Vitamin B1 Deficiency & Gluten Consumption

Vitamin B1 (Thiamin) – A Common Deficiency for those with Gluten Problems

Vitamin B1 – AKA thiamin is an essential nutrient the body uses to help generate energy from the foods we eat. This essential B vitamin also plays a role in the regulation of the heart muscle, and the production of the neurotransmitter, acetylcholine. This nutrient is commonly low in those with gluten sensitivity for two primary reasons:

1. Gluten damages the GI tract and causes malabsorption of nutrients.
2. Inflammation induced by gluten exposure increases the body’s demand for B-vitamins to aid in the energy production required to heal.

It is also important to note that processed grains (especially those being marketed as gluten free substitutes) are very low in vitamin B1. They have to be fortified with synthetic thiamin (B1) before they can be sold legally in the U.S.

Signs & Symptoms of Deficiency

• Difficulty digesting carbohydrates (sugars)
• May contribute to glucose intolerance
• Muscle pains
• Poor appetite, weight loss
• Fatigue, weakness
• Loss of mental alertness
• Depression
• Difficulty breathing
• Heart and vascular damage
• Swelling, tingling or burning sensation in the hands and feet (peripheral neuropathy)
• Nystagmus (uncontrolled eye movements)
• Cataracts (cloudy lens in the eye)
• May contribute to heart failure (heart fails as a pump)
• May contribute to Alzheimer’s disease

Vitamin B1 has been shown to be beneficial in the following conditions:

• Depression
• Beriberi
• Wernicke-Korsakoff syndrome
• Prevention of cataracts in combination with other vitamins
• Burns
• Congestive heart failure/cardiomyopathy, especially on diuretics
• Chronic ambulatory peritoneal dialysis
• Pregnancy
• Anorexia nervosa
• Cirrhosis of the liver

Drugs & Medications that deplete Vitamin B1:

Drug induced nutritional deficiencies are common. Because doctors don’t typically receive adequate nutritional education, the topic is often ignored, and patients are placed on medications without being well informed about nutrient loss. Common medications that cause vitamin B1 deficiency are listed below:

• Digoxin (Lanoxin)
• Furosemide (Lasix) and other loop diuretics (Bumex, Demadex)
• Thiazide (HCT) and other diuretics (Blood Pressure Lowering Medications)
• Alcohol (chronic use)

Laboratory Testing for Vitamin B1:

• Assays of red blood cell transketolase activity (TKAC) and thiamine pyrophosphate effect
• Direct assays with high performance liquid chromatography fluorimetry
• Lymphocyte proliferation functional tests

Food Sources for Thiamin:

• Found in most foods, but especially high in sunflower seeds, meats, mushrooms, Brussels sprouts, asparagus, peas, cabbage, broccoli,
• Pork, organ meats, such as liver and kidney, brewer’s yeast, and blackstrap molasses

If your doctor does not have an education in nutrition, encourage him/her to take Gluten Free Society’s Tier 1 and Tier 2 certification course. This 10 hour class is designed to get doctors and other health care providers up to speed on managing patients with gluten related issues. Part of that is knowing how to guide a patient through the nutritional pitfalls of healing. Remember that gluten sensitivity is a nutritional issue. If your doctor is not trained nutritionally, it will be hard for him/her to give you adequate guidance.

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  All the best, Dr. O