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  3. Vitamin B1 (Thiamine) whole blood test

What is Vitamin B1 (Thiamine) whole blood test?

Vitamin B1 is a water-soluble vitamin that performs multiple vital functions in the body. It has a critical role in energy metabolism, cell growth, development and functioning. 

Since excess of this vitamin gets excreted out through the kidneys, it is important to take thiamine regularly in diet otherwise, a deficiency can occur in 10 days. Severe thiamine deficiency can develop in 21 days if you are on a restricted intake.

The daily recommended dietary allowance of thiamine for adults is 1.2 mg in males and 1.1 mg in females. The recommended total dietary intake increases from childhood into adulthood and during pregnancy and breastfeeding. 

We get thiamine from dietary sources such as whole grains, meat, fish, and fortified foods such as cereals, bread and infant formula. We can also get thiamine from vitamin supplements.

However, instead of determining vitamin B1 level, this test measures the levels of  Thiamine diphosphate (TDP) - the main metabolically active form of thiamine, which constitutes nearly 80% of the vitamin B1 in the body. 

Thiamine and thiamine monophosphate, the other forms of vitamin B1, are not measured. A whole blood sample (instead of plasma test) is preferred as approximately 80% of the thiamine is present in the red blood cells.

  1. Why is Vitamin B1 (Thiamine) whole blood test performed?
  2. How do you prepare for a Vitamin B1 (Thiamine) whole blood test?
  3. How is a Vitamin B1 (Thiamine) whole blood test performed?
  4. Vitamin B1 (Thiamine) whole blood test results and normal range

Why is Vitamin B1 (Thiamine) whole blood test performed?

This test is used to determine vitamin B1 deficiency. It cannot be used to monitor supplementation therapy if the person is thiamine deficient.

Your doctor may order this test if you have symptoms of vitamin B1 deficiency.

Early signs of B1 deficiency are:

Symptoms of vitamin B1 deficiency in the later stages are:

This test may also be ordered if the doctor suspects you have conditions caused by vitamin B1 deficiency such as wet beriberi, dry beriberi and Wernicke–Korsakoff syndrome with symptoms as follows:

Symptoms of wet beriberi:

Symptoms of dry beriberi:

  • Atrophy (pain in the legs, muscle cramping and wasting)
  • Numbness and tingling of toes
  • Burning feeling in feet

Symptoms of Wernicke–Korsakoff syndrome:

  • Memory loss
  • Hallucinations
  • Confusion between real and imagined memories

Thiamine deficiency due to poor nutrition is seen in 80% of chronic alcoholics. Some people with the following conditions are also at risk of developing the deficiency:

  • Elderly
  • Chronic gastrointestinal conditions
  • Anorexia
  • Undergoing cancer therapy
  • On diuretic therapy
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How do you prepare for a Vitamin B1 (Thiamine) whole blood test?

Before a vitamin B1 blood test, you will be instructed to undergo fasting (no eating or drinking) for some hours. Consuming vitamin supplements may alter your test results, so if you are taking any supplements, your doctor may ask you to stop taking them.

How is a Vitamin B1 (Thiamine) whole blood test performed?

The test takes a few minutes. A technician will draw a small amount of blood from a vein in your arm.

  • He/she will first tie a tourniquet (a band) around your upper arm and wipe the injection site with an antiseptic.
  • A needle will then be inserted into the vein to draw the blood sample. You will feel mild pain as the needle goes in.
  • Once the sample is drawn, the technician will remove the tourniquet and the needle, and place a cotton swab on the injection site.

After the test, a mild bruise may develop at the blood withdrawal site, but it will fade on its own over time.

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Vitamin B1 (Thiamine) whole blood test results and normal range

Normal results:

The normal reference range for vitamin B1 levels in the blood is 70-180 nmol/L.

Abnormal results:

Decreased values of vitamin B1 may be due to the following conditions:

  • Alcoholism
  • If you are consuming antibiotics, sulpha drugs or oral contraceptives
  • Beriberi: dry beriberi (peripheral neurologic changes; i.e. symmetric foot drop); infantile beriberi; wet beriberi
  • Wernicke–Korsakoff syndrome
  • Dextrose infusions (frequent, long-continued or highly concentrated)
  • High-carbohydrate diet (mainly from milled (polished) rice)
  • Hyperthyroidism
  • Long-term total parenteral nutrition
  • Increased requirements (fever, lactation, pregnancy, strenuous physical exertion)
  • Renal dialysis
  • Poor memory
  • Impaired absorption (i.e. long-term diarrhoea)
  • Inadequate calorie or protein intake
  • Severe liver disease

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Harvard T.H. Chan. School of Public Health [internet]: Harvard University; B Vitamins
  2. Michigan Medicine: University of Michigan [internet]; Health Library
  3. American Pregnancy Association [internet]; Roles of Vitamin B in Pregnancy
  4. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms
  5. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests
  6. UW Health: American Family Children's Hospital [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; Vitamin B12 Test
  7. UFHealth [internet]: University of Florida; Vitamin B12 level. Gainesville. Florida. US; Vitamin B12 level
  8. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Vitamin B Complex
  9. National Institute of Health. Office of Dietary Supplements [internet]: Bethesda (MA), US. US Department of Health and Human Services Thiamin
  10. Naidoo DP, Bramdev A, Cooper K. Wernicke's encephalopathy and alcohol-related disease. Postgrad Med J 1991;67;978-981. PMID: 1775421.
  11. Brin M. Erythrocyte as a biopsy tissue for functional evaluation if thiamine adequacy. JAMA. 1964;187:762–766. PMID: 14094300.
  12. Majumdar SK, Shaw GK, O'Gorman P, Aps EJ, Offerman EL, Thomson AD. Blood vitamin status (B1, B2, B6, folic acid and B12) in patients with alcoholic liver disease. Int J Vitam Nutr Res. 1982;52(3):266–271. PMID: 7174224.
  13. Ball GFM. Vitamins: Their role in the human body. 2004. Oxford, Blackwell Publishing. pp 273-288.
  14. Herve C, Beyne P, Lettéron P, Delacoux E. Comparison of erythrocyte transketolase activity with thiamine and thiamine phosphate ester levels in chronic alcoholic patients. Clin Chim Acta. 1995;234(1-2):91–100. PMID: 7758226.
  15. Roberts NB. Taylor A. Sodi R: Chapter 37 Vitamins and Trace Elements. In: N Rifai, AR Horvath, CT Wittwer. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Sixth edition. St. Louis, MO. Elsevier, 2018. pp 639-718.
  16. National Health Service [internet]. UK; Blood Tests
  17. University of Iowa. Department of Pathology. Laboratory Services Handbook [internet]; Vitamin B1
  18. Fischbach FT. A Manual of Laboratory and Diagnostic Tests. 7th ed. July 2003. Lippincott Williams & Wilkins Publishers. Pp:708.
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