Medications That May Deplete THIAMINE
Thiamine helps convert food into energy and is essential for nerve and heart function. See which medications carry a reported association, how strong the evidence is, and what to discuss with your pharmacist.
Thiamine helps convert food into energy and is essential for nerve and heart function.
Common food sources: Whole grains and fortified cereals; Pork; Beans and lentils; Nuts and seeds.
Ask about thiamine if you take an associated medication (for example, a long-term loop diuretic in heart failure) and have symptoms like fatigue or worsening heart failure control — this is an area your care team can weigh.
HelloPharmacist pharmacist-reviewed education. The medication records below are licensed clinical data, shown as published.
Deep dive: Thiamine — uses, safety & drug interactions
Medications associated with THIAMINE depletion
Each record is shown as published in our licensed clinical database. Open a medication for its full nutrient report.
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Amikacin
Insignificant DepletionBrand names include Amikin, Arikayce
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Amikacin is an antibiotic, and like other antibiotics it can disrupt the normal bacteria living in your gut, which do produce a small amount of thiamine. That said, we get the vast majority of our thiamine from food rather than from gut bacteria, so any effect here is considered insignificant. Most people taking amikacin have nothing to worry about on this front, and routine thiamine supplements are not called for.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Amoxicillin
Insignificant DepletionBrand names include Amoxil Capsules, Trimox, Wymox
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is a theoretical idea that amoxicillin, like other antibiotics, could reduce the friendly gut bacteria that make a small amount of thiamine. In practice, though, your diet supplies the vast majority of the thiamine you need, so this interaction is considered insignificant for most people. No supplement is needed for a typical course of amoxicillin, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Amoxicillin Veterinary
Insignificant DepletionBrand names include Biomox
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that amoxicillin, like other antibiotics, could slightly reduce the amount of thiamine made by the good bacteria in your gut, but here is the reassuring part: your diet supplies the vast majority of the thiamine you need, not those bacteria. Because of that, this interaction is considered insignificant for most people, and a supplement is not needed. If you have any concerns, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Amoxicillin, Clavulanate Potassium
Insignificant DepletionBrand names include Augmentin, Augmentin XR, Clavulin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Amoxicillin-clavulanate, like other antibiotics, can alter the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, the vast majority of the thiamine you need comes straight from food, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed for a typical course of this antibiotic, but if you have questions about your diet or nutrition, your pharmacist is always a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Amoxicillin, Clavulanate Potassium →
Amoxicillin, Omeprazole Magnesium, Rifabutin
Insignificant DepletionBrand names include Talicia
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. The antibiotics in this triple-therapy regimen can alter the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, most of the thiamine you need comes straight from the food you eat, so any effect here is considered insignificant for the vast majority of people. No supplement is needed for most patients taking this combination, but mention it to your pharmacist or doctor if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Amoxicillin, Omeprazole Magnesium, Rifabutin →
Amphotericin, Tetracycline
Insignificant DepletionBrand names include Mysteclin-F
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. The thinking here is that tetracycline and amphotericin can shift the normal bacteria living in your gut, and those bacteria do make small amounts of thiamine. In practice, though, most of what your body needs comes from the food you eat, so this interaction is considered insignificant for the vast majority of people. No action is needed for most patients, but if you ever have questions about your diet or vitamin intake while on these medications, your pharmacist is a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ampicillin
Insignificant DepletionBrand names include Principen, Omnipen-N, Omnipen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Ampicillin, like other antibiotics, can disrupt the helpful bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine you need comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is typically needed, but if you have questions about your diet while taking ampicillin, your pharmacist is a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ampicillin, Sulbactam
Insignificant DepletionBrand names include Unasyn
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Ampicillin-sulbactam is an antibiotic, and antibiotics can disrupt the natural bacteria living in your gut, which normally produce small amounts of thiamine. That said, since most of the thiamine your body uses comes straight from food, not from gut bacteria, this interaction is considered insignificant for most patients. No supplement is needed, but if you have questions about your nutrition during treatment, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Avibactam Sodium, Ceftazidime
Insignificant DepletionBrand names include Avycaz
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. The thinking here is that ceftazidime-avibactam, like any antibiotic, could slightly disrupt the friendly bacteria in your gut that help produce small amounts of thiamine. In practice, though, this matters very little because you get the vast majority of your thiamine from food, not from gut bacteria. This interaction is rated insignificant, so most patients taking this antibiotic do not need to worry about it or take a supplement unless their doctor or pharmacist advises otherwise.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Azithromycin
Insignificant DepletionBrand names include Zithromax, Zmax, Azasite
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is a theoretical idea that azithromycin, like other antibiotics, could slightly reduce the friendly gut bacteria that produce small amounts of thiamine. In reality, we get most of our thiamine from food, not from gut bacteria, so this is rated as an insignificant concern. For a typical course of azithromycin, you do not need to worry about this or reach for a supplement, but your pharmacist is always happy to answer questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Aztreonam
Insignificant DepletionBrand names include Azactam
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Aztreonam, like other antibiotics, can disrupt the friendly bacteria that live in your gut, and those bacteria do produce small amounts of thiamine. That said, the vast majority of the thiamine your body uses comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No thiamine supplement is needed for this reason alone, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Bacampicillin
Insignificant DepletionBrand names include Penglobe
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Bacampicillin, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce small amounts of thiamine. That said, your body gets the vast majority of its thiamine from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for the typical person taking a short course of this antibiotic, but if you have concerns, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Bacitracin
Insignificant DepletionBrand names include Baci-IM, Bacitracin Ointment, Baciguent
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. In theory, bacitracin and other antibiotics could slightly reduce the friendly gut bacteria that help produce a small amount of thiamine, but here is the reassuring part: the vast majority of the thiamine your body needs comes from the food you eat, not from those bacteria. The evidence rates this as insignificant, so most people using bacitracin have nothing to worry about and do not need a thiamine supplement.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Benznidazole
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for converting food into energy and keeping your nerves working properly. Benznidazole, like other antibiotics, could theoretically reduce the friendly gut bacteria that produce small amounts of thiamine, but here is the reassuring part: we get the vast majority of our thiamine from food, not from gut bacteria, so this effect is not considered clinically meaningful. For most people taking benznidazole, no thiamine supplement is needed. If you have any concerns about your nutrition during treatment, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Birth control pills
Insignificant DepletionSome studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Some early research suggested that birth control pills might interfere with how well your gut absorbs thiamine, and a few studies noticed slightly lower activity of a thiamine-dependent enzyme in pill users. That said, other studies found no difference at all, and this is officially rated as an insignificant concern, meaning most people on the pill have nothing to worry about here. No routine supplement is needed, but if you ever have questions about your nutrition while on hormonal contraceptives, your pharmacist or doctor is a great starting point.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Bismuth Subsalicylate, Metronidazole, Tetracycline
Insignificant DepletionBrand names include Helidac
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical concern that antibiotics like metronidazole and tetracycline can disrupt the natural bacteria living in your gut, and those bacteria do produce small amounts of thiamine. In practice, though, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so this combination is rated as an insignificant depletion. For a standard course of this triple therapy, most people do not need a thiamine supplement, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Bismuth Subsalicylate, Metronidazole, Tetracycline →
Capreomycin
Insignificant DepletionBrand names include Capastat
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Because capreomycin is an antibiotic, there is a theoretical concern that it could disrupt the friendly bacteria in your gut that make small amounts of thiamine, which might nudge absorption down a little. That said, most of what your body needs comes from food, not gut bacteria, so this is considered insignificant for the vast majority of people. No supplement is needed for most patients taking capreomycin, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Carbenicillin Indanyl Sodium
Insignificant DepletionBrand names include Geocillin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for turning food into energy and keeping your nerves working properly. Carbenicillin indanyl sodium is an antibiotic, and antibiotics can theoretically shift the balance of bacteria living in your gut, which in turn could reduce how much thiamine those bacteria produce. In practice, though, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so this interaction is considered insignificant for most people. No thiamine supplement is needed for the typical course of this antibiotic, but if you have questions about your nutrition while taking it, your pharmacist or doctor is always a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefaclor
Insignificant DepletionBrand names include Ceclor CD, Ceclor
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cefaclor, like other antibiotics, can disrupt the helpful bacteria that normally live in your gut, and those bacteria do produce a small amount of thiamine. The catch is that most of the thiamine your body uses comes from the food you eat, not from gut bacteria, so this is considered an insignificant effect for the vast majority of people. No supplement is typically needed for a short course of cefaclor, but if you have concerns, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefadroxil
Insignificant DepletionBrand names include Duricef, Ultracef, Cef-Tab
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cefadroxil, like other antibiotics, can temporarily disrupt the helpful bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine your body uses comes straight from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed, but if you have questions about your nutrition while on an antibiotic, your pharmacist is always a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefamandole
Insignificant DepletionBrand names include Mandol
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Cefamandole, like other antibiotics, can temporarily disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because most of the thiamine your body needs comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people. No supplement is needed for the typical short course of this antibiotic, but if you have concerns, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefazolin
Insignificant DepletionBrand names include Ancef
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cefazolin, like other antibiotics, could theoretically reduce the helpful bacteria in your gut that produce small amounts of thiamine, but here is the reassuring part: most of what you need comes from food, not those bacteria. For the vast majority of patients taking this antibiotic, this is considered an insignificant concern and no supplement is needed. If you have questions about your nutrition during antibiotic treatment, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefdinir
Insignificant DepletionBrand names include Omnicef
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is a theoretical idea that cefdinir, like other antibiotics, could slightly reduce the helpful gut bacteria that make small amounts of thiamine, but here is the reassuring part: your diet supplies the vast majority of the thiamine you need, not those bacteria. The evidence rates this as insignificant, meaning most people taking a short course of cefdinir do not need to take a thiamine supplement. If you have any concerns, your pharmacist or doctor can give you personalized guidance.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefditoren Pivoxil
Insignificant DepletionBrand names include Spectracef
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. When you take an antibiotic like cefditoren pivoxil, it can disrupt the bacteria that normally live in your gut, and those bacteria do produce a small amount of thiamine. That said, most of the thiamine your body needs comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for the vast majority of people on a short antibiotic course. No supplement is needed, but if you have concerns about your nutrition, your pharmacist or doctor is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefepime
Insignificant DepletionBrand names include Maxipime
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Cefepime, like other antibiotics, can theoretically shift the balance of bacteria in your gut, and those bacteria do produce a small amount of thiamine. That said, your body gets the vast majority of its thiamine from food, not from gut bacteria, so this is considered an insignificant depletion and most people taking cefepime have nothing to worry about. No supplement is needed for most patients, but if you have questions about your nutrition while on an antibiotic, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefiderocol Sulfate Tosylate
Insignificant DepletionBrand names include Fetroja
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Cefiderocol, like other antibiotics, can disrupt the helpful bacteria that normally live in your gut, and those bacteria do produce a small amount of thiamine. That said, your body gets the vast majority of its thiamine from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No thiamine supplement is needed for most patients, but if you have any concerns, your pharmacist or doctor can help you sort it out.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefixime
Insignificant DepletionBrand names include Suprax
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body counts on for turning food into energy and keeping your nerves working properly. Because cefixime is an antibiotic, it can change the mix of bacteria living in your gut, and those bacteria normally make a small amount of thiamine. The key word there is 'small,' since most of the thiamine you need comes from what you eat, not from gut bacteria. For most people taking a course of cefixime, this is not a practical concern, and no supplement is needed unless your doctor or pharmacist tells you otherwise.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefmetazole
Insignificant DepletionBrand names include Zefazone
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for turning food into energy and keeping your nerves working properly. Cefmetazole, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The catch is that most of the thiamine your body needs comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for this one, but if you have concerns about your diet or your antibiotic course, your pharmacist is always a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefonicid
Insignificant DepletionBrand names include Monocid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Cefonicid, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, your diet supplies the vast majority of your daily thiamine, so any effect from this antibiotic is considered insignificant for most people. No supplement is generally needed, but if you have questions about your nutrition while on any antibiotic, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefoperazone
Insignificant DepletionBrand names include Cefobid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Cefoperazone, like other antibiotics, can alter the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, most of the thiamine your body needs comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for the vast majority of patients. No supplement is needed for most people taking this antibiotic, but if you have concerns, your pharmacist or doctor is a great person to check with.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefotaxime
Insignificant DepletionBrand names include Claforan
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cefotaxime and other antibiotics can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, most of the thiamine your body uses every day comes from the food you eat, so losing that bacterial contribution is not considered meaningful in practice. For most people taking this antibiotic, no supplement is needed, but feel free to mention it to your pharmacist if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefotetan
Insignificant DepletionBrand names include Cefotan
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Cefotetan, like other antibiotics, can temporarily disrupt the helpful bacteria living in your gut, and those bacteria do produce small amounts of thiamine. That said, the vast majority of the thiamine your body needs comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed for a typical course of this antibiotic, but if you have questions or concerns, your pharmacist is always a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefoxitin
Insignificant DepletionBrand names include Mefoxin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Cefoxitin, like other antibiotics, can disrupt the helpful bacteria that live in your gut, and those bacteria do make a small amount of thiamine. That said, your body gets the vast majority of the thiamine it needs from the food you eat, not from gut bacteria, so this is considered an insignificant depletion. For most people taking cefoxitin, no extra thiamine is needed, but feel free to mention it to your pharmacist or doctor if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefpodoxime Proxetil
Insignificant DepletionBrand names include Vantin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like cefpodoxime proxetil could slightly reduce the helpful bacteria in your gut that make small amounts of thiamine, but the reality is that most of what you need comes from the food you eat every day, not from gut bacteria. For a short antibiotic course, this is considered an insignificant concern, so no extra thiamine is needed for most people. Just keep eating a balanced diet, and if you have any questions, your pharmacist is happy to help.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefprozil
Insignificant DepletionBrand names include Cefzil
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Cefprozil, like other antibiotics, can temporarily change the balance of bacteria living in your gut, and those bacteria do help produce small amounts of thiamine. That said, the vast majority of the thiamine your body needs comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people taking a short antibiotic course. No supplement is needed, but if you have any concerns, your pharmacist or doctor is always a good sounding board.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ceftazidime
Insignificant DepletionBrand names include Fortaz, Tazidime, Ceptaz
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. Ceftazidime, like other antibiotics, can alter the natural bacteria living in your gut, and those bacteria do contribute a small amount of thiamine. That said, since most of the thiamine your body uses comes from food rather than gut bacteria, this interaction is considered insignificant for most people. No supplement is generally needed, but if you have concerns about your diet or nutritional status, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ceftibuten
Insignificant DepletionBrand names include Cedax
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Ceftibuten, like other antibiotics, can temporarily shift the balance of bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, the bulk of your daily thiamine comes from food, not gut bacteria, so this is considered an insignificant effect and supplements are not needed for most people taking this antibiotic.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ceftizoxime
Insignificant DepletionBrand names include Cefizox
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Ceftizoxime, like other antibiotics, can temporarily disrupt the friendly bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine you need comes straight from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is typically needed, but if you have questions about your nutrition while on an antibiotic, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ceftolozane Sulfate, Tazobactam Sodium
Insignificant DepletionBrand names include Zerbaxa
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. In theory, antibiotics like ceftolozane/tazobactam can disturb the normal bacteria living in your gut, and those bacteria do produce small amounts of thiamine. The key word, though, is small: most of the thiamine your body uses comes straight from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed, but if you have questions or concerns about your nutrition during treatment, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Ceftolozane Sulfate, Tazobactam Sodium →
Ceftriaxone
Insignificant DepletionBrand names include Rocephin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Ceftriaxone is an antibiotic, and antibiotics can disrupt the natural bacteria living in your gut. Those bacteria do make a small amount of thiamine, so in theory there could be a slight reduction. In practice, though, almost all the thiamine your body needs comes straight from what you eat, so this is considered insignificant for most patients and no supplement is needed.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cefuroxime
Insignificant DepletionBrand names include Ceftin, Kefurox, Zinacef
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cefuroxime, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so this interaction is considered insignificant for most people. No supplement is typically needed for a short course of this antibiotic, but if you have questions about your diet or nutrition while taking it, your pharmacist is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cephalexin
Insignificant DepletionBrand names include Keflex, Keftab, Cephalex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that cephalexin, like other antibiotics, could slightly reduce the amount of thiamine your gut bacteria produce, but the thing is, your diet supplies the vast majority of the thiamine you need anyway, so that small bacterial contribution barely registers. For most people taking a short course of cephalexin, this is not something to worry about, and a thiamine supplement is not considered necessary. That said, if you ever have questions about your nutrition while on an antibiotic, your pharmacist is always a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cephapirin
Insignificant DepletionBrand names include Cefadyl
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Cephapirin, like other antibiotics, can alter the friendly bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine you need comes straight from the food you eat, so this effect is considered insignificant for most people. No supplement is needed for a typical course of this antibiotic, but if you have any concerns, a quick chat with your pharmacist is always a good idea.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cephradine
Insignificant DepletionBrand names include Velosef, Anspor
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Cephradine, like other antibiotics, can temporarily disrupt the friendly bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, most of your daily thiamine comes from food rather than gut bacteria, so this connection is considered insignificant for the vast majority of people. No supplement is needed for most patients taking this antibiotic, but if you have questions about your diet or nutrition, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Chloramphenicol
Insignificant DepletionBrand names include Chloromycetin, Chloromycetin Ophthalmic, Chloromycetin Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body counts on for turning food into energy and keeping your nerves working properly. Chloramphenicol is an antibiotic, and like other antibiotics it can disrupt the helpful bacteria living in your gut, which normally produce small amounts of thiamine. That sounds concerning, but here is the reassuring part: you get the vast majority of your thiamine from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is typically needed, but if you have questions about your diet or how you are feeling while on this medication, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Chlortetracycline
Insignificant DepletionBrand names include Aureomycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for turning food into energy and keeping your nerves working properly. There is a theoretical idea that chlortetracycline, like other antibiotics, could reduce the small amount of thiamine that gut bacteria naturally produce, but here is the reassuring part: nearly all the thiamine your body needs comes from food, not from those bacteria. The evidence rates this as insignificant, so most people taking this antibiotic do not need to worry about thiamine or take a supplement because of it.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cinoxacin
Insignificant DepletionBrand names include Cinobac
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cinoxacin is an antibiotic, and antibiotics can theoretically shift the natural bacteria living in your gut, which normally produce small amounts of thiamine. In practice, though, we get most of our thiamine from the food we eat rather than from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed, but if you have questions about your diet or nutrition while taking any antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ciprofloxacin
Insignificant DepletionBrand names include Cipro, Ciprobay, Cipro XR
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Ciprofloxacin, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine you need comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for most patients taking ciprofloxacin, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Clarithromycin
Insignificant DepletionBrand names include Biaxin, Biaxin XL
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Clarithromycin, like other antibiotics, can temporarily shift the balance of bacteria living in your gut, and those bacteria do produce small amounts of thiamine. The thing is, your body gets the vast majority of its thiamine from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for a typical course of this antibiotic, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Clinafloxacin
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like clinafloxacin could slightly reduce thiamine levels by disrupting the gut bacteria that produce small amounts of it, but here is the reassuring part: most of the thiamine your body uses comes from the food you eat, not from gut bacteria. This is rated as insignificant, so the vast majority of people taking clinafloxacin do not need a thiamine supplement. If you still have questions, your pharmacist is always a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Clindamycin
Insignificant DepletionBrand names include Cleocin, Dalacin C, Cleocin T Gel
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Clindamycin, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce small amounts of thiamine. That said, your gut bacteria contribute very little to your overall thiamine supply since most of it comes straight from the foods you eat, so this interaction is considered insignificant for most people. No supplement is typically needed, but if you have questions about your diet or notice unusual fatigue, it is always fine to mention it to your pharmacist or doctor.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Clofazimine
Insignificant DepletionBrand names include Lamprene
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Clofazimine is an antibiotic, and like other antibiotics it can alter the natural bacteria living in your gut, which normally produce small amounts of thiamine. That said, because most of your daily thiamine comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people. No routine supplement is needed, but if you have any concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cloxacillin Sodium
Insignificant DepletionBrand names include Tegopen, Cloxi, Cloxapen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like cloxacillin could reduce thiamine levels by disrupting the gut bacteria that make small amounts of it, but here is the reassuring part: most of your thiamine comes from food, not from those bacteria. This interaction is rated insignificant, so the vast majority of people taking cloxacillin do not need a supplement for this reason.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Colistimethate
Insignificant DepletionBrand names include Coly-Mycin M
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for turning food into energy and keeping your nervous system working properly. Colistimethate is an antibiotic, and like other antibiotics it can disrupt the natural bacteria living in your gut, which do produce a small amount of thiamine. That said, because most of the thiamine your body needs comes from what you eat rather than from gut bacteria, any effect here is considered insignificant. For most people taking this medication, no extra thiamine is needed, but feel free to mention it to your pharmacist or doctor if you have concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cyclacillin
Insignificant DepletionBrand names include Cyclapen-W, Cylcapen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for energy production and healthy nerve function. Cyclacillin, like other antibiotics, can disrupt the helpful bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine your body needs comes straight from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is typically needed, but feel free to mention it to your pharmacist or doctor if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Cycloserine
Insignificant DepletionBrand names include Seromycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Cycloserine, like other antibiotics, can alter the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because we get the vast majority of our thiamine straight from the food we eat, this effect is considered insignificant for most people. No supplement is generally needed, but if you have questions about your nutrition while taking cycloserine, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Dalbavancin Hydrochloride
Insignificant DepletionBrand names include Dalvance
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like dalbavancin could slightly reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: your body gets the vast majority of its thiamine from the food you eat, not from bacteria in your gut. For this reason, the evidence rates this as insignificant, and most people receiving dalbavancin do not need to take a thiamine supplement. If you have questions or any concerns about your nutrition during treatment, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Dapsone
Insignificant DepletionBrand names include Avlosulfon, Aczone
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Dapsone is an antibiotic, and there is a theoretical idea that antibiotics can slightly reduce the amount of thiamine gut bacteria produce. In practice, though, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so this concern is not considered clinically meaningful for most people taking dapsone. No supplement is typically needed, but feel free to mention it to your pharmacist or doctor if you have any questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Daptomycin
Insignificant DepletionBrand names include Cubicin, Dapzura RT
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Like other antibiotics, daptomycin may slightly shift the balance of bacteria living in your gut, and since those bacteria produce small amounts of thiamine, there is a theoretical question about whether levels could dip. In practice, because we get the vast majority of our thiamine from food rather than from gut bacteria, this is not considered clinically meaningful for most people. No supplement is needed, but if you ever have questions about your diet or vitamin intake while on antibiotics, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Demeclocycline
Insignificant DepletionBrand names include Declomycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Demeclocycline, like other antibiotics, can alter the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The key word there is small: because most of the thiamine your body needs comes from the food you eat, not from gut bacteria, this interaction is considered insignificant for most people. No supplement is needed for the typical patient, but if you have questions or eat a very limited diet, it is always fine to bring it up with your pharmacist.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Desogestrel, Ethinyl Estradiol
Insignificant DepletionBrand names include Ortho-Cept 28, Ortho-Cept 21, Marvelon 21
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some older research suggesting that oral contraceptives like this one might slightly interfere with how well the gut absorbs thiamine, but follow-up studies have not consistently shown a real problem. Given the insignificant rating here, most people taking this pill do not need a thiamine supplement. If you are curious about your vitamin levels or eat a very limited diet, it is worth a quick chat with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Dicloxacillin Injection
Insignificant DepletionBrand names include Dynapen Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like dicloxacillin could slightly reduce the amount of thiamine-producing bacteria in your gut, but here is the reassuring part: your diet supplies the vast majority of the thiamine your body needs, so this bacterial change is unlikely to matter in practice. For most people receiving this antibiotic, no thiamine supplement is needed. If you have concerns about your nutrition during treatment, your pharmacist or doctor is always a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Dicloxacillin Sodium
Insignificant DepletionBrand names include Dynapen, Pathocil, Dycill
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. In theory, dicloxacillin and other antibiotics could slightly reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: your body gets almost all the thiamine it needs from food anyway, not from bacteria in your gut. For a short course of this antibiotic, this is not considered a real concern for most people, and routine thiamine supplements are not expected to be necessary.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Dirithromycin
Insignificant DepletionBrand names include Dynabac
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Dirithromycin, like other antibiotics, can temporarily shift the balance of bacteria in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine your body needs comes from the food you eat, not from gut bacteria, so any effect here is considered insignificant. Most people taking this antibiotic do not need a thiamine supplement, but if you have questions about your diet or nutrition during treatment, your pharmacist is a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Doripenem
Insignificant DepletionBrand names include Doribax
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Because doripenem is an antibiotic, it can temporarily disrupt the helpful bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the overwhelming majority of the thiamine your body needs comes from the food you eat, not from gut bacteria, so this is considered an insignificant concern. Most people taking doripenem do not need a thiamine supplement, but if you have questions about your nutrition during treatment, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Doxycycline
Insignificant DepletionBrand names include Vibra-Tabs, Vibramycin, Doryx
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Doxycycline, like other antibiotics, can shift the balance of bacteria living in your gut, and those bacteria do produce small amounts of thiamine. That said, the vast majority of the thiamine you need comes from what you eat, not from gut bacteria, so this is considered an insignificant concern. Most people taking doxycycline have no reason to worry about thiamine levels, but if you have questions about your diet or take doxycycline long-term, your pharmacist is a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Doxycycline Hyclate
Insignificant DepletionBrand names include Acticlate, Acticlate Cap, Lymepak
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Doxycycline, like other antibiotics, can alter the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. Even so, the vast majority of the thiamine your body uses comes from what you eat, so this effect is considered insignificant for most people. There is really no reason to worry or reach for a supplement unless your doctor or pharmacist advises otherwise.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Doxycycline monohydrate
Insignificant DepletionBrand names include Erfacea
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is some theoretical concern that doxycycline, like other antibiotics, could slightly reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: most of your thiamine comes from the food you eat, not from gut bacteria, so any effect is unlikely to matter in practice. For most people taking doxycycline, this is considered an insignificant concern and no supplement is needed. That said, if you have questions about your diet or nutrient levels, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Doxycyline
Insignificant DepletionBrand names include Doxychel
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Doxycycline, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The thing is, the vast majority of the thiamine your body uses comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for a typical course of doxycycline, but if you have questions specific to your situation, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Drospirenone
Insignificant DepletionSome studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is some older research suggesting that oral contraceptives like drospirenone might slightly reduce how well the gut absorbs thiamine, but other studies found no difference at all. Given the insignificant rating here, this is not something most people taking drospirenone need to worry about in practice. If you have any concerns, your pharmacist or doctor can help you sort out whether anything extra is needed for your situation.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Drospirenone, Estetrol
Insignificant DepletionBrand names include Nextstellis
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some older research suggesting that oral contraceptives like this one might slightly reduce how much thiamine the gut absorbs, but other studies found no difference at all. Given the mixed and limited evidence, this is considered an insignificant concern for most people, and routine thiamine supplements are not recommended just because you take this medication. If you are ever curious about your nutrient levels, your pharmacist or doctor is a good person to ask.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Drospirenone, Ethinyl Estradiol
Insignificant DepletionBrand names include Yasmin, Gianvi, Angeliq
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep nerves working properly. Some early research suggested that combination birth control pills like this one might slightly reduce how well the gut absorbs thiamine, though other studies found no difference at all. Given the conflicting evidence and the insignificant rating, this is not something most people taking this medication need to worry about. If you have concerns or eat a very limited diet, your pharmacist or doctor can help you decide whether anything extra is needed.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
drospirenone, ethinyl estradiol, levomefolate
Insignificant DepletionBrand names include Beyaz
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Some research found a slight drop in thiamine-related enzyme activity in people taking oral contraceptives, which suggested a possible link to mild thiamine reduction, but other studies found no difference at all. Given that the evidence is mixed and the rating here is insignificant, most people taking this pill do not need a thiamine supplement. If you have concerns or eat a very limited diet, a quick chat with your pharmacist or doctor can put your mind at ease.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for drospirenone, ethinyl estradiol, levomefolate →
Enoxacin
Insignificant DepletionBrand names include Penetrex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Enoxacin is an antibiotic, and like other antibiotics it can disrupt the normal bacteria living in your gut, which do produce a small amount of thiamine. That said, most of what your body needs comes straight from the food you eat, not from gut bacteria, so this is considered an insignificant concern for most people. No supplement is needed, but if you have questions about your diet or overall nutrition while taking this medication, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ertapenem
Insignificant DepletionBrand names include Invanz
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Because ertapenem is an antibiotic, it can disrupt the helpful bacteria that normally live in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine your body uses comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed, but if you have any concerns, your pharmacist or doctor is the right person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Erythromycin
Insignificant DepletionBrand names include Erythro S, PCE, E-Mycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body counts on for turning food into energy and keeping nerves working properly. There is some theoretical concern that erythromycin, like other antibiotics, could slightly reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: your diet provides the vast majority of the thiamine your body needs, so any shift in bacterial production is unlikely to matter much. For most people taking a course of erythromycin, this is not something to worry about or act on. That said, if you have any concerns about your nutrition while on an antibiotic, your pharmacist or doctor is always a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Erythromycin Ethylsuccinate
Insignificant DepletionBrand names include E.E.S. 400, E.E.S. Chewable, Wyamycin S
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like erythromycin ethylsuccinate might slightly reduce the good bacteria in your gut that help produce small amounts of thiamine, but here is the reassuring part: the vast majority of the thiamine you need comes from the food you eat, not from gut bacteria. The evidence rates this as insignificant, so most people taking this antibiotic do not need to take a thiamine supplement. If you have concerns, your pharmacist or doctor is always a good person to check with.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Erythromycin Ethylsuccinate, Sulfisoxazole
Insignificant DepletionBrand names include Pediazole
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is a theoretical concern that antibiotics like this combination product could reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: you get the vast majority of your thiamine from food, not from bacteria in your intestines, so this effect is considered clinically insignificant. For a typical short course of this antibiotic, most people do not need to take a thiamine supplement. If you have any concerns or are on a very restricted diet, it is worth a quick conversation with your pharmacist.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Erythromycin Ethylsuccinate, Sulfisoxazole →
Erythromycin Gluceptate
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is a theoretical idea that erythromycin, like other antibiotics, could slightly reduce the friendly gut bacteria that make small amounts of thiamine. In practice, though, we get most of our thiamine from food, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed, but if you ever have questions about your nutrition while on antibiotics, your pharmacist or doctor is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Erythromycin Lactobionate
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theory that erythromycin, like other antibiotics, could slightly reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: we get most of our thiamine from food, not from those bacteria, so this is considered an insignificant concern. Most people taking this antibiotic do not need to worry about or add a thiamine supplement. If you still have questions, your pharmacist is happy to talk it through with you.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Erythromycin Stearate
Insignificant DepletionBrand names include Erythro-S, Erythrocin, Ethril
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Erythromycin, like other antibiotics, can shift the balance of bacteria living in your gut, and those bacteria do contribute a small amount of thiamine. That said, most of what we need comes straight from the food we eat, so any effect here is considered insignificant for the vast majority of people. No supplement is needed for most patients taking this antibiotic, but if you have questions about your nutrition, your pharmacist or doctor is a great starting point.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Erythromycin, Sulfisoxazole
Insignificant DepletionBrand names include Eryzole
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like erythromycin and sulfisoxazole could slightly reduce thiamine by disrupting the friendly bacteria in your gut that produce small amounts of it. In practice, though, most of what your body needs comes from food, so this effect is considered insignificant for most people taking this combination. No supplement is generally needed, but if you have concerns, your pharmacist or doctor is happy to talk it through.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ethiny Estradiol, Levonorgestrel
Insignificant DepletionBrand names include Logynon, Microgynon 30 ED
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Some early research suggested that hormonal birth control pills like this one might slightly reduce how well the gut absorbs thiamine, and a few studies noticed a small drop in the activity of a thiamine-dependent enzyme in women taking oral contraceptives. The evidence is mixed though, and this is considered insignificant for most people, meaning no supplement is typically needed. If you have any concerns about your nutrition while on the pill, it is always worth a quick conversation with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethinyl Estradiol, Desogestrel
Insignificant DepletionBrand names include Linessa, Apri, Reclipsen
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is some early lab research suggesting that birth control pills like this one might slightly reduce how well your body uses thiamine, possibly by interfering with absorption in the gut, but the evidence is mixed and the effect, if any, appears to be very small. Most people taking this combination do not need a thiamine supplement, and current guidance does not recommend one routinely. That said, if you have questions about your nutrition while on hormonal contraceptives, your pharmacist or doctor is the right person to ask.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethinyl Estradiol, Drospirenone
Insignificant DepletionBrand names include Yaz
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Birth control pills containing ethinyl estradiol and drospirenone may slightly reduce how well thiamine is absorbed in the gut, though the research on this is genuinely mixed and the overall effect appears very small. For most people on this pill, this is not something to worry about or act on. If you have concerns, your pharmacist or doctor can help you decide whether anything needs to be done.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethinyl Estradiol, Ethynodiol Diacetate
Insignificant DepletionBrand names include Demulen 1/35, Zovia 1/35, Demulen Compack
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. This oral contraceptive combination may theoretically interfere with how well your gut absorbs thiamine, and a handful of studies have picked up a small dip in the activity of a thiamine-dependent enzyme in women taking the pill. That said, other studies found no change at all, and the overall evidence rates this as insignificant for most people. No routine supplement is needed, but if you ever have questions about your nutritional status while on hormonal birth control, your pharmacist or doctor is a great first stop.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Ethinyl Estradiol, Ethynodiol Diacetate →
Ethinyl estradiol, Levonogestrel
Insignificant DepletionBrand names include Lybrel
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Some early research hinted that birth control pills containing estrogen might slightly reduce how well the gut absorbs thiamine, but other studies found no difference at all. Given the mixed and limited evidence, this is considered an insignificant concern for most people on the pill, meaning routine thiamine supplements are not something most users need to worry about. That said, if you have questions about your nutrition while on hormonal contraceptives, your pharmacist or doctor is a great place to start.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethinyl Estradiol, Levonorgestrel
Insignificant DepletionBrand names include Levlite 28, Tri-Levlen 21, Tri-Levlen 28
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Some early research found that oral contraceptives like this one might slightly reduce how well the body absorbs or uses thiamine, possibly by interfering with certain enzyme activity in red blood cells, though other studies found no difference at all. Given that the evidence is mixed and the effect appears small, most people taking this medication do not need to worry about thiamine or take a supplement for it. If you have questions about your specific situation, your pharmacist or doctor is a great person to ask.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Ethinyl Estradiol, Levonorgestrel →
Ethinyl Estradiol, Norethindrone
Insignificant DepletionBrand names include Femhrt, Loestrin 21, Ovcon 35 21
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Birth control pills containing estrogen and progestin, like this combination, may slightly reduce how well the gut absorbs thiamine, though the research is honestly mixed and the effect appears very small. For most people on oral contraceptives, this is not something to worry about, and a thiamine supplement is not routinely needed. If you have questions or eat a very limited diet, it is worth a quick conversation with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
Insignificant DepletionBrand names include Estrostep Fe, Loestrin Fe, Microgestin FE
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some older research suggesting that oral contraceptives like this one might slightly reduce how well thiamine is absorbed in the gut, but other studies found no difference at all. Given that rating of insignificant depletion, most people taking this pill do not need a thiamine supplement. If you have any concerns, your pharmacist or doctor is a good person to check in with.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Ethinyl Estradiol, Norethindrone, Ferrous Fumarate →
Ethinyl Estradiol, Norgestimate
Insignificant DepletionBrand names include Ortho Tri-Cyclen 28, Ortho Tri-Cyclen Lo, Ortho-Cyclen
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is some early research suggesting that birth control pills might slightly reduce how well the gut absorbs thiamine, and a few studies found a small dip in activity of a thiamine-dependent enzyme in women on oral contraceptives. That said, the evidence is mixed and the effect, if it exists at all, appears too small to matter for most people. For now, routine supplementation is not considered necessary, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great resource.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethinyl Estradiol, Norgestrel
Insignificant DepletionBrand names include Ovral, Lo/Ovral, Cryselle
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Some early research hinted that birth control pills like this one might slightly reduce how well the gut absorbs thiamine, though the evidence is mixed and other studies found no difference at all. Because the overall effect appears to be very small, most people taking this medication do not need to add a thiamine supplement. If you have concerns or eat a diet that is already low in B vitamins, it is worth mentioning to your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ethynodiol Diacetate, Mestranol
Insignificant DepletionBrand names include Ovulen
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. This oral contraceptive may theoretically interfere with how the gut absorbs thiamine, and a handful of studies have picked up a small drop in the activity of a thiamine-dependent enzyme in women taking the pill, though other studies found no change at all. Given the conflicting and limited evidence, this is considered an insignificant depletion for most people, meaning routine supplementation is not expected to be necessary. That said, if you have any concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Etonogestrel
Insignificant DepletionBrand names include Implanon
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is some early research suggesting that hormonal contraceptives like etonogestrel might slightly reduce how well the gut absorbs thiamine, but other studies found no difference at all. Given that the evidence is mixed and the rating here is insignificant, most people using etonogestrel have no reason to worry about this or to add a thiamine supplement. If you have concerns, it is always fine to bring them up with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Etonogestrel, Ethinyl Estradiol
Insignificant DepletionBrand names include NuvaRing
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Some early research noticed a slight drop in thiamine-related enzyme activity in people using hormonal contraceptives like this one, possibly because the hormones may interfere a little with how thiamine is absorbed in the gut. That said, the evidence is mixed and the effect appears too small to matter for most people. This is rated insignificant, so routine supplementation is not considered necessary, but if you ever have questions about your nutrient levels, your pharmacist or doctor is a great starting point.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Fidaxomicin
Insignificant DepletionBrand names include Dificid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Fidaxomicin works mainly in the gut, and like most antibiotics, it can theoretically affect the bacteria in your intestines that produce small amounts of thiamine. That said, the vast majority of the thiamine your body uses comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed for this, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Finafloxacin
Insignificant DepletionBrand names include Xtoro
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses for energy production and healthy nerve function. Like other antibiotics, finafloxacin could theoretically affect the gut bacteria that produce small amounts of thiamine, but here is the reassuring part: you get the vast majority of your thiamine from food, not from those bacteria. For most people taking this antibiotic, this is considered an insignificant concern and no supplement is needed. That said, if you ever have questions about your diet or nutrient levels, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Flucloxacillin
Insignificant DepletionBrand names include Staphylex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like flucloxacillin could slightly reduce the gut bacteria that produce small amounts of thiamine, but here is the reassuring part: most of the thiamine you need comes from the food you eat, not from those bacteria. This interaction is rated as insignificant, so for the vast majority of people taking a short course of flucloxacillin, no supplement is needed. If you have questions about your individual situation, your pharmacist is always a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Fosfomycin
Insignificant DepletionBrand names include Monurol
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Because fosfomycin is an antibiotic, there is a theoretical concern that it could slightly reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: your body gets the vast majority of its thiamine from the food you eat, not from those bacteria. For a short antibiotic course like fosfomycin, this is considered an insignificant concern, and most people have no reason to take a thiamine supplement because of it.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Furazolidone
Insignificant DepletionBrand names include Furoxone
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Furazolidone, like other antibiotics, can alter the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, the vast majority of the thiamine you need comes from the food you eat, so this interaction is considered insignificant for most people. No supplement is needed, but if you have questions about your diet or nutrition while taking this medication, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Gatifloxacin
Insignificant DepletionBrand names include Tequin, Tequin Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Gatifloxacin, like other antibiotics, can disrupt the friendly bacteria living in your gut, and those bacteria do make a small amount of thiamine. That said, you get the vast majority of your thiamine from the food you eat, so this effect is considered insignificant for most people. No supplement is needed for a typical course of this antibiotic, but if you have questions about your diet or a longer treatment, your pharmacist is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Gemifloxacin
Insignificant DepletionBrand names include Factive
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Gemifloxacin, like other antibiotics, can shift the balance of bacteria living in your gut, and those bacteria normally produce small amounts of thiamine. That sounds concerning, but here is the reassuring part: you get the vast majority of your thiamine from food, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed, but if you have questions about your diet or any symptoms, your pharmacist is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Gentamicin (IV)
Insignificant DepletionBrand names include Garamycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like gentamicin could slightly reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: we get the vast majority of our thiamine from food, not from those bacteria, so any effect is unlikely to matter in practice. The evidence rates this as insignificant, meaning most patients receiving gentamicin do not need a thiamine supplement because of it. If you have questions or eat a very limited diet, it is worth mentioning to your pharmacist or doctor.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Gestodene
Insignificant DepletionBrand names include Minesse
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some older research suggesting that oral contraceptives like gestodene might slightly interfere with how well the gut absorbs thiamine, though other studies found no difference at all. Because the evidence is mixed and the effect appears small, this is considered insignificant for most people taking this medication, and a routine thiamine supplement is not something you would typically need. If you have questions or eat a very limited diet, it is always fine to bring it up with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Grepafloxacin
Insignificant DepletionBrand names include Raxar
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on to convert food into energy and keep your nerves working properly. Like other antibiotics, grepafloxacin may slightly disrupt the friendly bacteria in your gut that produce small amounts of thiamine, but here is the reassuring part: your body gets the vast majority of its thiamine from food, not from those bacteria. Because of that, this interaction is considered insignificant for most people, and no supplement is needed. If you have specific concerns, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Imipenem, Cilastatin
Insignificant DepletionBrand names include Primaxin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Imipenem-cilastatin is an antibiotic, and like other antibiotics it can shift the natural bacteria living in your gut, which normally produce small amounts of thiamine. That said, because most of the thiamine your body needs comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people. No supplement is needed for the typical course of this medication, but if you have concerns your pharmacist or doctor is a great first call.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Imipenem, Cilastatin, Relebactam
Insignificant DepletionBrand names include Recarbrio
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. This antibiotic combination may, in theory, reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: we get the vast majority of our thiamine from food, not from bacteria in the gut. For most people taking this medication, that small shift is not considered clinically meaningful, and a thiamine supplement is not needed. If you have concerns, your pharmacist or doctor can give you personalized guidance.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Isoniazid, Rifampin
Insignificant DepletionBrand names include Rifamate
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. There is a theoretical idea that antibiotics like isoniazid and rifampin could slightly reduce the amount of thiamine bacteria in your gut normally produce, but here is the reassuring part: your diet, not your gut bacteria, supplies the vast majority of your daily thiamine anyway. The evidence rates this as insignificant, meaning most people on these medications do not need a thiamine supplement. No action is needed for most patients, but feel free to bring it up with your pharmacist or doctor if you have concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Kanamycin
Insignificant DepletionBrand names include Kantrex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Kanamycin is an antibiotic, and antibiotics can disrupt the bacteria that normally live in your gut, which do produce a small amount of thiamine. That said, we get the vast majority of our thiamine from the food we eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for most patients taking kanamycin, but if you have any concerns, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Lactic Acid, Citric Acid, Potassium Bitartrate
Insignificant DepletionBrand names include Phexxi
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. This contraceptive product has been linked theoretically to slightly lower thiamine absorption in the gut, and a handful of studies did spot a small change in a thiamine-dependent enzyme in women using oral contraceptives, though other studies found no difference at all. Given the insignificant rating here, this is not something most people need to worry about or act on. If you have any concerns, a quick chat with your pharmacist or doctor can put your mind at ease.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Lactic Acid, Citric Acid, Potassium Bitartrate →
Lansoprazole, Amoxicillin, Clarithromycin
Insignificant DepletionBrand names include Prevpac
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. In theory, antibiotics like amoxicillin and clarithromycin could slightly reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: your body gets the vast majority of its thiamine from the food you eat, not from those bacteria. Because of that, this combination is rated as insignificant, and for most people taking this short course of triple therapy, no thiamine supplement is needed. If you have any concerns, your pharmacist is always a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Lansoprazole, Amoxicillin, Clarithromycin →
Lefamulin Acetate
Insignificant DepletionBrand names include Xenleta
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Lefamulin is an antibiotic, and antibiotics can theoretically affect the gut bacteria that produce small amounts of thiamine. In practice, though, most of your daily thiamine comes from food rather than gut bacteria, so this interaction is considered insignificant for the majority of people. No supplement is generally needed for a short antibiotic course, but if you have any concerns, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Levofloxacin
Insignificant DepletionBrand names include Levaquin, Levaquin Injection, Leva-pak
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Levofloxacin, like other antibiotics, can disrupt the friendly bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The thing is, nearly all the thiamine your body needs comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for the typical course of this antibiotic, but if you have questions about your diet or nutritional needs, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Levofloxacin (ophthalmic)
Insignificant DepletionBrand names include Levofloxacin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. In theory, antibiotics can disrupt the friendly bacteria in your gut that produce small amounts of thiamine, but because you get the vast majority of your thiamine from food rather than from those bacteria, this is not considered a real-world concern. Using levofloxacin as an eye drop makes this even less of an issue, since almost none of it is absorbed into your body. For most people, no supplement is needed, but if you have questions your pharmacist is always happy to talk it through.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Levonorgestrel
Insignificant DepletionBrand names include Plan B, Mirena, Levonelle One Step
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine (vitamin B1) is something your body needs to convert food into energy, and it also keeps your nerves working properly. There is some theoretical concern that hormonal contraceptives like levonorgestrel could reduce how well the gut absorbs thiamine, and a few studies have picked up a small dip in thiamine-related enzyme activity in people taking oral contraceptives. That said, other studies found no change at all, and the overall evidence rates this as insignificant, meaning the great majority of people using levonorgestrel do not need to take a thiamine supplement. If you are still curious about your levels or have symptoms like unusual fatigue, it is always fine to bring it up with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Levonorgestrel, Ethinyl Estradiol
Insignificant DepletionBrand names include Nordette, Logynon ED, Microgynon 30
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some early lab research suggesting that oral contraceptives like this one might slightly reduce thiamine absorption in the gut, but the evidence is mixed and no clear effect has been proven. For most people taking this medication, this is not something to worry about, and routine supplementation is not considered necessary. That said, if you have questions about your diet or vitamin levels, your pharmacist or doctor is a great person to ask.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Levonorgestrel, Ethinyl Estradiol →
Lincomycin HCl
Insignificant DepletionBrand names include Lincocin, Lincorex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Lincomycin, like other antibiotics, can disrupt the natural bacteria that live in your gut, and those bacteria do make a small amount of thiamine. That said, the vast majority of the thiamine you need comes from the food on your plate, not from gut bacteria, so this is considered an insignificant concern for most people. No supplement is needed for most patients taking this medication, but if you ever have questions about your nutrition while on an antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Linezolid
Insignificant DepletionBrand names include Zyvox, Zyvox Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Linezolid, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because most of the thiamine you need each day comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people. No supplement is needed for a typical course of linezolid, but if you have any concerns, your pharmacist or doctor is a good first call.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Lomefloxacin
Insignificant DepletionBrand names include Maxaquin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Lomefloxacin, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine you need comes straight from the food you eat, so this effect is considered insignificant for most people. No supplement is needed for most patients taking this antibiotic, but if you have concerns, your pharmacist or doctor is the right person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Loracarbef
Insignificant DepletionBrand names include Lorabid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Loracarbef, like other antibiotics, can temporarily shift the balance of bacteria in your gut, and those bacteria do produce a small amount of thiamine. The thing is, most of the thiamine you need comes from the food you eat, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for a typical course of this antibiotic, but if you have questions about your diet or other health conditions, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Meropenem
Insignificant DepletionBrand names include Merrem IV
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Meropenem is an antibiotic, and antibiotics can disrupt the normal bacteria living in your gut, which do produce a small amount of thiamine. That said, the vast majority of the thiamine your body uses comes from the food you eat, not from gut bacteria, so this is considered an insignificant concern. Most people taking meropenem do not need a thiamine supplement, but feel free to mention it to your pharmacist or doctor if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Meropenem, Vaborbactam
Insignificant DepletionBrand names include Vabomere
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like meropenem/vaborbactam could reduce the helpful gut bacteria that make a small amount of thiamine, but here is the reassuring part: your diet, not those bacteria, supplies most of your thiamine each day. The evidence rates this as insignificant, meaning the vast majority of patients on this antibiotic have nothing to worry about here and do not need a supplement.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Mestranol, Norethindrone
Insignificant DepletionBrand names include Necon 1/50, Ortho Novum 21, Ortho-Novum 1/50-28
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is some older research suggesting that oral contraceptives like this one might slightly affect how well the body uses thiamine, possibly by nudging down the activity of a thiamine-dependent enzyme in red blood cells. Even so, the effect appears small and inconsistent across studies, so for most people taking this medication it is not considered a real concern. No routine supplement is needed, but if you ever have questions about your nutrition while on the pill, your pharmacist is a great first stop.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Mestranol, Norethynodrel
Insignificant DepletionBrand names include Enovid-E
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. There is some research suggesting that oral contraceptives like this one might slightly reduce how well the gut absorbs thiamine, but the studies are mixed and the effect, if it exists at all, appears to be very small. For most people taking this medication, a thiamine supplement is simply not needed. If you have concerns or eat a diet already low in B vitamins, it is worth mentioning to your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Methacycline
Insignificant DepletionBrand names include Rondomycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Methacycline, like other antibiotics, can alter the natural bacteria living in your gut, and those bacteria do make a small amount of thiamine. That said, the overwhelming majority of the thiamine you need comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed for most patients taking this antibiotic, but if you have questions about your diet or nutrition, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Methenamine Hippurate
Insignificant DepletionBrand names include Urex, Hiprex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Methenamine hippurate is a urinary antiseptic, and like other antibiotics it can affect the helpful bacteria living in your gut, which normally produce small amounts of thiamine. That said, because most of the thiamine your body needs comes from the food you eat rather than from gut bacteria, this interaction is considered insignificant for most people. No supplement is needed, but mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Methenamine Mandelate
Insignificant DepletionBrand names include Mandelamine, Methimazole
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Methenamine mandelate is an antibiotic, and there is a theoretical idea that antibiotics can reduce the amount of thiamine-producing bacteria in the gut, which could slightly affect how much thiamine your body gets. In practice, because most of your daily thiamine comes from food rather than gut bacteria, this interaction is considered insignificant for most people. No supplement is needed, but if you have questions about your diet or nutrition, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Methenamine Mandelate, Potassium Acid Phosphate
Insignificant DepletionBrand names include Thiacide
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like this one could slightly reduce the amount of thiamine gut bacteria produce, but here is the reassuring part: we get the vast majority of our thiamine from food, not from gut bacteria, so any effect is considered insignificant in practice. Most people taking this medication have no reason to worry about their thiamine levels or to reach for a supplement. If you have questions or have other reasons to be concerned about your nutrition, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Methenamine Mandelate, Potassium Acid Phosphate →
Methenamine Mandelate, Sodium Acid Phosphate
Insignificant DepletionBrand names include Uroquid-Acid No. 2
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. This medication is an antibiotic, and there is a theory that antibiotics can slightly reduce the amount of thiamine that friendly gut bacteria produce. In practice, though, your diet supplies the vast majority of your daily thiamine, so this effect is not considered clinically meaningful for most people. No supplement is typically needed, but feel free to mention it to your pharmacist or doctor if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Methenamine Mandelate, Sodium Acid Phosphate →
Methenamine, Phenyl Salicylate, Methylene Blue
Insignificant DepletionBrand names include Prosed DS
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. This combination medication contains a mild antibiotic component that could, in theory, reduce the helpful bacteria in your gut that produce small amounts of thiamine. In practice, though, your diet supplies the vast majority of the thiamine your body uses, so this bacterial change is unlikely to matter at all. The evidence rates this as insignificant, meaning most people on this medication have nothing to worry about, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Methenamine, Phenyl Salicylate, Methylene Blue →
Methenamine, Sodium Biphosphate
Insignificant DepletionBrand names include Uro-Phosphate
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Because methenamine with sodium biphosphate is an antibiotic, there is a theoretical idea that it could slightly reduce how much thiamine certain gut bacteria produce, but here is the reassuring part: we get the vast majority of our thiamine from food, not from bacteria, so this effect is considered insignificant for most people. No supplement is generally needed, but if you have questions about your diet or notice unusual fatigue, it is always fine to bring it up with your pharmacist or doctor.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Metronidazole
Insignificant DepletionBrand names include Flagyl, Protostat, Nidazol
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Metronidazole is an antibiotic, and like other antibiotics it can disrupt the helpful bacteria living in your gut, which do produce a small amount of thiamine. That said, the big picture here is reassuring: most of the thiamine you need comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for the vast majority of people. No supplement is needed for most patients taking metronidazole, but if you have questions about your diet or nutrient levels, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Metronidazole, Tetracyline, Bismuth Subcitrate Potassium
Insignificant DepletionBrand names include Pylera
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. In theory, the antibiotics in this triple-therapy combination could mildly reduce the amount of thiamine that gut bacteria normally produce, but here is the reassuring part: your body gets the vast majority of its thiamine from food anyway, not from bacteria in your gut. Given the insignificant rating on this interaction, most people taking this short course of therapy do not need to worry about thiamine at all, but feel free to mention it to your pharmacist if you have concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Metronidazole, Tetracyline, Bismuth Subcitrate Potassium →
Mezlocillin
Insignificant DepletionBrand names include Mezlin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Mezlocillin, like other antibiotics, can shift the balance of bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The key word there is small, because most of the thiamine you need comes straight from the food you eat, not from gut bacteria. The evidence rates this as insignificant, so the vast majority of people taking mezlocillin have nothing to worry about here, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Minocycline
Insignificant DepletionBrand names include Vectrin, Dynacin, Minocin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Minocycline, like other antibiotics, can disrupt the helpful bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, most of the thiamine you need comes from the food on your plate, so any impact from this antibiotic is considered insignificant for most people. No supplement is generally needed, but if you have concerns, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Minocycline Hydrochloride
Insignificant DepletionBrand names include Ximino, Minolira
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Minocycline, like other antibiotics, can disrupt the friendly bacteria that live in your gut, and those bacteria do make a small amount of thiamine. That said, the great majority of the thiamine you need comes straight from the food you eat, not from gut bacteria, so any effect here is considered insignificant. Most people taking minocycline have nothing to worry about on this front, but feel free to mention it to your pharmacist if you have broader concerns about your diet.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Moxifloxacin
Insignificant DepletionBrand names include Avelox
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Moxifloxacin, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, the vast majority of the thiamine your body uses comes straight from the food you eat, so this effect is considered insignificant and supplements are not needed for most people taking this antibiotic. No action is required, but if you ever have questions about your nutrition while on an antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Nafcillin
Insignificant DepletionBrand names include Nallpen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Because nafcillin is an antibiotic, there is a theoretical idea that it could reduce the helpful gut bacteria that produce small amounts of thiamine. In practice, though, you get the vast majority of your thiamine from food, so losing a bit of bacterial synthesis is not expected to matter. This is rated as insignificant, meaning most people taking nafcillin have no reason to worry about thiamine, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Nafcillin Sodium
Insignificant DepletionBrand names include Unipen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Nafcillin, like other antibiotics, can shift the balance of bacteria living in your gut, and those bacteria normally produce a small amount of thiamine. The key word there is small: the vast majority of the thiamine you need comes straight from the food you eat, so this effect is considered insignificant for most people. No supplement is needed, but if you have questions about your diet while on this antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Nalidixic Acid
Insignificant DepletionBrand names include NegGram
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is a theoretical idea that nalidixic acid, like other antibiotics, could slightly reduce the friendly bacteria in your gut that help make small amounts of thiamine. In practice, though, most of the thiamine your body uses comes from food, not gut bacteria, so this interaction is considered insignificant for the vast majority of people. No supplement is needed for most patients taking this antibiotic, but feel free to mention it to your pharmacist or doctor if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Neomycin
Insignificant DepletionBrand names include Mycifradin, Neo-Fradin, Myciguent
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Neomycin is an antibiotic taken by mouth, and like most oral antibiotics, it can disrupt the bacteria that normally live in your gut. Those gut bacteria produce a small amount of thiamine, so in theory that process could be interrupted. In practice, though, nearly all the thiamine your body uses comes straight from the food you eat, so this effect is considered insignificant for most people. No supplement is needed for this one, but if you ever have questions about your nutrition while on any antibiotic, your pharmacist is always a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Netilmicin
Insignificant DepletionBrand names include Netromycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Like most antibiotics, netilmicin may slightly disrupt the helpful bacteria in your gut that produce small amounts of thiamine, but here is the reassuring part: you get the vast majority of your thiamine from the food you eat, not from those bacteria. The evidence rates this as insignificant, so for most people taking netilmicin there is nothing extra to do, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Nitrofurantoin
Insignificant DepletionBrand names include Macrodantin, Furadantin, Furatoin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. There is a theoretical idea that nitrofurantoin, like other antibiotics, could slightly reduce the amount of thiamine gut bacteria produce, but here is the reassuring part: your diet supplies the vast majority of the thiamine you need each day, so any effect from bacterial changes in the gut is considered too small to matter clinically. For most people taking this antibiotic, no thiamine supplement is needed. If you have questions about your specific situation, your pharmacist or doctor is the best person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Norelgestromin, Ethinyl Estradiol
Insignificant DepletionBrand names include Ortho Evra, Evra
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Some research has hinted that hormonal contraceptives like this patch may slightly reduce how well the gut absorbs thiamine, though the findings across studies are mixed and the effect appears very small. For most people using this medication, there is no practical concern here and no reason to start a thiamine supplement on your own. If you are curious or have symptoms you are worried about, it is always worth a quick conversation with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Norelgestromin, Ethinyl Estradiol →
Norethindrone Acetate, Ethinyl Estradiol, Ferrous Fumarate
Insignificant DepletionBrand names include Minastrin 24 FE, LoMinastrin FE
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is some early research suggesting that oral contraceptives like this one might slightly reduce thiamine absorption in the gut, though other studies found no difference at all. The evidence here is really mixed and the rating is insignificant, meaning most people taking this medication have nothing to worry about and routine supplementation is not considered necessary. That said, if you ever have questions about your B vitamin levels, it is worth a quick conversation with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Norethindrone Acetate, Ethinyl Estradiol, Ferrous Fumarate →
Norfloxacin
Insignificant DepletionBrand names include Norflox, Noroxin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Norfloxacin, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. Here is the reassuring part, though: the vast majority of the thiamine you need comes from the food you eat, not from gut bacteria, so this antibiotic is very unlikely to cause any meaningful drop in your thiamine levels. For a short course of norfloxacin, most people do not need to take any extra thiamine, but feel free to mention it to your pharmacist if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Norgestrel
Insignificant DepletionBrand names include Ovrette, Orval 21
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some early research suggesting that hormonal contraceptives like norgestrel might slightly reduce how well the gut absorbs thiamine, but the studies are mixed and the effect, if it exists at all, appears to be very small. For most people taking norgestrel, this is not something to worry about or act on. If you have questions or concerns about your nutritional status, a quick chat with your pharmacist or doctor can put your mind at ease.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Ofloxacin
Insignificant DepletionBrand names include Oflox, Floxin, Floxin Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Ofloxacin, like other antibiotics, can disrupt the helpful bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because you get the vast majority of thiamine from the food you eat rather than from gut bacteria, this effect is considered insignificant. Most people taking ofloxacin have nothing to worry about here, but if you have questions about your diet or feel something is off, your pharmacist or doctor is a good first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Oritavancin Diphosphate
Insignificant DepletionBrand names include Orbactiv, Kimyrsa
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Oritavancin is an antibiotic, and antibiotics in general can shift the mix of bacteria living in your gut, which means slightly less thiamine gets made there. That said, your gut bacteria contribute only a small portion of your daily thiamine to begin with since most of it comes straight from the food you eat. This interaction is considered insignificant, and for the vast majority of people taking this medication no supplement is needed.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Oxacillin
Insignificant DepletionBrand names include Prostaphlin, Bactocill
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Oxacillin, like other antibiotics, can alter the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, most of what your body needs comes from food rather than gut bacteria, so this interaction is considered insignificant for the vast majority of people. No supplement is needed for most patients taking oxacillin, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Oxytetracycline
Insignificant DepletionBrand names include Terramycin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Oxytetracycline, like other antibiotics, can disrupt the friendly bacteria that normally live in your gut, and those bacteria do produce small amounts of thiamine. That said, you get the vast majority of your daily thiamine from the food you eat, so losing a little bacterial production is not considered meaningful for most people. This interaction is rated as insignificant, meaning a supplement is not something most patients need to worry about while taking this antibiotic.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Oxytetracycline, Phenazopyridine, Sulfamethizole
Insignificant DepletionBrand names include Urobiotic
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. This combination of medications includes antibiotics that can, in theory, shift the balance of normal gut bacteria, which do produce a small amount of thiamine. In practice, though, the vast majority of the thiamine you need comes from the food you eat, not from bacteria in your intestines, so this is considered an insignificant concern for most people. No supplement is typically needed, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Oxytetracycline, Phenazopyridine, Sulfamethizole →
Ozenoxacin
Insignificant DepletionBrand names include Xepi
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Ozenoxacin is a topical antibiotic, and like other antibiotics, it could theoretically affect the gut bacteria that produce small amounts of thiamine. In practice, though, your diet supplies the vast majority of the thiamine your body uses, so this is considered an insignificant concern for most people. No supplement is needed, but if you have questions about your nutrition while using this medication, your pharmacist is always a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Paromomycin Sulfate
Insignificant DepletionBrand names include Humatin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Paromomycin is an antibiotic, and antibiotics can sometimes shift the balance of bacteria in your gut, which play a small role in producing thiamine. In practice, though, most of what your body needs comes from food, not from gut bacteria, so this interaction is considered insignificant for most people taking this medication. No extra thiamine supplement is needed for the typical patient, but if you have concerns, your pharmacist or doctor is the right person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin G
Insignificant DepletionBrand names include Pfizerpen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Penicillin G, like other antibiotics, can alter the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The thing is, we get the vast majority of our thiamine from food, not from gut bacteria, so this effect is considered insignificant for most people. No thiamine supplement is needed for a typical course of this antibiotic, but if you have questions about your diet or a longer treatment, your pharmacist is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin G Benzathine
Insignificant DepletionBrand names include Bicillin L-A, Permapen
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like Penicillin G Benzathine could slightly reduce the friendly gut bacteria that make a small amount of thiamine, but here is the reassuring part: the vast majority of the thiamine you need comes from the food you eat, not from those bacteria. Because of that, this is rated as insignificant, and most people taking this medication do not need to worry about or take a thiamine supplement. If you have questions about your diet or a specific concern, your pharmacist or doctor is a great person to check with.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin G Benzathine, Procaine
Insignificant DepletionBrand names include Bicillin C-R
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. The idea here is that antibiotics like this penicillin injection can disrupt the natural bacteria living in your gut, and those bacteria do produce small amounts of thiamine. In practice, though, most of what your body needs comes straight from the food you eat, so any reduction from this source is considered insignificant. No supplement is needed for most people, but as always, your pharmacist or doctor is the right person to ask if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Penicillin G Benzathine, Procaine →
Penicillin G Potassium
Insignificant DepletionBrand names include Pentids, Pentids 400, Pentids 800
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. Penicillin G Potassium, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, most of the thiamine your body uses comes from the food you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed for the typical course of this medication, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin G, Procaine
Insignificant DepletionBrand names include Penicillin G Procaine
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Penicillin G Procaine, like other antibiotics, can disrupt the friendly bacteria living in your gut, and those bacteria do contribute a small amount of thiamine. The thing is, the vast majority of the thiamine you need comes straight from your diet, not from gut bacteria, so this is considered an insignificant concern. For a typical short course of this antibiotic, most people do not need to do anything differently, though you are always welcome to mention any questions to your pharmacist.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin V
Insignificant DepletionBrand names include Pen-Vee
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Penicillin V, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do make a small amount of thiamine. Even so, the vast majority of the thiamine your body uses comes from what you eat, not from gut bacteria, so this interaction is considered insignificant for most people. No supplement is typically needed during a short course of Penicillin V, but if you have questions about your diet or nutrition, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin V Potassium
Insignificant DepletionBrand names include V-Cillin K, Veetids, Pen VK
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that penicillin V, like other antibiotics, could slightly reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: your body gets the vast majority of its thiamine from food, not from those bacteria, so this barely registers as a concern in practice. The evidence rates this as insignificant, meaning most people finishing a course of penicillin V have nothing to worry about on this front. No action is needed, but if you have questions about your diet or a longer course of antibiotics, your pharmacist is always a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Penicillin VK
Insignificant DepletionBrand names include Robicillin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for turning food into energy and keeping your nerves working properly. Penicillin VK, like other antibiotics, can disrupt the helpful bacteria that normally live in your gut, and those bacteria do produce small amounts of thiamine. That said, the vast majority of the thiamine your body uses comes straight from the food you eat, not from gut bacteria, so this is considered an insignificant concern. Most people taking a short course of Penicillin VK have nothing to worry about here, and no supplement is needed.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Pentamidine
Insignificant DepletionBrand names include Pentam 300
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Because pentamidine is an antibiotic, there is a theoretical concern that it could reduce the good bacteria in your gut that produce small amounts of thiamine. In practice, though, most of what you need comes from food rather than gut bacteria, so this interaction is considered insignificant for most people taking pentamidine. No supplement is generally needed, but if you have questions about your nutrition while on this medication, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Phenazopyridine, Sulfamethizole
Insignificant DepletionBrand names include Thiosulfil-A, Thiosulfil-A Forte
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Sulfamethizole, the antibiotic in this combination, can theoretically reduce the amount of thiamine-producing bacteria in your gut, but here is the reassuring part: most of your daily thiamine comes from the food you eat, not from gut bacteria, so this effect is not considered clinically meaningful. For the vast majority of people taking this medication short-term, no thiamine supplement is needed, though you are always welcome to run any questions by your pharmacist.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Phenazopyridine, Sulfisoxazole
Insignificant DepletionBrand names include Azo-Gantrisin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. The antibiotic sulfisoxazole in this combination can shift the balance of normal gut bacteria, and those bacteria do produce small amounts of thiamine. That said, most of what your body needs comes straight from the food you eat, not from gut bacteria, so any change here is considered minor. For a short course of this medication, the evidence says there is nothing to worry about and no supplement is needed.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Piperacillin
Insignificant DepletionBrand names include Pipracil
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Piperacillin, like other antibiotics, can temporarily disrupt the helpful bacteria that live in your gut, and those bacteria do produce a small amount of thiamine. The thing is, you get the vast majority of your thiamine from the food you eat, not from gut bacteria, so this interaction is considered insignificant. For most people taking piperacillin, no extra thiamine is needed, but feel free to mention it to your pharmacist or doctor if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Piperacillin , Tazobactam
Insignificant DepletionBrand names include Zosyn
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Piperacillin/tazobactam is an antibiotic, and antibiotics in general can alter the natural bacteria living in your gut, which normally produce small amounts of thiamine. That said, because most of your daily thiamine comes from food rather than gut bacteria, this effect is considered insignificant, and for most people taking this antibiotic there is no real concern. No thiamine supplement is needed, but if you have questions about your nutrition during treatment, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Pivampicillin
Insignificant DepletionBrand names include Pondicillin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Pivampicillin is an antibiotic, and like other antibiotics it can disrupt the friendly bacteria living in your gut that normally produce small amounts of thiamine. That said, because most of the thiamine your body needs comes from food rather than gut bacteria, this effect is considered insignificant for most people. There is nothing you need to do differently, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Pivmecillinam
Insignificant DepletionBrand names include Selexid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for turning food into energy and keeping your nerves working properly. Pivmecillinam is an antibiotic, and there is a theoretical idea that antibiotics could slightly reduce the amount of thiamine your gut bacteria produce. In practice, though, your diet supplies the vast majority of the thiamine your body needs, so this is considered insignificant for most people taking this medication. No supplement is needed for typical short courses, but if you have questions about your nutrition, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Plazomicin Sulfate
Insignificant DepletionBrand names include Zemdri
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Plazomicin is an antibiotic, and antibiotics can sometimes shift the balance of bacteria living in your gut, which normally produce small amounts of thiamine. That said, the vast majority of the thiamine your body uses comes straight from food, not from gut bacteria, so this is considered an insignificant concern for most people. No thiamine supplement is needed for this reason, but feel free to mention it to your pharmacist or doctor if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Pretomanid
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Like other antibiotics, pretomanid may slightly affect the gut bacteria that produce small amounts of thiamine, but here is the reassuring part: we get the vast majority of our thiamine from food, not from those bacteria. For most people taking pretomanid, this is considered an insignificant concern, and a thiamine supplement is not something most patients need to worry about. If you have questions about your diet or nutritional status while on this medication, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Pyrazinamide
Insignificant DepletionBrand names include Tebrazid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. Pyrazinamide, like other antibiotics, could theoretically affect thiamine by altering the friendly bacteria in your gut that help produce small amounts of it. In practice, though, since most of your thiamine comes from the food you eat rather than gut bacteria, this is considered insignificant for most people. No supplement is generally needed, but mention it to your pharmacist if you have concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Quinupristin, Dalfopristin
Insignificant DepletionBrand names include Synercid
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. In theory, antibiotics like quinupristin/dalfopristin could slightly reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: you get the vast majority of your thiamine from food, not from bacteria in your intestines. The evidence rates this as insignificant, meaning most people taking this antibiotic have nothing to worry about on the thiamine front and do not need a supplement.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Retapamulin
Insignificant DepletionBrand names include Altabax, Altargo
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Retapamulin is a topical antibiotic used on the skin, and like other antibiotics, it could theoretically affect the gut bacteria that produce a small amount of thiamine. In practice, though, your body gets the vast majority of its thiamine straight from food, so this is considered an insignificant concern. Most people using retapamulin have nothing to worry about here, but if you ever have questions about your nutrition while on any antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Rifabutin
Insignificant DepletionBrand names include Mycobutin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Because rifabutin is an antibiotic, there is a theoretical concern that it could reduce the amount of thiamine-producing bacteria in your gut, but here is the reassuring part: we get the vast majority of our thiamine from food, not from gut bacteria, so this is very unlikely to matter in practice. For most people taking rifabutin, no extra thiamine is needed. That said, if you have questions about your diet or overall nutrition while on this medication, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Rifampin
Insignificant DepletionBrand names include Rifadin, Rimactane, Rifadin Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Rifampin is an antibiotic, and antibiotics in general can slightly reduce the good bacteria in your gut that normally produce small amounts of thiamine. That said, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so this is considered an insignificant depletion for most people. No extra thiamine supplement is needed, but if you have questions about your nutrition while on rifampin, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Rifamycin
Insignificant DepletionBrand names include Aemcolo
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Rifamycin, like other antibiotics, may slightly reduce the helpful gut bacteria that produce small amounts of thiamine, but here is the reassuring part: we get the vast majority of our thiamine from food, not from those bacteria, so this effect is considered insignificant for most people. No supplement is needed for most patients taking this antibiotic. If you have concerns about your diet or nutrition while on rifamycin, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Rifapentine
Insignificant DepletionBrand names include Priftin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like rifapentine could slightly reduce the amount of thiamine that gut bacteria produce, but here is the reassuring part: your diet already supplies the vast majority of the thiamine you need, so this bacterial effect is considered too small to matter clinically. For most people taking rifapentine, this is not something that requires any action. That said, if you have questions about your nutrition while on this medication, your pharmacist or doctor is a good person to check in with.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Rifaximin
Insignificant DepletionBrand names include Xifaxan
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for turning food into energy and keeping your nerves working properly. Rifaximin works mostly inside the gut, and there is a theoretical idea that antibiotics like it could slightly reduce the friendly bacteria that make a small amount of thiamine. In practice, though, almost all the thiamine your body needs comes straight from food, so this is not considered clinically meaningful for most people. No supplement is needed for the average rifaximin user, but if you have any concerns, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Secnidazole
Insignificant DepletionBrand names include Solosec
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses for energy production and healthy nerve function. Secnidazole is an antibiotic, and antibiotics can theoretically disrupt the normal bacteria living in your gut, which do produce small amounts of thiamine. That said, most of what your body needs comes from food, not gut bacteria, so this is considered insignificant for most people taking secnidazole. No supplement is needed, but if you have questions about your diet or vitamin intake, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Segesterone Acetate, Ethinyl Estradiol
Insignificant DepletionBrand names include Annovera
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Some research has found a slight drop in thiamine-related enzyme activity in people using hormonal contraceptives, which has raised the question of whether these medications might reduce how well the gut absorbs thiamine. That said, the evidence is mixed and the overall effect is considered insignificant, meaning this is more of a theoretical concern than a practical one for most users of this contraceptive ring. No routine supplement is needed, but if you have questions or notice unusual fatigue or nerve-related symptoms, it is always worth a quick conversation with your pharmacist or doctor.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Full nutrient report for Segesterone Acetate, Ethinyl Estradiol →
Sparfloxacin
Insignificant DepletionBrand names include Zagam
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nervous system working properly. Sparfloxacin is an antibiotic, and antibiotics in general can slightly disrupt the helpful bacteria living in your gut, which normally produce small amounts of thiamine. That said, because we get most of our thiamine from food rather than from gut bacteria, this interaction is considered insignificant for most people. No supplement is needed for the typical patient taking sparfloxacin, but if you have questions about your diet or nutrition, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Spectinomycin
Insignificant DepletionBrand names include Trobicin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Because spectinomycin is an antibiotic, there is a theoretical concern that it could disrupt the friendly bacteria in your gut that produce small amounts of thiamine. In practice, though, most of the thiamine you need comes from the food you eat, not from gut bacteria, so this is considered insignificant for nearly everyone. No supplement is needed, but if you ever have questions about your nutrition while taking antibiotics, your pharmacist is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Streptomycin
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Streptomycin, like other antibiotics, can alter the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The thing is, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so any effect here is considered insignificant. Most people taking streptomycin do not need a thiamine supplement, but if you have questions about your diet or vitamin intake, your pharmacist or doctor is a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulbactam, Durlobactam
Insignificant DepletionBrand names include Xacduro
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like sulbactam/durlobactam could disrupt the gut bacteria that produce small amounts of thiamine, but here is the reassuring part: we get the vast majority of our thiamine from food, not from gut bacteria, so the impact is considered insignificant. Most people taking this antibiotic have no reason to worry about thiamine or add a supplement. If you have concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfadiazine
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Sulfadiazine, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because most of the thiamine your body uses comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people. No supplement is needed for the typical short course of this medication, but if you have questions about your nutrition during treatment, your pharmacist or doctor is a good resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfadiazine, Sulfamerazine, Sulfamethazine
Insignificant DepletionBrand names include Triple Sulfoid, Terfonyl
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Sulfonamide antibiotics like these can theoretically reduce the amount of thiamine-producing bacteria in your gut, but here is the reassuring part: most of your daily thiamine comes from food, not from gut bacteria, so the impact on your overall thiamine levels is considered insignificant. For most people taking these medications, no special supplement is needed, though feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Sulfadiazine, Sulfamerazine, Sulfamethazine →
Sulfadiazine, Trimethoprim
Insignificant DepletionBrand names include Coptin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. The thinking here is that antibiotics like this combination can disturb the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, your diet supplies the vast majority of what your body needs, so this is considered an insignificant concern. Most people taking this antibiotic short-term have nothing to worry about on the thiamine front, but if you have questions about your nutrition, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfamerazine, Sulfamethazine
Insignificant DepletionBrand names include Neotrizine
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. These sulfonamide antibiotics may slightly reduce the amount of thiamine that certain gut bacteria produce, but here is the reassuring part: your diet, not those bacteria, supplies nearly all the thiamine your body uses each day. The effect is considered insignificant for most people taking these medications, so routine supplementation is not expected to be necessary. If you have concerns about your diet or are on long-term therapy, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfamethazole
Insignificant DepletionBrand names include Proklar
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. There is a theoretical idea that antibiotics like sulfamethazole could slightly reduce the amount of thiamine your gut bacteria produce, but here is the reassuring part: your diet, not gut bacteria, supplies the great majority of the thiamine your body needs each day. The evidence rates this depletion as insignificant, so most people taking this antibiotic do not need to worry about it or take a supplement. If you have questions about your specific situation, your pharmacist or doctor is always a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfamethizole
Insignificant DepletionBrand names include Thiosulfil Forte
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. Sulfamethizole, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because most of the thiamine your body uses comes straight from the food you eat, this disruption is not considered clinically meaningful for most people. No supplement is needed for the typical patient taking this antibiotic, but if you have questions about your diet or nutritional status, your pharmacist or doctor is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfamethoxazole
Insignificant DepletionBrand names include Gantanol
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Sulfamethoxazole is an antibiotic, and antibiotics can theoretically reduce the amount of thiamine-producing bacteria living in your gut. That said, because most of your daily thiamine comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people, and a supplement is not needed. If you have concerns, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfamethoxazole, Trimethoprim
Insignificant DepletionBrand names include Bactrim, Bactrim DS, Cotrim DS
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. The thinking here is that antibiotics like sulfamethoxazole/trimethoprim can shift the normal bacteria living in your gut, and those bacteria do produce small amounts of thiamine. In practice, though, your diet supplies the vast majority of the thiamine your body needs, so any effect from the medication is considered insignificant. Most people taking this antibiotic have nothing to worry about on this front, but if you have questions about your nutrition while on any medication, your pharmacist or doctor is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfapyridine
Insignificant DepletionInterference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Sulfapyridine, like other antibiotics, can slightly disrupt the friendly bacteria living in your gut that produce small amounts of thiamine. That said, because most of the thiamine your body needs comes from the food you eat rather than from gut bacteria, this effect is considered insignificant in practice. Most people taking sulfapyridine have nothing to worry about here, but if you have any concerns about your diet or overall nutrient intake, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Sulfisoxazole
Insignificant DepletionBrand names include Gantrisin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Sulfisoxazole is an antibiotic, and there is a theoretical idea that antibiotics could reduce the amount of thiamine gut bacteria produce, but here is the key point: we get most of our thiamine from food, not from bacteria, so this interaction is considered insignificant for most people. No supplement is needed for the typical patient taking this medication, but if you have questions about your diet or nutrition while on an antibiotic, your pharmacist is always a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Tedizolid Phosphate
Insignificant DepletionBrand names include Sivextro
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. Like other antibiotics, tedizolid phosphate may theoretically reduce the amount of thiamine-producing bacteria living in your gut, but here is the reassuring part: your body gets the vast majority of its thiamine from food, not from those bacteria, so this is not considered clinically meaningful. For most people taking this antibiotic, no thiamine supplement is needed. That said, if you have questions about your nutrition during treatment, your pharmacist or doctor is a good person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Telavancin
Insignificant DepletionBrand names include Vibativ
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs for energy production and healthy nerve function. Telavancin, like other antibiotics, can theoretically affect the gut bacteria that produce small amounts of thiamine, but here is the reassuring part: most of what your body needs comes from food, not from those bacteria. For the vast majority of people taking telavancin, this is not a practical concern, and no supplement is needed. If you have questions about your diet or nutritional status, your pharmacist or doctor is a great person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Telithromycin
Insignificant DepletionBrand names include Ketek
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Telithromycin is an antibiotic, and like most antibiotics it can temporarily disrupt the friendly bacteria living in your gut, which normally produce a small amount of thiamine. That said, most of what we need comes from food, not gut bacteria, so this interaction is considered insignificant for the vast majority of people. No supplement is needed for most patients taking a short course of this medication, but feel free to mention it to your pharmacist or doctor if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Temafloxacin
Insignificant DepletionBrand names include Omniflox
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Temafloxacin, like other antibiotics, can disrupt the natural bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because the vast majority of the thiamine you need comes straight from the food you eat rather than from gut bacteria, this effect is considered insignificant for most people. No supplement is needed, but if you have questions about your nutrition while taking an antibiotic, your pharmacist is a great place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Tetracycline
Insignificant DepletionBrand names include Sumycin, Sumycin 250, Tetrex BID
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working well. Tetracycline is an antibiotic, and there is a theoretical idea that it could reduce the gut bacteria that normally make small amounts of thiamine. In practice, though, your diet supplies the vast majority of the thiamine you need, so this is not considered clinically meaningful. Most people taking tetracycline do not need to do anything about this, but your pharmacist is always a good resource if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ticarcillin
Insignificant DepletionBrand names include Ticar
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Because ticarcillin is an antibiotic, there is a theoretical concern that it could reduce the friendly gut bacteria that produce small amounts of thiamine. In practice, though, we get most of our thiamine from food rather than from gut bacteria, so this interaction is considered insignificant for most people. No supplement is needed, but if you ever have questions about your nutrition while on antibiotics, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ticarcillin , Clavulanate
Insignificant DepletionBrand names include Timentin
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nervous system working properly. The thinking here is that antibiotics like ticarcillin-clavulanate can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. In practice, though, your gut bacteria contribute very little to your daily thiamine supply compared to what you get from food, so this interaction is considered insignificant for most people. No supplement is needed for the typical short course of this antibiotic, but if you have any concerns, your pharmacist or doctor is the right person to ask.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Tigecycline
Insignificant DepletionBrand names include Tygacil
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. Tigecycline, like other antibiotics, can disrupt the normal bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, since most of the thiamine your body needs comes from the food you eat rather than from gut bacteria, this effect is considered insignificant for the vast majority of patients. For a typical course of tigecycline, you almost certainly do not need a thiamine supplement, but your pharmacist or doctor can give you personalized guidance.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Tobramycin
Insignificant DepletionBrand names include Nebcin, Tobi Podhaler, Bethkis
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Tobramycin, like other antibiotics, can shift the balance of bacteria living in your gut, and those bacteria do produce a small amount of thiamine. The thing is, you get the vast majority of your thiamine from food, not from gut bacteria, so this effect is considered insignificant for most people. No supplement is needed for this reason, but if you have questions about your diet or vitamin intake while on tobramycin, your pharmacist is a good place to start.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Trimethoprim
Insignificant DepletionBrand names include Proloprim, Trimpex
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Trimethoprim is an antibiotic, and like other antibiotics it can disrupt the helpful bacteria living in your gut, which normally produce small amounts of thiamine on their own. That said, because most of the thiamine your body needs comes from the food you eat rather than from gut bacteria, this is considered an insignificant concern for the vast majority of people. No supplement is needed for most patients taking trimethoprim, but if you have questions about your diet or a specific health condition, your pharmacist or doctor is a great resource.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Troleandomycin
Insignificant DepletionBrand names include Tao
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Troleandomycin is an antibiotic, and antibiotics in general can shift the natural bacteria living in your gut, which normally produce a small amount of thiamine on their own. That said, because most of the thiamine we need comes from the food we eat rather than from gut bacteria, this interaction is considered insignificant for most people. No supplement is needed, but if you ever have questions about your nutrition while taking any antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Trovafloxacin
Insignificant DepletionBrand names include Trovan, Trovan Injection
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. Trovafloxacin is an antibiotic, and like other antibiotics it can alter the natural bacteria living in your gut, which normally produce small amounts of thiamine. That said, because most of the thiamine your body uses comes straight from the food you eat rather than from gut bacteria, any effect here is considered insignificant for most people. No supplement is needed, but if you have general questions about your nutrition while on any antibiotic, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Ulipristal Acetate
Insignificant DepletionBrand names include Ella
Some studies have reported a small reduction in activity of the thiamine-dependent enzyme erythrocyte transketolase in females taking oral contraceptives, suggesting mild thiamine deficiency. However, other studies have found no effect. Routine use of thiamine supplements with oral contraceptives isn't necessary.
Thiamine is a B vitamin your body uses to convert food into energy and keep nerves working properly. Ulipristal acetate, like other hormonal contraceptives, has been theorized to slightly reduce how well the gut absorbs thiamine, though research on this has been mixed and no clear, meaningful effect has been established. Given that this is rated as insignificant, most people taking ulipristal acetate have nothing to worry about here. No routine supplementation is needed, but if you have questions about your diet or any symptoms, it is always fine to bring them up with your pharmacist.
References (4)
- Thorp VJ. Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc 1980;76:581-4.. DOI
- Briggs MH, Briggs M. Thiamine status and oral contraceptives. Contraception 1975;11:151-4. PubMed
- Lewis CM, King JC. Effect of oral contraceptive agents on thiamin, riboflavin, and pantothenic acid status in young women. Am J Clin Nutr 1980;33:832-8..
- Vir SC, Love AH. Effect of oral contraceptive agents on thiamin status. Int J Vit Nutr Res 1979;49:291-5.
Vancomycin
Insignificant DepletionBrand names include Vancocin, Vancoled
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to turn food into energy and keep your nerves working properly. Vancomycin, like other antibiotics, can disrupt the friendly bacteria living in your gut, and those bacteria do produce small amounts of thiamine. The thing is, almost all of the thiamine your body needs comes straight from the food you eat, not from gut bacteria, so this effect is considered insignificant. For most people taking vancomycin, no extra thiamine is needed, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Vancomycin Hydrochloride
Insignificant DepletionBrand names include Firvanq
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body uses to turn food into energy and keep your nerves working properly. Vancomycin is an antibiotic, and antibiotics in general can disrupt the natural bacteria living in your gut, which normally produce small amounts of thiamine. That said, your gut bacteria contribute very little to your overall thiamine supply since most of it comes from what you eat, so this interaction is considered insignificant for most patients. No supplement is needed for the average person taking this medication, but feel free to mention it to your pharmacist if you have any concerns.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Vonoprazan, Amoxicillin
Insignificant DepletionBrand names include Voquezna Dual
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body depends on for turning food into energy and keeping your nerves working properly. Amoxicillin, the antibiotic in this combination, can theoretically shift the balance of bacteria living in your gut, and those bacteria do produce a small amount of thiamine. That said, because most of the thiamine you need comes straight from the food you eat rather than from gut bacteria, this interaction is considered insignificant for the vast majority of people taking this short course of treatment. No supplement is needed, but if you have questions or notice anything unusual, your pharmacist is a great first stop.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Vonoprazan, Amoxicillin, Clarithromycin
Insignificant DepletionBrand names include Voquezna Triple
Interference with the normal gastrointestinal flora by antibiotics may reduce bacterial synthesis of thiamine. However, the majority of the daily thiamine requirement is obtained from the diet, rather than synthesis by the GI flora. Therefore this isn't likely to be clinically significant, and thiamine supplements aren't necessary.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. The clarithromycin and amoxicillin in this triple therapy can theoretically shift the natural balance of bacteria in your gut, and those bacteria do produce a small amount of thiamine. That said, almost all the thiamine your body needs comes from the food you eat, not from gut bacteria, so this is considered an insignificant concern for most people. No supplement is needed, but feel free to mention it to your pharmacist if you have questions.
References (1)
- Goldin BR, Lichtenstein AH, Gorbach SL. Nutritional and metabolic roles of intestinal flora. In: Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease, 8th ed. Malvern, PA: Lea & Febiger, 1994.
Full nutrient report for Vonoprazan, Amoxicillin, Clarithromycin →
Acetaminophen, Caffeine, Pyrilamine
Moderate DepletionBrand names include Midol Max Strength Menstrual
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body needs to convert food into energy and keep your heart and nerves working properly. This combination product contains caffeine, which acts as a mild diuretic, meaning it nudges your kidneys to excrete more fluid, and some research suggests diuretics can cause thiamine to be flushed out in the urine over time. The concern is rated moderate, so it is worth keeping on your radar, particularly if you use products like this regularly, eat a limited diet, or are older. Ask your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Acetaminophen, Caffeine, Pyrilamine →
Acetaminophen, Pamabrom, Pyrilamine
Moderate DepletionBrand names include Midol Max Strength PMS, Pamprin, Pamprin ES
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Pamabrom, the mild diuretic in this combination product, works by nudging your kidneys to shed extra water, and that process can carry some thiamine (a B vitamin your nerves and heart muscle depend on) out with it. The risk is considered moderate, and it tends to matter most for older adults who take diuretics long-term or whose diets are already low in B vitamins. If you use this product only occasionally for menstrual bloating, this likely is not a concern, but regular or heavy use is worth a conversation with your pharmacist or doctor.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Acetaminophen, Pamabrom, Pyrilamine →
Acetazolamide
Moderate DepletionBrand names include Diamox, Ak-Zol
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into energy. Acetazolamide works as a diuretic, meaning it makes your kidneys produce more urine, and that extra urine can carry thiamine out of the body faster than normal. The concern is most relevant for older adults on long-term, higher-dose diuretic therapy, especially those who may not be getting enough thiamine through diet. If either of those applies to you, it is worth asking your pharmacist or doctor whether your levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Amiloride, Hydrochlorothiazide
Moderate DepletionBrand names include Moduretic, Amilzide, Moduret 25
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on for energy metabolism. Diuretics like this combination pill can cause the kidneys to flush out more thiamine than usual through urine, and over time that extra loss may add up, especially in older adults or anyone whose diet is not thiamine-rich. This is rated a moderate concern, meaning most patients do fine, but long-term users, particularly those on higher doses, are worth watching. If you have been on this medication for several months, it is a reasonable thing to bring up with your pharmacist or doctor.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Ammonium Chloride
Moderate DepletionIncreased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy production. Ammonium chloride works as a diuretic, meaning it makes the kidneys produce more urine, and that extra urine can carry thiamine out of the body faster than normal. This is rated a moderate concern, and it tends to matter most for older adults or anyone whose diet is already low in thiamine, especially with long-term use at higher doses. Worth a conversation with your pharmacist or doctor to see whether your situation calls for any monitoring.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Atenolol, Chlortalidone
Moderate DepletionBrand names include AtenixCo, Totaretic, Tenoret 50
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into usable energy. Chlorthalidone is a diuretic, meaning it works by making your kidneys remove excess fluid, and that process can also flush thiamine out in the urine over time. This is rated a moderate concern, and it seems most relevant for older adults on long-term, higher-dose diuretic therapy who are not getting enough thiamine through diet. If that sounds like your situation, it is worth bringing up with your pharmacist or doctor to see whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Atenolol, Chlorthalidone
Moderate DepletionBrand names include Tenoretic
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Chlorthalidone is a diuretic, and diuretics can cause your kidneys to flush out more thiamine (vitamin B1, which your body uses to turn food into energy and keep your heart and nerves working) than usual through your urine. This concern is rated moderate, meaning it is real enough to keep an eye on, though it tends to matter most for older adults or those not getting enough thiamine from food. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Azilsartan, Chlorthalidone
Moderate DepletionBrand names include Edarbyclor
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Chlorthalidone is a diuretic, meaning it helps your kidneys remove extra fluid, but that same flushing action can carry thiamine (a B vitamin your heart, nerves, and muscles depend on) out in the urine. This concern is rated moderate, and it appears most likely in older adults who take higher diuretic doses for many months and whose diet may already be low in thiamine. If you are a long-term user, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Benazepril, Hydrochlorothiazide
Moderate DepletionBrand names include Lotensin HCT
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. The hydrochlorothiazide in this combination is a diuretic, and diuretics can cause the kidneys to flush thiamine out in the urine faster than normal. This is rated a moderate concern, meaning it is not a guaranteed problem for everyone, but long-term users, older adults, or anyone not eating well may be at higher risk. Worth a conversation with your pharmacist or doctor, especially if you have been on this medication for several months.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bendroflumethiazide
Moderate DepletionBrand names include Naturetin, Aprinox, Neo-NaClex
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Bendroflumethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush more thiamine out in the urine than usual, which over time may lower your body's stores. This is rated a moderate concern, particularly for older adults or anyone whose diet is already low in thiamine, and it is worth bringing up with your pharmacist or doctor if you have been on this medication long term.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bendroflumethiazide, Nadolol
Moderate DepletionBrand names include Corzide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on to convert food into energy. Bendroflumethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine than usual in the urine, which over time may lower your body's stores. This is rated a moderate concern, and it matters most for older adults on long-term therapy who may not be getting enough thiamine through diet. Worth bringing up with your pharmacist or doctor, especially if you have heart failure or are over 60.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bendroflumethiazide, Potassium
Moderate DepletionBrand names include Neo-NaClex-K, Centyl K
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on for energy production. Bendroflumethiazide is a diuretic, a water pill, and diuretics like this one can cause the kidneys to flush out more thiamine in the urine than usual. This is rated a moderate concern, mostly for older adults on long-term diuretic therapy who may not be getting enough thiamine from food to begin with. It is worth bringing up with your doctor or pharmacist, especially if you have been on this medication for several months.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bendroflumethiazide, Rauwolfia Serpentina
Moderate DepletionBrand names include Rauzide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on to convert food into energy. Bendroflumethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine in the urine than usual, which over time can chip away at your body's supply. This concern is rated moderate, meaning it is worth keeping an eye on, particularly for older adults or anyone who may not be getting enough thiamine through diet. If you have been on this medication long-term, it is a reasonable thing to bring up with your pharmacist or doctor at your next visit.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Bendroflumethiazide, Rauwolfia Serpentina →
Benzthiazide
Moderate DepletionBrand names include Exna
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nerves depend on to convert food into energy. Benzthiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine in the urine than normal, which over time may nudge levels lower. This is rated moderate, so it is not a concern for every person, but long-term users, especially older adults or those with limited dietary variety, are worth watching more closely. If you have been on this medication for a while, it is a reasonable thing to bring up with your pharmacist or doctor.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bisoprolol, Hydrochlorothiazide
Moderate DepletionBrand names include Ziac
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into energy. The hydrochlorothiazide in this combination is a diuretic, meaning it makes your kidneys produce more urine, and some of that extra urine can carry thiamine out of the body along with it. This is rated moderate, so it is a real consideration, especially for older adults or anyone whose diet may already be a bit low in this vitamin. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bumetanide
Moderate DepletionBrand names include Burinex
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. Bumetanide, like other loop diuretics, works by making your kidneys push out extra fluid, and unfortunately thiamine gets swept out in that urine as well. This is a moderate concern worth paying attention to, particularly for older adults on higher doses or those who may not be getting enough thiamine through their diet. If you have been on bumetanide for a long time, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Bumetanide, Potassium
Moderate DepletionBrand names include Burinex K
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nerves depend on to produce energy properly. Bumetanide, like other loop diuretics, works by making your kidneys flush out extra fluid, but that process can also carry thiamine out in the urine, gradually lowering your body's supply. This is a moderate concern, particularly for older adults on higher doses over many months or those whose diet may already be short on thiamine. If either of those situations fits you, it is worth asking your pharmacist or doctor whether your levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Caffeine, Potassium Salicylate, Salicylamide
Moderate DepletionBrand names include Trim-Elim
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body uses to convert food into energy and keep your heart and nerves working properly. This combination product contains salicylate compounds that can act like mild diuretics, and diuretics may cause the kidneys to flush out more thiamine than usual in the urine. That said, meaningful thiamine loss is more of a concern with high-dose, long-term diuretic use, particularly in older adults whose diets may already be low in this vitamin. If you have been using this medication regularly for a while, it is worth bringing up thiamine levels with your pharmacist or doctor to decide whether any monitoring or support makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Caffeine, Potassium Salicylate, Salicylamide →
Candesartan Cilexetil, Hydrochlorothiazide
Moderate DepletionBrand names include Atacand HCT
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into energy. The hydrochlorothiazide in this combination works as a diuretic, meaning it makes your kidneys produce more urine, and that extra fluid flushing can carry thiamine out of the body along with it. This is rated a moderate concern, especially for older adults on long-term diuretic therapy who may not be getting enough thiamine through diet. It is worth asking your pharmacist or doctor whether your levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Candesartan Cilexetil, Hydrochlorothiazide →
Captopril, Hydrochlorothiazide
Moderate DepletionBrand names include Capozide, Acezide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. The hydrochlorothiazide in this combination works as a diuretic, meaning it makes your kidneys produce more urine, and that extra urine can carry thiamine out of the body along with it. This is rated a moderate concern, and while it is not a problem for every patient, older adults or those with lower dietary intake may be at higher risk over time. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Chlorothiazide
Moderate DepletionBrand names include Diuril
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on to convert food into energy. Chlorothiazide is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine can carry thiamine out of the body faster than usual. This is a moderate concern, particularly for older adults, people with lower dietary intake, or anyone on higher doses for many months. It is worth bringing up with your pharmacist or doctor so they can decide whether your situation calls for any monitoring or a supplement.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Chlorothiazide, Methyldopa
Moderate DepletionBrand names include Aldoclor 150, Aldochlor, Aldoclor 250
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. Chlorothiazide is a diuretic, meaning it makes your kidneys produce more urine, and that process can sweep extra thiamine out of your body before it is absorbed and used. This concern is rated moderate, and it tends to matter most for older adults on higher doses over many months, especially those whose diet is already low in thiamine. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Chlorothiazide, Reserpine
Moderate DepletionBrand names include Diupres
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nerves depend on for energy. Chlorothiazide is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine flow can carry thiamine out of the body faster than normal. This is rated a moderate concern, particularly for older adults on long-term, higher-dose diuretic therapy or anyone whose diet may be low in thiamine to begin with. It is worth mentioning to your pharmacist or doctor so they can decide whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Chlorthalidone
Moderate DepletionBrand names include Hygroton, Thalitone
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into usable energy. Chlorthalidone, like other diuretics, works by making your kidneys remove extra fluid, and some thiamine gets flushed out in the urine along the way. This is rated a moderate concern, especially for older adults who may already be getting less thiamine from their diet and who have been on higher diuretic doses for months. It is worth bringing up with your pharmacist or doctor, who can check whether any monitoring or dietary guidance makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Chlorthalidone, Clonidine
Moderate DepletionBrand names include Clorpres, Combipres
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Chlorthalidone is a diuretic, meaning it helps your kidneys remove extra fluid, and that same process can flush thiamine (vitamin B1, which your heart and nervous system depend on for energy) out through your urine faster than usual. This concern is rated moderate, and it tends to be most relevant for older adults, people eating a limited diet, or those who have been on higher diuretic doses for many months. Most younger, well-nourished patients do not develop a problem, but if you have been on this medication long-term, it is worth bringing up with your pharmacist or doctor to see whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Cryptenamine, Methyclothiazide
Moderate DepletionBrand names include Diutensen
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into usable energy. Methyclothiazide is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine can carry thiamine out of the body faster than normal. This is most relevant for older adults on higher diuretic doses over many months, especially if dietary intake is low. It is worth bringing up with your doctor or pharmacist, particularly if you have heart failure, since low thiamine can sometimes make that condition harder to manage.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Cyclothiazide
Moderate DepletionBrand names include Fluidil, Anhydron
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Cyclothiazide is a thiamine diuretic, and like other diuretics it works by making your kidneys flush out more fluid, and unfortunately thiamine can get swept out in that extra urine as well. This is rated a moderate concern, meaning it does not affect everyone but is worth watching, especially in older adults or anyone eating a limited diet over the long term. If you have been on this medication for several months, it is worth a conversation with your pharmacist or doctor about whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Deserpidine, Hydrochlorothiazide
Moderate DepletionBrand names include Oreticyl Forte, Oreticyl
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. The hydrochlorothiazide in this combination works in the kidneys, and diuretics as a class can cause the body to flush thiamine out through the urine faster than usual. This is rated a moderate concern, so it is not something to ignore, particularly for older adults or anyone whose diet may be low in thiamine already. If you have been on this medication long-term, it is worth bringing up with your pharmacist or doctor to see whether any monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Deserpidine, Methyclothiazide
Moderate DepletionBrand names include Enduronyl Forte, Enduronyl
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body depends on for energy production and keeping nerves and the heart working properly. The methyclothiazide in this combination is a diuretic, meaning it makes your kidneys produce more urine, and research suggests that diuretics can cause extra thiamine to be flushed out along with that urine. This concern is rated moderate, and it appears most relevant for older adults on higher doses who may not be getting enough thiamine through diet. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine status is something to keep an eye on.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Enalapril Maleate, Hydrochlorothiazide
Moderate DepletionBrand names include Vaseretic
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into usable energy. The hydrochlorothiazide in this combination pill is a diuretic, meaning it makes your kidneys excrete more fluid, and thiamine gets swept out in that extra urine along the way. This is a moderate concern, especially for older adults on long-term diuretic therapy who may not be getting enough thiamine through diet. It is worth bringing up with your pharmacist or doctor, particularly if you notice unusual fatigue or heart-related symptoms.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Enalapril Maleate, Hydrochlorothiazide →
Ethacrynic Acid
Moderate DepletionBrand names include Edecrin
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nerves depend on to produce energy, and ethacrynic acid, like other loop diuretics, works partly by making your kidneys flush out more fluid through urine. That flushing action can carry thiamine out of the body along with the excess fluid, which is why prolonged use at higher doses has been linked to lower thiamine levels in some patients. This is rated as a moderate concern, so it is not something to ignore, especially for older adults or anyone eating a limited diet while taking this medication long term. Ask your doctor or pharmacist whether your thiamine level should be checked or whether a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Fosinopril, Hydrochlorothiazide
Moderate DepletionBrand names include Monopril HCT
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nerves depend on to turn food into energy. The hydrochlorothiazide in this combination works in the kidneys to remove excess fluid, but that process can also cause the body to flush out more thiamine in the urine than it should. This is rated a moderate concern, particularly for older adults who may not get enough thiamine through diet alone. It is worth bringing up with your doctor or pharmacist, especially if you have been on this medication long-term.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Furosemide
Moderate DepletionBrand names include Lasix
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nervous system depend on to produce energy. Furosemide works in the kidneys to pull extra fluid out of the body, and one side effect is that it can sweep thiamine out through the urine along with that fluid. This is most relevant for people who have been on higher doses (think more than 80 mg a day) for several months, especially older adults or anyone whose diet is not very varied. If that sounds like your situation, it is worth bringing up with your pharmacist or doctor, since low thiamine is a real concern for people being treated for heart failure.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Furosemide, Potassium
Moderate DepletionBrand names include Diumide-K Continus, Lasikal
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nervous system depend on to produce energy properly. Furosemide works as a powerful diuretic, meaning it makes your kidneys flush out a lot of extra fluid, and unfortunately thiamine gets swept out along with it in the urine. This concern is most relevant for people taking higher doses (think more than 80 mg daily) over several months, and especially for older adults who may not be getting enough thiamine through food to begin with. If you have been on a high dose of furosemide for a while, it is worth having a conversation with your pharmacist or doctor about whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Guanethidine, Hydrochlorothiazide
Moderate DepletionBrand names include Esimil
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body needs to turn food into energy and keep your heart and nerves working properly. Hydrochlorothiazide is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine flow can carry thiamine out of the body faster than normal. This is more of a real-world concern for older adults, people eating a limited diet, or those on higher diuretic doses over many months. If you fall into any of those groups, it is worth mentioning to your pharmacist or doctor so they can decide whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Guanethidine, Hydrochlorothiazide →
Hydralazine, Hydrochlorothiazide
Moderate DepletionBrand names include Apresoline-Esidrix, Apresazide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles all depend on for energy. Hydrochlorothiazide is a diuretic, meaning it makes the kidneys produce more urine, and that extra urine can carry thiamine out of the body along with it. This is a moderate concern rather than a minor one, so it is worth paying attention to, especially if you are older, eat a limited diet, or take high doses long-term. Ask your pharmacist or doctor whether your levels should be checked or whether a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydralazine, Hydrochlorothiazide, Reserpine
Moderate DepletionBrand names include Ser-Ap-Es, Unipres, Uniserp
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to work properly. The hydrochlorothiazide in this combination medication is a diuretic, meaning it makes your kidneys flush out more fluid, and along with that extra urination, thiamine can get washed out too. This is rated a moderate concern, and the risk seems highest in older adults who may not be getting enough thiamine from food to begin with. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Hydralazine, Hydrochlorothiazide, Reserpine →
Hydrochlorothiazide
Moderate DepletionBrand names include Esidrix, Hydro, Microzide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into usable energy. Hydrochlorothiazide is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine output can carry thiamine out of the body faster than normal. This concern is rated moderate, but it seems most relevant for older adults, people whose diets may already be low in thiamine, or those on higher diuretic doses for a long time. If you fall into any of those groups, it is worth bringing up with your pharmacist or doctor to see whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Irbesartan
Moderate DepletionBrand names include Avalide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and energy metabolism depend on, and the diuretic portion of this combination (hydrochlorothiazide) can cause the kidneys to flush more of it out in the urine than usual. This matters most for older adults who may already be getting limited thiamine from their diet, and it is rated a moderate concern rather than a minor or theoretical one. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine levels are worth keeping an eye on.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Labetalol
Moderate DepletionBrand names include Trandate HCT
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to produce energy properly. Hydrochlorothiazide is a diuretic, meaning it makes your kidneys excrete more fluid, and research shows diuretics can cause thiamine to get flushed out in the urine along with that extra fluid. This is a moderate concern, particularly for older adults on long-term or higher-dose diuretic therapy who may not be getting enough thiamine through diet. If that sounds like your situation, it is worth bringing up with your pharmacist or doctor to see whether any monitoring or supplementation makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Lisinopril
Moderate DepletionBrand names include Zestoretic, Prinzide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on for energy production, and the diuretic component of this combination (hydrochlorothiazide) can cause your kidneys to flush out more thiamine than usual in your urine. This is rated a moderate concern, meaning it does not affect everyone, but older adults or those with lower dietary intake may be at greater risk over time. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Losartan Potassium
Moderate DepletionBrand names include Hyzaar
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nervous system depend on to convert food into energy. The diuretic portion of this combination works in your kidneys to pull excess fluid out of your body, and that same process can wash out more thiamine in your urine than usual. This is rated as a moderate concern, so it is not something to panic about, but it is worth paying attention to, particularly if you are older, have heart failure, or do not always eat a balanced diet. Ask your pharmacist or doctor whether your situation warrants checking your thiamine levels.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Hydrochlorothiazide, Losartan Potassium →
Hydrochlorothiazide, Methyldopa
Moderate DepletionBrand names include Aldoril 15, Methazide, Aldoril 25
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into energy. The diuretic component of this combination works on the kidneys to remove extra fluid, but it can also flush thiamine out in the urine along the way. This is rated a moderate concern, meaning it does not affect everyone, but older adults, people with low dietary intake, or those on higher doses for many months are more likely to notice an impact. Worth a quick conversation with your pharmacist or doctor to find out whether your situation calls for any monitoring.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Metoprolol
Moderate DepletionBrand names include Lopressor HCT
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nerves depend on to produce energy properly. The diuretic component of this combination (hydrochlorothiazide) works in the kidneys, and diuretics as a class have been linked to the body flushing out more thiamine in the urine than normal, which over time can nudge levels lower. The concern is rated moderate, meaning it is not something everyone needs to act on right away, but long-term users who are older or eat a limited diet may be worth monitoring more closely. If you have been on this medication for a while, it is a reasonable thing to bring up with your pharmacist or doctor.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Moexipril
Moderate DepletionBrand names include Uniretic
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and energy metabolism genuinely depend on, and hydrochlorothiazide (the diuretic in this combination) can cause the kidneys to flush more of it out in the urine than usual. The concern is rated moderate, meaning it is not a worry for every patient but is real enough to take seriously, particularly for older adults, people with lower dietary intake, or those on higher doses over many months. If heart failure is part of your picture, your doctor or pharmacist is especially worth checking in with about whether your thiamine levels should be monitored.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Pindolol
Moderate DepletionBrand names include Viskazide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on for energy. Hydrochlorothiazide works as a diuretic, meaning it makes your kidneys flush out extra fluid, and in doing so it can also cause thiamine to be lost in the urine over time. This concern is rated moderate, and it seems to matter most for older adults on higher diuretic doses who may not get enough thiamine through food. If you have been on this medication for a while, it is worth bringing up with your pharmacist or doctor to see whether any monitoring or dietary changes make sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Propranolol
Moderate DepletionBrand names include Inderide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into energy. Hydrochlorothiazide works as a diuretic, meaning it makes your kidneys produce more urine, and that extra urine output can carry thiamine out of the body faster than usual. This concern is rated moderate and tends to be most relevant for older adults, people with lower dietary intake, or those on higher diuretic doses for a long time. If any of those factors apply to you, it is worth bringing up with your pharmacist or doctor to see whether monitoring or a supplement makes sense.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Quinapril
Moderate DepletionBrand names include Accuretic
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into usable energy. Hydrochlorothiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush more thiamine out in the urine than normal, which over time may nudge levels lower. This is rated moderate, meaning it is not a concern for everyone, but older adults on long-term diuretic therapy or those with a heart condition deserve a closer look. If either description fits you, it is worth bringing up with your pharmacist or doctor to see whether monitoring or a supplement makes sense for your situation.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Reserpine
Moderate DepletionBrand names include Hydropres, Serpasil-Esidrix, Serpasil-Esidrix #1
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to turn food into usable energy. The diuretic component of this medication works in the kidneys, and as it pushes extra fluid out through urine, thiamine can get flushed out along with it. This is rated as moderate depletion, so it does not affect everyone, but older adults, people on higher doses, and those who may not be getting enough thiamine through food are worth watching more closely. If you have been on this medication for a while, it is a reasonable thing to bring up with your pharmacist or doctor.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Spironolactone
Moderate DepletionBrand names include Spirozine, Aldactazide, Aldactide 25
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system genuinely depend on, and diuretics like hydrochlorothiazide and spironolactone can cause your kidneys to flush more of it out in your urine than usual. This concern is rated moderate, meaning it is not just theoretical, but it tends to matter most for older adults, people eating a limited diet, or those taking higher doses over many months. If you fall into one of those groups, it is worth bringing up with your pharmacist or doctor to see whether your thiamine level is worth keeping an eye on.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Full nutrient report for Hydrochlorothiazide, Spironolactone →
Hydrochlorothiazide, Timolol
Moderate DepletionBrand names include Timolide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nervous system depend on for energy. Hydrochlorothiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine in the urine than usual, which over time can quietly lower your body's supply. This is rated a moderate concern, and the risk is highest in older adults who may already have a lower dietary intake. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your thiamine level is something to keep an eye on.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Triamterene
Moderate DepletionBrand names include Maxzide, Dyazide, Maxzide-25
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to work properly. This diuretic combination can cause your kidneys to flush out more thiamine than usual in your urine, and over time that extra loss can add up, especially in older adults or anyone whose diet is already low in this vitamin. The concern here is real enough to take seriously, though it tends to be more of a risk with long-term, higher-dose use than with short courses. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydrochlorothiazide, Valsartan
Moderate DepletionBrand names include Diovan HCT
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on for energy production. Because hydrochlorothiazide is a diuretic, it causes your kidneys to pass more fluid, and some thiamine gets flushed out in that extra urine over time. This is rated a moderate concern, meaning most people do fine, but older adults on long-term diuretic therapy or those who don't get much thiamine from food may be at higher risk. If you've been on this medication for a while, it's worth mentioning to your pharmacist or doctor so they can decide whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydroflumethiazide
Moderate DepletionBrand names include Saluron
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on to turn food into energy. Hydroflumethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine in the urine than usual, which over months may chip away at your body's supply. The concern is rated moderate, meaning it is not a worry for everyone, but older adults on long-term therapy or those with a limited diet may be at higher risk, especially if heart failure is also in the picture. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your thiamine level deserves a closer look.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Hydroflumethiazide, Reserpine
Moderate DepletionBrand names include Salutensin-Demi, Salutensin
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system genuinely depend on, so it is worth paying attention to here. Hydroflumethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine in the urine than usual, which over time may chip away at your body's supply. This concern is rated moderate, meaning it is real enough to watch for, particularly in older adults or anyone whose diet may not be rich in thiamine. If you have been on this medication long-term, it is a reasonable thing to bring up with your pharmacist or doctor at your next visit.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Indapamide
Moderate DepletionBrand names include Lozol, Lozide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nerves depend on to turn food into usable energy. Indapamide is a diuretic, meaning it makes your kidneys remove more fluid through urine, and thiamine can get flushed out along with that extra fluid. This is rated moderate, so it is a real consideration, particularly for older adults or anyone who has been on a diuretic for a long time and eats a limited diet. It is worth bringing up with your pharmacist or doctor, especially if you have heart concerns.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Irbesartan, Hydrochlorothiazide
Moderate DepletionBrand names include CoAprovel
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body uses to convert food into energy and keep your heart and nerves working properly. The hydrochlorothiazide in this combination pill is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine can carry thiamine out of the body faster than normal. This concern is most relevant for older adults who have been on diuretics for several months and whose diet may already be low in thiamine. If that sounds like you, it is worth bringing up with your pharmacist or doctor, as some patients in that situation do benefit from monitoring or a supplement.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Mannitol
Moderate DepletionBrand names include Osmitrol, Bronchitol
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Mannitol is a diuretic, meaning it pulls extra fluid out through the kidneys, and that process can carry thiamine out in the urine along with it. The concern is rated moderate, so it is not a trivial footnote, especially for older adults or anyone on high doses for a long stretch of time. If you have been using mannitol regularly, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Methazolamide
Moderate DepletionBrand names include Neptazane
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on to convert food into usable energy. Because methazolamide works as a diuretic (it makes the kidneys produce more urine), it can cause the body to flush out more thiamine than usual, which over time may leave some people running low. This concern is most real for older adults or anyone whose diet is already light on thiamine, so if you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Methyclothiazide
Moderate DepletionBrand names include Enduron, Aquatensen
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Methyclothiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush more thiamine out in the urine than normal, which over time may lower levels in some people. This concern is rated moderate, and it appears most relevant for older adults on long-term, higher-dose diuretic therapy who may not be getting enough thiamine from food. If that sounds like your situation, it is worth bringing up with your pharmacist or doctor to see whether any monitoring makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Methyclothiazide, Pargyline
Moderate DepletionBrand names include Eutron
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on for energy production, and methyclothiazide, a thiazide diuretic, can cause your kidneys to flush more of it out in your urine than normal. Over time, especially at higher doses or in older adults who may not be getting enough thiamine through food, this loss can become meaningful. This is rated a moderate depletion concern, so if you have been on this medication long-term, it is worth bringing up with your pharmacist or doctor to see whether your levels should be checked or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Methyclothiazide, Reserpine
Moderate DepletionBrand names include Diutensen-R
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is the vitamin your heart and nervous system depend on to convert food into energy. Methyclothiazide is a diuretic, meaning it makes your kidneys excrete more fluid, and along with that extra fluid, some thiamine gets flushed out in the urine as well. This is rated as moderate depletion, so it is a real consideration, especially for older adults or anyone whose diet is not very varied. It is worth mentioning to your pharmacist or doctor if you have been on this medication long-term, since they can check whether monitoring or a supplement makes sense for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Metolazone
Moderate DepletionBrand names include Diulo, Zaroxolyn, Mykrox
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine (vitamin B1) is something your heart, nerves, and muscles all depend on to convert food into energy. Metolazone is a diuretic, meaning it makes your kidneys produce more urine, and that extra urine can carry thiamine out of the body along with it. This is a moderate concern, so it does not affect everyone, but older adults or those taking higher doses for a long time are worth watching more closely. If you have been on metolazone for several months, it is a reasonable thing to bring up with your pharmacist or doctor.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Polythiazide
Moderate DepletionBrand names include Renese
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart muscle and nervous system depend on to produce energy properly. Diuretics like polythiazide can cause the kidneys to flush out more thiamine than usual in the urine, which over time may reduce levels in the body. This risk appears most relevant for older adults, people eating poorly, or those on higher diuretic doses for many months. If any of those apply to you, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Polythiazide, Prazosin
Moderate DepletionBrand names include Minizide
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Polythiazide is a thiazide diuretic, a water pill, and like other diuretics it can cause the kidneys to flush out more thiamine in the urine than usual. This is rated a moderate concern, meaning it is something worth keeping an eye on, especially for older adults or anyone on long-term diuretic therapy with a less-than-ideal diet. Ask your pharmacist or doctor whether your situation calls for any monitoring or follow-up.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Polythiazide, Reserpine
Moderate DepletionBrand names include Renese R
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system genuinely depend on, and the diuretic portion of this combination pill can cause the kidneys to flush more of it out in the urine than usual. Over time, especially in older adults or anyone not getting enough thiamine through food, that extra loss can add up to a real deficiency. This is rated moderate, meaning it does not affect everyone but is worth keeping an eye on, particularly with long-term use. Ask your pharmacist or doctor whether your diet, age, or heart health make monitoring or a supplement a smart idea for you.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Quinethazone
Moderate DepletionBrand names include Hydromox
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Quinethazone is a diuretic, and diuretics as a class can cause the kidneys to flush more thiamine out in the urine than normal, gradually lowering your body's supply. This is rated as moderate depletion, meaning it is a real concern worth watching, particularly for older adults or anyone not getting enough thiamine through food. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Quinethazone, Reserpine
Moderate DepletionBrand names include Hydromox R
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system both depend on to work properly. Quinethazone is a diuretic, meaning it helps the body shed excess fluid through urine, and that same process can carry extra thiamine out with it, gradually lowering your body's supply. This is rated a moderate concern, so it does not affect everyone, but older adults on long-term diuretic therapy or anyone with a limited diet may be at greater risk. It is worth bringing up with your pharmacist or doctor, especially if you have heart failure or have been on this medication for several months.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Reserpine, Trichlormethiazide
Moderate DepletionBrand names include Naquival, Metatensin #2, Metatensin #4
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body counts on for energy production and healthy nerve and heart function. Trichlormethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush out more thiamine than normal through the urine, which over time may lower your body's levels. This is rated a moderate concern, meaning it does not affect everyone but is worth watching, particularly in older adults or those whose diet may already be low in thiamine. If you have been on this medication long-term, it is a good idea to ask your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Sacubitril, Valsartan
Moderate DepletionBrand names include Entresto
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Sacubitril/valsartan contains a diuretic component that causes the kidneys to flush out more fluid, and thiamine, a B vitamin your heart and nerves depend on for energy, can get swept out along with that extra urine. This is a real enough concern, rated moderate, particularly for older adults or anyone on higher diuretic doses for several months with limited dietary intake. It does not mean everyone on this medication will become deficient, but it is worth bringing up with your doctor or pharmacist, especially if you notice unusual fatigue or other new symptoms.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Spironolactone
Moderate DepletionBrand names include Aldactone, Spiroton, Carospir
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nerves depend on to produce energy properly. Spironolactone is a diuretic, meaning it makes your kidneys remove extra fluid, and that process can also flush thiamine out through the urine over time. This is a moderate concern, so it does not mean everyone on spironolactone will run low, but long-term users, especially older adults or those eating a limited diet, may be worth monitoring. If you have been on spironolactone for a while, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Theobromine
Moderate DepletionIncreased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Theobromine is a mild diuretic, meaning it nudges your kidneys to produce more urine, and that extra urine can carry thiamine (a B vitamin your heart and nervous system depend on) out of your body faster than usual. The concern is most relevant for older adults taking higher doses over many months, particularly if their diet is already low in thiamine. Because the rating here is moderate, this is worth keeping on your radar rather than ignoring, so if you have been on theobromine long-term, it is a good idea to ask your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Torsemide
Moderate DepletionBrand names include Demadex, Soaanz
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart and nervous system depend on to convert food into energy. Torsemide, like other loop diuretics, works by pushing your kidneys to flush out excess fluid, and thiamine gets swept out in that extra urine along the way. This is a moderate concern, particularly for older adults or anyone on high doses for months at a time, since low thiamine can quietly make heart failure harder to manage. If you have been on torsemide long-term, it is worth asking your pharmacist or doctor whether your thiamine levels should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Trichlormethiazide
Moderate DepletionBrand names include Metahydrin, Naqua, Marazide II
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your body uses to convert food into energy and to keep your heart and nerves working properly. Trichlormethiazide is a thiazide diuretic, and diuretics as a class can cause the kidneys to flush more thiamine out in the urine than usual, which over time may lower your levels. This is rated a moderate concern, meaning it does not happen to everyone, but people who are older, eating a limited diet, or taking higher doses for many months are the ones most worth watching. If any of those apply to you, it is worth bringing up with your pharmacist or doctor to decide whether monitoring or a supplement makes sense.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Urea
Moderate DepletionBrand names include Ureaphil
Increased urinary thiamine excretion and thiamine deficiency may occur in some people treated with diuretics, especially in high doses (e.g., more than 80 mg furosemide daily) for several months. Although most case reports involve furosemide, animal data suggest that the effect may occur with any diuretic. Diuretic-induced thiamine deficiency appears to be most common in elderly people with inadequate dietary intake and to be rare in people less than 60 years of age. Thiamine deficiency in people taking diuretics is a concern because it might worsen heart failure. Limited research suggests that supplementation with thiamine 200 mg daily may improve left ventricular ejection fraction and functional capacity in some thiamine-deficient people treated with high doses of furosemide for heart failure. However, other studies have found no improvement. It's too soon to recommend routine thiamine supplementation for people on prolonged, high-dose diuretic therapy. Monitor for thiamine deficiency.
Thiamine is a B vitamin your heart, nerves, and muscles depend on for energy. Urea is a diuretic, meaning it makes the kidneys produce more urine, and that extra urine can carry thiamine out of the body faster than normal. This is a moderate concern, particularly for older adults or anyone taking high doses of a diuretic for many months. If that sounds like your situation, it is worth asking your pharmacist or doctor whether your thiamine level should be checked.
References (9)
- Brady JA, Rock CL, Horneffer MR. Thiamin status, diuretic medications, and the management of congestive heart failure. J Am Diet Assoc 1995;95:541-4. PubMed
- Shimon I, Almog S, Vered Z, et al. Improved left ventricular function after thiamine supplementation in patients with congestive heart failure receiving long-term furosemide therapy. Am J Med 1995;98:485-90. PubMed
- Seligmann H, Halkin H, Rauchfleisch S, et al. Thiamine deficiency in patients with congestive heart failure receiving long-term furosemide therapy: a pilot study. Am J Med 1991;91:151-5. PubMed
- Leslie D, Gheorghiade M. Is there a role for thiamine supplementation in the management of heart failure? Am Heart J 1996;131:1248-50. PubMed
- Saif MW. Is there a role for thiamine in the management of congestive heart failure? (letter) South Med J 2003;96:114-5. PubMed
- Schoenenberger AW, Schoenenberger -Berzins R, der Maur CA, et al. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol. 2012 Mar;101(3):159-64. PubMed
- Lubetsky A, Winaver J, Seligmann H, et al. Urinary thiamine excretion in the rat: effects of furosemide, other diuretics, and volume load. J Lab Clin Med 1999;134:232-7.. PubMed
- Levy WC, Soine LA, Huth MM, Fishbein DP. Thiamine deficiency in congestive heart failure (letter). Am J Med 1992;93:705-6. PubMed
- Pfitzenmeyer P, Guilland JC, d'Athis P, et al. Thiamine status of elderly patients with cardiac failure including the effects of supplementattion. Int J Vitam Nutr Res 1994;64:113-8.
Alogliptin, Metformin
Insufficient EvidenceBrand names include Kazano
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body needs to turn food into usable energy, and there is an old, animal-based theory that metformin might interfere with how thiamine works inside cells. The idea comes from research on a related drug, not from human studies with metformin itself, so this connection has never been confirmed in people. With an "insufficient evidence" rating like this, there is really nothing to act on right now, though if you have been on metformin long-term and have questions, it is always worth a quick conversation with your pharmacist or doctor.
References (2)
Canagliflozin, Metformin
Insufficient EvidenceBrand names include Invokamet
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to turn blood sugar into usable energy inside your cells. Some early animal research suggested that metformin might interfere with how thiamine works in that energy-making process, which could theoretically affect a byproduct called lactic acid. That connection has never been confirmed in people, though, and the evidence is currently too thin to draw any real conclusions. For now, most people taking this combination do not need to act on this, but if you are curious about your thiamine status, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Canagliflozin, Metformin Hydrochloride
Insufficient EvidenceBrand names include Invokamet XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to convert food into usable energy, and it plays a key role in keeping that process running smoothly inside your cells. Some early animal research suggested that metformin (one of the two drugs in this combination) might interfere with how thiamine works in the body, which is an interesting theory, but it has never been confirmed in people. The evidence here is truly preliminary, so most patients taking this medication do not need to worry about thiamine right now. If you are curious or have concerns, it is always a good idea to bring it up with your pharmacist or doctor at your next visit.
References (2)
Full nutrient report for Canagliflozin, Metformin Hydrochloride →
Dapagliflozin Propanediol, Metformin
Insufficient EvidenceBrand names include Xigduo XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to convert food into energy, and it plays a key role in keeping that process running smoothly inside your cells. Some early animal research suggested that metformin might interfere with how thiamine works at a cellular level, which could theoretically affect energy metabolism, but this connection has never been confirmed in people taking metformin. Given that the evidence is rated insufficient, there is no established reason for concern right now. Still, if you are a long-term metformin user and curious, it is worth bringing up with your pharmacist or doctor.
References (2)
Full nutrient report for Dapagliflozin Propanediol, Metformin →
Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride
Insufficient EvidenceBrand names include Qternmet XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body needs to turn food into usable energy, and there is an old, unproven theory that metformin (one of the drugs in this combination) might interfere with how thiamine works inside cells. That idea came from animal studies on a related drug and has never been confirmed in people taking metformin. Given the 'insufficient evidence' rating, this is not something most patients need to worry about, but if you take this medication long-term and have questions, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Full nutrient report for Dapagliflozin, Metformin Hydrochloride, Saxagliptin Hydrochloride →
Empagliflozin, Linagliptin, Metformin Hydrochloride
Insufficient EvidenceBrand names include Trijardy XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to turn food into usable energy, and it plays a specific role in keeping cellular metabolism running smoothly. Some animal research with an older, related drug raised the idea that metformin might interfere with thiamine's activity in that process, but this connection has never been confirmed in people actually taking metformin. Given that the evidence is truly insufficient right now, there is no reason to be alarmed. If you are curious whether this is worth tracking for you personally, it is a great question to bring up with your pharmacist or doctor.
References (2)
Full nutrient report for Empagliflozin, Linagliptin, Metformin Hydrochloride →
Empagliflozin, Metformin
Insufficient EvidenceBrand names include Synjardy
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to turn food into usable energy, and there is an older theory suggesting metformin might interfere with how thiamine works in cells. This idea came from animal studies on a related drug called phenformin and has never been confirmed in people taking metformin. The evidence here is simply too limited to draw any real conclusions, so most patients taking this combination do not need to worry about it. That said, if you have questions about your nutrition while on these medications, it is always worth a quick chat with your pharmacist or doctor.
References (2)
Empagliflozin, Metformin Hydrochloride
Insufficient EvidenceBrand names include Synjardy XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to turn food into usable energy, and it plays a key role in how cells process sugar for fuel. Some early animal research hinted that metformin (one of the two drugs in this combination) might interfere with how thiamine works inside cells, which could theoretically affect the way pyruvate is handled during energy production. That connection has never been confirmed in people, though, so this is considered a theoretical concern with insufficient evidence at this point. Most people taking this medication do not need to worry about their thiamine levels, but if you are curious or have questions, it is always fine to bring it up with your pharmacist or doctor.
References (2)
Full nutrient report for Empagliflozin, Metformin Hydrochloride →
Ertugliflozin, Metformin Hydrochloride
Insufficient EvidenceBrand names include Segluromet
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to convert food into energy, and your nerves and heart depend on it to work properly. There is some early, animal-based research suggesting metformin could interfere with how thiamine functions inside cells, possibly nudging certain byproducts toward lactic acid instead of usable energy. That said, this idea has never been confirmed in people taking metformin, so the evidence is really too thin to draw any firm conclusions. If you have been on this medication long-term and are curious whether this applies to you, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Full nutrient report for Ertugliflozin, Metformin Hydrochloride →
Fluorouracil
Insufficient EvidenceBrand names include Efudex, Tolak
People receiving 5-fluorouracil-containing chemotherapy regimens may be at risk for thiamine deficiency. 5-fluorouracil might interfere with activation of thiamine or increase its breakdown. However, there isn't enough research to recommend routine thiamine supplementation. Thiamine deficiency has been reported with other chemotherapy regimens, but this is likely due to reduced dietary intake associated with cancer and its treatment.
Thiamine is a B vitamin your body uses to convert food into energy and keep your nerves working properly. There is some early, theoretical concern that fluorouracil may interfere with how the body activates thiamine or may speed up its breakdown, but this has not been well studied and the clinical significance is simply not known yet. Keep in mind that people going through cancer treatment often eat less, which may play a bigger role in any thiamine changes than the drug itself. If you are concerned, bring it up with your oncologist or pharmacist before considering any supplement.
References (3)
- Aksoy M, Basu TK, Brient J, Dickerson JW. Thiamin status of patients treated with drug combinations containing 5-fluorouracil. Eur J Cancer 1980;16:1041-5. PubMed
- Ulusakarya A, Vantelon JM, Munck JN, et al. Thiamine deficiency in a patient receiving chemotherapy for acute myeloblastic leukemia (letter). Am J Hematol 1999;61:155-6. DOI
- De Reuck JL, Sieben GJ, Sieben-Praet MR, et al. Wernicke's encephalopathy in patients with tumors of the lymphoid-hemopoietic systems. Arch Neurol 1980;37:338-41.. PubMed
Fluorouracil (IV)
Insufficient EvidenceBrand names include Fluorouracil
People receiving 5-fluorouracil-containing chemotherapy regimens may be at risk for thiamine deficiency. 5-fluorouracil might interfere with activation of thiamine or increase its breakdown. However, there isn't enough research to recommend routine thiamine supplementation. Thiamine deficiency has been reported with other chemotherapy regimens, but this is likely due to reduced dietary intake associated with cancer and its treatment.
Thiamine is a B vitamin your body needs to convert food into energy and keep your nerves working properly. There is some early thinking that fluorouracil could interfere with the way your body activates thiamine or speed up how it breaks down, though the research here is still very limited. The evidence rating is 'insufficient,' meaning scientists have noticed a possible connection but do not yet have enough data to say how meaningful it is in practice. If you are on a fluorouracil-based regimen and have concerns about nutrition or fatigue, it is worth bringing up with your oncologist or pharmacist.
References (3)
- Aksoy M, Basu TK, Brient J, Dickerson JW. Thiamin status of patients treated with drug combinations containing 5-fluorouracil. Eur J Cancer 1980;16:1041-5. PubMed
- Ulusakarya A, Vantelon JM, Munck JN, et al. Thiamine deficiency in a patient receiving chemotherapy for acute myeloblastic leukemia (letter). Am J Hematol 1999;61:155-6. DOI
- De Reuck JL, Sieben GJ, Sieben-Praet MR, et al. Wernicke's encephalopathy in patients with tumors of the lymphoid-hemopoietic systems. Arch Neurol 1980;37:338-41.. PubMed
Glipizide, Metformin
Insufficient EvidenceBrand names include Metaglip
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body needs to turn food into usable energy, particularly inside your cells' energy-producing centers. There is some early animal research suggesting metformin might interfere with how thiamine works in that process, which could theoretically play a role in a rare side effect called lactic acidosis. That said, this has never been confirmed in people taking metformin, so the evidence is really too thin to draw conclusions. Most people on this medication do not need to take any action, but if you are curious about your thiamine status, it is worth a conversation with your pharmacist or doctor.
References (2)
Glyburide, Metformin
Insufficient EvidenceBrand names include Glucovance
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to turn blood sugar into usable energy inside your cells. Some animal research on older diabetes drugs raised the idea that metformin might interfere with how thiamine works in that process, which could theoretically affect how the body handles a byproduct called pyruvate. That connection has never been confirmed in people taking metformin, so right now the evidence is too thin to draw any firm conclusions. If you have concerns, it is worth mentioning to your pharmacist or doctor at your next visit.
References (2)
Linagliptin, Metformin Hydrochloride
Insufficient EvidenceBrand names include Jentadueto XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to turn blood sugar into usable energy inside your cells. Some early animal research suggested that metformin might interfere with how thiamine works in that energy-conversion process, which is actually one theory about why metformin can occasionally be linked to a condition called lactic acidosis. That said, this connection has never been confirmed in people taking metformin, so the evidence right now is far too thin to say this is a real concern. If you are curious whether this applies to you, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Full nutrient report for Linagliptin, Metformin Hydrochloride →
Mephenytoin
Insufficient EvidenceBrand names include Mesantoin
Some evidence suggests that chronic treatment with phenytoin might reduce levels of thiamine in plasma and cerebrospinal fluid, and reduce uptake of thiamine into nerve tissue. Theoretically, this could contribute to side effects of phenytoin such as polyneuropathy and cerebellar ataxia. However, it isn't clear whether affected patients also had other factors contributing to thiamine deficiency, such as dietary insufficiency. There isn't enough evidence to recommend routine thiamine supplementation.
Thiamine is a B vitamin your nerves and brain depend on to work properly. Some research hints that phenytoin-type medications like mephenytoin may interfere with how nerve tissue takes up thiamine, and might lower thiamine levels in the blood and spinal fluid over time. That said, the evidence here is quite thin, and it is not clear whether other factors, like a low-thiamine diet, played a role in the patients studied. If you have been on mephenytoin long term, it is worth mentioning this to your pharmacist or doctor, but right now there is not enough evidence to recommend routine supplementation for everyone.
References (3)
- Botez MI, Botez T, Ross-Chouinard A, Lalonde R. Thiamine and folate treatment of chronic epileptic patients: a controlled study with the Wechsler IQ scale. Epilepsy Res 1993;16:157-63.. PubMed
- Botez MI, Joyal C, Maag U, Bachevalier J. Cerebrospinal fluid and blood thiamine concentrations in phenytoin-treated epileptics. Can J Neurol Sci 1982;9:37-9.. PubMed
- Patrini C, Perucca E, Reggiani C, Rindi G. Effects of phenytoin on the in vivo kinetics of thiamine and its phosphoesters in rat nervous tissues. Brain Res 1993;628:179-86.. PubMed
Metformin
Insufficient EvidenceBrand names include Glucophage
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body needs to properly convert food into usable energy inside your cells. There is some early, animal-based research suggesting metformin could interfere with how thiamine works in that energy process, which in theory might nudge the body toward producing more lactic acid as a byproduct. That said, this idea has never been confirmed in people taking metformin, so right now the evidence is too thin to draw any real conclusions. If you have concerns, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Metformin Hydrochloride
Insufficient EvidenceBrand names include Riomet ER
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to pull energy out of carbohydrates, and your cells absolutely need it to keep metabolism running smoothly. Some early animal research with an older, related drug hinted that this class of medication might interfere with how thiamine works inside cells, possibly nudging more waste products toward lactic acid rather than usable energy. That idea has never been confirmed in people taking metformin, so the evidence right now is too thin to draw real conclusions. If you have concerns, it is worth a quick conversation with your pharmacist or doctor, but most people taking metformin do not need to worry about this.
References (2)
Metformin, Linagliptin
Insufficient EvidenceBrand names include Jentadueto
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to convert food into usable energy inside your cells. Some early animal studies hinted that metformin might interfere with how thiamine works in that process, which is an interesting idea, but it has never been confirmed in people taking metformin. Right now the evidence is simply too thin to know whether this matters at all in practice, so most people on metformin do not need to act on this. If you are curious or have concerns, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Metformin, Rosiglitazone
Insufficient EvidenceBrand names include Avandamet
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to convert food into usable energy, particularly inside your cells' powerhouses. Some animal research with older diabetes drugs hinted that metformin might interfere with how thiamine works in that energy process, but this has never been confirmed in people taking metformin. The evidence here is truly preliminary, so most people on this medication have no reason to worry. If you are curious or have symptoms like unusual fatigue, it is worth a quick conversation with your pharmacist or doctor.
References (2)
Metformin, Sitagliptin
Insufficient EvidenceBrand names include Janumet, Janumet XR
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body needs to convert food into usable energy, particularly inside your cells' power centers. Some early animal research suggested that metformin might interfere with how thiamine works in that energy process, which could theoretically play a role in a rare but serious side effect called lactic acidosis. That said, this has never been confirmed in humans, and there is currently not enough evidence to know whether this is a real concern in practice. For now, most people on metformin do not need to act on this, but if you are curious about your thiamine status, it is worth bringing up with your pharmacist or doctor.
References (2)
Phenobarbital, Phenytoin
Insufficient EvidenceBrand names include Dilantin with PB
Some evidence suggests that chronic treatment with phenytoin might reduce levels of thiamine in plasma and cerebrospinal fluid, and reduce uptake of thiamine into nerve tissue. Theoretically, this could contribute to side effects of phenytoin such as polyneuropathy and cerebellar ataxia. However, it isn't clear whether affected patients also had other factors contributing to thiamine deficiency, such as dietary insufficiency. There isn't enough evidence to recommend routine thiamine supplementation.
Thiamine is a B vitamin your nerves and brain depend on to work properly. Some research hints that phenytoin may interfere with how nerve tissue takes up thiamine, which is interesting because nerve-related side effects are already known with long-term phenytoin use. That said, the evidence is quite thin, and it is not clear whether diet or other factors played a role in the cases studied. There is not enough information to suggest routine supplementation, so if you have been on phenytoin for a long time and have questions about your nutrient levels, it is worth a conversation with your pharmacist or doctor.
References (3)
- Botez MI, Botez T, Ross-Chouinard A, Lalonde R. Thiamine and folate treatment of chronic epileptic patients: a controlled study with the Wechsler IQ scale. Epilepsy Res 1993;16:157-63.. PubMed
- Botez MI, Joyal C, Maag U, Bachevalier J. Cerebrospinal fluid and blood thiamine concentrations in phenytoin-treated epileptics. Can J Neurol Sci 1982;9:37-9.. PubMed
- Patrini C, Perucca E, Reggiani C, Rindi G. Effects of phenytoin on the in vivo kinetics of thiamine and its phosphoesters in rat nervous tissues. Brain Res 1993;628:179-86.. PubMed
Phenytoin
Insufficient EvidenceBrand names include Dilantin Kapseals, Dilantin, Di-Phen
Some evidence suggests that chronic treatment with phenytoin might reduce levels of thiamine in plasma and cerebrospinal fluid, and reduce uptake of thiamine into nerve tissue. Theoretically, this could contribute to side effects of phenytoin such as polyneuropathy and cerebellar ataxia. However, it isn't clear whether affected patients also had other factors contributing to thiamine deficiency, such as dietary insufficiency. There isn't enough evidence to recommend routine thiamine supplementation.
Thiamine is a B vitamin your nerves and brain depend on to work properly. Some research has found that long-term phenytoin use may reduce thiamine levels in the blood and nervous system, and could possibly limit how well nerve tissue takes it up, though scientists are still unsure exactly why this happens. The evidence here is genuinely thin, and it is not clear whether other factors, like diet, played a role in the patients studied. If you have been on phenytoin for years and have questions about this, it is worth a conversation with your pharmacist or doctor.
References (3)
- Botez MI, Botez T, Ross-Chouinard A, Lalonde R. Thiamine and folate treatment of chronic epileptic patients: a controlled study with the Wechsler IQ scale. Epilepsy Res 1993;16:157-63.. PubMed
- Botez MI, Joyal C, Maag U, Bachevalier J. Cerebrospinal fluid and blood thiamine concentrations in phenytoin-treated epileptics. Can J Neurol Sci 1982;9:37-9.. PubMed
- Patrini C, Perucca E, Reggiani C, Rindi G. Effects of phenytoin on the in vivo kinetics of thiamine and its phosphoesters in rat nervous tissues. Brain Res 1993;628:179-86.. PubMed
pioglitazone, metformin
Insufficient EvidenceBrand names include ActoPlus Met
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to convert food into usable energy, and it plays a key role in how your cells process sugar. Some animal research with older diabetes drugs in the same family as metformin raised the idea that metformin might interfere with how thiamine works in the body, but this has not been shown to happen in people taking metformin. The evidence here is really just theoretical at this point, so most patients do not need to worry about it. If you have questions or want peace of mind, your pharmacist or doctor is a good person to ask.
References (2)
Saxagliptin, metformin XR
Insufficient EvidenceBrand names include Kombiglyze
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body needs to properly convert food into usable energy, particularly inside your cells' energy centers. Some animal research with older diabetes drugs in the same family as metformin hinted that metformin might interfere with how thiamine works in that energy process, but this has never been confirmed in humans taking metformin itself. The evidence here is genuinely insufficient, so there is no reason to worry right now. That said, if you are curious or have symptoms like unusual fatigue, it is always worth a conversation with your pharmacist or doctor.
References (2)
Sitagliptin, Metformin
Insufficient EvidenceBrand names include Zituvimet
Thiamine is involved in the entrance of glycolytic pyruvate into the mitochondrial Kreb's cycle. Reducing thiamine activity might lead to increased amounts of pyruvate being converted to lactic acid. This effect might be responsible for some of the cases of lactic acidosis associated with metformin. This theoretical effect is based on preclinical animal research with phenformin, a similar drug that was produced prior to metformin. This has not yet been substantiated in humans or with the use of metformin.
Thiamine is a B vitamin your body uses to pull energy out of carbohydrates and keep your nerves working properly. Some early animal research suggested that metformin might interfere with how thiamine works inside cells, which could theoretically affect certain chemical steps in energy metabolism. That said, this has never been confirmed in people taking metformin, and the evidence is far too limited to draw conclusions. For now, most patients do not need to do anything about this, but if you are curious or have concerns, your pharmacist or doctor is a good person to ask.
References (2)
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
THIAMINE & medications: FAQs
Which medications can lower THIAMINE?
I take one of these medications — am I deficient in THIAMINE?
Should I start a THIAMINE supplement?
Where does this information come from?
Other commonly implicated nutrients
Wondering about your THIAMINE levels?
Ask a licensed pharmacist — free, no appointment needed.
Sources & How We Checked
Medication associations with THIAMINE are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.