Thiamine (Vitamin B1) Deficiency During Pregnancy

Thiamine, or vitamin B1, is a water-soluble vitamin that is essential for energy metabolism and the proper functioning of the nervous system. It acts as a coenzyme in the conversion of carbohydrates into energy and is involved in the synthesis of neurotransmitters that the brain and nerves rely on for communication. During pregnancy, thiamine needs increase to support the higher metabolic demands of both the mother and the growing baby.

Thiamine deficiency, historically associated with the condition known as beriberi, is uncommon in its severe form in modern India but mild insufficiency can still occur, particularly in women with poor dietary diversity. The body has limited storage capacity for thiamine, so a consistent daily intake through food or supplements is necessary to maintain adequate levels.

A diet heavily based on polished white rice with limited variety of other foods is a well-known risk factor for thiamine deficiency. The milling process that produces white rice removes the bran layer where most of the thiamine is concentrated. In coastal regions of Andhra Pradesh, including Visakhapatnam, where rice is a dietary staple consumed at multiple meals, this can be a relevant concern if the overall diet lacks diversity.

Severe and prolonged morning sickness (hyperemesis gravidarum) is another significant cause of thiamine deficiency during pregnancy. Women who cannot keep food down for extended periods may rapidly deplete their thiamine stores. Chronic vomiting also increases thiamine excretion, compounding the problem. In rare but serious cases, this can lead to a condition called Wernicke's encephalopathy, which affects the brain.

High consumption of tea and coffee, particularly with meals, can also reduce thiamine absorption. Certain compounds in these beverages, known as tannins and polyphenols, can inactivate thiamine in the digestive tract. Pregnant women who drink multiple cups of tea daily with or immediately after meals may want to be mindful of this effect.

Early symptoms of thiamine deficiency include persistent fatigue, irritability, and a reduced ability to concentrate. These symptoms can easily be mistaken for normal pregnancy-related tiredness. A loss of appetite and mild nausea, particularly in the later stages of pregnancy when these symptoms are less expected, may also indicate low thiamine levels.

As the deficiency becomes more pronounced, neurological symptoms may develop. These include tingling, numbness, or a burning sensation in the hands and feet, known as peripheral neuropathy. Muscle weakness, particularly in the legs, and difficulty walking can also occur. In severe cases, confusion, memory problems, and rapid heartbeat may develop, indicating a medical emergency that requires immediate treatment.

For the mother, thiamine deficiency can lead to significant fatigue and neurological symptoms that affect daily functioning. In cases of hyperemesis gravidarum, untreated thiamine deficiency can progress to Wernicke's encephalopathy, a potentially life-threatening neurological condition that causes confusion, vision problems, and difficulty with coordination. This condition is a medical emergency and requires intravenous thiamine replacement.

For the baby, thiamine is crucial for brain development and the formation of the nervous system. Adequate maternal thiamine levels support the healthy development of neural pathways and cognitive function. Severe maternal deficiency has been associated with an increased risk of low birth weight and, in extreme cases, infantile beriberi in the newborn, which can affect the heart and nervous system.

Including a variety of thiamine-rich foods in your daily diet is the most effective way to prevent deficiency. Whole grains and unpolished rice (brown rice) are excellent sources, as are millets like ragi, bajra, and jowar. Replacing at least one serving of white rice with brown rice or a millet-based roti can meaningfully increase your thiamine intake. Parboiled rice, which is common in many parts of South India, retains more thiamine than regular polished rice.

Other good sources include legumes such as moong dal, masoor dal, and black-eyed peas, as well as peanuts, sunflower seeds, and potatoes. For non-vegetarian women, pork and fish are particularly rich in thiamine. Fortified breakfast cereals and bread can also contribute to daily intake.

Women who are experiencing severe morning sickness should seek medical attention early, as their healthcare provider may recommend thiamine supplementation to prevent deficiency. Most prenatal vitamins available in Visakhapatnam contain thiamine as part of their formulation, providing a baseline level of protection.

If you are experiencing severe and prolonged vomiting during pregnancy, especially if you are unable to keep food or liquids down for more than 24 hours, seek medical attention promptly. Your doctor may administer intravenous fluids along with thiamine and other B vitamins to prevent deficiency. Early intervention is critical in cases of hyperemesis gravidarum.

You should also consult your doctor if you develop tingling or numbness in your extremities, unexplained muscle weakness, or any confusion or memory difficulties. These neurological symptoms warrant urgent evaluation. Healthcare providers at Heamac Healthcare in Visakhapatnam can assess your symptoms, check your nutritional status, and recommend appropriate treatment to ensure a safe and healthy pregnancy.