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Wet Brain: Thiamine, Diet, and Abstinence

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Schematic drawing of the human brain, showing regions vulnerable to alcoholism-related abnormalities.

Schematic drawing of the human brain, showing regions vulnerable to alcoholism-related abnormalities.

What Is Wet Brain?

Wet brain is a term used to describe brain disease that is often associated with heavy alcohol consumption. The medical name for one of these conditions is Wernicke-Korsakoff syndrome (WKS). This syndrome is considered by some to be two separate conditions: Wernicke’s encephalopathy and Korsakoff’s psychosis. Some consider Wernicke-Korsakoff syndrome as one condition that involves different parts of the brain as it progresses.

Wernicke's encephalopathy affects the cerebellum, the part of the brain that controls coordination and balance and some forms of learning. Korsakoff's psychosis involves the part of the brain responsible for memory.

Wernicke-Korsakoff Syndrome

Both conditions are caused by nutritional deficiencies, especially thiamine or vitamin B1 deficiency, in combination with nerve tissue damage caused by the toxic effects of alcohol. Alcohol affects the way thiamine is absorbed in the body and can also contribute to a poor diet—a “liquid diet” consisting of little more than alcohol. So, heavy consumption of alcohol can lead to vitamin B1 deficiency which can lead to wet brain. Proper diet and thiamine supplements can prevent wet brain in heavy alcohol consumers. Abstinence, which means stopping alcohol use, can prevent further brain and nerve damage.

Wet brain can also be caused by liver disease, poor diet, or vomiting for several days, such as during morning sickness in pregnancy, or with bulimia, an eating disorder that involves “purging” or vomiting to avoid weight gain. It can also develop following gastric bypass surgery and in elderly persons who live alone and are malnourished. Some research suggests there may also be a genetic component involving an inherited lack of the enzyme transketolase that contributes to the development of brain disease.

Whether it is considered a separate condition or the earlier part of a progression, Wernicke’s encephalopathy has a better prognosis than Korsakaff’s psychosis. Wernicke’s encephalopathy affects the cerebellum, the part of the brain that controls coordination and balance and some forms of learning. Korsakoff’s psychosis involves the part of the brain responsible for memory.

When recognized and treated early, Wernicke’s encephalopathy responds well and very rapidly to thiamine treatment. Korsakoff’s psychosis does not respond as well or as quickly to thiamine treatment, although 20% of people with Korsakoff’s psychosis do recover. The recovery process is slow, taking 6 to 12 months. Discontinuing use of alcohol is required.

Wernicke’s encephalopathy is a short-lived and severe condition, while Korsakoff’s psychosis is long-lasting and debilitating. When brain damage is more severe, the course of care shifts from treatment to support and care for the patient and caregivers. People with Korsakoff’s syndrome often require nursing home or custodial care.

Up to 80% of alcoholics have a thiamine deficiency. Some of these will develop serious brain disorders such as WKS. Approximately 80-90% of alcoholics who do develop Wernicke’s encephalopathy will go on to develop Korsakoff’s psychosis. There may be a genetic component that explains why some alcoholics with thiamine deficiency do not develop WKS, but more research needs to be done to understand why some people are more vulnerable than others.

Symptoms of Korsakoff's Psychosis

Korsakoff’s psychosis involves severe memory loss and confabulation—making up stories or talking fluently without facts. A person with Korsakoff’s retains other cognitive functions, including intellect. Their use of confabulation is an attempt to fill in memory gaps. They are not deliberate or intentional lies: that would require more memory than they have. If you asked the person if you had met before, the person with Korsakoff’s psychosis would make up an elaborate story about how you met that is entirely fantasy. The person is not able to process and store new information and cannot recall things that happened five minutes after they happen. They will often repeat themselves as a result of not remembering they said something or the response to what they said. Korsakoff’s psychosis often follows DTs (delirium tremens) when a person is withdrawing from alcohol without adequate medical supervision.

Symptoms of Wernicke's Encephalopathy

Wernicke’s encephalopathy is characterized by three symptoms:

  1. mental confusion – confused, delirious, and apprehensive.
  2. paralysis of the nerves that move the eyes – nystagmus; difficulty moving eyes to follow a visual stimulus.
  3. difficulty with muscle coordination, walking (ataxia), and balance; an unsteady gait.

Nystagmus is often the first symptom to appear. It is also the first symptom to disappear in response to treatment. It is not necessary to have all three symptoms of Wernicke’s encephalopathy. The disorder may be present in a person who has only one or two of the symptoms. Autopsies have shown that many cases of thiamine deficiency-related encephalopathy were not diagnosed in life because not all of the symptoms were present.

Cerebral atrophy (brain shrinkage) or alcoholic dementia is related to alcoholism, as well, and is typically seen in people in their 50s and 60s. This condition also responds to thiamine treatment, healthy diet, and discontinuation of alcohol use. The damage that has already been done is not reversible, but treatment can stabilize the condition and prevent further progression. There are other alcohol-related brain disorders, including: alcoholic cerebellar degeneration, portosystemic encephalopathy (PSE), central pontine myelinolysis, and Marchiafava-Bignami disease.

The term “wet brain” is an informal term, not a medical term, used to describe a number of irreversible, organic brain diseases related to alcohol that cause mental impairment and physical disabilities and can result in the need for nursing home care.

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Read More From Healthproadvice

A Caregiver's Perspective

  • YouTube - Robert's Story
    Robert's series of 12 videos that describe in detail his perspective as a devoted husband and caregiver to his wife with Wernicke's Encephalopathy, from the first signs and symptoms to finding treatment and a partial recovery.

Robert's Website


This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2010 Kim Harris


Kim Harris (author) on May 04, 2012:

I am so sorry to hear about the loss of your brother to Korsakoff's, Mare12360. The 12 steps talk a lot about how alcoholism leads to death, insanity or imprisonment, but most people don't really grasp what this means. Those who do are often so devastated by the disease's effects that they are at a loss as to how to respond. Thanks for taking a minute to read and post a comment, mare 12360.

mare12460 on May 02, 2012:

Sadly my brother was just diagnosed with Korsakoff's psychosis. No one in my family had heard about this illness prior to his run-in with it. If only the education level was more wide spread... Even the medical community - especially in a small town - didn't seem to be in-tune. Now I've lost my brother and his family has lost their husband/father. He will need permanent long-term care 24/7 - probably in a nursing home. Alcohol is evil and this illness needs a voice to educate the masses... Thanks for taking the first step in that regard.

Kim Harris (author) on February 27, 2011:

Thanks so much fucsia. I was really glad I found the video on Robert's story. It takes some to listen to the whole video, but he does a good job explaining it from the caregiver's point of view.

fucsia on February 27, 2011:

Very informative and detailed Hub. Great work!

Kim Harris (author) on January 24, 2011:

Thank you ImChemist... for reading, rating and commenting. I appreciate it!

ImChemist on January 24, 2011:

Thanks for your informative hub , that i rated it useful.

Kim Harris (author) on January 05, 2011:

I'm thinking they had been talking openly for quite some time about their conditions before they agreed to the filming. They may even have done it in the spirit of helping others or something. But yeah, it would be weird to be talked about like that. And they both did seem really nervous about the camera. Thanks for stopping by to read and comment psychicdog. on January 05, 2011:

Good lesson re Vitamin B. Bit hard to take the Doctor1979 talking like he does - pointing out a man's defects in front of him! - cold, analytical and a bit dehumanizing - the guy is still a person with feelings (isn't he?) and pointing out his defects was a bit harsh I thought.

Kim Harris (author) on December 22, 2010:

Thanks vocalcoach. Isn't it amazing how much we learn from each other?! So much to learn, so little time. Can you imagine if one day you woke up and there was nothing left to learn!

Audrey Hunt from Pahrump NV on December 22, 2010:

A simply wonderful hub Kim! I have learned so much from this information. Thank you and God Bless!

Kim Harris (author) on December 08, 2010:

It sounds like that could be another hub, Bard. Thanks for stopping by to read and comment. I'm glad you're keeping up with your vitamins.

Steve Andrews from Lisbon, Portugal on December 08, 2010:

I found out about the benefits of B1 many years ago when I was into Scientology. Taking vitamins was one of the benefits I got from my time in it and something I learned from L Ron Hubbard. I always make sure I have Vitamin B complex tablets here.

Kim Harris (author) on December 04, 2010:

Ah. Thanks Baileybear. Big bear hugs!

Baileybear on December 04, 2010:

yes, I tweeted and facebooked

Kim Harris (author) on December 03, 2010:

Not many people know about wet brain. Everyone who reads my hub will know! twitter, tweet and stumble upon! Thanks Baileybear.

Baileybear on December 03, 2010:

Wet brain - I'd never heard of that. I imagine alcoholics would have at least a pickled liver!

Kim Harris (author) on December 03, 2010:

interesting is good. thanks daydreamer. I have to say though, I'm wondering what exactly you found to be so interesting!

daydreamer13 on December 03, 2010:

I found this very interesting!

Kim Harris (author) on December 02, 2010:

I know, pretty brutal, eh Micky! Thanks for passing through, Micky.

Micky Dee on December 02, 2010:

Wow. That's rough. This is a great message. Thank you Kim. God bless.

Kim Harris (author) on December 01, 2010:

thanks must65gt..... and no sense starting now!

must65gt on December 01, 2010:

never was a serious drinker, now I'm glad! lol...great hub and much useful information. thanks

Kim Harris (author) on November 28, 2010:

@epi. The pro bono thing was supposed to be funny, but I went back to check and I don't get it either now! Erase it if u want. Thanks for the thanksgiving blessings and for being a loyal reader. Happy Holidays to you too.

Kim Harris (author) on November 28, 2010:

Thank you Kaie........ eaaential for all of us, and especially for heavy drinkers!

Kaie Arwen on November 28, 2010:

Very informative........... the B vitamins are essential! Kaie

epigramman on November 27, 2010:

.....most of what you write (as of late) is way over my head but believe me it's fun to learn and be educated especially from someone like you my friend - I didn't even understand your PRO-BONO comment to me - but yes I liked Sonny Bono too much more than I ever liked Cher!!!!

Abstinence - isn't that when you stay away from 'nooky' and wet brain - isn't that when men watch too much Sunday afternoon football????

Either way you always put together a solid hub - I love your expertise and your passion - and I am here post Thanksgiving to wish you all of the good things life like health and happiness - and every day for me is a thankful day for having good people like you in my Hub life - and I will never ever forget that wonderful tribute hub you did for me - awesome are you and lucky is me!!!! (poor grammar - who cares)

Kim Harris (author) on November 27, 2010:

Thanks for reading it and commenting Jess. Have a safe, healthy and happy holiday season.

Jess Killmenow from Nowheresville, Eastern United States on November 27, 2010:

I'll have to think twice about my drinking this holiday season! Thanks for this thorough and thought provoking article!

Kim Harris (author) on November 24, 2010:

The advertising behind drinking makes it appear like everyone who drinks is beautiful, sexy, fun, popular, etc, and is aimed at a 20 something audience. That 20 something audience has a lot of legal consequences related to alcohol that makes getting a job more challenging. But if you put the 20 something mentality of "it will never happen to me" together with the fact that the physical consequences take many years to present, you have a captive audience for a lifetime.

Thanks for your comments, Tony. Good point re rights to privacy. Even if the people signed a valid consent back in the 70s, it's unlikely they anticipated being posted on YouTube. Yikes!

Tony McGregor from South Africa on November 23, 2010:

This is really very good. I was never a heavy drinker (though I had my moments when young!) but I have known quite a few.

It is the attitude of society that I think is so harmful. People look at "drunks" as people to be laughed at, and drinking becomes something to joke about. For example, at one place where I worked many years ago the acceptable lunch was to go out for what was called a "hydraulic sandwich" which was described as "a piece of bread between two beers." Now that might sound funny but that's the attitude which somehow makes excessive drinking acceptable.

The video you have posted here is a grim reminder that drinking has some really serious consequences. I did wonder, while watching the vid, about the men shown - were their rights to privacy not rather infringed by the vid? I felt uncomfortable watching, a bit voyeuristic.

A good and "sobering" Hub with lots of useful information.

Love and peace


Kim Harris (author) on November 23, 2010:

If you're still hubbing, you're in good shape. (a cue for me to check out your latest hubs) If I make it to 81 I'll come looking for you vern!

Vernon Bradley from Yucaipa, California on November 22, 2010:

I am "drinking" several packets of emergence each day which seems to have a good combo of B complex, including Thiamine and electrolytes, C, and a bunch of other "stuff." I have been taking good care of myself with diet and exercise since about 1987, even sober for 7 years, so perhaps I gave myself a little padding for the subsequent abuse. I am still eating well, drink lots of water, and still working at getting more sleep, altho this "place" keeps me up!! 100 is awesome age to look forward to. See you there!!


Kim Harris (author) on November 21, 2010:

take your thiamine too! I thought I was noticing fewer typos lately, Vern. Congrats on your continued sobriety, and say hi to your group from me. Disturbing you is my greatest pleasure. It's what I live for, ma raison d'etre. I've never aspired to live to 100 - 80 seems fair to me - but if I have to live to 100 to keep disturbing you, then that's just what I'll do! Seriously, thanks for stopping to read and comment, vern. love your comments.

Vernon Bradley from Yucaipa, California on November 21, 2010:

Well, you did an absolutely mawvelous job of scaring the sh*t out of me!! Before I read your hub, I was able to walk just fine, type pretty well, and did not feel confused. Now....!

Well, I have been studying about the brain for a long time and knew well about the irreversible damage to the cerebellum and would keep checking in each day while I was drinking!! How is that for what? Insanity!! But I have to tell you, reading this hub leaves a pit in my stomach. I plan to live at least to one hundred, and it hurts deep inside how I may have on my own, with no help from nature, diminished my chances. but I am a hopeful person and I can still remember beyond what I think a person my age can readily remember in terms of numbers, etc., and even peoples' names and their connection to my life. Met a young man in the grocery store the other day and was able to remember who he was and how he was connected to me. Could not believe that I could do that!! Felt relieved!

Anywho, this hub was a bit TOO GOOD. Chill out!!! lol

Wake up calls are life giving, and I am still sober. Still going to the most wonderful meetings in the world, and they are just down the street!



Kim Harris (author) on November 21, 2010:

Thank you, Quill for reading my hub and giving your feedback. I like the idea that my hub can help spread understanding!

"Quill" on November 21, 2010:

Thanks kimh039... very well put together, an enjoyable read and something which is far to common today, yet little understood.


Kim Harris (author) on November 21, 2010:

@Tony again. Oops. I meant Robert's story.

Kim Harris (author) on November 21, 2010:

@alekhouse - Thank you! You're my role model for well thought out and put together hubs. I'm really glad you found it so interesting.

Kim Harris (author) on November 21, 2010:

@Tony - Thank you much! I included the link to David's story to show his patience and understanding. 12 videos is a lot to watch (although I did! I found them fascinating), but he articulates in detail what it is really like from a loved one's perspective.

Nancy Hinchliff from Essex Junction, Vermont on November 21, 2010:

Really good hub, Kim...well thought out and put together. I found it extremely interesting

Tony DeLorger from Adelaide, South Australia on November 21, 2010:

Thanks Kim. As always well structured and explanitory. Mental illnesses in general need so much more focus and understanding in society.

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