Deficiency of vitamin B1 is rare in the modern world, but still occurs in regions where malnutrition is endemic or where the population consumes foods lacking vitamin B1. Most of those regions are in Africa or South-East Asia. Chronic deficiency of vitamin B1 is actually very dangerous as it can trigger a potentially fatal brain condition known as Wernicke’s encephalopathy. That condition is also known to occur in chronic alcoholics, since excessive alcohol consumption depletes vitamin B1 (as well as other B vitamins), and if usually fatal unless treated promptly by IV infusions of B vitamins, commonly known as the “banana bag” (due to its yellow color stemming from vitamin B2 inside). The study below found that usage of the blockbuster GLP-1 drugs such as Ozempic, Wegovy, Mounjaro, etc can trigger severe vitamin B1 deficiency and trigger the dreaded neurological condition. Even if the drug dose is lowered so that it causes a less severe form of B1 deficiency, that it still a cause of concern. Vitamin B1 is one of the crucial factors in the rate-limiting step/enzyme of glucose oxidation known as pyruvate dehydrogenase (PDH). Lower PDH function has been causally linked to all sorts of mental and physiological conditions including depression, psychosis, diabetes, heart disease, and cancer. This is not surprising, considering that low PDH function results in the accumulation of pyruvate with its subsequent conversion into lactate, and lactate is now known to be a direct cause (or exacerbator) of all above mentioned conditions. Not to mention that lactic acidemia, which can also occur in cases of severe B1 deficiency, is even more lethal than Wernicke’s encephalopathy and has 30%-40% mortality rate even with treatment in hospital ER. Now, we can add all those conditions as risk factors related to GLP-1 drug sage, and that is on top of the already known risks of blindness and gastroparesis.
https://www.sciencedirect.com/science/article/abs/pii/S0261561425003516?dgcid=rss_sd_all
https://www.ynetnews.com/health_science/article/b1puaaonzl
“…Weight loss and diabetes drugs from the GLP-1 family, including Ozempic, Wegovy and Mounjaro, have emerged as a breakthrough in the effective and safe treatment of obesity, which is defined globally as an epidemic. The drugs promote significant weight loss and improve diabetes control, and their use is expanding in Israel and worldwide. A new study, however, originating at Sheba Medical Center following the hospitalization of a patient with unusual findings, now raises an important question: In rare cases, could these medications be associated with a severe neurological complication, and is it preventable?”
“…Following the case, Dr. Adam Goldman, an internal medicine specialist and Gastroenterology Fellow at Sheba Medical Center, led a large-scale study in collaboration with physicians from Sheba’s Internal Medicine department and Dr. Dana Lev to examine a possible association between GLP-1 medications and Wernicke’s encephalopathy. The researchers analyzed the FDA Adverse Event Reporting System (FAERS), which includes drug safety data, alongside a systematic review of medical literature. In total, 15 documented cases of Wernicke’s encephalopathy following GLP-1 use were identified: 8 occurred after treatment with semaglutide, marketed as Ozempic or Wegovy; 6 followed treatment with tirzepatide, marketed as Mounjaro; and 1 after treatment with liraglutide, marketed as Victoza. In most cases, patients experienced vomiting, rapid weight loss or malnutrition following treatment. Another challenge was that many did not present with all the classic symptoms of Wernicke’s encephalopathy, complicating early diagnosis.”
