Volume 34, Issue 4 p. 558-564
Review

Role of Thiamin in Health and Disease

Bertha F. Polegato MD, PhD,

Corresponding Author

Bertha F. Polegato MD, PhD

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

Corresponding Author:

Bertha F. Polegato, Internal Medicine Department, Botucatu Medical School, São Paulo State University (Unesp), Av. Prof. Mário Rubens Guimarães Montenegro, s/n, UNESP – Campus de Botucatu, São Paulo 18618687, Brazil.

Email: berthafurlan@fmb.unesp.br

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Amanda G. Pereira MS,

Amanda G. Pereira MS

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Paula S. Azevedo MD, PhD,

Paula S. Azevedo MD, PhD

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Nara A. Costa PhD,

Nara A. Costa PhD

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Leonardo A. M. Zornoff MD, PhD,

Leonardo A. M. Zornoff MD, PhD

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Sergio A. R. Paiva MD, PhD,

Sergio A. R. Paiva MD, PhD

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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Marcos F. Minicucci MD, PhD,

Marcos F. Minicucci MD, PhD

Internal Medicine Department, Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil

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First published: 15 January 2019
Citations: 23

Financial disclosure: None declared.

Conflicts of interest: None declared.

Abstract

Thiamin is a hydrosoluble vitamin that plays a role in several biological processes, mainly in glucose metabolism. There are several risk factors for developing thiamin deficiency, such as malnutrition, refeeding syndrome, gastrointestinal surgery, and alcoholism. Recently, the role of thiamin in critically ill patients has gained prominence, and the prevalence of thiamin deficiency was found to be increased in patients with severe burns, major surgery, septic shock, end-stage renal disease, and heart failure. In adults, thiamin deficiency presents as encephalopathy, dry beriberi (with neurological signs and symptoms), or wet beriberi (with cardiovascular signs and symptoms). Thiamin deficiency can be diagnosed clinically, and all clinicians should be aware of this disease, especially in patients with risk factors for thiamin deficiency. Thiamin supplementation should be started as early as possible in patients suspected to have thiamin deficiency. Treatment is safe, inexpensive, simple, and life-saving. Diagnosis is confirmed on a positive response to treatment.