Synopsis

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

Vitamin B1 (thiamine mononitrate) is scientifically validated for use in treating and preventing thiamine deficiency in individuals with alcoholism. Chronic alcohol consumption impairs thiamine absorption in the gut, reduces hepatic storage, and disrupts utilization, leading to an increased risk of deficiency. Thiamine deficiency in alcoholics is a well-established cause of Wernicke’s encephalopathy, an acute neurological disorder characterized by confusion, ataxia, and ophthalmoplegia, which can progress to Korsakoff’s psychosis if untreated. Numerous clinical guidelines—including those from the World Health Organization (WHO) and national health authorities—recommend prophylactic and therapeutic thiamine supplementation in patients with suspected alcohol use disorder, especially before administering glucose-containing fluids, since glucose can precipitate or worsen Wernicke’s encephalopathy in thiamine-deficient patients.

Multiple randomized and observational studies have demonstrated that thiamine administration in this population is safe and can prevent or reverse early neurological complications of thiamine deficiency. The use of thiamine in alcoholism is not based on tradition but on a clear mechanistic understanding of the pathophysiology of deficiency, substantial clinical experience, and strong evidence from medical literature. For these reasons, the evidence supporting thiamine (as thiamine mononitrate or hydrochloride) for the prevention and treatment of deficiency-related complications in alcoholism is rated as 5 (strong scientific evidence).

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