Synopsis

Source of validity: Scientific
Rating (out of 5): 5

Thiamin (vitamin B1) is scientifically validated for use in the management of alcoholism, particularly to prevent and treat Wernicke-Korsakoff syndrome—a serious neurological disorder caused by thiamin deficiency and commonly associated with chronic alcohol misuse. Chronic alcohol consumption impairs thiamin absorption in the gastrointestinal tract, reduces its storage in the liver, and interferes with its utilization in cells. As a result, individuals with alcoholism are at high risk for thiamin deficiency.

Wernicke-Korsakoff syndrome manifests first as Wernicke’s encephalopathy (confusion, ataxia, ophthalmoplegia) and, if untreated, can progress to Korsakoff’s psychosis (severe memory impairment and confabulation). These conditions are medical emergencies and can be fatal or cause permanent brain damage. Numerous clinical studies and medical guidelines (including those from the World Health Organization and major neurology associations) recommend prophylactic and therapeutic thiamin supplementation in people with alcoholism, especially during withdrawal or before administering intravenous glucose, as glucose administration can precipitate acute symptoms in thiamin-deficient patients.

Thiamin supplementation is typically given intravenously or intramuscularly in high doses for those at risk. The evidence base consists of observational studies, randomized controlled trials, and decades of clinical experience, making the recommendation well-established and standard in medical practice.

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