# Prevalence of Thiamine Deficiency in Hospitalized Non-Alcoholic Veterans

> **NIH VA I21** · VA SIERRA NEVADA HEALTH CARE SYSTEM · 2022 · —

## Abstract

Background: Thiamine deficiency (TD) causes a variety of thiamine deficiency disorders (TDDs) such as
neuropsychiatric disturbances, polyneuropathy, ataxia, weakness and falling, and non-ischemic heart failure.
Left untreated, TD can be associated with poor quality of life, loss of independence, and inability to complete
activities of daily living. The prevalence of TD in non-alcohol using hospitalized Veterans is not known but is
probably much higher than the general population. Loss of functional ability leads to increased need for
rehabilitation.
The objective of this proposal is to measure the prevalence of TDDs in Veterans who do not use excess
alcohol who are ill enough to require hospitalization, determine if inflammation increases the risk of developing
TD, and determine the optimal cutoff points for two biomarkers of TD to diagnose of TDDs. The central
hypothesis is that TD prevalence is as high as 25% in hospitalized non-alcoholic Veterans, far greater than
the historically reported prevalence of 3% or less, and that TDD’s occur in the “low normal” range of current
cutoff values for available thiamine bioassays. A secondary hypothesis is that inflammatory conditions, which
are known to cause cachexia and malnutrition, put hospitalized Veterans at increased risk as they often
present with acute inflammatory conditions. The rationale underlying this proposal is that hospital practitioners
currently underdiagnose and undertreat TDDs which leads to continued morbidity and loss of function. If our
hypothesis is correct that the prevalence is as high as 25%, this knowledge will increase awareness of the
problem and lead practitioners to diagnose and treat them more often. In addition, clarifying the “abnormally
low” biomarker cutoff levels by measuring them in Veterans with TDDs is very important as the current
“normal” ranges were determined in healthy volunteers. The central hypothesis will be tested by pursuing three
specific aims: 1) determine the prevalence of TD, as defined by whole blood and plasma thiamine levels
together with symptom responsive disease in consecutively hospitalized medicine patients who do not use
excessive alcohol; 2) define TDDs as cases with low or “low normal” thiamine levels and symptoms that
improve with thiamine replenishment; 3) determine if acute and chronic inflammatory conditions with elevated
biomarkers of inflammation increase the risk of developing TDD. We expect to find the prevalence of TD is
closer to 25% and that the low end of “normal” biomarker levels as published by reference laboratories is too
low, missing a percentage of TDDs.
Research design: To accomplish these aims, we will utilize a prospective cohort study design to determine
the prevalence of TD in consecutively hospitalized non-alcoholic medicine patients, as defined by low or “low
normal” thiamine biomarker levels and thiamine responsive symptoms. Nested within this we will conduct an
open label treatment study with those exhibiting sy...

## Key facts

- **NIH application ID:** 10486405
- **Project number:** 1I21RX004101-01
- **Recipient organization:** VA SIERRA NEVADA HEALTH CARE SYSTEM
- **Principal Investigator:** Elisabeth Mates
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10486405

## Citation

> US National Institutes of Health, RePORTER application 10486405, Prevalence of Thiamine Deficiency in Hospitalized Non-Alcoholic Veterans (1I21RX004101-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10486405. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*