Should people who drink alcohol take thiamine supplements?

Thiamine, also known as vitamin B1, is an essential nutrient your body cannot store in large amounts. It plays a central role in carbohydrate metabolism and brain energy production. Chronic alcohol consumption reduces both the absorption of thiamine in the intestine and its effective use by tissues. Over time, this creates a high risk for deficiency.

The most feared complications of thiamine deficiency are Wernicke’s encephalopathy, a sudden neurological disorder with confusion, poor coordination, and eye movement problems, and Korsakoff’s syndrome, a long-lasting memory disorder. Together these conditions are sometimes called Wernicke-Korsakoff syndrome.

Why thiamine supplementation matters

• Guideline consensus: Clinical guidelines consistently recommend thiamine supplementation for people with alcohol use disorder, particularly those at risk for deficiency.
• Evidence of benefit: Supplementation can restore thiamine levels, prevent neurological complications, and has been linked to improved survival in critically ill patients with alcohol use disorder.
• Limitations: Oral thiamine may be poorly absorbed if deficiency is already severe or alcohol use is ongoing. In those cases, doctors often use intravenous or intramuscular thiamine.

Should all drinkers take thiamine?

For individuals with alcohol use disorder or heavy chronic intake, supplementation is strongly advised. For moderate drinkers without malnutrition, the evidence is less clear, but given thiamine’s safety profile, many clinicians consider supplementation a reasonable preventive measure.