A note on Diuretics and Thiamine deficiency
A very under-appreciated cause of thiamine deficiency is use of diuretics as well as any polyuria in ICU, and/or accompanied by poor nutrition. Loss of thiamine via diarrhea, dialysis and vomiting is well known but in ICU setting loss via diuretics become a significant factor. Polyuria for any reason may cause thiamine deficiency, and should be supplemented. CHF patients who are on chronic diuretic therapy are particularly prone to thiamine deficiency.
References:
1. Wooley, JA. Characteristics of thiamin and its relevance to the management of heart failure. Nutr Clin Pract. Oct-Nov 2008. 23:487-93.
2. Sica DA. Loop diuretic therapy, thiamine balance, and heart failure. Congest Heart Fail. 2007 Jul-Aug. 13(4):244-7.
3. Hanninen SA, Darling PB, Sole MJ, et al. The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure. J Am Coll Cardiol. 2006 Jan 17. 47(2):354-61.
A very under-appreciated cause of thiamine deficiency is use of diuretics as well as any polyuria in ICU, and/or accompanied by poor nutrition. Loss of thiamine via diarrhea, dialysis and vomiting is well known but in ICU setting loss via diuretics become a significant factor. Polyuria for any reason may cause thiamine deficiency, and should be supplemented. CHF patients who are on chronic diuretic therapy are particularly prone to thiamine deficiency.
References:
1. Wooley, JA. Characteristics of thiamin and its relevance to the management of heart failure. Nutr Clin Pract. Oct-Nov 2008. 23:487-93.
2. Sica DA. Loop diuretic therapy, thiamine balance, and heart failure. Congest Heart Fail. 2007 Jul-Aug. 13(4):244-7.
3. Hanninen SA, Darling PB, Sole MJ, et al. The prevalence of thiamin deficiency in hospitalized patients with congestive heart failure. J Am Coll Cardiol. 2006 Jan 17. 47(2):354-61.
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