The vitamin deficiency putting diabetics in danger from COVID-19

As researchers explore the effects of COVID-19, trying to understand who, how and why some are hit so hard while others will barely have symptoms, they’re discovering that the disease may be more deadly in people who aren’t getting enough of certain vitamins and nutrients.

Take zinc, omega 3 fatty acids and vitamin D, for example. Low levels of each of these nutrients have been associated with worse outcomes of COVID-19, including higher death rates.

Now there may be another deficiency to add to that list. One study has discovered a link between a shortage of a critical vitamin and severe COVID-19 in a particular patient population…

Thiamine levels and COVID-19 in diabetics

A study recently found thiamine deficiency was higher in critically ill COVID-19 patients also suffering from diabetes. Thiamine, or vitamin B1, is critical for good brain and nervous system function and helps protect the kidneys.

Researchers examined the demographic, anthropometric and laboratory data of 270 severely ill COVID-19 patients admitted to the intensive care unit. Roughly half the patients were men, and the median age was 74.

The study specifically focused on measures of arterial lactate, bicarbonate and plasma thiamine. Patients with diabetes were compared with those without diabetes, and a correlation was performed between thiamine and lactate levels. Anyone with a thiamine level below 28 micrograms per liter was considered to have a thiamine deficiency.

The median value of thiamine among the study patients was 54 micrograms per liter, with 15.6 percent having thiamine deficiency. However, when specifically focusing on the COVID-19 patients with diabetes, 26.3 percent were found to have a thiamine deficiency and 69.3 percent had hyperlactatemia. This means COVID-19 patients with diabetes were four times as likely to be deficient in thiamine.

The study also found a strong negative correlation between thiamine and arterial lactate levels. While diabetes itself does not necessarily raise lactate levels in the blood, it does predispose people to developing hyperlactatemia in cases like shock or a health crisis like that brought on by severe COVID-19.

Diabetes and maintaining thiamine levels

We have to work to maintain healthy levels of thiamine. The body does not make its own thiamine, so the only way to get it is through diet and supplements. And like all B complex vitamins, thiamine is water-soluble, meaning the body is constantly excreting it in urine, so a diuretic medication can reduce our thiamine levels.

Some of the physical and chemical conditions that can cause thiamine loss include high pH, elevated temperatures and the presence of sulfites, which are used to preserve meat products. Also, heavy consumption of foods like coffee, tea and chocolate that contain tannins, caffeine, theobromine and theophylline can inactivate thiamine, causing a shortage.

People with diabetes have additional challenges in keeping their thiamine levels up. Diabetes can make it difficult to metabolize thiamine, and one of the most common diabetes medications, metformin, is believed to cause deficiency in thiamine and vitamin B12. And if you have loss of kidney function, that can also impair your thiamine levels.

What to do to raise thiamine levels

There are plenty of good dietary sources of thiamine. The food product with the highest concentration of thiamine is brewer’s yeast. Tuna, pork, beef, poultry and organ meats also contain large amounts of thiamine. And if you’re looking for more plant-based sources, the vitamin can also be found in whole-grain or enriched cereals and rice, green vegetables, legumes, wheat germ and bran, dried fruit, seeds and nuts and blackstrap molasses.

If you have diabetes and really want to be certain you’re getting enough thiamine, make sure you’re taking a supplement that contains the B vitamin. Thiamine can be found in most multivitamins and B complex vitamins.

The National Institutes of Health recommends a daily dose of 1.2 mg for adult men, 1.1 mg for adult women who aren’t pregnant, and 1.4 mg for adult women who are pregnant or lactating. However, if you’re severely deficient in thiamine, which you might be if you are a diabetic, you’ll want to take at least 100 mg two or three times a day.

Sources:

Association between thiamine deficiency and hyperlactatemia among critically ill patients with diabetes infected by SARS-CoV-2 — Journal of Diabetes

Evidence for altered thiamine metabolism in diabetes: Is there a potential to oppose gluco- and lipotoxicity by rational supplementation? — World Journal of Diabetes

Vitamin B1 (Thiamine) — Mount Sinai

Thiamine deficiency in diabetes mellitus and the impact of thiamine replacement on glucose metabolism and vascular disease — The International Journal of Clinical Practice

The Vitamin Everyone Needs (Especially Diabetics) For Kidney Protection — Easy Health Options

Thiamine (vitamin B1) — NHS

Causes of Thiamine Deficiency — Cornell University

Metformin‐induced encephalopathy: the role of thiamine — Internal Medicine Journal

Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults — Frontiers in Psychiatry