Evidence supporting the use of: Vitamin B1 (thiamine HCl)
For the health condition: Alcoholism

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Synopsis

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

Vitamin B1 (thiamine HCl) is scientifically validated for use in the treatment and support of individuals with alcoholism. Chronic alcohol consumption impairs thiamine absorption, storage, and utilization, leading to a high risk of thiamine deficiency among individuals with alcohol use disorder. Thiamine deficiency can cause serious neurological complications, most notably Wernicke's encephalopathy, a potentially life-threatening acute syndrome characterized by confusion, ataxia, and ophthalmoplegia. If left untreated, Wernicke's encephalopathy can progress to Korsakoff's syndrome, a chronic and debilitating memory disorder.

Numerous clinical guidelines, including those by the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE), recommend prophylactic and therapeutic thiamine supplementation for people with alcoholism, especially those who are malnourished or presenting with symptoms suggestive of Wernicke’s encephalopathy. Parenteral (intravenous or intramuscular) thiamine is preferred in acute cases due to poor gastrointestinal absorption in these patients. The strength of evidence is high, with numerous observational studies, randomized controlled trials, and expert consensus supporting its use. Failure to provide thiamine supplementation in at-risk individuals can result in irreversible neurological damage or death. Thus, thiamine is a cornerstone of medical management for those with alcohol dependence or withdrawal.

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