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The leading risk factor for thiamine deficiency in the United States is Alcoholism. In fact, the link between alcoholism, heart disease, and thiamine deficiency is so strong that researchers have formally identified a specific disease called beriberi heart disease, which usually leads to congestive heart failure. Chronic alcoholics may need 10-100 times the ordinary thiamine requirement. Heavy users of coffee and tea may also have increased risk of thiamine deficiency, since these beverages act as diuretics and remove both water and water-soluble vitamins, including thiamine, from your body. Your need for thiamine is also increased by chronic stress, chronic diarrhea, chronic fever, and smoking. People with these health problems may need 5-10 times the ordinary amount of thiamine.

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