Data on Mood and Vitamin B-1 (thiamine)

According to clinical nutritionist Blake Graham, all vitamins and minerals are involved in one or more biochemical pathways and/or physiological actions which influence the function of the human brain. Most vitamin and mineral deficiencies result in psychiatric symptoms in a significant number of people, and in people with psychiatric diagnoses these deficiencies are often associated with more severe symptoms and poorer outcome from conventional treatment. Vitamin and mineral deficiencies may act as an exacerbating factor secondary to malnutrition, alcoholism, etc. or may be a primary causative factor. Either way, optimisation of nutrient levels is in each patients best interest.

Several named vitamin deficiency diseases may result from the lack of sufficient B-vitamins.  Also, several unnamed, sub-clinical responses can result from B-vitamin deficiency.

 

Vitamin B1 (thiamine)

Thiamine deficiency, whether mild, moderate or severe, commonly results in psychiatric symptoms.

Deficiency causes beriberi. Symptoms of this disease of the nervous system include weight loss, emotional disturbances, Wernicke’s encephalopathy (impaired sensory perception), weakness and pain in the limbs, periods of irregular heartbeat and edema (swelling of bodily tissues).  Heart failure and death may occur in advanced cases. Chronic thiamine deficiency can also cause Korsakoff’s syndrome, an irreversible psychosis characterized by amnesia and confabulation, or the confusion of true memories with false memories.

Thiamine plays a vital role in metabolism of glucose.  Ingestion of excessive simple carbohydrates automatically increases the need for this vitamin. This is referred to as high calorie malnutrition.  

Nine young men were deprived of thiamine to study the effects of thiamine deficiency. After thiamine deficiency was induced, 5/9 of the men developed marked irritability and depression. (J Broek,  1957).

Another thiamine deprivation study reported symptoms of fearfulness, agitation and emotional instability. (RD Williams. 1943) In one study, low thiamine levels were significantly associated with reduced mood in women, but not in men, (Benton D. 1995) while another study reported thiamine deficient individuals were more anxious and more depressed based on ratings from the Adjective checklist, although not more depressed based on the Frieburg personality inventory scale. (Heseker H. 1992) Severe thiamine deficiency induced by chronic alcoholism, referred to as Wernicke-Korsakoff syndrome, is well known to be associated with a large array of psychiatric and cognitive symptoms. (Mann. 2000)

Thiamine is required for the activity of pyruvate dehydrogenase, which catalyzes the conversion of pyruvate to acetyl-coenzyme A. If activity of this enzyme is impaired, excess pyruvate may be converted into lactate (H. Wick. 1977), which can cause anxiety. (RA Buist. 1985) Thiamine is also required for other aspects of energy metabolism. (Mann. 2000) High doses of thiamine (400 mg) have been documented to inhibit platelet monoamine oxidase activity (Connor DJ. 1981), although it is not clear if this is a pharmacological effect due to mega-doses or an effect achieved at normal physiological doses.

Investigations into thiamine status of psychiatric patients have produced mixed results. One study reported 0/36 inpatients with major depression, excluding those with high alcohol consumption, had thiamine deficiency upon laboratory testing, (Bell IR. 1991) while Carney reported 30% of 172 and 78% of 74 mixed psychiatric inpatients had low thiamine levels respectively. (MW Carney. 1982) (MW Carney. 1979) 7/12 agoraphobia patients were also found to be deficient in thiamine. (LC Abbey. 1981). Given that the one study excluding patients with alcoholism found no patients with thiamine deficiency (Bell IR. 1991), the discrepancy of these studies is probably due to thiamine deficiency being largely secondary to alcoholism and malnutrition present in many psychiatric patients. Differing laboratory techniques and reference ranges may also be another issue. Thiamine deficiency should be suspected in the presence of alcoholism and malnutrition. 

Thiamine can  mimic the action of acetylcholine in the brain. (Meador 1993)  It also functions as a coenzyme involved in the synthesis of acetylcholine, GABA, and glutamate. (Bell 1992).

The emphases in this article are mine.  Blake Graham joins the list of professionals who state that vitamin and mineral defieicies can cause mental health issues. 

Also, the statement “Ingestion of excessive simple carbohydrates automatically increases the need for (thiamine)” is very illustrative.  Ingestion of carbohydrates has been shown to increase serotonin production; some perinatal mood professionals have presented this data as a possible treatment approach, encouraging women to eat small, carbohydrate-rich meals throughout the day to keep their energy up.  But this research typically does not question if using simple carbohydrates is a good overall approach to combatting depression, or if it could be an exacerbating symtpom of an underlying problem.  The excessive ingestion of simple carbohydrates causes a myriad of health issues including obesity, diabetes and gestational diabetes, nutrient deficiencies and mood issues.

I am chilled to recall that Andrea Yates’ last meal before entering infamy consisted of dry, sugary cereal.  And, in the news the week of 10-10-2008 was a story about a mentally ill homeless man who was set on fire.  He was a fixture in the community where he lived and was known well by the shopkeeper who provided a daily meal of Dr. Pepper and potato chips.

It is possible that using simple carbohydrates excessively can be considered a form of self-medication.  There is an underlying reason people may choose to self-medicate with simple carbohydrates- more on this later from a guest author on WellPostpartum Weblog.

 

 

References:

Abbey, LC. Agoraphobia. J Orthomol Psychiatry, 11:243-59, 1982

Bell IR, Edman JS, Morrow FD, Marby DW, Mirages S, Perrone G, Kayne HL, Cole JO. B complex vitamin patterns in geriatric and young adult inpatients with major depression. J Am Geriatr Soc. 1991 Mar;39(3):252-7.

Bell, I., Edman, J., Morrow, F., Marby, B., Perrone, G., Kayne, H., et al.

(1992). Vitamin B1, B2, and B6 augmentation of tricyclic antidepressant treatment in geriatric depression with cognitive dysfunction. Journal of the American College of Nutrition, 11, 159–163.

 Benton D, Haller J, Fordy J. Vitamin supplementation for 1 year improves mood. Neuropsychobiology. 1995;32(2):98-105.

 Broek, J, H Guetzkow. Psychologic Effects of Thiamine Restriction and Deprivation in Normal Young Men. American Journal of Clinical Nutrition, 1957.

 Buist, RA. Anxiety neurosis: The lactate connection. Int Clin Nutr Rev, 5(1):1-4, 1985

 Carney, MW,  A Ravindran, MG Rinsler and DG Williams. Thiamine, riboflavin and pyridoxine deficiency in psychiatric in- patients. The British Journal of Psychiatry 141: 271-272 (1982)

 Carney, MW, DG Williams and BF Sheffield. Thiamine and pyridoxine lack newly-admitted psychiatric patients. The British Journal of Psychiatry 135: 249-254 (1979)

 Connor DJ. Thiamine intake and monoamine oxidase activity. Biol Psychiatry. 1981 Sep;16(9):869-72.

 Heseker H, Kubler W, Pudel V, Westenhoffer J. Psychological disorders as early symptoms of a mild-to-moderate vitamin deficiency. Ann N Y Acad Sci. 1992 Sep 30;669:352-7.

 Mann J & Truswell AS. Essentials of Human Nutrition. 2nd edition. New York: Oxford University Press; 2002.

 Meador, K., Nichols, M., Franke, P., Durkin, M., Oberzan, R., Moore, E., et al. (1993). Evidence for a central cholinergic effect of high-dose thiamine. Annals of Neurology, 34, 724–726.

 H. Wick, K. Schweizer, R. Baumgartner. Thiamine dependency in a patient with congenital lacticacidaemia due to pyruvate dehydrogenase deficiency. Inflammation Research. Volume 7, Number 3 / September, 1977.

 RD Williams, HL Mason, MH Power, RM Wilder. Induced thiamine (vitamin B1) deficiency in man; relation of depletion of thiamine to development of biochemical defect and of polyneuropathy. Arch Int Med. 71:38-53, 1943.

 

 

 

 

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