Journal
NUTRITION IN CLINICAL PRACTICE
Volume 27, Issue 1, Pages 41-50Publisher
WILEY
DOI: 10.1177/0884533611426149
Keywords
thiamine; vitamin B-1; beriberi; metabolic acidosis; critical illness; micronutrients; enteral nutrition; parenteral nutrition; refeeding syndrome; congestive heart failure
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Clinicians involved with nutrition therapy traditionally concentrated on macronutrients and have generally neglected the importance of micronutrients, both vitamins and trace elements. Micronutrients, which work in unison, are important for fundamental biological processes and enzymatic reactions, and deficiencies may lead to disastrous consequences. This review concentrates on vitamin B-1, or thiamine. Alcoholism is not the only risk factor for thiamine deficiency, and thiamine deficiency is often not suspected in seemingly well-nourished or even overnourished patients. Deficiency of thiamine has historically been described as beriberi but may often be seen in current-day practice, manifesting as neurologic abnormalities, mental changes, congestive heart failure, unexplained metabolic acidosis, and so on. This review explains the importance of thiamine in nutrition therapy and offers practical tips on prevention and management of deficiency states. (Nutr Clin Pract. 2012; 27: 41-50)
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