From the Guidelines
The recommended oral thiamine daily dose for treating alcoholism is 100 mg, taken three times a day, as suggested by the most recent and highest quality study 1. To implement this:
- Take one 100 mg thiamine tablet with each meal (breakfast, lunch, dinner)
- Continue this regimen daily for at least several weeks, or as directed by a healthcare provider
- Thiamine supplements are available over-the-counter This high-dose thiamine supplementation is crucial for alcoholics because:
- Chronic alcohol use interferes with thiamine absorption and utilization
- Alcoholics often have poor nutrition, further depleting thiamine levels
- Thiamine deficiency can lead to serious neurological complications like Wernicke-Korsakoff syndrome In severe cases or for patients unable to take oral medication, intramuscular or intravenous thiamine may be necessary initially, with a dose of 100-300 mg/day, as recommended by 1 and 1. Always consult a healthcare provider for personalized dosing and treatment, especially if there are other health conditions present. It is also important to note that oral or intravenous glucose should not be given to people at risk of or with suspected thiamine deficiency, as it can precipitate Wernicke-Korsakoff syndrome, as warned by 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: ... An oral therapeutic multivitamin preparation containing 5 mg to 10 mg thiamine, administered daily for one month, is recommended to achieve body tissue saturation. The oral thiamine daily dose for the treatment of conditions related to alcoholism, such as Wernicke-Korsakoff syndrome, is not directly stated, but for body tissue saturation, 5 mg to 10 mg of thiamine is recommended daily in a multivitamin preparation 2.
From the Research
Oral Thiamine Daily Dose for Alcoholism Treatment
- The daily oral thiamine dose for the treatment of alcoholism is not universally agreed upon, with different studies suggesting various dosages 3, 4, 5, 6, 7.
- According to one study, patients with alcohol use disorder may be given 25 mg of thiamine four times a day, rather than 50 mg twice a day, based on the pharmacokinetic properties of thiamine 3.
- Another study recommends the following oral thiamine dosages:
- A review of the literature found that thiamine doses ranging from 100 to 1500 mg intravenous and up to 300 mg intramuscular resulted in symptom improvement, with minimal adverse drug events 5.
- A randomized controlled trial found no significant differences in cognitive function or neurological functioning between different thiamine dosage conditions, including 100 mg daily, 100 mg thrice daily, and 300 mg thrice daily 7.