Thiamin (or thiamine) is another name for vitamin B1. It is a water-soluble, nontoxic B vitamin that is depleted within 2 weeks of not eating normally. Potentially life-threatening complications can develop for mom and baby if depleted. Patients with Hyperemesis Gravidarum (HG) need a lot of thiamin: 100 mg/day before 20 weeks, 250 mg/day after 20 weeks, and to continue supplementing for three months postpartum or when ending breastfeeding.
Vitamin B1 is one of a group of 8 essential nutrients called B vitamins which are very important during pregnancy. Each one is unique. You can buy it without a prescription.
- B1 is thiamin
- B2 is riboflavin
- B3 is niacin
- B5 is pantothenic acid
- B6 is pyroxidine
- B7 is biotin
- B9 is folate or folic acid
- B12 is cobalamin
HG patients need substantially higher doses of thiamin (B1) than someone with a healthy pregnancy due to:
- high carbohydrate diet
- coexisting deficiencies
- limited food variety and intake
- impaired absorption
- reduced muscle mass for storage
Recommended dose of thiamin/B1 (prefer Benfotiamine):
- 100 mg 1 to 3x/day
- 250 mg/day minimum after 20 weeks
- Continue for 3 months after eating normally or after breastfeeding.
Thiamin is not toxic, so taking more is okay.
Signs of Thiamin Deficiency
- difficulty walking, talking, and/or thinking normally
- refractory nausea/vomiting
- vision changes (blurry)
- pain (head/abdomen)
- elevated heart rate
- loss of coordination
- depression, apathy
- slow intestine movement
Things to remember:
- Always get 200 mg B1 IV with IV dextrose (IV with D5 or TPN) and 100 mg IV or orally daily (more with a high carbohydrate diet).
- B1 lab testing is unreliable.
- Avoid B1 shots (atrophy, pain).
- Multiple doses daily improves absorption.
- Oral absorption is decreased by vomiting and malnutrition (up to 70% lost).
- It takes several months of high dose oral thiamin to reverse deficiency.
Thiamin (B1) is not a solo treatment for nausea and vomiting, but B1 may help nausea and vomiting. Supplementation is critical in HG: It protects your heart and brain and supports baby’s development.
Please take your thiamin daily!
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