Evidence supporting the use of: Vitamin B1 (thiamine diphosphate)
For the health condition: Wasting

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin B1 (thiamine), particularly in its active coenzyme form thiamine diphosphate (TDP, also called thiamine pyrophosphate), is scientifically supported for use in treating or preventing wasting conditions that stem from thiamine deficiency. Wasting refers to unintended loss of muscle mass and weight, often resulting from chronic diseases, malnutrition, or absorption disorders. Thiamine is an essential nutrient that serves as a coenzyme for several key enzymes in carbohydrate metabolism, including pyruvate dehydrogenase, alpha-ketoglutarate dehydrogenase, and transketolase. Deficiency leads to impaired energy metabolism, particularly in tissues with high metabolic demand such as muscle and nerve.

The classic wasting syndromes associated with thiamine deficiency are wet and dry beriberi. Dry beriberi is characterized by peripheral neuropathy and significant muscle wasting, while wet beriberi mainly affects the cardiovascular system but can also involve muscle atrophy. Administration of thiamine reverses these symptoms if given early. Clinical guidelines recommend thiamine supplementation in populations at risk for deficiency, such as those with chronic alcoholism, malabsorption syndromes, or severe malnutrition, all of which can present with wasting.

However, in cases of wasting not directly caused by thiamine deficiency (e.g., cancer cachexia or AIDS-related wasting), there is no strong evidence that thiamine supplementation alone improves outcomes unless a deficiency is present. Thus, the scientific justification for thiamine use in wasting is moderate and condition-specific, primarily targeting situations where deficiency is a contributing factor.

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