thiamine (generic name)

a vitamin b complex - treats Thiamin deficiency, Atherosclerosis, Coma/hypothermia of unknown origin, Crohn's disease, Didmoad, Heart failure, ...
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Interactions with Drugs

Reduced levels of thiamin in blood and cerebrospinal fluid have been reported in individuals taking phenytoin (Dilantin®) for extended periods of time.

Antacids may lower thiamin levels in the body by decreasing absorption and increasing excretion or metabolism.

Barbiturates may lower thiamin levels in the body by decreasing absorption and increasing excretion or metabolism.

Loop diuretics, particularly furosemide (Lasix®), have been associated with decreased thiamin levels in the body by increasing urinary excretion (and possibly by decreasing absorption and increasing metabolism). Examples of other loop diuretics include bumetanide (Bumex®), ethacrynic acid (Edecrine®), and torsemide (Demadex®). Theoretically, this effect may also occur with other types of diuretics, including thiazide diuretics such as chlorothiazide (Diuril®), chlorthalidone (Hygroton®, Thalidone®), hydrochlorothiazide (HCTZ, Esidrix®, HydroDIURIL®, Ortec®, Microzide®), indapamide (Lozol®), and metolazone (Zaroxolyn®), or potassium-sparing diuretics, such as amiloride (Midamor®), spironolactone (Aldactone®), and triamterene (Dyrenium®). Effects may be most pronounced with larger doses taken over extended periods of time.

Tobacco use decreases thiamin absorption and may lead to decreased levels in the body.

Effects of neuromuscular blocking agents (NMBAs) may be enhanced with concomitant (simultaneous) use of thiamin.

Some antibiotics destroy gastrointestinal flora (normal bacteria in the gut), which manufacture some B vitamins. In theory, this may decrease the amount of thiamin available to humans, although the majority of thiamin is obtained through the diet (not via bacterial production).

Oral contraceptives (birth control pills/OCPS) may decrease levels of some B vitamins, vitamin C, and zinc in the body.

People receiving fluorouracil-containing chemotherapy regimens may be at risk for developing symptoms and signs of thiamin deficiency.

In theory, metformin may reduce thiamine activity, and based on animal research, taking thiamin and metformin together may contribute to the risk of lactic acidosis.

Thiamin has been shown to improve vasodilation (the widening of blood vessels) in patients with high blood sugar levels or diabetes. This response was not seen in patients with normal blood sugar levels. Therefore, thiamin may increase the effects of vasodilators in these patients.

Interactions with Herbs and Dietary Supplements

Consumption of betel nuts (Areca catechu L.) may reduce thiamine activity due to chemical inactivation, and may lead to symptoms and signs of thiamin deficiency.

Horsetail (Equisetum arvense L.) contains a thiaminase-like compound that can destroy thiamine in the stomach and theoretically causes symptomatic thiamine deficiency. Horsetail products are available without this property and, for example, the Canadian government requires that horsetail products be certified free of thiaminase activity.

In theory, diuretic herbs may decrease thiamin levels in the body by increasing urinary excretion.

Thiamin has been shown to improve vasodilation (the widening of blood vessels) in patients with high blood sugar levels or diabetes. This response was not seen in patients with normal blood sugar levels. Therefore, thiamin may increase the effects of vasodilators in these patients.

Attribution

This information is based on a systematic review of scientific literature, edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MSc, MPhil (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration): Catherine Ulbricht, PharmD (Massachusetts General Hospital); Christine Ulbricht, BS (University of Massachusetts); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).

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