Clinical reviews
Thiamine deficiency
This can present as Wernicke’s encephalopathy, which is a medical emergency
- By: Clare Bolton, Andrew Jones
Thiamine, also known as vitamin B1, is a coenzyme that has a vital role in the metabolism of carbohydrates. Thiamine deficiency may impair cardiac and neurological functioning and can present as a neurological syndrome known as Wernicke’s encephalopathy, which is a medical emergency.
Management of thiamine deficiency is most commonly required when dealing with patients who drink heavily. The rise in alcohol related deaths in the United Kingdom suggests that doctors may increasingly be treating conditions caused by thiamine deficiency.1 However, thiamine deficiency can affect patients with a wide range of medical and surgical problems, making it a challenge in any specialty.
Records dating back to 2700 BC in China refer to symptoms of thiamine deficiency, including muscle weakness and paralysis. This disease was called beriberi meaning “wasted, wasted.” It was common in Asia and was thought to be an infectious disease.2 It wasn’t until the late 1800s that the