Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin B1 (thiamine), particularly in its active form thiamine diphosphate, is used in the management of patients with cirrhosis of the liver primarily due to the increased risk of thiamine deficiency in this population. Chronic liver disease and cirrhosis are frequently associated with malnutrition, impaired nutrient absorption, and increased metabolic demands. Alcoholic liver disease, a common cause of cirrhosis, is especially linked to thiamine deficiency due to poor dietary intake, decreased absorption, and impaired storage of thiamine in the liver.

Thiamine is an essential cofactor for several enzymes involved in carbohydrate metabolism and energy production. Deficiency can lead to severe neurological complications, most notably Wernicke encephalopathy, which is potentially reversible with prompt thiamine administration. Clinical guidelines recommend thiamine supplementation in patients with liver disease, especially those with a history of alcohol misuse, to prevent or treat deficiency-related complications.

However, it should be noted that while thiamine supplementation is scientifically validated for preventing deficiency and associated neurological syndromes in cirrhosis, there is limited direct evidence that thiamine itself treats or reverses liver cirrhosis. Its use is therefore primarily supportive, addressing the high risk of deficiency in this population rather than modifying the underlying liver disease. The overall evidence for this supportive use is moderate, justifying a mid-level rating.

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