It’s a concept that Clinical Dietitian Hannah Posluszny, MSPH, RDN has been actively exploring since recently joining the Princeton Center for Eating Disorders team.
Thiamin, or vitamin B1, has a vital role in the growth and function of cells. Needed daily, this nutrient is naturally found in whole grain products, meat, fish, beans, and certain vegetables. It’s also added to products like breads, cereals, and baby formulas.
A lack of thiamin can lead to a condition called Beriberi – which can also be a complication of refeeding syndrome. Beriberi has two types: wet Beriberi, affecting the cardiovascular system, and dry Beriberi, affecting the nervous system. Both can have serious complications. To complicate matters, blood testing for thiamin is not always accurate.
Reviewing the Research
With the help of Princeton University pre-med student Annie Robinson as part of the Princeton Center for Eating Disorders Clinical Research Program, Posluszny conducted a literature review that included case studies and retrospective chart reviews relating to thiamin and eating disorders. She is currently developing a review article to be submitted for publication as a summary of this research, which includes cases where patients took thiamin supplements to prevent refeeding syndrome or treat its early stages.
The larger question still looms: should thiamin supplementation be incorporated into certain eating disorder protocols in some way? And, based on accuracy challenges in testing for thiamin levels, should it be given proactively?
“Thiamin is relatively inexpensive and is water soluble, so it does not have the potential for harm,” explains Posluszny, who earned her master’s degree at Johns Hopkins School of Public Health and her RDN at The Johns Hopkins Hospital, where providers were attentive to thiamin considerations for malnourished patients.
“If ASPEN has guidelines for thiamin use in patients who are malnourished, it seems that it could be a beneficial addition to the electrolyte mix to help prevent thiamin deficiency and refeeding syndrome complications in patients with eating disorders,” she adds. “In the meantime, we’re digging deeper to determine if and how it might play a role in inpatient treatment.”