Evidence supporting the use of: Vitamin B1 (thiamine hydrochloride)
For the health condition: Congestive Heart Failure

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Thiamine (Vitamin B1) supplementation in congestive heart failure (CHF) is supported by some scientific evidence, although the overall quality and size of studies is limited. Thiamine is essential for myocardial energy metabolism, and deficiency may contribute to cardiac dysfunction. Patients with CHF are at increased risk of thiamine deficiency, particularly those taking long-term loop diuretics (such as furosemide), which can increase urinary thiamine excretion. Several small-scale clinical trials and observational studies suggest that thiamine supplementation may improve left ventricular ejection fraction and symptoms in patients with CHF, especially in those with confirmed deficiency. For example, a 2000 randomized, double-blind, placebo-controlled trial (Shimon et al., Am J Med) found modest improvements in cardiac function with thiamine supplementation in patients with CHF. However, larger meta-analyses and systematic reviews (e.g., Seligmann et al., 2022, ESC Heart Fail) conclude that while there is a plausible mechanism and some positive effects, the overall evidence is of low to moderate quality, and routine supplementation is not universally recommended unless deficiency is suspected or confirmed. In summary, thiamine is used in CHF based on both mechanistic reasoning and clinical studies, but evidence strength is moderate at best.

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