Certain patients are at risk for developing thiamine (vitamin B1) deficiency. The identification of one or more risk factors should prompt an evaluation of the patient's thiamine status.


Persons at risk for thiamine deficiency:

(1) infants

(2) chronic alcoholics

(3) elderly (> 65 years of age)

(4) socially isolated

(5) refugee or displaced person or prisoner of war

(6) migrant workers with marginal diet

(7) food faddist

(8) chronic vomiting

(9) pregnancy

(10) person on a chronic low thiamine diet (see below)

(11) cancer patients

(12) dysentery or diarrhea

(13) malnutrition (prolonged fasting, anorexia nervosa, starvation)

(14) gastric plication


Low-thiamine diet:

(1) diet predominantly polished rice or refined wheat

(2) presence of antithiamine compounds

(3) thiamine unfriendly cooking methods

(4) high carbohydrate diet without vitamin supplementation

(5) breast milk from thiamine deficient mothers

(6) long term parenteral nutrition without vitamin supplementation


Times when thiamine deficiency may become manifest (increased requirements for thiamine):

(1) high carbohydrate load or carbohydrate infusion

(2) refeeding after starvation

(3) stress

(4) infection with fever

(5) hyperthyroidism

(6) illness

(7) pregnancy


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