Thiamin: a deficiency that is mostly about alcohol, not about diet

In wealthy countries, thiamin deficiency is rarely a story about food. Long-term alcohol use disorder is the most common cause, and that shapes both who should worry and what actually helps.

What it does in the body

• Thiamin plays a critical role in energy metabolism and therefore in the growth, development and function of cells. — general adults Evidence E source

How much you need

• The RDA for thiamin is 1.2 mg a day for men and 1.1 mg for women aged 19 to 50. — general adults Evidence E source
• In a region where infant beriberi still kills, 1.2 mg of thiamine a day for a nursing mother raised her milk thiamine as much as eight times that dose did. — healthy lactating mothers in Kampong Thom, Cambodia, randomised at two weeks postpartum and supplemented through 24 weeks Evidence B source
• Fortifying an everyday condiment worked too: Cambodian women eating thiamine-fortified fish sauce for six months had markedly higher blood thiamine than controls. — pregnant women in Prey Veng province, Cambodia, mean age 26 and 23 weeks pregnant at entry, and their breastfed infants Evidence B source
• One thick pork chop covers the entire daily thiamine reference value on its own (1.2 mg, exactly the label figure). — pork chop, lean only eaten (WWEIA category Pork, FNDDS code 22101020) Evidence E source
• Whether Americans are short of thiamine depends on which yardstick you pick: 43% fall below the label Daily Value, but only about 27% fall below the requirement the Daily Value is built from. — US adults aged 19 and over Evidence E source
• Where thiamine deficiency is a public-health problem, the fix is not supplements but fortified staple flour, and WHO's own review records the amounts actually used. — populations relying on maize flour or corn meal as a staple; the cited studies covered Mexican children, Brazilian children and adolescents, and a refugee camp in Kenya Evidence E source

How well your body absorbs it

• The form on the label changes how much thiamine reaches the blood more than the number of milligrams does: the fat-soluble precursor benfotiamine delivered roughly eleven times the plasma thiamine of ordinary thiamine hydrochloride. — healthy Chinese volunteers Evidence B source
• A second, independent trial found the same direction: a fat-soluble thiamine derivative raised plasma thiamine more than threefold over plain thiamine nitrate. — healthy Korean male volunteers Evidence B source
• Not all thiamine derivatives are equal to each other either: with the dose held at 100 mg, benfotiamine beat both alternatives and thiamine disulfide came last. — healthy volunteers Evidence C source
• Simmered pork keeps 40% of its thiamine if you pour the liquid away and 55% if you keep it: the drippings carry a quarter of what survives cooking. — pork products, fresh and cured, simmered Evidence E source
• The British and American composition tables put cooked lean pork at 0.59 and 0.66 mg of thiamine per 100 g. The British table shows the number going UP with cooking, which is water leaving, not thiamine arriving. — lean pork, raw and cooked Evidence E source

What too little does

• The usual result of thiamin deficiency is beriberi, which damages the nerves in the limbs and wastes the body. — people with thiamin deficiency Evidence E source
• When thiamine deficiency reaches the brain, the signs are eye movement problems, confusion and unsteady walking, in that order of frequency, not vague tiredness. — 82 women who developed Wernicke encephalopathy after hyperemesis gravidarum, from 66 papers up to December 2021 Evidence C source
• The signs do reverse: in nine of ten published cases of Wernicke's encephalopathy, intravenous thiamine brought partial or full recovery of symptoms. — patients with Wernicke's encephalopathy; 27 studies, of which 20 were case reports and seven were larger studies covering 688 patients Evidence C source

Who is most likely to fall short

• People with alcohol dependence have up to 80% risk of developing thiamin deficiency, because ethanol affects its absorption and storage. — general adults Evidence E source
• In wealthy countries, long-term alcohol use disorder is the most common cause of thiamin deficiency. — people with chronic alcohol use disorders Evidence E source
• Thiamine deficiency peaks about three months after bariatric surgery, when roughly one patient in five has it, and settles back near the pre-surgery level within a year. — patients with obesity undergoing bariatric surgery, in 41 studies Evidence C source
• In anorexia nervosa, published estimates of how many people are thiamine deficient run from none of them to more than half, depending on how you measure it. — cohorts of patients with anorexia nervosa, 17 studies retained from 42 full texts screened Evidence C source
• Semaglutide taken for obesity has now produced published cases of Wernicke's encephalopathy: six of them, and most ended badly. — four women and two men, mean age 47.2 years (SD 13.9, range 37-74), on semaglutide for an average of 4.9 months (SD 3.6, range 2.5-12 months); five of six had other illnesses Evidence D source
• Kidney disease is its own thiamine risk, and the dose that separated recovery from permanent damage was the same 500 mg three times a day. — patients with acute or chronic kidney disease who developed Wernicke's encephalopathy Evidence D source

What the evidence does and does not show

• The NIH says larger, well-designed studies are still needed before thiamin supplements can be called useful in Alzheimer's disease. — people with Alzheimer's disease Evidence E source
• Seven randomised trials in 274 people with chronic heart failure showed no gain in heart pumping function from thiamine, though it did fix the deficiency itself. — people with chronic heart failure, 7 trials Evidence A source
• A review of seven clinical studies of thiamine in diabetes found the results conflicting, with trials too small and too short to settle the question. — people with diabetes and its cardiovascular complications, 7 studies Evidence A source
• For treating or preventing Wernicke's encephalopathy, a fifteen-fold difference in thiamine dose made no measurable difference to cognition or neurological signs. — alcohol misuse patients: asymptomatic but at risk in the prevention trial, symptomatic in the treatment trial Evidence B source
• Giving thiamine intravenously to intensive-care patients, where deficiency is common, shortened shock by about eleven hours but did not save lives, and kept people in intensive care slightly longer. — critically ill patients in 35 randomised trials, searched to April 2023 Evidence A source
• In septic shock, thiamine cut in-hospital deaths by a fifth and more than halved the need for dialysis, but the whole result rests on 438 patients. — adults with septic shock in six randomised controlled trials Evidence A source
• Given as part of the hydrocortisone, vitamin C and thiamine cocktail, the combination changed no mortality figure at all: the odds ratio for death at 28 to 30 days was exactly 1.00. — patients with sepsis or septic shock; nine clinical trials and nine cohort studies Evidence A source
• A second meta-analysis of the same question found no benefit of thiamine in heart failure at all, including on the very measure our other card reports as improved. — adults with chronic or acute heart failure in eight randomised controlled trials Evidence A source
• A 2026 meta-analysis with nearly twice the patients did not reproduce the septic-shock mortality benefit: the reduction in deaths was no longer statistically significant. — adults with sepsis or septic shock in nine randomised controlled trials Evidence A source
• Thiamine is sold for stuttering. A 2025 systematic review that looked for the evidence found it insufficient. — mostly adolescents and adults with persistent developmental stuttering; 39 studies covering 17 drug classes and 4 dietary treatments Evidence D source

What too much does

• No Tolerable Upper Intake Level was set for thiamin, because there are no reports of adverse effects from high intakes. — general adults Evidence E source

Medicines it interacts with

• The diuretic furosemide flushes thiamin out in urine and has been linked to levels falling into the deficient range. — people taking furosemide Evidence E source
• Read from the full text, the treating doses in those cases were 500 mg of intravenous thiamine, given three times a day, around four hundred times the daily requirement. — the three of six semaglutide cases whose treatment regimen was fully reported Evidence D source

What to do with this

Whole grains, pork, legumes, seeds and fortified flour cover thiamin without any planning, and no upper limit was set because high intakes have not caused harm.

The reason to read this page is alcohol. Long-term heavy drinking is the most common cause of thiamin deficiency in wealthy countries, partly because alcohol interferes with absorption and partly because it replaces food. If that describes you or someone you look after, treat thiamin as a medical question rather than a supplement one. Untreated deficiency damages nerves in a way that does not fully reverse.

One medicine is worth flagging. The diuretic furosemide increases thiamin loss in urine, and levels have been measured falling into the deficient range.

If you have seen thiamin recommended for heart failure or for diabetes, here is where that stands. Seven randomised trials in 274 people with chronic heart failure found no gain in ejection fraction, walking distance or symptom class, although the supplement did correct the deficiency when one was there. In diabetes, a 2025 review of seven clinical studies found the results conflicting and the trials too small to settle anything.

Two more things about the dose have been settled, and they point the same way. Where thiamin is a prescribed medicine, in people at risk from alcohol, a fifteen-fold spread of dose changed nothing measurable about cognition or neurological signs. In Cambodian mothers, 1.2 mg a day raised the thiamine in their milk as much as 10 mg did. If you are taking thiamin at all, the size of the tablet is the least interesting decision in front of you.

In intensive care the answer splits, and nobody has put it back together. Thiamine given alone in septic shock, pooled over six trials in 438 patients, cut deaths in hospital by a fifth and more than halved the need for dialysis. The same vitamin inside the hydrocortisone, vitamin C and thiamine cocktail produced an odds ratio for death at 28 to 30 days of exactly 1.000. The largest analysis, 35 trials in critically ill patients, found shock about eleven hours shorter and no difference in how many people died. Those three results have not been reconciled, and anyone quoting the first one without the other two is selling something.

Two groups deserve a mention that the diet advice skips. About one patient in five is thiamin deficient three months after weight-loss surgery, and the figure settles back near where it started within a year. In anorexia nervosa the published estimates run from none of the patients to more than half, depending on whether somebody measured blood or asked about food.

Both of the big trial results got retested, and both shrank

Unsettled. The heart-failure question has a second meta-analysis now, and it came out emptier than the first. Eight randomised trials in 384 patients showed no benefit from thiamine on anything measured. Ejection fraction came out at a mean difference of -0.19, with a confidence interval running from -2.78 to 0.96. NYHA class, BNP, symptoms and quality of life were all unchanged. Thiamine status itself was on the unchanged list too, and that is the part worth noticing, because the older review had that one down as the thing thiamine did reliably. So two pooled analyses of the same literature now disagree about whether the supplement even corrects the deficiency it is given for. Until somebody explains that gap, treat thiamine as having nothing to offer a heart failing for some other reason.

Unsettled. The sepsis picture moved the same way. A 2026 meta-analysis pooled nine trials and 520 patients, close to twice the base of the earlier one, and the survival benefit stopped being statistically significant. The odds ratio for short-term death was 0.78 with a p value of 0.18. The dialysis finding did hold, and held strongly, at an odds ratio of 0.26. Lactate at 24 hours came down a little. The result that survived replication is the kidney one, and the result people quote at you is the one that did not. One footnote is worth keeping. In the two studies that looked only at patients who were genuinely thiamine deficient, 51 people between them, the odds ratio for death was 0.18. Small number of patients, large claim, and it points where this whole page points. Thiamine treats thiamine deficiency.

The form on the label does more than the milligrams do

If you do end up taking thiamine, one thing on the box changes the outcome more than the dose does. Ordinary thiamine hydrochloride dissolves in water, and the gut lets only so much of it through. The fat-soluble precursors get past that ceiling. In healthy volunteers, benfotiamine delivered about eleven times the plasma thiamine of thiamine hydrochloride, and roughly twice the thiamine diphosphate inside red blood cells. An independent crossover trial in Korean volunteers found the same direction, with a fat-soluble derivative giving more than three times the plasma thiamine of plain thiamine nitrate. Hold the dose at 100 mg and the three forms still separate: benfotiamine beat both rivals on every measure taken, and thiamine disulfide came last.

Put that beside the dose findings and you get an awkward pair. Fifteen times the dose changed nothing clinical. Changing the form changed the blood level elevenfold. Nobody has shown that the higher blood level makes a sick person better. The milligram number on the front of the box is the least informative thing printed on it.

Myth. Thiamine helps stuttering. It is sold for that. A 2025 systematic review went looking across 39 studies, 17 drug classes and four dietary treatments, and filed thiamine under insufficient evidence, next to copper, green tea and Ayurvedic supplements.

Two newer ways to end up deficient

Not for everyone. Weight-loss drugs have started producing this diagnosis. A review of published case reports found six people who developed Wernicke's encephalopathy while taking semaglutide for obesity, four women and two men, average age 47, an average of five months on the drug. All six had long-running gut symptoms and large weight loss before the neurological trouble began. One died. One recovered well. The other four were left with chronic Korsakoff syndrome, and one of those also lost the use of their legs for good. Six published cases against millions of prescriptions is no reason to stop a drug that is working for you. Months of vomiting, or months of barely eating, on any drug at all, is a reason to say so out loud to whoever prescribed it.

Kidney disease carries its own version of the same risk, and the published reports describe the same run-up: appetite gone, vomiting, weight loss, abdominal pain, diarrhoea. In those reports what separated full recovery from permanent damage was the size of the treating dose. Thiamine into a vein at 500 mg three times a day often gave complete recovery. Korsakoff's syndrome turned up among the people given less. The semaglutide cases were treated the same way, 500 mg three times a day, which is roughly four hundred times the daily requirement. That number is here so nobody mistakes this for something a tablet off a shelf addresses.

What cooking does to the number in the table

Pork carries a real amount of thiamine in a real portion. USDA puts lean pork chop at 0.656 mg per 100 g. A thick chop weighs about 180 g, so it holds 1.2 mg, the entire Daily Value used on labels. A regular chop gets you 0.8 mg, a thin one 0.6 mg.

Then you cook it. USDA's retention table gives simmered pork 40 per cent of its thiamine if you pour the cooking liquid away, and 55 per cent if you use it. A quarter of everything that survives the heat is sitting in the pan. That same 40 against 55 split runs through ground, cured and roast pork, and boiled legumes show it too, 35 against 45. Keeping the liquid is the one change here that does real work, and it costs nothing.

One oddity in the tables needs explaining, because it reads like an error. The British composition table shows lean pork going from 0.46 mg per 100 g raw to 0.59 mg cooked, and the American table puts cooked lean chop at 0.66. Cooking does not create thiamine. Water leaves the meat, so what is left gets concentrated into less weight. Per 100 g the number climbs while the thiamine on your plate falls.

One last question, which is whether any of this is your problem. In the 2021 to 2023 national survey, American adults took in a median of 1.31 mg of thiamine a day. Measured against the 1.2 mg Daily Value printed on labels, 42.9 per cent came up short, which sounds alarming. Measured against the requirement that the Daily Value is built out of, about 27 per cent of young women and 30 per cent of young men came up short. Same people, same food, two yardsticks. The gap between those two headlines is most of the story, because the Daily Value is deliberately set high enough to cover almost everybody, so landing below it is ordinary rather than a diagnosis.

Where thiamine deficiency really is a population problem, the fix has never been supplements. WHO's review of maize flour fortification records what was actually used: 4.4 mg of thiamine per kilogram of flour in a Kenyan refugee camp, 5 mg per kilogram in Mexican nixtamalized corn flour. That is the same enriched flour sitting near the top of the food list on this page, and it is why most people reading this will never have to think about thiamine again.

Where to get it from food

The bottom line

The requirement is 1.2 mg a day for men and 1.1 mg for women, and no upper limit was set because high intakes have not been shown to cause harm. Whole grains, pork, legumes and fortified products cover it easily. What matters clinically is the alcohol link, because up to 80 per cent of people with alcohol dependence develop deficiency, and the result is beriberi, which damages nerves in the limbs. One drug is worth knowing about too: the diuretic furosemide flushes thiamin out in urine. Thiamin is also sold for heart failure, and seven randomised trials in 274 patients found it corrected the deficiency without improving how the heart pumped. Two of the claims on this page have since been tested again, and both came out weaker. A second meta-analysis, eight trials in 384 heart-failure patients, found no benefit from thiamine on anything it measured, thiamine status included. A 2026 meta-analysis in 520 sepsis patients no longer found a significant drop in deaths, although the drop in dialysis held. If you take thiamine anyway, the form on the box matters more than the number of milligrams: benfotiamine reaches the blood about eleven times better than ordinary thiamine hydrochloride.

Sources

1. thi-01 · Position of an expert body · expert body statement
   This vitamin plays a critical role in energy metabolism and, therefore, in the growth, development, and function of cells.
   NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
2. thi-02 · Position of an expert body · expert body statement
   19–50 years: 1.2 mg for males, 1.1 mg for females. (value from the source's table, not a sentence)
   NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
3. thi-r3-03 · Randomised controlled trial(s) · randomised controlled dose-response trial
   The estimated dose required to reach 90% of the maximum average total thiamine concentration in human milk (191 µg/L) is 2.35 (95% CI: 0.58, 7.01) mg/d. The mean ± SD milk thiamine concentrations were significantly higher in all intervention groups (183 ± 91, 190 ± 105, and 206 ± 89 µg/L for 1.2, 2.4, and 10 mg, respectively) compared with the placebo group (153 ± 85 µg/L; P < 0.0001) and did not significantly differ from each other.
   American Journal of Clinical Nutrition, 2021 · checked 2026-09-17 · independently re-checked
4. thi-r3-04 · Randomised controlled trial(s) · randomised controlled trial
   In modified intent-to-treat analysis, mean baseline-adjusted endline eTDP was higher among women in the low-concentration (282nM; 95% CI, 235nM to 310nM) and high-concentration (254nM; 95% CI, 225nM to 284nM) groups compared with the control group (193nM; 95% CI, 164nM to 222M; P < .05); low-concentration and high-concentration groups did not differ (P = .19).
   JAMA Pediatrics, 2016 · checked 2026-09-17 · independently re-checked
5. thi-a-12 · Position of an expert body · reference dataset
   Pork, chop, lean only eaten · Thiamin 0.656 MG на 100 г [fdc_id 2705868] · 1 thick 180 г 1.2 MG · 1 regular 120 г 0.8 MG · 1 thin 90 г 0.6 MG
   USDA FNDDS 2021-2023 (fdc_id 2705868) and 21 CFR 101.9(c)(8)(iv) · checked 2026-09-21 · independently re-checked
6. thi-a-13 · Position of an expert body · national dietary survey
   thiamin_mg · усі 19+ n=4886 median 1.31 mean 1.47 · Daily Value FDA (не EAR) = 1.2 floor: усі 19+ 42.9% · EAR (DRI, National Academies) = 0.9 floor: ж 19-30 26.6% проти Daily Value 47.9%
   NHANES 2021-2023 (DR1TOT/DEMO), weighted; EAR from DRI, National Academies · checked 2026-09-21 · independently re-checked
7. thi-a-14 · Position of an expert body · agency guideline
   the pre-post study in the refugee camp in Kenya (33) provided 97%-extraction fortified maize meal containing (per kg) 2100 µg retinol equivalents, 4.4 mg thiamine
   WHO, Fortification of maize flour and corn meal with vitamins and minerals, 2016 · checked 2026-09-21 · independently re-checked
8. thi-a-03 · Randomised controlled trial(s) · randomised crossover pharmacokinetic trial
   Compared to thiamine hydrochloride, the bioavailability of thiamine in plasma and TDP in erythrocyte after oral administration of benfotiamine were 1147.3 ± 490.3% and 195.8 ± 33.8%, respectively.
   Journal of Clinical Pharmacology, 2014 · checked 2026-09-21 · independently re-checked
9. thi-a-04 · Randomised controlled trial(s) · randomised crossover pharmacokinetic trial
   The AUClast value of plasma thiamine showed a >300% increase when thiamine was given as the test formulation in study B.
   Clinical Therapeutics, 2016 · checked 2026-09-21 · independently re-checked
10. thi-a-05 · Observational data · randomised crossover bioavailability trial
    All biokinetic data demonstrated a significantly improved thiamine bioavailability from benfotiamin compared with the other preparations. The lowest bioavailability was detected with thiamindisulfide.
    International Journal of Clinical Pharmacology and Therapeutics, 1998 · checked 2026-09-21 · independently re-checked
11. thi-a-10 · Position of an expert body · reference dataset
    PORK,FRSH,CHOPS,SIMMERED,WO/DRIPPNG — thiamin_mg 40.0 · PORK,FRSH,CHOPS,SIMMERED,W/DRIPPNGS — thiamin_mg 55.0 · LEGUMES,CKD 2/2.5HRS,BOILED,DRAINED — thiamin_mg 40.0 · LEGUMES,CKD 2/2.5HRS,BLD,WATER USED — thiamin_mg 45.0
    USDA Table of Nutrient Retention Factors, Release 6 (2007) · checked 2026-09-21 · independently re-checked
12. thi-a-11 · Position of an expert body · reference dataset
    CoFID 18-529 Pork, diced, raw, lean — Thiamin (mg) 0.46 · CoFID 18-527 Pork, diced, casseroled, lean — Thiamin (mg) 0.59 · FNDDS 2705868 Pork, chop, lean only eaten — Thiamin 0.656 MG на 100 г
    CoFID 2021 (Public Health England, OGL v3.0) and USDA FNDDS 2021-2023 · checked 2026-09-21 · independently re-checked
13. thi-05 · Position of an expert body · expert body statement
    The most common effect of thiamin deficiency is beriberi, which is characterized mainly by peripheral neuropathy and wasting
    NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
14. thi-t3 · Observational data · systematic review of case reports and case series
    Regarding clinical presentation, ocular signs and symptoms were reported by 77/82 (93.9%) women, 61/82 (74.4%) presented with ataxia and 63/82 (76.8%) with confusion. Dysarthria affected 15/82 women (18,3%), while muscular weakness was present in 36/82 (43.9%) and impaired reflexes in 42/82 (51.2%). Memory impairment involved 25/82 (30.5%) of the study population.
    Oliviero et al., Journal of Maternal-Fetal and Neonatal Medicine, 2023 · checked 2026-09-17 · independently re-checked
15. thi-t8 · Observational data · systematic review of case reports and retrospective studies
    500 mg IV thiamine TID was reported in 12 case reports (60%). 18 (90%) of case reports had partial or complete resolution of symptoms following IV thiamine.
    Singh et al., General Hospital Psychiatry, 2024 · checked 2026-09-17 · independently re-checked
16. thi-04 · Position of an expert body · expert body statement
    People with alcohol dependence have up to 80% risk of developing thiamin deficiency due to ethanol's effects on absorption and storage.
    NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
17. thi-06 · Position of an expert body · expert body statement
    In highly industrialized countries, chronic alcohol use disorders appear to be the most common cause of thiamin deficiency
    NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
18. thi-t4 · Observational data · systematic review and proportional meta-analysis of observational studies
    The pooled prevalence of thiamine deficiency was 7% (95% CI: 4-12%) at baseline. We observed that 19% (95% CI: 0-68%), 9% (95% CI: 3-17%), and 6% (95% CI: 3-9%) of patients had developed thiamine deficiency at 3 months, 6 months, and 1 year after surgery, respectively.
    Mousapour et al., Obesity Surgery, 2024 · checked 2026-09-17 · independently re-checked
19. thi-t5 · Observational data · systematic review of observational studies
    The prevalence rates of thiamine deficiency in AN varied from 5.9% to 100% when based on self-report dietary intake. When objective measurements were taken, rates ranged from 0% to 56.7%.
    Hughes et al., European Child and Adolescent Psychiatry, 2025 · checked 2026-09-17 · independently re-checked
20. thi-a-07 · Mechanistic or laboratory data · systematic review of case reports
    Six cases were identified. All patients experienced prolonged gastrointestinal symptoms and substantial weight loss before neurological deterioration.
    Obesity (Silver Spring), 2026 · checked 2026-09-21 · independently re-checked
21. thi-a-09 · Mechanistic or laboratory data · systematic review of case reports
    Parenteral thiamine 500 mg 3 times per day often led to full recovery, while Korsakoff's syndrome was found in those receiving low doses.
    Journal of Renal Nutrition, 2024 · checked 2026-09-21 · independently re-checked
22. thi-08 · Position of an expert body · expert body statement
    Larger, well-designed studies are needed to determine whether thiamin supplements are beneficial for Alzheimer's disease.
    NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
23. thi-t1 · Meta-analysis or systematic review · meta-analysis of randomised controlled trials
    Our meta-analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.
    Wang et al., Clinical Cardiology, 2024 · checked 2026-09-16 · independently re-checked
24. thi-t2 · Meta-analysis or systematic review · systematic review of clinical studies
    Despite promising pre-clinical results for thiamine, clinical trials have yielded conflicting and contradictory findings due to limitations like small sample sizes and insufficient follow-up.
    Alshahrani et al., International Journal of Molecular Sciences, 2025 · checked 2026-09-16 · independently re-checked
25. thi-t6 · Randomised controlled trial(s) · randomised controlled trial
    Study 1: Asymptomatic At-Risk patients (N = 393) received either 100 mg daily, 100 mg thrice daily, or 300 mg thrice daily, for 3 days. Study 2: Symptomatic patients (N = 127) received either 100 mg thrice daily, 300 mg thrice daily, or 500 mg thrice daily, for 5 days. ... No significant differences were observed between any of the dosage conditions for either Study 1 or Study 2 on cognition or neurological functioning.
    Dingwall et al., Alcoholism: Clinical and Experimental Research, 2022 · checked 2026-09-17 · independently re-checked
26. thi-t7 · Meta-analysis or systematic review · systematic review and meta-analysis of randomised controlled trials
    Evidence suggested that thiamine administration resulted in little to no difference in mortality (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.75 to 1.06; Low CoE); however, thiamine administration may reduce shock duration (mean difference [MD], -11.43 h; 95% CI, -20.16 to -2.69 h; Low CoE), lactate level (MD, -0.34 mmol/L; 95% CI, -0.63 to -0.05 mmol/L; Low CoE), and SOFA score (MD, -1.29; 95% CI, -1.91 to -0.66; Low CoE).
    Yasuda et al., Clinical Nutrition, 2024 · checked 2026-09-17 · independently re-checked
27. thi-r3-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomised trials
    Six RCTs (enrolling 438 patients) met the inclusion criteria...Thiamin showed significant effects on in-hospital mortality (RR 0.80, 95% CI 0.65-0.99; P = 0.04) and renal replacement therapy (RR 0.48, 95% CI 0.31-0.74; P = 0.0009).
    Nutrition in Clinical Practice, 2026 · checked 2026-09-17 · independently re-checked
28. thi-r3-02 · Meta-analysis or systematic review · systematic review and meta-analysis of trials and cohorts
    This study evaluated nine clinical trials (1358 participants) and nine cohorts (339,437 participants) and is the most comprehensive systematic review in this field...However, no significant difference was observed between the intervention and control groups in hospital mortality (Odds Ratio (OR) = 0.811, 95% CI: 0.544-1.209, p = 0.304), 28- to 30-day mortality (OR = 1.000; 95% CI: 0.782-1.279, p = 0.998), new onset acute kidney injury requiring renal replacement therapy ((OR = 0.856, 95% CI: 0.526, 1.391; p = 0.529)
    Current Medicinal Chemistry, 2025 · checked 2026-09-17 · independently re-checked
29. thi-a-01 · Meta-analysis or systematic review · systematic review and meta-analysis of randomised trials
    Eight studies including 384 patients were included in this review. The results of overall systematic review showed no benefit of thiamine supplementation in HF patients.
    Complementary Therapies in Medicine, 2022 · checked 2026-09-21 · independently re-checked
30. thi-a-02 · Meta-analysis or systematic review · meta-analysis of randomised trials
    Nine studies enrolling 520 patients were included. Patients in the thiamine group were significantly associated with decreased proportion of Renal Replacement Therapy (RRT, Odds Ratio [OR = 0.26], p = 0.0007), decreased 24 h lactate level (Mean Difference [MD = -0.35], p = 0.004), and larger 24 h SOFA score change (MD = 1.15, p < 0.00001). No statistical significance was detected in short-time mortality (OR = 0.78, p = 0.18)
    Clinics (Sao Paulo), 2026 · checked 2026-09-21 · independently re-checked
31. thi-a-06 · Mechanistic or laboratory data · systematic review
    Dietary treatments (copper, thiamine, green tea, Ayurvedic supplements) had insufficient evidence.
    Neuroscience and Biobehavioral Reviews, 2025 · checked 2026-09-21 · independently re-checked
32. thi-03 · Position of an expert body · expert body statement
    Because of the lack of reports of adverse effects from high thiamin intakes, the FNB did not establish ULs for thiamin.
    NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
33. thi-07 · Position of an expert body · expert body statement
    Research has linked the use of furosemide to decreases in thiamin concentrations, possibly to deficient levels, as a result of urinary thiamin loss
    NIH Office of Dietary Supplements, Thiamin - Health Professional Fact Sheet · checked 2026-09-16 · extracted
34. thi-a-08 · Mechanistic or laboratory data · systematic review of case reports
    In two cases, the patient was started on 500 mg thiamine IV and later switched to 3 × 500 mg thiamine IV [20, 21]. In the last case study, 3 × 500 mg thiamine IV was immediately started [24].
    Obesity (Silver Spring), 2026 · checked 2026-09-21 · independently re-checked