Thiamine's Mood-Mending Qualities

By Richard N. Podell, M.D.

Thiamine, also known as vitamin B1, is essential for the citric acid function known as the Krebs cycle—the primary biochemical path by which useful energy is extracted from glucose, amino acids and fats. The RDA of 1.1 to 1.5 mg a day provides enough thiamine to prevent beriberi, a potentially deadly deficiency disease, but is it enough to optimize biochemical function or to maximize a person's subjective well-being? How many people would feel better if they took more? Does medical science have the testing skills to tell who needs how much?

Researchers from the department of psychology at the University of Wales in Swansea, together with the Basel, Switzerland-based Hoffman-LaRoche pharmaceutical company, recently put these questions to the test. One hundred twenty healthy female college students were given either 50 mg thiamine, considered a high dose, or a placebo. At the beginning of the study all but one volunteer had normal thiamine levels as measured by the standard erythrocyte transketolase test.

Despite their ostensibly normal nutritional status, after two months the students who took extra thiamine more than doubled their scores on the clear-headedness and mood subclasses of the bipolar Profile of Mood States (POMS) psychological test. Students treated with placebo showed no change. Those taking thiamine also increased their quickness on a reaction-time test. Again, the placebo group was unchanged. Finally, improvement also occurred on POMS subscales that measured if a participant felt confident, composed or elated. However, these latter results were not statistically significant.¹

The same group of researchers had previously demonstrated the benefit of thiamine supplementation in people with subtle, borderline or subclinical thiamine deficiency.^2,3 The current work with healthy college students augments earlier research by showing that young women with normal thiamine levels can benefit from megadose supplements.

I was disappointed that the authors did not cite the pioneering research of Derrick Lonsdale, M.D., and Raymond J. Shamberger, Ph.D., formerly of the Cleveland Clinic in Ohio. Lonsdale and Shamberger identified 20 patients with neuroticlike symptoms. Eight had biochemical evidence of thiamine deficiency; 12 did not. However, all improved substantially after an open trial of thiamine supplements plus a diet that restricted refined sugar.⁴

Most nutrition-oriented physicians in the United States would argue that improving one's overall diet is as important as supplementing with thiamine—and with good reason. Biochemically, the more calories consumed, especially carbohydrates, the more thiamine is required for the Krebs cycle to process the food into energy.

Other research emphasizes the importance of vitamin B1:

• In one double-blind Israeli study, researchers gave intravenous thiamine or placebo for one week to 30 patients who were being treated for congestive heart failure. Echocardiography showed greater contraction power and increased urine excretion in the thiamine group.⁵
  
  
• A New Zealand study found that 15 percent of a large group of randomly selected older people had thiamine deficiency as measured by the transketolase test. Their subjective quality of life scores and blood pressure improved after taking thiamine. Extra thiamine had no effect on those with normal transketolase.⁶
  
  
• A 1957 study found that thiamine deficiency was associated with increased hypochondriasis, depression and hysteria scores on the Minnesota Multiphasic Personality Inventory test (MMPI).⁷

The bottom line is that vitamin supplements, such as thiamine, are beginning to prove their value—even for people whose nutritional status is considered normal. This way of thinking is a departure from the traditional disease-focused medical model, which assumes nutritional shortfalls aren't relevant until they become severe enough to cause illness. The traditional model assumes adding more nutrients adds nothing to the body's chemistry or function. From this perspective, the level of thiamine intake that's good enough for one should be good for all.

But the holistic model is pushing doctors, nutritionists and patients to rethink this approach to health. More people than ever are considering the relevance of biochemical individuality and enzyme enhancement with nutritional cofactors.

It is easy to see the progress made. Who would have thought even 10 years ago that physicians would be recommending greater than RDA doses of folic acid to pregnant women or that the government would be adding folic acid to our food supply? This is surely a tribute to how far we've come.

Richard N. Podell, M.D., is director of the Podell Medical Center in New Providence, N.J.

References

1. Benton D. Thiamine supplementation improves mood and cognitive functioning. Psychopharmacology 1997;129:66-71.

2. Benton D, et al. Vitamin supplementation for one year improves mood. Europsychobiology 1995;32:98-105.

3. Benton D, et al. The impact of long-term vitamin supplementation on cognitive function. Psychopharmacology 1995;117:298-305.

4. Lonsdale D, Shamberger R. Red cell transketolase as an indicator of nutritional deficiency. Am J Clin Nutr 1980;33:205-11.

5. Shimon I, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485.

6. Wilkinson T, et al. The response to treatment of subclinical thiamine deficiency in the elderly. Am J Clin Nutr 1997;66:925-8.

7. Brozek J. Psychological effects of thiamine restriction and deprivation in normal young men. Am J Clin Nutr 1957;5:109-18.