Thiamine (vitamin B1) in septic shock: A targeted therapy

Ari Moskowitz, Michael W. Donnino

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


Thiamine (vitamin B1) is a water-soluble vitamin essential for human health. Thiamine deficiency is causal and/or contributory in a number of debilitating diseases including beri-beri, the Wernicke-Korsakoff syndrome, optic neuropathy, and others. While thiamine deficiency is relatively rare in developed nations as a result of dietary supplementation, thiamine deficiency is more common in nutritionally compromised populations. Thiamine pyrophosphate, a thiamine derivative, is essential to the citric acid cycle and thiamine deficiency can result in impaired aerobic respiration and cellular energy production. Thiamine also plays an important role in the pentose phosphate pathway and other key metabolic processes. Although thiamine deficiency is a known cause of lactic acidosis, it has been recently evaluated as a potential contributor to refractory lactic acidosis and organ injury in septic shock and other shock states. In this article, we review the epidemiology of thiamine deficiency in septic shock and the existing evidence base supporting thiamine supplementation. We conclude that specific sepsis phenotypes may stand to benefit the most from thiamine supplementation, and efforts might be made to identify and supplement these patients early in their hospital course.

Original languageEnglish (US)
Pages (from-to)S78-S83
JournalJournal of Thoracic Disease
StatePublished - Feb 1 2020
Externally publishedYes


  • Alcoholism
  • Sepsis
  • Septic shock
  • Thiamine
  • Vitamin B1

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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