Marrs · Cells 2021 · narrative review · n=?

Hiding in Plain Sight: Modern Thiamine Deficiency.

Cited 79 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review with mechanistic discussion and broad secondary citations, containing no original data.

PubMed 34685573 · doi:10.3390/cells10102595 · record verified 2026-08-29

What was done

This narrative review summarizes the role of thiamine (vitamin B1) as an essential cofactor in mitochondrial energy metabolism (glucose, fatty acid, and amino acid pathways), discusses environmental and pharmaceutical depletion mechanisms, and evaluates current Recommended Daily Allowance (RDA) guidelines against reported clinical deficiency rates.

What was found

The adult thiamine RDA is reported as 1.1 mg for females and 1.2 mg for males. Although standard diets typically supply this amount, the review reports that measurable thiamine deficiency occurs across multiple patient populations with incidence rates ranging from 20% to over 90% across different cited studies. No original clinical data, pooled effect sizes, or specific study characteristics are provided in the abstract.

Why it matters

The review argues that standard dietary thiamine recommendations may be inadequate to prevent deficiency in modern clinical populations exposed to metabolic stressors and depleting agents.

Limits

The abstract describes a narrative review without systematic search or meta-analytic methodology. It does not define the specific patient cohorts, diagnostic thresholds used to measure deficiency, or the individual study designs that yielded the 20% to >90% prevalence range.

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