Vitamin B Deficiency & Alcoholism: Causes And Effects [Evidence-Based]

Causes & Effects of Vitamin B deficiency in alcoholism

We are aware of the fact that alcohol addiction has damaging effects on the nervous system. Acetaldehyde formed as a result of the breakdown of alcohol plays a key role in accelerating brain damage caused by excessive alcohol intake.

It initiates derangement of neurotransmitters or brain chemistry. It shrinks brain tissue, destroys brain cells and suppresses the activity of the central nervous system.

It interacts with various receptors in the brain and modulates multiple biochemical pathways in the brain to cause tolerance and increase addiction. These events later lead to cognitive decline, memory lapse, neurological deficits and even neurodegeneration.

One aspect that contributes to the neurotoxic potential of excess alcohol is micronutrient deficiency. Depletion of various vitamins and minerals in the body makes the environment conducive for toxicity and damage.

Vitamin B complex is vital for optimal brain and nervous system function. The two most important causes of vitamin B deficiency in alcoholism are:

  • Consuming a poor diet or a diet deficient in micronutrients like vitamin B
  • Inhibition of absorption and metabolism of vitamin B by excessive alcohol intake

Deficiencies of B vitamin members can lead to serious health conditions, especially during alcohol withdrawal. This post investigates how alcoholism leads to deficiencies of important members of Vitamin B complex and how these deficiencies impact the patients’ health.

After understanding the impact of B vitamin deficiency in alcoholism, you may be interested in knowing therapeutic benefits of B complex for alcohol addiction and withdrawal.

Suggested Vitamin B Complex Supplements for Alcoholism

Alcohol withdrawal is a complex process that requires medical attention. Please consult your healthcare provider before taking any health supplements. Please read the ingredient list before purchasing any supplement.

If you are already on the road to recovery, then discuss the potential of B vitamins with your doctor. I have listed two supplements: one includes all the B-complex members and the other is benfotiamine (thiamine or B1 analogue).

For alcoholism recovery, its best to take a complete B vitamin supplement. Benfotiamine may be added to the regime but the dosage needs to be monitored.

Please follow the manufacturer’s suggested dose or consult your doctor about the same.

Thorne Research Basic B-Complex
Doctor’s Best Benfotiamine with Benfopure
b complex supplement

Image Credit: Thorne Research, Inc.

Image Credit: Doctor’s Best, Inc.

It contains all B complex vitamins in a bioavailable form with an extra dose of vitamin B12.

They are allergen free and vegetarian capsules.

It contains benfotiamine or Allithiamine which is a garlic-derived soluble form of vitamin B1.

It can be taken in combination with vitamin B complex or alone.

They are gluten and soy free, vegetarian capsules.

Purchase from Amazon (US, UK and Canada)

Purchase from iHerb (Global)

Purchase from Amazon (US, UK and Canada)

Purchase from iHerb (Global)

Alcoholism and Vitamin B Deficiency: Causes & Effects

Let’s explore the impact of deficiencies of each member of vitamin B complex in alcoholism.

1.Thiamine (Vitamin B1) deficiency

Thiamine or vitamin B1 is involved in various functions such as energy production, the breakdown of carbohydrates, immune system activation, communication between brain and nerve cells, signalling or communication between cells and tissues.

How does alcoholism cause thiamine deficiency?

Inadequate intake of thiamine is one of the prime reasons for vitamin B1 deficiency in alcoholic patients.

Alcoholism causes thiamine deficiency by reducing the rate of absorption of the vitamin from the intestines. It also impairs transport of the vitamin to the tissues where it can be utilised.

How does thiamine deficiency affect patients with chronic alcoholism?

Thiamine deficiency in alcoholism can cause cognitive impairment.

A recent study published in Free Radical Biology and Medicine, 2017 reveals that chronic alcohol consumption with thiamine deficiency causes ‘dramatic brain dysfunction’ including accumulation of amyloid beta protein.

Amyloid beta protein accumulation is indicative of dementia and Alzheimer’s.

The Wernicke-Korsakoff syndrome is a neuropsychiatric condition occurring as a result of thiamine deficiency. Wernicke’s encephalopathy is the first phase of the disorder which can be reversed by supplementing with thiamine; else it progresses into Korsakoff’s syndrome.

Thiamine supplementation is emphasised as one of the most important measures for preventing Wernicke-Korsakoff’s syndrome in chronic alcoholism.

Supplementation with thiamine during alcohol withdrawal helps protect cognition. In an animal model, thiamine supplementation was found to reverse alcohol toxicity, reduce inflammation, restore normal brain chemistry and support rapid recovery of brain and liver health.

Benfotiamine is a synthetic analogue of thiamine similar to the compounds allithiamines found in garlic. It has a higher bioavailability than thiamine.

Portari et al. have demonstrated that benfotiamine, due to its high bioavailability, is as effective as or better than thiamine in rectifying vitamin B1 deficiency.

A study published in Drug and Alcohol Dependence, 2013 reported the effects of benfotiamine supplementation in chronic alcoholism.

120 individuals with alcohol dependence but not seeking treatment were enrolled in the study. They received 600mg benfotiamine or placebo daily for 24 weeks. Further, a follow up of 24 weeks was conducted.

63% of the population in the treatment group and 55% in the placebo group completed the 24-week study. Significant reduction in alcohol consumption was observed in both groups, but the reductions were significantly greater in benfotiamine group.

9 out of 10 women experienced a significant reduction in alcohol consumption within one month of benfotiamine treatment. No major adverse effects were noted.

Researchers concluded that benfotiamine might discourage alcohol consumption, especially in women.

Further research by the same group revealed that benfotiamine supplementation helps reduce depression and other psychiatric symptoms in men with severe alcoholism and it supports recovery.

Quick Gist: Thiamine deficiency in alcohol abuse disorder can cause cognitive impairment and neuropsychiatric conditions like Wernicke-Korsakoff syndrome. Supplementation with B1 is essential during alcohol withdrawal.

Benfotiamine, an analogue of vitamin B1, is proven to reduce alcohol consumption and psychiatric symptoms in individuals with alcoholism.

2.Riboflavin (Vitamin B2) deficiency

Vitamin B2 or riboflavin helps in conversion of food to energy. It serves as an antioxidant, maintains the immune system and is a vital nutrient for healthy hair and skin. It is also involved in the synthesis of vitamin B3.

How does alcoholism cause riboflavin deficiency?

Riboflavin deficiency is observed in chronic alcoholism and may be linked to severity of the alcoholic liver disease.

Alcohol consumption can induce riboflavin deficiency when an individual is already consuming a diet deficient in nutrients. Also, the toxic effects of alcohol can impact riboflavin absorption.

How does riboflavin deficiency impact patients with chronic alcoholism?

Riboflavin deficiency can affect iron metabolism and lead to anaemia and fatigue. It may contribute to migraine development.

Homocysteine is an amino acid that regulates our vascular health and blood pressure. Alcoholism can contribute to high homocysteine levels and impact heart and vascular health.

Riboflavin, in combination with other B complex vitamins, can lower homocysteine levels in alcohol-dependent patients.

In alcoholism, riboflavin deficiency impairs the liver’s antioxidant defences, thus increasing the risk of alcohol-induced liver injury. Its supplementation may protect against alcoholic liver disease.

Cytoflavin is an antioxidant formulation which includes riboflavin and other raw materials required for cellular energy production. It is said to improve cognition, neurological symptoms and influence activity of the nervous system.

Few research studies have demonstrated that cytoflavin effectively reduces alcohol cravings and psychiatric symptoms occurring during alcohol withdrawal.

Quick Gist: Riboflavin deficiency in alcoholism may lead to alcoholic liver disease and anaemia. Its supplementation helps protect vascular and liver health.

Cytoflavin, an antioxidant formulation containing vitamin B2, is proven to reduce alcohol cravings and mental health-related symptoms during alcohol withdrawal.

3.Niacin (Vitamin B3) deficiency

Niacin is also known as Nicotinic acid. It is involved in energy metabolism. Other functions of vitamin B3 include: lowering cholesterol levels, maintaining heart health, reducing inflammation, maintaining nervous system activity, participating in hormone synthesis.

How does alcoholism cause niacin deficiency? How does niacin deficiency affect alcoholic individuals?

Pellagra is a condition caused by a deficiency of niacin and its precursor tryptophan. Alcohol dependence causes pellagra by several ways: inducing B complex deficiencies, affecting stomach and gut health, inducing malnutrition or inhibiting conversion of tryptophan to niacin.

Tryptophan is an amino acid that is required for synthesis of our happy hormone serotonin. Pellagra may even cause depression and anxiety as a result of tryptophan deficiency or production of toxic metabolites from tryptophan.

Alcohol-induced pellagra can be treated by supplementing with niacin, other B vitamins and protein.

Quick Gist: Niacin supplementation can help reverse alcohol-induced pellagra and help protect cognition.

4.Pyridoxine (Vitamin B6) deficiency

Vitamin B6 is essential for the production of neurotransmitters (brain chemistry) which regulate our mood and cognition. It is essential for brain development and function, protecting heart health, improving immune function etc.

How does alcoholism cause Vitamin B6 deficiency? How does vitamin B6 deficiency affect patients with chronic alcoholism?

Vitamin B6 deficiency in alcoholism may occur as a result of inadequate intake. However, supplementation of B6 does not elevate the vitamin levels when the patient continues to consume alcohol.

This indicates that alcohol consumption and its oxidation can worsen vitamin B6 deficiency.

Alcoholic individuals have lower vitamin B6 levels than non-alcoholic individuals. On a biochemical level, it is observed that acetaldehyde (a toxic by-product of alcohol which is responsible for hangover effects) impairs pyridoxine production and metabolism in the body.

B6 deficiency may lower protection against inflammation, cause convulsions and alcohol withdrawal seizures.

Supplementation with B6 may assist in lowering homocysteine levels and protecting heart health in alcoholic patients. It may help resolve alcohol-induced anaemia.

Pyridoxine hydrochloride has been used to treat alcohol withdrawal symptoms and delirium tremens.

Metadoxine is an ionic complex of pyridoxine and pyrrolidone. It is used in alcohol detoxification and to reduce psychiatric symptoms during alcohol withdrawal.

Quick Gist: Vitamin B6 deficiency in alcoholism can cause inflammation and alcohol withdrawal seizures. Its supplementation helps reduce alcohol withdrawal symptoms and aids in detoxification.

5.Folic Acid (Vitamin B9) deficiency

Folic acid and folate are required for proper brain development and nervous system function. It is essential for the production of genetic material. It regulates mental health and also supports red blood cell function along with vitamin B12.

How does alcoholism cause folate deficiency?

Folate deficiency is common among those suffering from alcohol use disorder, and this may be associated with abnormalities in blood-related parameters.

Transporters are proteins that support absorption and delivery of certain molecules to the site of action. Chronic alcoholism is found to impair folate absorption by adversely affecting the activity of folate transporters.

Also, excess alcohol intake reduces the uptake of folate by liver and pancreas which in turn disturbs the body’s natural folate status and metabolism.

How does folate deficiency affect patients with chronic alcoholism?

Folate is a vital nutrient that supports DNA synthesis and enhances brain health. Chronic alcohol intake and low dietary folate intake may increase cancer risk.

Folic acid supplementation helps improve antioxidant status, prevents DNA damage and protects liver health from deleterious effects of binge drinking (Alcohol and Alcoholism, 2016).

It can improve heart and kidney function by improving the activity of antioxidant enzymes.

Folic acid supplemented diet can help increase bile flow and lower cholesterol levels, thus preventing hypercholesterolemia in alcoholic patients. It also lowers homocysteine levels to protect vascular health in alcohol addiction disorder.

Acetaldehyde accumulation in the body, as a result of the breakdown of alcohol, can have an anticoagulant effect and increase bleeding risk. Folic acid, as well as other B vitamins such as B1, B6, lower the anticoagulant activity of acetaldehyde.

Folic acid supplementation, along with B12, can resolve alcohol-induced peripheral neuropathy.

Quick Gist: Folic acid supplementation helps reduce DNA damage, improve antioxidant status, treat peripheral neuropathy and improve heart and liver function in alcoholic patients.

6.Cobalamin (Vitamin B12) deficiency

Vitamin B12 is essential for the production of genetic material and cellular energy. It works in combination with vitamin B9/ folate to assist function of red blood cells, support immune function and regulate mood. It also protects heart, eye and bone health.

How does alcoholism cause vitamin B12 deficiency?

Alcohol consumption leads to reduced absorption of vitamin B12. Glutathione is one of the antioxidant enzymes present in our body which is also involved in the production of vitamin B12.

A study published in Alcohol, Clinical and Experimental Research, 2011 demonstrated that alcohol depletes glutathione levels and reduces the ability to synthesise vitamin B12 (methylcobalamin).

How does vitamin B12 deficiency affect patients with chronic alcoholism?

Vitamin B12 deficiency may cause psychiatric symptoms such as delusion, mania, depression.

B12 deficiency in alcoholism may lead to the development of optic neuropathy and cause loss of vision.

Apart from affecting liver health and antioxidant status, vitamin B12 deficiency may even result in megaloblastic anaemia in alcoholic patients. This anaemia occurs as a result of low B12 and folate levels which disrupts DNA synthesis and prevents the development of red blood cells.

B12 supplementation, along with folic acid, can resolve alcohol-induced peripheral neuropathy.

Detecting B12 deficiency in patients with alcoholism may not be easy for clinicians as alcohol-induced liver damage may cause false reporting of B12 levels.

Quick Gist: Vitamin B12 deficiency may have multiple implications in alcoholism: cognitive impairment, anaemia, peripheral neuropathy, mood disturbances. Its supplementation can help protect nerve health and mood in alcohol addiction.

Dosage Of Vitamin B For Alcoholism

For severe alcoholism and alcohol withdrawal symptoms, it is best to consult a physician for vitamin B supplementation and dosage. Critically ill patients may require parenteral supplementation of vitamins instead of oral supplements.

Food may not be the best source of B vitamins for chronic alcoholic patients due to limited absorption and alcoholic liver disease.

However, if you are already on the road to recovery and initiated the process of alcohol abstinence, the inclusion of B vitamin-rich foods is likely to benefit you.

For individuals with less complicated symptoms of alcohol dependence, oral high dose vitamin B supplementation is favourable. Research studies have indicated that a dose of 250-300mg vitamin B1 and B3 initially (followed up by maintenance doses) can help such individuals.

High dose vitamin B supplement may help lower alcohol dependence, cravings and assist in smoother recovery. Please consult a health practitioner for appropriate dosage of vitamin B supplements.

Precautions with Vitamin B Use

B complex vitamins are safe if taken in recommended dosages. Vitamin B supplementation may cause yellowing of urine, but this does not pose any health risk.

Very high doses may cause side effects such as stomach issues, sleep issues, nausea, loss of appetite, skin reactions.

However, vitamin B6 at high doses can cause toxicity and even neuropathy. Folic acid supplementation may mask B12 deficiency and cause damage.

It’s best to supplement with a complete B vitamin supplement.

Vitamin B12 may interact with medications like chloramphenicol, proton pump inhibitors, histamine antagonists, metformin, etc.

Thiamine may interact with digoxin, diuretics, and phenytoin.

Please consult a health practitioner before taking vitamin B supplements.

Conclusion

Chronic alcohol intake and poor diet contribute to vitamin B deficiency in patients with alcohol use disorder.

Thiamine (Vitamin B1) depletion can exacerbate alcohol withdrawal syndrome. Deficiency of riboflavin (Vitamin B2) contributes to oxidative stress while extreme deficiency of niacin (vitamin B3) causes alcohol-induced pellagra.

Pyridoxine supplementation facilitates alcohol detoxification and reduces psychiatric symptoms associated with alcohol withdrawal.

Folate and vitamin B12 depletion resolves alcohol-induced neuropathy, anaemia and lowers homocysteine levels to protect vascular health. Supplementation with B vitamins helps protect cognition and mood and supports recovery from alcoholism.

Do check out my next post on therapeutic benefits of B complex for alcohol addiction and withdrawal.

Alcohol withdrawal is a very complex process and requires medical attention. Please discuss the therapeutic potential of vitamin B in alcohol addiction with your doctor before taking supplements.

Alcohol cessation initiates recovery of various systems in our body which were damaged by excessive alcohol consumption. Vitamin B supplements help accelerate this recovery.

Learn about the causes and damaging effects of vitamin B complex deficiency in alcoholism.

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