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We are entirely dependent on dietary intake or supplementation, and even with adequate dietary intake, absorption can be impaired by a range of factors including age-related changes to stomach acid production, certain medications, and digestive conditions

Access to treatment then comes down to families who can afford to pay for it out-of-pocket, which creates an equity issue and forces children who could benefit the most from intervention to stop, Shah said

Finally, a more recent paper looked at various markers related to thiamine in FMS, alcoholism, and myofascial pain syndrome

The obesity and metabolic disease burden (with over a billion overweight or obese individuals worldwide) ensures continued demand