Thiamine deficiency is a medical condition of low levels of thiamine (vitamin B). It has higher levels of protein, thiamine, riboflavin, phosphorus, calcium, and iron than wheat flour. Wakame also has high levels of sodium, calcium, iodine, thiamine and niacin. In the 1930s, some flour began to be enriched with iron, niacin, thiamine and riboflavin. Benfotiamin is a lipid derivative of thiamine vitamin. They also contain significant amounts of manganese, copper, vitamin E, thiamine, and magnesium. Levels of serum glucose may rise, and B vitamin thiamine may fall. Other treatments may include sodium bicarbonate, thiamine, and magnesium. Conditions resulting in thiamine deficiency and its effects include chronic alcoholism and severe malnutrition. Pine nuts contain thiamine (vitamin B) and protein. Biochemically, arsenic prevents use of thiamine resulting in a clinical picture resembling thiamine deficiency. The most effective method of preventing AKS is to avoid B vitamin/thiamine deficiency. Many people with beriberi can be treated with thiamine alone. One review found thiamine and vitamin E to be likely effective. Blood should be immediately taken to test for thiamine, other vitamins and minerals levels.