Beriberi (Thiamine Deficiency) Treatment & Management

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

Approach Considerations

In suspected cases of thiamine deficiency, prompt administration of parenteral thiamine is indicated. The recommended dose is 50mg given intramuscularly for several days. The duration of therapy depends on the symptoms, and therapy is indicated until all symptoms have disappeared. Maintenance is recommended at 2.5-5mg per day orally unless a malabsorption syndrome is suspected.

Thiamine, even at high concentrations, is not toxic in a person with normal renal function. No cases of thiamine toxicity have been reported from the use of thiamine at the dosages indicated, even in patients in critical condition.

An optimal method for delivering the needed thiamine in a bioavailable form must be determined for the long-term treatment of each patient. Depending on the cause of the vitamin deficiency, a referral to an alcohol dependency clinic may be needed.

Most outpatient care is targeted at delivering thiamine in a bioavailable form to rehabilitated patients. Clinical follow-up with measurement of thiamine diphosphate activity may be warranted if relapse or noncompliance is suspected.

Support for cardiac function is necessary in cases of wet beriberi, because lack of cardiac function support leads to low-output cardiac failure when the thiamine deficiency is corrected.

Follow-up care until delivery of current pregnancy, intensive care for advanced cardiomyopathy, definitive care for hyperthyroidism, or further workup of intestinal derangement may be warranted in patients with thiamine deficiency.

Activity

The level of activity and the presence of a high energy consumption state (eg, hyperthyroidism, pregnancy, lactation, severe disease) increase the daily requirements of thiamine.

Proceed to Medication
 
 
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.

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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
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