Diabetes And Thiamine:
Could Your Vitamin B1 Levels Be Lower?
You know your blood sugar.
You know your HbA1c.
You probably know more about carbohydrates than you ever wanted to.
But there is another nutrient most people with diabetes rarely hear about.
Thiamine, also known as vitamin B1.
Research has found lower concentrations of several thiamine markers in people
with diabetes compared with people without diabetes.
Diabetes puts glucose under the microscope.
Finger-prick tests. Continuous glucose monitors. HbA1c results.
Food labels. Carbohydrates. Medication.
You get very good at watching sugar.
But glucose metabolism does not happen in isolation.
Your body relies on vitamins, minerals and enzymes to help turn the food you
eat into usable energy.
One of those nutrients is thiamine, or vitamin B1.
What Is Thiamine?
Thiamine is a water-soluble B vitamin also known as vitamin B1.
The body cannot make enough thiamine by itself, so it needs to come from diet
or other appropriate nutritional sources.
Thiamine plays an important role in normal energy metabolism and is involved
in biochemical pathways used to process carbohydrates.
Why does that make diabetes interesting?
Because diabetes affects the way the body handles glucose, while thiamine is
involved in several pathways connected with normal glucose metabolism.
Researchers have therefore spent years investigating whether diabetes is
associated with altered thiamine status.
Are Thiamine Levels Lower In People With Diabetes?
Research suggests they can be.
What does the research show?
A systematic review and meta-analysis published in 2023 found that people
with diabetes had lower concentrations of several measures of thiamine status
than people without diabetes.
These included lower concentrations of thiamine, thiamine monophosphate and
total thiamine compounds.
Other markers showed a tendency towards lower levels but did not reach
statistical significance.
This is important because it supports an association between diabetes and
altered thiamine status.
It does not mean everyone with diabetes is thiamine deficient.
And it does not mean everyone with diabetes needs supplements or IV vitamins.
Why Might Thiamine Levels Be Lower?
One particularly interesting theory involves the kidneys.
Increased Thiamine Clearance
Research has found markedly increased renal clearance of thiamine in some
people with diabetes.
In simple terms, more thiamine may be lost through the kidneys and urine.
Altered Thiamine Handling
Diabetes may alter the way thiamine is transported, distributed or retained
within the body.
Researchers are still investigating exactly what these changes mean
clinically.
An older study found a striking difference
One study involving people with type 1 and type 2 diabetes found substantially
lower plasma thiamine concentrations alongside greatly increased renal
thiamine clearance compared with healthy controls.
That finding helped trigger further research into the relationship between
diabetes and vitamin B1.
Does This Mean Thiamine Treats Diabetes?
No.
Vitamin B1 should not be presented as a replacement for diabetes medication,
blood glucose monitoring, diet, exercise or established diabetes care.
Clinical research examining thiamine supplementation has not shown consistent
improvements in glycaemic outcomes such as HbA1c.
If you have diabetes, continue taking prescribed medicines and follow the
treatment plan agreed with your GP or diabetes team.
What Does Vitamin B1 Do In The Body?
Energy Metabolism
Thiamine contributes to normal energy-yielding metabolism and helps the body
use nutrients from food.
Nervous System
Vitamin B1 contributes to normal functioning of the nervous system.
Heart Function
Thiamine also contributes to normal heart function.
What Are The Symptoms Of Thiamine Deficiency?
Severe thiamine deficiency is uncommon in people eating a varied diet, but
deficiency can occur in certain circumstances.
Possible symptoms can vary depending on the severity and duration of
deficiency.
- Persistent tiredness
- Weakness
- Reduced appetite
- Difficulty concentrating
- General feeling of low energy
- Neurological symptoms in more severe deficiency
- Muscle weakness
- Problems with coordination in severe cases
- Changes in mental state in serious deficiency
- Cardiovascular symptoms in severe deficiency
These symptoms are not specific to vitamin B1 deficiency.
Fatigue, weakness and neurological symptoms can have many different causes
and should be assessed appropriately.
Who Is More At Risk Of Thiamine Deficiency?
Diabetes is only one possible part of the picture.
Poor Nutritional Intake
People eating a very restricted or inadequate diet may consume insufficient
vitamin B1.
Alcohol Dependence
Chronic excessive alcohol use is a well-recognised risk factor for serious
thiamine deficiency.
Malabsorption
Conditions affecting the digestive system can interfere with normal nutrient
absorption.
Bariatric Surgery
Certain weight loss procedures can increase the risk of vitamin and mineral
deficiencies.
Prolonged Vomiting
Extended periods of vomiting can significantly reduce food intake and
nutritional status.
Increased Nutritional Demand
Certain illnesses or physiological states may alter nutritional requirements.
Should Everyone With Diabetes Take Thiamine?
No.
The fact that studies have identified lower thiamine markers in people with
diabetes does not automatically mean every person with diabetes needs a
supplement.
A person’s nutritional needs depend on their diet, medication, health,
symptoms, medical history and wider clinical circumstances.
A more useful question is:
“Am I getting enough of the nutrients my body needs?”
That question opens the door to looking at the whole person rather than
chasing a single vitamin because of one research finding.
Food Sources Of Vitamin B1
For most people, a balanced diet is the starting point.
Thiamine can be found in foods including:
Wholegrains
Wholegrain breads, cereals and grains can contribute vitamin B1 to the diet.
Legumes
Beans, lentils and peas can provide useful amounts of thiamine.
Nuts & Seeds
Certain nuts and seeds are useful dietary sources of vitamin B1.
Pork
Pork is naturally rich in thiamine.
Fortified Foods
Some breakfast cereals and other foods are fortified with B vitamins.
Balanced Diet
Eating a varied diet remains the foundation of good nutritional intake.
What About IV Vitamins?
This is where we need to separate nutrition from hype.
IV vitamin therapy delivers fluids and selected nutrients intravenously rather
than through the digestive system.
That does not make IV therapy a treatment for diabetes.
At Holden’s Chemist Express, our IV vitamin services are offered to suitable
adults following a personalised clinical consultation.
Our pharmacy team reviews your medical history, current medication, health
and individual circumstances before deciding whether IV therapy is
appropriate.
Important
Do not book an IV vitamin drip expecting it to lower your blood glucose,
improve your HbA1c or replace prescribed diabetes treatment.
IV vitamin therapy is intended to support general wellbeing where clinically
appropriate and should sit alongside appropriate nutrition, hydration, rest
and medical care.
Our Pharmacy-Led IV Vitamin Services
Holden’s Chemist Express provides pharmacy-led IV vitamin therapy from our
clinics in Scawsby, Doncaster and Newark.
Every appointment includes a clinical consultation and suitability
assessment before treatment is provided.
Energy IV Drip
Designed to support hydration, normal energy metabolism and general wellbeing
for suitable adults.
Recovery IV Drip
Designed to complement hydration, nutrition, rest and recovery routines after
demanding activity.
Myers’ Cocktail
A broader IV vitamin formulation available following individual clinical
assessment.
How Our IV Vitamin Service Works
Book Your Appointment
Choose Scawsby, Doncaster or Newark and select an available appointment.
Clinical Consultation
A trained healthcare professional reviews your health, medication and
individual circumstances.
Suitability Assessment
We determine whether your chosen treatment is appropriate. If it is not, we
will explain why.
IV Treatment
Where suitable, your agreed IV treatment is administered by a trained
healthcare professional.
Monitoring
You are monitored throughout the infusion within our pharmacy clinic.
Aftercare
Our team provides appropriate aftercare guidance before you leave.
Frequently Asked Questions
Is thiamine lower in people with diabetes?
Research has found lower concentrations of several thiamine markers in people
with diabetes compared with people without diabetes. However, this does not
mean every person with diabetes has thiamine deficiency.
Why might diabetes affect thiamine levels?
Research has identified increased renal clearance of thiamine in some people
with diabetes, meaning thiamine may be lost from the body more rapidly through
the kidneys. Other aspects of thiamine handling may also be involved.
Does thiamine lower blood sugar?
Thiamine is involved in normal carbohydrate metabolism, but supplementation
should not be presented as a diabetes treatment. Clinical research has not
shown consistent improvements in glycaemic measures such as HbA1c.
Can thiamine replace my diabetes medication?
No. Vitamin supplements and IV vitamin therapy should never replace
prescribed diabetes medication or medical care.
Should everybody with diabetes take vitamin B1?
No. Nutritional requirements vary between individuals. Diet, symptoms,
medication, health conditions and clinical circumstances all need to be
considered.
Can people with diabetes have an IV vitamin drip?
Suitability depends on your individual health, medication, diabetes control
and wider medical history. Every Holden’s Chemist Express IV therapy
appointment includes a clinical suitability assessment before treatment.
Are IV vitamin drips a treatment for diabetes?
No. IV vitamin therapy should not be used as a replacement for established
diabetes treatment, glucose monitoring, nutrition or medical care.
You Monitor Your Glucose.
What About The Rest Of Your Nutrition?
Research suggests diabetes may be associated with altered thiamine status,
but one research finding should never become a self-diagnosis.
If you are interested in pharmacy-led IV vitamin therapy for general
wellbeing, explore our treatment options and speak to our clinical team.
This page provides general health information and does not diagnose thiamine
deficiency or provide diabetes treatment advice. IV vitamin therapy is not a
treatment for diabetes and should not replace prescribed medication, blood
glucose monitoring, diet, hydration or medical care. If you have persistent
fatigue, unexplained neurological symptoms, poorly controlled diabetes or
other worrying symptoms, seek advice from your GP or diabetes healthcare
team.
Clinical sources:
Ziegler D et al. Association between diabetes and thiamine status:
a systematic review and meta-analysis, 2023.
Thornalley PJ et al. High prevalence of low plasma thiamine concentration
in diabetes linked to increased renal thiamine clearance, 2007.
Systematic review of thiamine supplementation and glycaemic outcomes in
type 2 diabetes, 2022.