Polyneuropathy and vitamin B1
– Why diabetics should be vigilant against a vitamin B1 deficiency

Diabetic polyneuropathy is a widespread secondary complication of diabetes. Approximately one out of three patients with type 1 or type 2 diabetes is affected by the serious nerve disorder. Diabetic neuropathy is triggered by processes which develop as a result of the permanently elevated blood sugar level: Blood vessels and nerves are affected and damaged by harmful glucose metabolites. The consequences include feelings of numbness, abnormal sensations ranging from tingling to pain, and motor disorders of the limbs. The progression of polyneuropathy can lead to complications and even to the loss of limbs. Here you will learn about the crucial role played by the right diet and compensation of vitamin B1 deficiency and how existing polyneuropathy can be treated!

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TOPPIC OVERVIEW

What is vitamin B1 and what are its functions?

Vitamin B1 fulfills important functions in our body in carbohydrate metabolism. It helps break down carbohydrates ingested with food and convert them into energy. In addition, vitamin B1 affects the release of certain messengers, among others, and thus performs important tasks in the proper functioning of the nervous system.

Since vitamin B1 can be stored in the body only for a few weeks, it should be consumed daily in food. Vitamin B1 is needed for the breakdown of glucose – thus if a particularly large amount of carbohydrates needs to be metabolized, there may briefly be an increased need for vitamin B1. This can also occur in diabetes patients in a hyperglycemic state. The correspondingly higher vitamin B1 need can often not be covered by the “normal” daily intake of 1 to 1.3 mg as recommended by the German Nutrition Society (DGE) for healthy adults.

Vitamin B1, thiamine and benfotiamine – a brief definition

Thiamine is the scientific name for vitamin B1 and in technical literature, this synonym for vitamin B1 is frequently seen. By contrast, benfotiamine is a precursor of thiamine which is converted in the body into vitamin B1. The benefit of benfotiamine: While thiamine is water-soluble and only poorly absorbed in the intestines when consumed as a dietary supplement or drug, benfotiamine has fat-soluble properties. As a result, benfotiamine is absorbed by the body better than thiamine when administration has to take place in the form of tablets. Thus benfotiamine can effectively compensate for a vitamin B1 deficiency.

Vitamin B1 is found in these foods

Healthy people can generally cover their daily vitamin B1 needs well through a balanced diet and have little need to use dietary supplements. In particular, whole-grain products, which are rich in thiamine, are advisable, as are legumes, pork, and certain types of fish and vegetables. When preparing meals, it should be kept in mind that thiamine is sensitive to heat and light. For this reason, prepare your vegetables by cooking them gently and preferably store your food in a dark place to preserve the thiamine content of the food.

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Diabetics belong to the vitamin B1 deficiency high-risk group

Even with a balanced diet, there are certain factors which can promote a vitamin B1 deficiency. Substances such as alcohol, coffee, or black tea can inhibit the absorption and/or use of vitamin B1 when they are consumed regularly or in large quantities. But metabolic diseases such as diabetes may also be responsible for a thiamine deficiency. One scientific study shows that diabetics frequently struggle with low vitamin B1 levels. The cause of this is the increased need due to the disrupted glucose metabolism on the one hand, but also the increased excretion of the water-soluble vitamin via the kidneys. Because of these sources of risk, diabetics are affected particularly frequently by vitamin B1 deficiency and its serious consequences and should therefore take effective preventive measures.

Danger of a vitamin B1 deficiency: The threat of nerve damage

If vitamin B1 is lacking in the organism, carbohydrate metabolism may be negatively affected. Symptoms of a thiamine deficiency include overacidification of the blood, fluid retention, or nerve damage. A vitamin B1 deficiency may therefore contribute to triggering or worsening polyneuropathy (nerve damage). In diabetics, the disrupted glucose metabolism results in an excess of damaging glucose degradation products. These metabolites promote inflammation and strengthen the effects of oxidative stress on the blood vessels. The walls of the blood vessels are consequently attacked and very small veins die off. Inadequately supplied nerve pathways remain which then also die off – and make neuropathy worse or even trigger it. A more detailed overview of secondary diabetic complications which are triggered by damage to blood vessels as a result of permanently increased blood glucose levels can be found here: Secondary complications of diabetes – What are the risks associated with diabetes?

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Effectively treat diabetic polyneuropathy due to a vitamin B1 deficiency

If diabetic polyneuropathy due to a vitamin B1 deficiency has already appeared, the progression of the disease can be counteracted. Effectively treating existing diabetic polyneuropathy is not an easy task. A lasting improvement in nerve function and an associated improvement in quality of life can only be achieved with determined cooperation by the patient. This frequently requires a lifestyle change and elimination of bad habits.

This includes more exercise and an appropriate diet,  helps improving awareness of the body and counteract deficiencies such as gait unsteadiness as well as supports the loss of excess body weight, if applicable. The nerve toxins nicotine and alcohol should ideally be completely avoided. It is also advisable to effectively correct an existing vitamin B1 deficiency.

Here you can learn what role alpha-lipoic acid plays, in addition to benfotiamine, in the treatment of diabetic neuropathy.

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