Deficiency is caused by poor intake, malabsorption, alcoholism, and intravenous feeding with high glucose intake. Effects include neuropathy, cardiac failure, and severe acidosis without sepsis. The normal requirement is 0.5 to 1 mg/1000 kcal intake (3 mg/day in intravenous nutrition). Assessment of thiamine deficiency is by whole-blood transketolase activity with and without added thiamine pyrophosphate. In deficiency transketolase levels rise by more than 16 per cent with added thiamine pyrophosphate.
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