B19.0

Thiamine Research

54 peer-reviewed studies · Evidence score: 9/10

Effect of nutritional interventions on the psychological symptoms of premenstrual syndrome in women of reproductive age: a systematic review of randomized controlled trials

Robinson J et al. • Nutrition reviews (2025)

There is some evidence to support the use of nutritional interventions for improving psychological symptoms of PMS.

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.
Further research warranted to confirm findings

Systematic Reviewn=3,254

DOI

Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials

Borges-Vieira JG et al. • Nutritional neuroscience (2023)

As for anxiety symptoms, the availability of results is limited to adjuvant vitamin D therapy.

Systematic review examining Methylfolate efficacy
Further research warranted to confirm findings

Systematic Reviewn=2,256

DOI

Effect of intravenous thiamine administration on critically ill patients: A systematic review and meta-analysis of randomized controlled trials

Nakanishi N et al. • Clinical nutrition (Edinburgh, Scotland) (2024)

Although thiamine administration may reduce shock state, it may not reduce mortality, and slightly increases the length of ICU stay.

Conversely, thiamine administration resulted in a slight increase in the length of ICU stay (MD, 0.40 days; 95% CI, 0.01-0.79 days; High CoE).
Although thiamine administration may reduce shock state, it may not reduce mortality, and slightly increases the length of ICU stay.
Further research warranted to confirm findings

Meta-Analysisn=3,494

DOI

Efficacy and Safety of Hydrocortisone, Ascorbic Acid, and Thiamine Combination Therapy for the Management of Sepsis and Septic Shock: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Deng J et al. • International archives of allergy and immunology (2024)

HAT appears beneficial in reducing vasopressor use and improving organ function in sepsis/septic shock patients.

At 72 h, HAT reduced SOFA scores from baseline (mean difference [MD] -1.16, 95% confidence interval [CI]: -1.58 to -0.74, I2 = 0%) compared to placebo/SoC, based on moderate quality of evidence.
HAT also reduced the duration of vasopressor use (MD -18.80 h, 95% CI: -23.67 to -13.93, I2 = 64%) compared to placebo/SoC, based on moderate quality of evidence.
HAT increased hospital LOS (MD 2.05 days, 95% CI: 0.15-3.95, I2 = 57%) compared to placebo/SoC, based on very low quality of evidence.

Meta-Analysisn=2,594

DOI

Hydrocortisone Combined with Vitamin C and Thiamine in the Treatment of Sepsis/Septic Shock: A Systematic Review with Meta-Analysis and Trial Sequential Analysis

Lu D et al. • Clinical and investigative medicine. Medecine clinique et experimentale (2023)

HVT regimen did not reduce the mortality of patients with sepsis/septic shock and was not associated with a significant improvement in outcomes.

Meta-analysis showed that HVT regimen did not reduce all-cause (RR=0.96, 95% CI: 0.83 - 1.11, P=0.60), hospital (RR=1.03, 95% CI: 0.83 - 1.27, P=0.80) or intensive care unit (ICU) mortalities (RR=1.05, 95% CI: 0.86 - 1.28, P=0.65).
HVT regimen did not reduce the mortality of patients with sepsis/septic shock and was not associated with a significant improvement in outcomes.
The TSA result showed that more RCTs with high quality and large sample sizes are needed to further confirm the results.

Meta-Analysisn=1,572

DOI

The outcome of IV vitamin C therapy in patients with sepsis or septic shock: a meta-analysis of randomized controlled trials

Liang B et al. • Critical care (London, England) (2023)

In this meta-analysis, IVVC in sepsis or septic shock patients significantly improved delta SOFA score and reduced the duration of vasopressor use, whereas it was not associated with reduction in short-term mortality and had higher adverse events.

Treatment with IVVC was not shown to improve short-term mortality (OR, 0.89; 95% CI, 0.77 to 1.04; p = 0.14); nevertheless, dose at 25-100 mg/kg/d subgroup associated with a significant reduction in short-term mortality (OR, 0.80; 95% CI, 0.65 to 0.97; p = 0.03).
An increase adverse event was observed in IVVC therapy (OR, 1.98; 95% CI, 1.06 to 3.68; p = 0.03).
In this meta-analysis, IVVC in sepsis or septic shock patients significantly improved delta SOFA score and reduced the duration of vasopressor use, whereas it was not associated with reduction in short-term mortality and had higher adverse events.

Meta-Analysisn=3,364

DOI

B1 Vitamin Deficiency After Bariatric Surgery, Prevalence, and Symptoms: a Systematic Review and Meta-analysis

Bahardoust M et al. • Obesity surgery (2022)

The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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.

Meta-Analysisn=1,494

DOI

Effect of adjunctive vitamin C, glucocorticoids, and vitamin B1 on longer-term mortality in adults with sepsis or septic shock: a systematic review and a component network meta-analysis

Fujii T et al. • Intensive care medicine (2022)

This meta-analysis examined the effects of Thiamine.

Adding glucocorticoid to other treatments shortened duration of vasopressor therapy (incremental mean difference, - 29.8 h [95% CI - 44.1 to - 15.5]) and ICU stay (incremental mean difference, - 1.3 days [95% CI - 2.2 to - 0.3]).
We did not find any evidence that vitamin C or B1 affect organ dysfunction or ICU length of stay.
Metabolic resuscitation with vitamin C, glucocorticoids, vitamin B1, or combinations of these drugs was not significantly associated with a decrease in longer-term mortality.

Meta-Analysisn=10,257

DOI

Diagnosis and treatment of Wernicke's encephalopathy: A systematic literature review

Cantu-Weinstein A et al. • General hospital psychiatry (2024)

IV thiamine can alleviate neurological symptoms, cognitive dysfunction, and brain imaging lesions associated with WE.

Of the case reports, 11 (55%) cases were female, and the average age of all cases was 45 years (SD = 15).
The other seven studies included 688 patients; the average age was 52 years (SD = 9), and 266 (38.7%) were female.
Among the case reports, neurological and clinical findings were used to diagnose WE in 16 (80%) cases.

Systematic Reviewn=688

DOI

Dietary supplements for dysmenorrhoea

Pattanittum P et al. • The Cochrane database of systematic reviews (2016)

There is no high quality evidence to support the effectiveness of any dietary supplement for dysmenorrhoea, and evidence of safety is lacking.

Supplements versus other supplementsThere was no evidence of a difference in effectiveness between ginger and zinc sulphate (MD 0.02 points, 95% CI -0.58 to 0.62; one RCT, 101 women).
Vitamin B1 may be more effective than fish oil (MD -1.59 points, 95% CI -2.25 to -0.93; one RCT, 120 women).
There is no high quality evidence to support the effectiveness of any dietary supplement for dysmenorrhoea, and evidence of safety is lacking.

Meta-Analysisn=3,101

DOI

Thiamine deficiency and supplementation in critically ill patients: A systematic review

Woolum JA et al. • Journal of Critical Care (2018)

Thiamine deficiency is highly prevalent in ICU patients and supplementation may reduce lactate levels and improve clinical outcomes.

Thiamine deficiency prevalence ranged from 20-70% in critically ill patients
IV thiamine reduced lactate levels more rapidly than placebo in deficient patients
Early thiamine supplementation may reduce need for renal replacement therapy

Systematic Reviewn=1,350

DOI

Does thiamine supplementation affect heart failure? A systematic review and meta-analysis of randomized control trials

Syed ARS et al. • Heart & lung : the journal of critical care (2023)

To conclude, except for heart rate, thiamine supplementation had no effect on the outcomes of heart failure patients.

To conclude, except for heart rate, thiamine supplementation had no effect on the outcomes of heart failure patients.
Further research warranted to confirm findings

Meta-Analysisn=298

DOI

Episodic Ataxias: Primary and Secondary Etiologies, Treatment, and Classification Approaches

Hassan A • Tremor and other hyperkinetic movements (New York, N.Y.) (2023)

Primary and secondary EA are frequently treatable which should prompt a search for the cause.

Systematic review examining Biotin efficacy
Further research warranted to confirm findings

Systematic Review

DOI

Effect of vitamin B1 supplementation on blood creatinine and lactate levels and clinical outcomes in patients in intensive care units: a systematic review and meta-analysis of randomized controlled trials

Karimi E et al. • Nutrition reviews (2024)

This meta-analysis provides evidence that thiamine supplementation has a protective effect against blood creatinine increase in ICU patients.

However, there was no statistically significant difference in the lactate level between the thiamine supplementation and placebo groups (P = .26).
This meta-analysis provides evidence that thiamine supplementation has a protective effect against blood creatinine increase in ICU patients.
However, further high-quality trials are needed to discover the effect of thiamine supplementation on clinical and biochemical outcomes in ICU patients.

Meta-Analysis

DOI

Wernicke's Encephalopathy in Acute and Chronic Kidney Disease: A Systematic Review

Oudman E et al. • Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation (2024)

Parenteral thiamine 500 mg 3 times per day often led to full recovery, while Korsakoff's syndrome was found in those receiving low doses.

Parenteral thiamine 500 mg 3 times per day often led to full recovery, while Korsakoff's syndrome was found in those receiving low doses.
To prevent WE in kidney failure, we suggest administering high doses of parenteral thiamine in patients with kidney disease who present with severe malnutrition and (prodromal) signs of thiamine deficiency.

Systematic Review

DOI

Association between diabetes and thiamine status - A systematic review and meta-analysis

Ziegler D et al. • Metabolism: clinical and experimental (2023)

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.

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.
Further research warranted to confirm findings

Meta-Analysis

DOI

Association between neuropathy and B-vitamins: A systematic review and meta-analysis

Stein J et al. • European journal of neurology (2021)

PN is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine.

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).

Meta-Analysisn=46

DOI

Vitamin Supplementation and Dementia: A Systematic Review

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.

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.

Systematic Review

DOI

Vasoplegic syndrome after cardiovascular surgery: A review of pathophysiology and outcome-oriented therapeutic management

Datt V et al. • Journal of cardiac surgery (2021)

Currently, the VPS is frequently encountered (9%-40%) in cardiac surgical patients with predisposing patient-specific risk factors and combined with inflammatory response to CPB.

Despite the recent advances in therapy, the mortality remains as high as 30%-50%.
It effectively increases vascular tone and lowers CO, and significantly decreases the 30 days mortality.
MB significantly reduces morbidity and mortality of VPS.

Systematic Review

DOI

Determining the Role of Thiamine Deficiency in Systolic Heart Failure: A Meta-Analysis and Systematic Review

Jain A et al. • Journal of cardiac failure (2015)

Thiamine deficiency is more prevalent in the HF population, and its supplementation may be beneficial.

TD is more common in HF patients than control subjects (odds ratio 2.53, 95% confidence interval 1.65-3.87).
Thiamine deficiency is more prevalent in the HF population, and its supplementation may be beneficial.
The therapeutic role of thiamine in HF warrants further study.

Meta-Analysisn=54

DOI

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