Tuesday, January 24, 2017

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.


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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