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Impairment of this process leads to conversion of H2O2 to hydroxyl free radicals, which causes cellular injuries in neuronal cells, which presents as delirium.[27] Predisposing Factors to Thiamine Deficiency Thiamine deficiency can result from conditions that restrict eating, such as orofacial cancers, or limit adequate vitamin absorption, such as gastric bypass surgery,[28] gastric and colon cancer, hyperemesis gravidarum, or starvation by choice or associated with sepsis, surgical complications, and coma.[27,29,30] By far the most common cause of thiamine deficiency throughout the world is alcoholism,[31] as described in landmark studies of alcoholic Wernicke-Korsakoff syndrome (WKS).[32,33] Individuals with alcoholism are at special risk for thiamine deficiency because of poor diet associated with their lifestyle and because chronic alcoholism compromises thiamine absorption from the gastrointestinal tract, impairs thiamine storage, and may reduce thiamine phosphorylation essential for cellular function.[31,3437] Table 2 outlines the predisposing factors for thiamine deficiency

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The interaction between glutathione and vitamin B12 may also protect against diseases 15 related to low vitamin B12