One important nutritional problem associated with alcoholism is thiamine deficiency. Thiamine is also known as vitamin B1 and the body does not make it so we need to take it in through our diets. People who consume a lot of alcohol every day often do not have adequate diettary intake and alcohol can impair the absorption of thiamine that is ingested. The body stores several weeks worth of thiamine. If the body becomes depleted of thiamine it can cause Wernicke's encephalopathy, which has three signs:
- Confusion
- Ataxia (difficulty with coordination and unsteady walking)
- Ophthalmoplegia (difficulty with eye movements)
Not all three of these three symptoms are usually present in the same patient. Wernicke's encephalopathy is a medical emergency and should be treated immediately by administration of thiamine. If Wernicke's encephalopathy is not treated sufficiently, it may lead to a more permanent disorder called Korsakoff syndrome, which is characterised by:
- Impaired memory, such as difficulty learning new information. At times this can be severe enough to be described as anterograde amnesia.
- Impaired executive function: difficulty with problem solving, planning, reasoning, impulse control, etc.
- Confabulation: falsely recalling information such as events or conversations that never actually happened.
- Achronogenesis: difficulty sequencing events from the past in temporal order such as whether they moved interstate before they were married or whether their first child was born before or after they were hospitalised.
- Psychiatric features such as delusions
If you are concerned about excessive alcohol intake a good first point of contact is your GP. Some people who drink a lot of alcohol take thiamine supplements to decrese the chance of developing Wernicke's encephalopathy.
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