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Overview :
Certain patients are at risk for developing thiamine (vitamin
B1) deficiency. The identification of one or morre risk factors should prompt an
evaluation of the patient's thiamine status.
Persons at risk for thiamine deficiency:
(1) infants
(2) chronic alcoholics
(3) elderly (> 65 years of age)
(4) socially isolated
(5) refugee or displaced person or prisoner of war
(6) migrant workers with marginal diet
(7) food faddist
(8) chronic vomiting
(9) pregnancy
(10) person on a chronic low thiamine diet (see below)
(11) cancer patients
(12) dysentery or diarrhea
(13) malnutrition (prolonged fasting, anorexia nervosa,
starvation)
(14) gastric plication
Low-thiamine diet:
(1) diet predominantly polished rice or refined wheat
(2) presence of antithiamine compounds
(3) thiamine unfriendly cooking methods
(4) high carbohydrate diet without vitamin
supplementation
(5) breast milk from thiamine deficient mothers
(6) long term parenteral nutrition without vitamin
supplementation
Times when thiamine deficiency may become manifest (increased
requirements for thiamine):
(1) high carbohydrate load or carbohydrate infusion
(2) refeeding after starvation
(3) stress
(4) infection with fever
(5) hyperthyroidism
(6) illness
(7) pregnancy
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