and patterns should signal that your relationship with alcohol is becoming unhealthy and potentially dangerous. Be aware of the indicators that suggest chronic alcohol abuse.

Don’t wait too long for these issues to take hold of your life. Our alcohol detox center offers a safe space and support from skilled medical professionals who help you manage the symptoms of alcohol addiction and get back on track.

How does alcohol cause thiamine deficiency?

Alcohol is a serious thiamine adversary. The more you drink, the faster your body is drained of vitamin B1. Heavy alcohol use impairs the way cells use thiamine for vital functions.

Because intermediate products of [carbohydrate metabolism] are needed for the generation of other essential molecules in the cells (e.g., building blocks of proteins and DNA as well as brain chemicals), a reduction in thiamine can interfere with numerous cellular functions. (Martin, et. al.)

Langlais, Ph. D. explains why chronic heavy drinkers often lack vitamin B1.

Alcohol metabolism in the liver generates toxic byproducts that damage liver cells. Alcohol is notorious for damaging your liver. The liver plays a crucial role in metabolizing ethanol which requires a significant amount of energy. Thiamine is essential for energy production and detoxification, and alcohol metabolism requires a lot of thiamine. Acetaldehyde and other toxic alcoholic metabolites damage liver cells, disrupting the ability of the liver to activate it.
Ethanol and toxins damage the intestinal lining, altering gene expression of thiamine absorption transporters. Alcoholic metabolites trigger inflammation and oxidative stress which injure the mucosal epithelial cells responsible for nutrient uptake. The production of key intestinal thiamine transporters is disrupted, and the absorption of dietary thiamine is completely blocked. The damage is so significant that your body can’t even absorb thiamine from food.
Alcohol metabolism depletes thiamine supplies in the body. Thiamine is not stored in the body long-term anyway. Martel, et. al. suggest that the half-life of thiamine in the body is around 14 to 18 days. You need to take thiamine regularly to maintain adequate levels. With chronic alcohol consumption, your thiamine reserves are depleted faster than your body can replenish them.
Alcohol triggers cells to increase the production of thiamine efflux transporters. Thiamine efflux transporters are tiny pumps that cycle thiamine out of cells. Even when they desperately need more thiamine to cope with alcohol stress, they are flushing out their limited reserves. Meanwhile, cells need more thiamine for more energy. To make matters worse, fresh thiamine supplies have been cut off, since alcohol blocks absorption from the gut.
Processing alcohol burns through cellular energy. Detoxifying ethanol and its byproducts depletes the cell’s energy reserves. As a critical cofactor for energy metabolism, thiamine stores are exhausted quickly.
Alcoholics often have poor eating habits. Langlais explains that “alcoholics may eat nothing for days, and when they do eat, their food is often high in carbohydrates and low in vitamins such as thiamine.” On top of that, “high carbohydrate intake further depletes the already low thiamine levels, because two enzymes involved in the breakdown of carbohydrates…are thiamine-requiring enzymes.”

Alcohol depletes other vital nutrients such as vitamin C, zinc, magnesium, folate, and a number of others. When you drink, the body prioritizes metabolizing alcohol over other nutrients—such as thiamine—that your body actually needs. This nutritional deficiency can have significant health effects.

That’s why proper nutrition plays a huge part in recovering from alcoholism. At Ardu Recovery Center, we focus on nutritional therapy to help you get your health back on track while achieving lasting sobriety.

Does alcohol withdrawal deplete thiamine?

Alcohol withdrawal is a turbulent transitional state where someone who is alcohol-dependent drastically reduces or stops drinking. While it would make sense that your body starts stocking up on thiamine once alcohol is removed, your body is heavily malnourished from regular alcohol use or chronic alcoholism. Remember that thiamine is an essential enzymatic cofactor that aids metabolism and digestion. During withdrawal, the demand for thiamine dramatically spikes even as absorption plummets.

Here’s how alcohol withdrawal acts to deplete thiamine:

During withdrawal, you often experience diarrhea or struggle with vomiting. These make it even harder for your battered gut to absorb any B1 from food.
Your overstressed liver struggles to release stored thiamine into your bloodstream.
Your body works overtime to produce stress hormones and neurotransmitters to counteract the effects of alcohol. This burns through the thiamine your cells desperately need.
Parts of your brain go wild firing signals since they’re used to being dampened by alcohol. Your brain needs thiamine to power rapid neuronal signaling, so it gobbles it up.
Your heart races as a response to withdrawal and depends on the thiamine supply to beat steadily.
Cells struggle to produce enough energy to handle the shock of withdrawal, running thiamine dry to fuel crisis metabolism mode.

An article published by the Cleveland Clinic Journal of Medicine highlights the importance of thiamine supplementation during withdrawal. Those going through alcohol withdrawal are at a high risk of deficiency.

The article suggests that:

All patients hospitalized for alcohol withdrawal show evidence of malnutrition and thiamine malabsorption. They should receive high-dose parenteral thiamine to prevent and treat associated neurological complications such as Wernicke-Korsakoff syndrome.
Hospitalized alcohol withdrawal patients who do not have severe complications should still be evaluated for risk of thiamin deficiency.
Oral thiamine supplements are not effective for correcting thiamine deficiency in people with alcohol use disorder. Alcohol damage decreases the absorption of thiamine from the gut, so deficient patients require intravenous thiamine instead.

Alcohol withdrawal symptoms can range from mild to life-threatening and can turn into alcohol withdrawal syndrome. You don’t have to face this challenge alone. We offer compassionate care and treatment to ensure your safety and success.

We are here to guide you every step of the way, offering evidence-based therapies, medication-assisted treatment, counseling, and holistic approaches to address the physical, emotional, and spiritual aspects of addiction.

How does alcohol lead to Wernicke-Korsakoff syndrome?

Wernicke-Korsakoff syndrome (WKS) is a brain and memory disorder that involves two related neurological conditions: Wernicke’s encephalopathy and Korsakoff’s psychosis. They both result from a severe thiamin deficiency, often from chronic alcoholism.

Wernicke’s encephalopathy is characterized by an acute onset of confusion, eye movement abnormalities, and a loss of muscle coordination due to damage to critical brain regions. When left untreated, it can progress to Korsakoff’s psychosis, a serious case of memory impairment. The two neurological disorders were regarded once as separate entities, but recently they have been used interchangeably to suggest one deficiency-related brain disease.

Italian researchers suggest that “between 30 and 80% of alcoholics are thiamine deficient, and this puts them at risk of developing the Wernicke–Korsakoff (WK) syndrome.” Martin, et. al. reveal that “Approximately 80 to 90 percent of alcoholics with WE develop Korsakoff ’s psychosis, a chronic neuropsychiatric syndrome characterized by behavioral abnormalities and memory impairments.”

Years of excessive alcohol intake lead to a severe lack of vitamin B1. Thiamine is important for brain cell metabolism and neuronal signaling, so a chronic deficiency causes the gradual degeneration of vulnerable brain regions involved in memory. The body craves thiamine, tipping the brain into a crisis where neuronal function is rapidly affected and impaired. This leads to acute Wernicke’s encephalopathy.

Martin, et. al. suggest that alcohol-related thiamine deficiency can also cause a variety of other subtler forms of neurological dysfunction.

Thiamin deficiency is the established cause of an alcohol-linked neurological disorder known as Wernicke-Korsakoff syndrome (WKS), but it also contributes significantly to other forms of alcohol-induced brain conditions These include various degrees of cognitive impairment, including the most severe, alcohol-induced persisting dementia (i.e., “alcoholic dementia”).

Heavy drinking can be detrimental to brain function. It can cause permanent brain damage, not just fogginess or headaches the next morning. The good news is the brain can bounce back from alcohol’s deleterious effects. Once alcohol has been taken out of the equation, some neurological damage can be restored.

At our addiction recovery center, we specialize in helping people break free from the grip of alcohol addiction. Remember, you don’t have to face recovery alone. We are here to support you every step of the way. If you’re ready to take the first step toward a healthier, alcohol-free life, reach out to us today.

What is the best thiamine dose for alcoholics?

Alcoholic patients struggling with thiamine deficiency should receive 300 mg intravenously or intramuscularly every day for several days. According to the Treatment of Alcohol Problems, parenteral administration of thiamine is the best way to go because of poor gastrointestinal thiamine uptake.

After that, patients should take 300 mg of thiamine orally every day for several weeks to rebuild cellular stores. Even those with no clear deficiency symptoms may benefit from thiamine supplementation to compensate for malnutrition and aid recovery.

It’s hard battling the bottle, but your brain and body need support, so give them a chance to heal by boosting thiamine levels however possible. Ardu Recovery Center can help you start your recovery from alcohol’s negative impact on your life in a judgment-free environment.

Get help with Ardu

Anyone struggling with alcohol abuse or addiction can enroll in our addiction treatment program. Our dedicated team of professionals is here to guide and support you through the recovery process, laying the foundation for long-term sobriety and relapse prevention.

You can start your treatment with medically reviewed detox practices before moving on to group therapy or individual therapy sessions for alcohol addiction treatment. Our experienced team will accompany you through detox, rehab, and beyond.

We offer both residential treatment facilities and outpatient programs specialized in treating alcohol addiction. The compassionate team at our alcohol and drug rehab center provides:

Medically supervised detox, as well as holistic detox, to safely eliminate alcohol from the body.
Psychotherapies such as cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, and family therapy help you and your loved ones deal with addiction.
Dual diagnosis treatment, which is integrated treatment for any co-occurring mental health or behavioral disorders.
Transitional aftercare programs and resources to strengthen ongoing recovery.

Reach out now to discuss your unique needs—help is always available. And if you have any questions, feel free to come over and meet the staff.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Alcohol and thiamine FAQ

What nutrients are depleted by alcohol?

Chronic alcohol use depletes many of the vital nutrients that the body requires to function properly. These include:

B vitamins: thiamine, folate, vitamin B6
Vitamin C
Vitamin D
Minerals: magnesium, calcium, zinc, phosphate
Essential fatty acids
Proteins
Antioxidants

How long should you take thiamine after quitting drinking?

Current guidelines advise that you should continue thiamine supplementation for 1-2 months after you’ve finished detox and alcohol withdrawal. This way, you ensure the replenishment of long-depleted intracellular stores.

An initial 3-5 day course of parenteral thiamine is ideal to rapidly counteract deficiency. This can transition to an oral thiamine regimen of at least 300 mg daily for the next several weeks. People’s needs vary based on the extent of prior deficiency, as well as their ongoing dietary intake and absorption capacity during early sobriety. It’s also important to check blood nutrient levels to determine the optimal duration of supplementation.

What vitamin does alcohol deplete the most?

Among all vitamins, thiamine is typically most depleted in chronic alcoholics. Extremely low levels of thiamine lead to neurological disorders such as Wernicke-Korsakoff syndrome, which has been observed in a subset of chronic alcoholics and those who regularly abuse alcohol. Alcohol metabolism prevents intestinal thiamine absorption while accelerating its excretion and bodily utilization.

What are the symptoms of low B1?

Early symptoms of B1 deficiency include fatigue, irritability, poor appetite, and nausea. As the deficiency progresses, more serious signs emerge such as:

Muscle weakness
Tingling or numbness in hands and feet
Confusion and disorientation
Loss of coordination
Vision changes
Cardiovascular irregularities

Severe deficiency can lead to Wernicke Korsakoff syndrome with acute neurological crisis featuring paralysis, seizures, cognitive deficits, and coma. Rapid treatment is vital at this stage to counteract the detrimental effects of thiamine deficiency and avoid permanent brain damage.

Is it good to take thiamine every day?

For those in recovery from alcohol addiction, daily administration of thiamine is advised for at least 1-2 months and is likely beneficial as a long-term protective measure. Healthy adults with no medical issues may also find that daily low-dose thiamine provides energy, mood, and neurological benefits given its crucial role in cell metabolism.

Megadoses of B1 should not be taken casually long-term given the potential risks of nerve, heart, and gut complications in predisposed individuals. For preventive use, a daily intake of up to 100mg of thiamine is considered safe.

What is the best vitamin for liver repair?

Specific B vitamins top the list for supporting liver regeneration and health. These include:

Thiamine, niacin (B3), pyridoxine (B6), folic acid (B9), and cobalamin (B12) all enable essential enzymatic liver functions.
Antioxidants such as vitamin C, E, and glutathione precursors aid detox pathways.
Vitamin D modulates inflammatory processes.

When you supplement a mix of vital B vitamins, antioxidants, and vitamin D, you can facilitate the repair of your liver.

Who should not take vitamin B1?

People with known hypersensitivity or allergies to thiamine or thiamine derivatives should avoid vitamin B1. Given potential risks such as anaphylaxis (allergic reaction) or exacerbation of the underlying disease, the following groups should be cautious when they supplement thiamine:

Elderly
Very young
Pregnant or nursing women
Those with end-stage renal disease

Otherwise, vitamin B1 is well-tolerated and crucial for health when integrated into a complete nutrition plan under medical guidance.

Can you recover from Wernicke-Korsakoff?

Prompt diagnosis and immediate treatment in the early stages of Wernicke’s encephalopathy—the acute neurologic complications caused by severe thiamine deficiency—can lead to substantial recovery and prevent progression to permanent Korsakoff psychosis with disabling memory loss.

Lasting impacts such as residual cognitive deficits, coordination issues, impaired recall ability, or other detrimental effects of thiamine deficiency may persist. Unfortunately, if treatment is too late and cell death in key brain regions progresses substantially, full reversal may not be possible. That’s why urgency plays a key role in identifying thiamine depletion. Abstinence from alcohol alongside intensive rehabilitation can stabilize and improve functionality long-term even once dementia settles in.

Can alcohol-induced thiamine deficiency lead to anterograde amnesia?

Anterograde amnesia refers to the loss of the brain’s ability to form new memories following a traumatic event or neurological damage. It is characterized by the inability to remember events, experiences, and newly learned information that occur after the onset of amnesia. This happens despite retaining access to memories established before injury or disease.

Chronic alcohol-induced thiamine deficiency often precipitates acute anterograde amnesia through metabolic crises triggering lesions in crucial memory areas like the mammillary bodies and thalamic nuclei. The profound deficit leaves one bewildered, disjointed, and incapable of using ongoing experience to update understanding of oneself or the world.

What kind of brain damage can alcohol-induced thiamine deficiency cause?

Alcohol-induced thiamine deficiency triggers manifestations such as cognitive dysfunction, memory deficits, and frontal lobe damage. It stems from inadequate dietary thiamine intake and can lead to severe alcohol-induced brain damage.

The brain disorder leads to cerebellar degeneration, affecting the cerebellum and vermis. Clinical manifestations include lesions in alcoholics, particularly in the mammillary bodies and thalamic nuclei. Lack of prompt treatment exacerbates the damage, resulting in irreversible brain stem and cortical damage. The neuropathological study underscores the importance of understanding the alcohol-specific brain damage mechanism, emphasizing the need for in-depth research on alcohol-induced thiamine deficiency and its neurological repercussions.

Resources

Alcohol-related thiamine deficiency – Alcohol and Drug Foundation. (n.d.). https://adf.org.au/insights/alcohol-related-thiamine-deficiency/

Berre, A. L., Pitel, A., Chanraud, S., Beaunieux, H., Eustache, F., Martinot, J., Reynaud, M., Martelli, C., Rohlfing, T., Pfefferbaum, A., & Sullivan, E. V. (2015, June 23). Sensitive biomarkers of alcoholism’s effect on brain macrostructure: similarities and differences between France and the United States. Frontiers in Human Neuroscience. https://doi.org/10.3389/fnhum.2015.00354

Martin, P. R., Singleton, C. K., & Hiller-Sturmhöfel, S. (2003). The Role of Thiamine Deficiency in Alcoholic Brain Disease. Alcohol Research & Health, 27(2), 134-142. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6668887/

Langlais PJ (1995). Alcohol-Related Thiamine Deficiency: Impact on Cognitive and Memory Functioning. Alcohol Health and Research World, 19(2), 113-121. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875731/

Martel, J. L. (2022, October 12). Vitamin B1 (Thiamine). StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK482360/

Ganatra, R. B., Breu, A. C., & Ronan, M. V. (2023, January 1). Which patients hospitalized with alcohol withdrawal syndrome should receive high-dose parenteral thiamine? Cleveland Clinic Journal of Medicine. https://doi.org/10.3949/ccjm.90a.22026

Mancinelli, R., & Ceccanti, M. (2009, January 16). Biomarkers in Alcohol Misuse: Their Role in the Prevention and Detection of Thiamine Deficiency. Alcohol and Alcoholism. https://doi.org/10.1093/alcalc/agn117

Thiamine and Other Supplements. (n.d.). https://alcoholtreatmentguidelines.com.au/chapter-8-alcohol-withdrawal/thiamine-and-other-supplements