This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Treatment of thiamine deficiency

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Thiamine must be replaced. It is given i.v. or i.m. in a dose appropriate to the deficiency:

  • mild chronic deficiency - 10-25 mg daily
  • severe deficency - 200-300 mg daily

Prevention and treatment of Wernicke's encephalopathy (1)

  • treatment is urgent as once the amnesic syndrome - Korsakoff psychosis - is established
  • only 50% of patients can be expected to show any improvement
  • untreated, the condition is fatal
  • offer thiamine to people at high risk of developing, or with suspected, Wernicke's encephalopathy. Thiamine should be given in doses toward the upper end of the 'British national formulary' range. It should be given orally or parenterally as follows:
    • offer prophylactic oral thiamine to harmful or dependent drinkers:
      • if they are malnourished or at risk of malnourishment or
      • if they have decompensated liver disease or
      • if they are in acute withdrawal or - before and during a planned medically assisted alcohol withdrawal
    • offer prophylactic parenteral thiamine followed by oral thiamine to harmful or dependent drinkers:
      • if they are malnourished or at risk of malnourishment or
      • if they have decompensated liver disease
      • and in addition
        • attend an emergency department or
        • are admitted to hospital with an acute illness or injury
    • offer parenteral thiamine to people with suspected Wernicke's encephalopathy. Maintain a high level of suspicion for the possibility of Wernicke's encephalopathy, particularly if the person is intoxicated. Parenteral thiamine should be given for a minimum of 5 days, unless Wernicke's encephalopathy is excluded. Oral thiamine should follow parenteral therapy
      • a review has suggested (2)
        • in the hospital setting
          • give intravenous thiamine 300 to 500mg three times a day for 3 to 5 days with daily review
          • if the individual is still symptomatic after 5 days of treatment, then give intravenous thiamine 300mg to 500mg once daily for a further 3 to 5 days for as long as clinical improvement continues
          • other causes for their confusion should be explored

Reference:

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.