nutritional disorders
Thiamin Deficiency
Treatment of Thiamin Deficiency
Supplemental thiamin, with dose based on clinical manifestations Ensuring that dietary supplies of thiamin are adequate is important regardless of symptoms. Because IV glucose can worsen thiamin deficiency, people with alcohol use disorder and others at risk of thiamin deficiency should receive IV thiamin 100 mg before receiving IV glucose solutions. Give thiamin 100 mg IV before giving IV glucose to people with alcohol use disorder and others at risk of thiamin deficiency. The thiamin dose is For mild polyneuropathy: 10 to 20 mg orally once a day for 2 weeks For moderate or advanced neuropathy: 20 to 30 mg/day (as a single or divided dose), continued for several weeks after symptoms disappear For edema and congestion due to cardiovascular beriberi: 100 mg IV once a day for several days Heart failure is also treated. ForWernicke-Korsakoff syndrome,thiamin is given for several days. Although evidence has not established any single superior regimen, a common one is 500 mg IV infused over 30 minutes 3 times a day for 2 consecutive days and 250 mg IV or IM once a day for an additional 5 days in combination with other B vitamins. Anaphylactic reactions to IV thiamin are rare. Symptoms of ophthalmoplegia may resolve in a day; improvement in patients with Korsakoff psychosis may take 1 to 3 months. Recovery from neurologic deficits is often incomplete in Wernicke-Korsakoff syndrome and in other forms of thiamin deficiency. Because thiamin deficiency often occurs with other B vitamin deficiencies, multiple water-soluble vitamins are usually given for several weeks. Patients should continue to consume a nutritious diet, supplying 1 to 2 times the daily recommended intake of vitamins; all alcohol intake should stop. 