Beriberi (Thiamine Deficiency) Medication

  • Author: Dieu-Thu Nguyen-Khoa, MD; Chief Editor: George T Griffing, MD   more...
 
Updated: Dec 13, 2011
 

Medication Summary

The goals of pharmacotherapy are to correct the vitamin deficiency, reduce morbidity, and prevent complications. Suspected cases of thiamine deficiency are treated with prompt administration of parenteral thiamine; therapy continues until all symptoms of the deficiency have disappeared. Even at high concentrations, thiamine is not toxic in a person with normal renal function. Most outpatient care is targeted at delivering thiamine in a bioavailable form to rehabilitated patients.

Next

Vitamins

Class Summary

Vitamins are essential for normal deoxyribonucleic acid (DNA) synthesis. Thiamine pyrophosphate, the biologically active form of thiamine (vitamin B-1), acts as a coenzyme in carbohydrate metabolism through the decarboxylation of alpha ketoacids. It also takes part in the formation of glucose by acting as a coenzyme for the transketolase in the pentose monophosphate pathway.

View full drug information

Thiamine

 

Thiamine is used to replenish the body's stores of the coenzyme thiamine pyrophosphate. The duration of parenteral thiamine therapy depends on the symptoms of thiamine deficiency; treatment is administered until all symptoms are gone.

Previous
 
Contributor Information and Disclosures
Author

Dieu-Thu Nguyen-Khoa, MD  Associate Professor of Clinical Medicine, University of California, Los Angeles, David Geffen School of Medicine; Physician Specialist, Department of Primary Care and Community Medicine, ValleyCare Olive View-UCLA Medical Center

Dieu-Thu Nguyen-Khoa, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Dennis W Cope, MD, FACP  Emeritus Professor of Clinical Medicine, University of California, Los Angeles, David Geffen School of Medicine; Chief, Department of Internal Medicine, Olive View-UCLA Medical Center

Dennis W Cope, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Ginette V Busschots, MD  Assistant Professor, Department of Emergency Medicine, Foote Hospital, University of Michigan Medical School

Disclosure: Nothing to disclose.

Phyllis A Vallee, MD  Associate Program Director, Department of Emergency Medicine, Henry Ford Hospital

Phyllis A Vallee, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Medical Association, and Michigan State Medical Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Stanley Wallach, MD Executive Director, American College of Nutrition; Clinical Professor, Department of Medicine, New York University School of Medicine

Stanley Wallach, MD is a member of the following medical societies: American College of Nutrition, American Society for Bone and Mineral Research, American Society for Clinical Investigation, American Society for Clinical Nutrition, American Society for Nutritional Sciences, Association of American Physicians, and Endocrine Society

Disclosure: Nothing to disclose.

References

  1. Wooley, JA. Characteristics of thiamin and its relevance to the management of heart failure. Nutr Clin Pract. Oct-Nov 2008;23:487-93. [Medline].

  2. Isselbacher KJ, Braunwald E, Wilson JD. Harrison's Principles of Internal Medicine. 13th ed. New York, NY: McGraw-Hill; 1994:474-475.

  3. McCormick DB. Shils ME, Young VR, eds. Modern Nutrition in Health and Disease. Philadelphia, Pa: Lea and Febiger; 1988:355-61.

  4. Rosen P, Barkin R. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, Mo: Mosby Year Book; 1998:2138-40.

  5. Thiamine. Monograph. Altern Med Rev. Feb 2003;8(1):59-62. [Medline].

  6. Beers MH, Berkow R, Bogin RM, eds. The Merck Manual. 17th ed. Whitehouse Station, NJ: Merck & Co; 1999:45-6.

  7. Cole PD, Kamen BA. "Beriberi" interesting!. J Pediatr Hematol Oncol. Dec 2003;25(12):924-6. [Medline].

  8. National Academy of Sciences. Dietary Guidance: Dietary Reference Intake Reports. USDA National Agricultural Library; [Full Text].

  9. The National Academies Press. Nutrition - Dietary Reference Intakes: DRIs): Recommended Dietary Allowances and Adequate Intakes, Vitamins. Available at http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity Files/Nutrition/DRIs/RDA and AIs_Vitamin and Elements.pdf. Accessed July 27, 2011.

  10. Karuppagounder SS, Xu H, Pechman D, et al. Translocation of amyloid precursor protein C-terminal fragment(s) to the nucleus precedes neuronal death due to thiamine deficiency-induced mild impairment of oxidative metabolism. Neurochem Res. Mar 4 2008;[Medline].

  11. Indraccolo U, Gentile G, Pomili G, et al. Thiamine deficiency and beriberi features in a patient with hyperemesis gravidarum. Nutrition. Sep 2005;21(9):967-8. [Medline].

  12. Zuccoli G, Gallucci M, Capellades J, et al. Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients. AJNR Am J Neuroradiol. Aug 2007;28(7):1328-31. [Medline].

  13. Hazell AS. Astrocytes are a major target in thiamine deficiency and Wernicke's encephalopathy. Neurochem Int. Jul-Aug 2009;55(1-3):129-35. [Medline].

  14. Zuccoli G, Pipitone N. Neuroimaging findings in acute Wernicke's encephalopathy: review of the literature. AJR Am J Roentgenol. Feb 2009;192(2):501-8. [Medline].

  15. Masumoto K, Esumi G, Teshiba R, et al. Need for thiamine in peripheral parenteral nutrition after abdominal surgery in children. JPEN J Parenter Enteral Nutr. Jul-Aug 2009;33(4):417-22. [Medline].

  16. Matrana MR, Davis WE. Vitamin deficiency after gastric bypass surgery: a review. South Med J. October/ 2009;102:1025-31. [Medline].

  17. Ahmed A, Daida Y, Novotny R. PS2-02: Micronutrient Deficiencies After Bariatric Surgery: Does Ethnicity Matter?. Clin Med Res. Nov 2011;9(3-4):165. [Medline].

  18. Braverman LE, Utiger RD. Werner and Ingbar's The Thyroid: A Fundamental and Clinical Text. 7th ed. Baltimore, Md: Lippincott Williams & Wilkins; 1996:694, 864.

  19. Al-Attas OS, Al-Daghri NM, Alfadda A, Abd Al-Rahman SH, Sabico S. Blood Thiamine and Derivatives as measured by High-Performance Liquid Chromatography: Levels and Associations in DM Patients with Varying Degrees of Microalbuminuria. J Endocrinol Invest. Nov 22 2011;[Medline].

  20. Sica DA. Loop diuretic therapy, thiamine balance, and heart failure. Congest Heart Fail. Jul-Aug 2007;13(4):244-7. [Medline].

  21. Hanninen SA, Darling PB, Sole MJ, et al. The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure. J Am Coll Cardiol. Jan 17 2006;47(2):354-61. [Medline].

  22. Aasheim ET, Bjorkman S, Sovik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. Jul 2009;90(1):15-22. [Medline].

  23. Rao SN, Mani S, Madap K, et al. High prevalence of infantile encephalitic beriberi with overlapping features of Leigh's disease. J Trop Pediatr. May 8 2008;[Medline].

  24. Fattal-Valevski A, Azouri-Fattal I, Greenstein YJ, et al. Delayed language development due to infantile thiamine deficiency. Dev Med Child Neurol. Aug 2009;51(8):629-34. [Medline].

  25. Weise Prinzo Z, de Benoist B. Meeting the challenges of micronutrient deficiencies in emergency-affected populations. Proc Nutr Soc. May 2002;61(2):251-7. [Medline].

  26. Shenoy VV, Patil PV, Nagar VS, et al. Congestive cardiac failure and anemia in a 15-year-old boy. J Postgrad Med. Jul-Sep 2005;51(3):225-7. [Medline].

  27. Angstadt JD, Bodziner RA. Peripheral polyneuropathy from thiamine deficiency following laparoscopic Roux-en-Y gastric bypass. Obes Surg. Jun-Jul 2005;15(6):890-2. [Medline].

  28. Koike H, Iijima M, Mori K, et al. Postgastrectomy polyneuropathy with thiamine deficiency is identical to beriberi neuropathy. Nutrition. Nov-Dec 2004;20(11-12):961-6. [Medline].

  29. Lu J, Frank EL. Rapid HPLC measurement of thiamine and its phosphate esters in whole blood. Clin Chem. May 2008;54(5):901-6. [Medline].

  30. Tran HA. Increased troponin I in "wet" beriberi. J Clin Pathol. May 2006;59(5):555. [Medline].

 
Previous
Next
 
Table. Nutritional Needs for Specific Age Groups[9]
Population Age Allowance, mg/day
Recommended Dietary Allowances (RDAs)
Boys9-13 years0.9
Men>14 years1.2
Girls9-13 years0.9
Women14-18 years1.0
Women>19 years1.1
Pregnant/lactating women. . .1.4
Children1-3 years0.5
Children4-8 years0.6
Adequate Intakes (AIs)
Infant0-6 months0.2
Infant7-12 months0.3
Previous
Next
 
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.