What?
A recent study investigating the use of thiamine in sepsis has revealed that when given in the first 24 hours, thiamine can help the body fight off infections and reduce the death rate of infections that cause sepsis.
The study included 1049 patients with sepsis. Some patients who had sepsis were given the vitamin thiamine and some were randomly selected to not have it. Randomisation (i.e. the act of randomly selecting some people to receive treatment) is very important to reduce bias; and it allows researchers to identify that the the effect of the drug is actually due to the drug and not due to chance.
It has been theorised that thiamine helps to reduce lactate levels in the body. Lactate levels in the blood increase when cells start to die; and the blood lactate level is a common marker, used to measure the extent of sepsis within the body.
Why?
Sepsis is the body’s reaction to an infection in the bloodstream, commonly bacteria. Sepsis is a complex response of chemicals in the body to fight off an infection – and is not an infection itself, as widely believed. Sepsis can and often does result in fever, but the chemicals released in this inflammatory response can also result in other changes in the body, such as widening of blood vessels leading to dangerously low blood pressure, or inflammation and damage to the lungs.
A fever and a cough do not necessarily mean a patient has sepsis. That can be triggered naturally by a relatively mild illnesses, such as a viral infection. Patients and relatives can often assume something as harmless as a simple viral cough may represent ‘sepsis’. The word ‘sepsis’ however has unfortunately been overused and misinterpreted in many ways; leading to worry among patients and their relatives. There are set criteria one must meet to be diagnosed with sepsis – these can be found here.
Some symptoms of sepsis include: confusion, high heart rate, fever and shortness of breath.
When the body cannot fight off a serious infection, sometimes it goes in to a state of ‘shock’ where the organs cannot control what is happening around the body and slowly shut down. Some studies have shown that some patients who go in to ‘shock’ or organ shut down are often related to having a low vitamin called thiamine in their blood. Thiamine can be found in fish, meat and whole grains. Therefore this study was undertaken to test whether higher thiamine levels in the blood can result in better survival rates in those with sepsis. As mentioned above, the study was able to demonstrate that giving thiamine to those with sepsis resulted in better outcomes.
How (does it affect you)?
Given that thiamine is a simple and harmless vitamin with limited side effects, this study has added enormously to evidence supporting its use in patients with sepsis. This is new research, and is one single study. So thiamine’s use in sepsis remains under investigation. Therefore, if you or a loved one has sepsis, they will currently not receive thiamine supplementation. The current treatment for sepsis includes prompt intravenous antibiotics, fluids, and oxygen as required. However, given the positive effect of thiamine, there is good reason for future clinical guidelines to include it, as part of the treatment for sepsis.
If you has a fever, and feel very unwell, you should immediately contact 999, or 111 to be signposted to an appropriate service to be seen by a doctor. This is even more important if you are taking chemotherapy for cancer, as the immune system will be less effective due to the effects of anti-cancer medication. It is tremendously important, therefore, that antibiotics are given as quickly as possible, to prevent sepsis becoming a life-threatening condition. This is the reason that there is such emphasis on sepsis recognition in hospitals.
Find out more about sepsis here.
As always, best wishes from myHSN!
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