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Orthomolecular Medicine News Service, February 9, 2008

Vitamin Supplementation Prevents Anorexia

(OMNS February 9, 2008) Anorexia is primarily due to vitamin deficiency. Approximately one in twenty teenage girls in America is struggling with an eating disorder. Parents can help eliminate the risk of anorexia by providing their children with vitamin supplements.

Anorexia is an acknowledged clinical marker of beriberi, the disease specifically caused by a deficiency of vitamin B1 (thiamine). [1] Anorexia is also commonly observed as an early symptom of pellagra (niacin deficiency) [2] and is a known complication of scurvy, vitamin C deficiency. [3] Prevention is especially important, because beriberi/anorexia often does not respond well even to treatment with high doses of thiamine for months, and sometimes does not respond at all. [1] But as a rule, high potency vitamin supplements are an effective cure for the loss of muscle mass caused by beriberi and the skin lesions caused by pellagra.

The vitamin B1 in almost every multivitamin and B-complex vitamin pill is either thiamine mononitrate or thiamine hydrochloride. The bodyís ability to absorb these two forms of thiamine is limited [4] by the maximum amount that can be handled by the bodyís two specialized thiamine transport proteins. [5]. This means many doses per day of oral thiamine are necessary for effective treatment. Another class of thiamine molecules, called allithiamines, are much better absorbed. [6] Since allithiamines are not included in standard multivitamin preparations, we recommend their reformulation to include this specific form of B1.

The conventional medical approach to eating disorders such as anorexia typically includes psychological/behavioral treatment, medication, and food-groups dietetics. It is surprisingly rare for physicians to link eating disorders with vitamin deficiency, and few doctors recommend vitamin supplements for prevention.

Dieting without supplementation causes vitamin deficiency, and vitamin deficiency can lead to anorexia. Dieting is the number one cause of vitamin/mineral deficiency in America. Deficiency is entirely preventable with nutrition supplements. A fraction of the population is more prone to becoming thiamine deficient while dieting due to genetic conditions associated with proteins that bind thiamine [7,8]. The risk of thiamine deficiency is also increased by eating processed foods. A high intake of simple carbohydrates requires increased thiamine intake. Vitamin and mineral supplements contain no calories, and do not cause weight loss nor weight gain. They do help promote normal appetite.

Harold Foster, PhD writes:
"In both open and closed trials in sub-Saharan Africa, mixtures of nutrients were given to HIV-positive patients, some of whom were in the late stages of AIDS. Even just twice the US RDA of ascorbic acid and four times the US RDA for thiamine resulted in improvements of appetite . . . after only a few days of supplementation."

Erik Paterson, MD, writes:
"Many years ago, an emaciated, teenage girl was made to come to see me by her worried parents because of her revulsion against food. She admitted that she hardly ate anything, but explained that she felt that she was fat: a typical case of anorexia nervosa. I tried to persuade her to eat right. She adamantly refused. So I made a deal with her. I pointed out that by not eating she was making herself malnourished with respect to vitamins. The deal was that I would not pester her to eat if she would take vitamin pills, specifically vitamin C and B-complex vitamins. She agreed. Two weeks later she and her parents returned to tell me that she had developed a strong appetite. After another month, her emaciation was clearly disappearing. She never became anorexic again." [9]

A well-formulated daily multivitamin supplement, at least 1,000 mg per day of vitamin C, plus additional B-vitamins will greatly reduce the incidence of anorexia and other eating disorders. If you are helping to care for a family member with anorexia, and your physician didnít recommend vitamin supplements, get a second opinion.


[1] D. Lonsdale. Evid Based Complement Alternat Med. 2006 March; 3(1): 49-59.
[2] S. R. Roberts. "Pellagra: Its Symptoms and Treatment," The American Journal of Nursing, Vol. 20, No. 11 (Aug., 1920), p 885-890.
[3] L. Goebel. Last bullet in section on physical symptoms.
[4] D. Bender. "The Nutritional Biochemistry of the Vitamins," Cambridge University Press, 2003, page 151.
[5] V.S. Subramanian et al. "Vitamin B1 (thiamine) uptake by human retinal pigment epithelial (ARPE-19) cells: mechanism and regulation." Journal of Physiology (Oxford, United Kingdom, 2006), Volume Date 2007, 582(1), 73-85.
[6] T.P.S. Nibber, "Reply to Dr. Lonsdale," Townsend Letter for Doctors and Patients, August-Sept. 2004.
[7] B.H. Robinson, N. MacKay, K. Chun, and M. Ling, "Disorders of pyruvate carboxylase and the pyruvate dehydrogenase complex." Journal of Inherited Metabolic Disorders, 19, 452-62.
[8] D. Bender, "The Nutritional Biochemistry of the Vitamins", Cambridge University Press, 2003. Sections on Thiamine Responsive Pyruvate Dehydrogenase Deficiency (p 156) and on Maple Syrup disease (p 158).

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The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.

Editorial Review Board:

Carolyn Dean, M.D., N.D.
Damien Downing, M.D.
Harold D. Foster, Ph.D.
Steve Hickey, Ph.D.
Abram Hoffer, M.D., Ph.D.
Bo H. Jonsson, MD, PhD
Thomas Levy, M.D., J.D.
Erik Paterson, M.D.

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