In the field of neuropsychiatry, we are constantly inundated by how closely related diseases of the mind and diseases of the body are. This elegant interplay is especially present in long-term overuse of alcohol.
Vitamin B1, or Thiamine, is an essential vitamin important for cellular function and metabolism. Since humans cannot naturally produce Thiamine, we must get it from our food intake. Lucky for us, whole grains, fruits, vegetables, meats, and beans all contain this essential vitamin (“Thiamin – Vitamin B1,” 2019). The chronic use of alcohol can lead to deficiencies of Thiamine in several ways. For many individuals struggling with AUD, a varied diet is often sacrificed in order to consume alcohol, limiting intake of Thiamine. Additionally extended use of alcohol can cause gastritis, an inflammation of the stomach-lining (that causes vomiting and diarrhea), which reduces the amount of thiamine that is absorbed through dietary intake. Lastly, the metabolic reaction that breaks down carbohydrates (found in high levels in wine and beer), requires thiamine and further depletes existing stores (Thomson, 2000).
The deficiency of thiamine in the brain leads to dysfunction in neurons and their supporting cells. This progressive degeneration of brain tissue causes the acute condition, Wernicke’s Encephalopathy (WE). WE causes delirium, reduced muscle coordination (ataxia), impaired movement of the eyes, and potential coma (National Institute of Neurological Disorders, 2019). A patient with WE is quickly treated with high levels of thiamine, the condition will quickly subside, and the patient will return to their normal brain function (Arts, Walvoort, & Kessels, 2017).
If left untreated, the patient will develop Korsakoff’s Syndrome (KS) (Arts, Walvoort, & Kessels, 2017). KS is a condition marked by mild to moderate anterograde and retrograde amnesia. Anterograde amnesia is the inability to form new memories, while retrograde amnesia is the inability to retrieve old memories (Peter Robert Martin, Singleton, & Hiller-Sturmhöfel, 2003).
Together these two disorders are referred to as Wernicke-Korsakoff Syndrome (WKS) (McCormick, et al., 2011). Understanding the connection between vitamin B and WKS helps us to illustrate how connected our physiological and neurological health truly are! Our hope is that by understanding the cause and symptoms of this condition you can better support those in your community struggling with AUD!