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B17.5
Thiamine – Forschung
Hilft vermutlich
51 begutachtete Studien
Was die Evidenz sagt
Hilft vermutlich
Thiamine half in etwa der Hälfte (6/11) der Studien, die einen Effekt gemessen haben — vielversprechend, aber nicht einhellig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2005–2026 mit einer typischen Studiengröße von 163 Teilnehmenden.
Basierend auf 51 Studien · 10 Meta-Analysen · 10 RCTs · 27,438 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Was die Studien gefunden haben
6geholfen2unklar3nicht geholfen· 40 weitere ohne bewertete Effektdaten
Nach Outcome
Therapeutic & clinical
Hilft vermutlich41 Studien
Beriberi & Wernicke-Korsakoff
Überwiegend Mechanismus / Beobachtung10 Studien
Heart & blood pressure
Überwiegend Mechanismus / Beobachtung4 Studien
Glucose & metabolic
Zu wenige bewertete Studien2 Studien
Cognitive function
Zu wenige bewertete Studien2 Studien
Women's healthKann helfen, Menstruationsbeschwerden und PMS-Symptome zu reduzieren · 1-3 Zyklen · Liefert essenzielle Nährstoffe für eine gesunde Schwangerschaft · Fortlaufend
Zu wenige bewertete Studien2 Studien
Anxiety & stress
Zu wenige bewertete Studien2 Studien
Safety profile
Zu wenige bewertete Studien2 Studien
Energy & fatigueVerbesserte Energie durch Kohlenhydratstoffwechsel · 2-4 Wochen
Zu wenige bewertete Studien1 Studie
Inflammation
Zu wenige bewertete Studien1 Studie
In Zahlen
Aus 26 Studien mit messbaren Effekten gezogen
Wahrscheinlich echte Effekte
57%
über Studien hinweg
Untersuchte Personen
27k
typische Studie: 163 Personen
Stärkste Designs
20
10 gepoolt, 10 randomisiert
Zeigte Nutzen
55%
6/11 Studien
Wie lange Studien liefen
1–4 Wochen
1
1–3 Monate
2
3+ Monate
2
Untersuchte Populationen
Heart failure patients2
Patients who underwent bariatric surgery1
Episodic ataxia patients1
Individuals with diabetes1
Aktives Forschungsgebiet
44 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2024
200520152026
1Systematische ÜbersichtCited 16×n=3,254 · very large study2025
There is some evidence to support the use of nutritional interventions for improving psychological symptoms of PMS.
Robinson J et al. · Nutrition reviews (2025)
There is some evidence to support the use of nutritional interventions for improving psychological symptoms of PMS.
However, more research using consistent protocols, procedures to minimize risk of bias, intention-to-treat analysis, and clearer reporting is required to provide conclusive nutritional recommendations for improving PMS-related psychological outcomes.
3Vitamin B1 deficiency prevalenceMeta-AnalyseCited 21×n=1,494 · large study2022
Bahardoust M et al. · Obesity surgery (2022)
Groß Nutzen
← SchlechterKein EffektBesser →
Twenty-seven percent of patients who underwent bariatric surgeries experience vitamin B1 deficiency.
A total of 11 studies examining 1494 patients were included in this meta-analysis.
Thiamine supplements should be prescribed for the patients for the rest of their lives, and also standard post-surgery follow-ups are necessary in terms of monitoring dietary factors.
Diabetes is associated with lower levels of various thiamine markers, suggesting that individuals with diabetes may have higher thiamine requirements than those without diabetes, but well-designed studies are required to confirm these findings.
Ziegler D et al. · Metabolism: clinical and experimental (2023)
Sehr groß Nutzen
← SchlechterKein EffektBesser →
Compared to controls, individuals with diabetes showed lower concentrations of thiamine (pooled estimate SMD [95 % CI]: -0.97 [-1.89, -0.06]), thiamine monophosphate (-1.16 [-1.82, -0.50]), and total thiamine compounds (-1.01 [-1.48, -0.54]).
Diabetes is associated with lower levels of various thiamine markers, suggesting that individuals with diabetes may have higher thiamine requirements than those without diabetes, but well-designed studies are required to confirm these findings.
7Neuropathy symptom improvementMeta-AnalyseCited 49×n=46 · small study2021
PN is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine.
Stein J et al. · European journal of neurology (2021)
Sehr groß Schaden
← SchlechterKein EffektBesser →
Borderline
B12 treatment (vs. the comparators) showed a non-significant association with symptom improvement (1.36 (0.66-2.79), n = 4, I2 = 28.9%).
Treatment with B1 was associated with a significant improvement in symptoms (5.34 [1.87-15.19], n = 3, I2 = 64.6%, p = 0.059).
Analysis of seven trials combined showed a non-significant higher odds ratio for improvement under treatment with the B-vitamins (2.58 [0.98-6.79], I2 = 80.0%, p < 0.001).
The findings of this systematic review suggest that supplementation of B Complex vitamins, especially folic acid, may have a positive effect on delaying and preventing the risk of cognitive decline.
Gil Martínez V et al. · Nutrients (2022)
The findings of this systematic review suggest that supplementation of B Complex vitamins, especially folic acid, may have a positive effect on delaying and preventing the risk of cognitive decline.
Ascorbic acid and a high dose of vitamin E, when given separately, also showed positive effects on cognitive performance, but there is not sufficient evidence to support their use.
The results of vitamin D supplementation trials are not conclusive in assessing the potential benefits that vitamin D might have on cognition.
The final outcomes of ongoing trials of vitamin supplementation are awaited with interest.
Jovic TH et al. · Nutrients (2020)
Vitamins A to E highlighted potentially beneficial roles in the fight against COVID-19 via antioxidant effects, immunomodulation, enhancing natural barriers, and local paracrine signaling.
Level 1 and 2 evidence supports the use of thiamine, vitamin C, and vitamin D in COVID-like respiratory diseases, ARDS, and sepsis.
Although there are currently no published clinical trials due to the novelty of SARS-CoV-2 infection, there is pathophysiologic rationale for exploring the use of vitamins in this global pandemic, supported by early anecdotal reports from international groups.
We performed a GRADE evaluation of the quality of evidence for interventions.
Latthe PM et al. · BMJ clinical evidence (2011)
Systematic review examining Thiamine efficacy
Further research warranted to confirm findings
12Prevalence of peripheral neuropathy in chronic alcohol abusersMeta-AnalyseCited 109×2019
There is presently sparse data to support a particular management strategy in alcohol-related peripheral neuropathy, but the limited data available appears to support the use of vitamin supplementation, particularly of B-vitamin regimens inclusive of thiamine.
Julian T et al. · Journal of neurology (2019)
Kein klarer Effekt
← SchlechterKein EffektBesser →
The prevalence of peripheral neuropathy amongst chronic alcohol abusers is 46.3% (CI 35.7- 57.3%) when confirmed via nerve conduction studies.
Alcohol-related peripheral neuropathy generally presents as a progressive, predominantly sensory axonal length-dependent neuropathy.
The most important risk factor for alcohol-related peripheral neuropathy is the total lifetime dose of ethanol, although other risk factors have been identified including genetic, male gender, and type of alcohol consumed.
Better prospective studies using contemporary phenotype-based audiovestibular assessment are needed.
Chen JJ et al. · International journal of molecular sciences (2026)
Vestibular involvement was also reported, but the evidence was smaller and less phenotypically specific, consisting mainly of syndromic reports, broad peripheral/central classifications, and historical nystagmographic findings.
Direct treatment evidence was very limited; improvement after thiamine replacement was reported in alcohol-related Wernicke-spectrum presentations, but no established disease-specific therapy was identified.
Overall, current human clinical evidence supports heightened clinical awareness but not disease-specific screening algorithms or targeted therapeutic recommendations.
14Anemia and micronutrient deficiencySystematische Übersicht2026
The following review highlights the current state of knowledge and the relevance of these micronutrient deficiencies in the broader context of nutritional anemia.
Datta Mitra A et al. · Nutrients (2026)
Increasing numbers of persons, mainly in low- and middle-income nations, are faced with malnutrition and malabsorption syndromes, giving rise to various micronutrient deficiencies that can lead to anemias refractory to treatment with iron, folate or vitamin B12.
Though relatively uncommon, such underlying nutrient deficiencies may be difficult to recognize as they can coexist with more common causes and there may be few or no specific clinical characteristics pinpointing a particular micronutrient.
The main examples of these micronutrients contributing to a small but important burden of anemia are other B-group vitamins, pyridoxine and thiamine, ascorbic acid, the fat-soluble vitamins, A and E and other trace elements such as copper, zinc and selenium.
15Substance use risks and nutritional complicationsSystematische Übersicht2026
Mitigation requires a lifelong, multidisciplinary framework involving preoperative risk stratification, validated screening (e.g., AUDIT-C), and targeted nutritional supplementation to safeguard the long-term metabolic and psychological benefits of MBS.
Campuzano-Donoso M et al. · Nutrients (2026)
Procedures like Roux-en-Y gastric bypass (RYGB) radically alter ethanol metabolism, eliminating first-pass metabolism and accelerating gastric emptying, while simultaneously recalibrating reward pathways, creating a "reward gap" that facilitates addiction transfer.
These physiological shifts exacerbate critical micronutrient deficiencies (thiamine, B12, iron), increase the risk of post-bariatric hypoglycemia, and correlate with higher rates of liver cirrhosis and suicide.
Furthermore, substance use is a primary driver of suboptimal weight loss trajectories and weight regain.
Awareness of this clinical overlap is critical to initiate timely treatment in thiamine deficiency states and NMOSD
Zhang X, Kattah JC. · Current neurology and neuroscience reports (2026)
The common denominator is the astrocyte, as cytotoxic edema due to impaired mitochondrial dysfunction and lactic acidosis in instances of thiamine deficiency causes downregulation of the AQP-4 receptor leading to vasogenic edema and breakdown of the blood-brain-barrier (BBB).
Similar dysfunction of the AQP-4 receptor occurs because of IgG binding antibodies in NMOSD.
Impaired glutamate transport in the astrocytic podocytes regardless of the AQP4 receptor etiologic mechanism causes excitotoxicity.
17Systematische Übersichtn=11 · very small study2026
We then review thiamine and lactate physiology, and provide clinicians with evidence based recommendations to consider when treating patients with persistent lactic acidosis who are vitally stable.
Jaffee W, Grahnke K, Tito AG, Pellnat A. · The American journal of the medical sciences (2026)
These cases typically presume tissue hypoxia and anaerobic metabolism leading to lactic acidosis.
Thiamine deficiency is an underappreciated cause of type B lactic acidosis, which is not caused by anaerobic metabolism.
We present a case series of 11 patients admitted to the medicine service who were not in shock, and who had a lactic acidosis (average of 4.5 mmol/L) that improved after thiamine administration (resolving to <2 mmol/L in 10 of 11 patients).
This systematic-review examined the effects of Thiamine.
Pereira AG et al. · Medical principles and practice : international journal of the Kuwait University, Health Science Centre (2025)
Overall, 100-300 mg daily doses are enough to improve symptoms.
In this review, we aim to (1) provide a clinical update about how to identify and treat the Beriberi and (2) describe the historical perspective, pathophysiological mechanisms, and other relevant aspects which may have applications in clinical management of Beriberi. </p>.
This review aims to highlight the essential role of vitamin B1 in supporting metabolic health, especially given that deficiencies can develop in patients with disease-related malnutrition as well as in those with an inadequate diet.
In addition, it is a prerequisite for the functioning of key enzymes in the biosynthesis of pentose sugars, which are essential in the synthesis of nucleic acids.
Additionally, thiamine has antioxidant properties that help reduce oxidative stress in cells; thus, by relieving this stress, thiamine indirectly supports the maintenance of DNA integrity.
Ensuring adequate thiamine intake through diet or supplements can support overall cellular health and potentially aid in DNA repair processes.
20Diabetes and cardiovascular complicationsSystematische Übersicht2025
Although large-scale, multicenter studies with longer follow-up periods are needed, the association between thiamine and chronic metabolic dysfunction related to CV risk suggests its crucial role in preventing severe heart failure (HF).
Serra M, Mollace R, Ritorto G, Ussia S, Altomare C, Tavernese A, Preianò M, Palma E, Muscoli C, Mollace V, Macrì R. · International journal of molecular sciences (2025)
Significant improvements in cardiometabolic diseases, substantially impacted by thiamine imbalances, are observed with thiamine supplementation.
To provide a summary of clinical study results, this systematic review assessed the impact of thiamine supplementation on diabetes and its CV complications.
The studies included in this systematic review were retrieved from PubMed and Medline databases, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and following the Population Intervention Comparison Outcome (PICO) framework.