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Thiamine deficiency: a commonly unrecognised but easily treatable condition
  1. Tritia Schostak1,
  2. Iňigo San Millan2,
  3. Alkesh Jani1,
  4. Richard Joseph Johnson1,2
  1. 1Division of Nephrology, Department of Medicine, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
  2. 2Division of Endocrinology, Department of Medicine, University of Colorado—Anschutz Medical Campus, Aurora, Colorado, USA
  1. Correspondence to Dr Richard Joseph Johnson, University of Colorado—Anschutz Medical Campus, Aurora, USA; richard.johnson{at}


Thiamine is present in many foods and is well recognised as an essential nutrient critical for energy metabolism. While thiamine deficiency is commonly recognised in alcoholism, it can present in many other settings where it is often not considered and goes unrecognised. One challenging aspect to diagnosis is that it may have varied metabolic, neurological and cardiac presentations. Here we present an overview of the disorder, focusing on the multiple causes and clinical presentations. Interestingly, thiamine deficiency is likely increasing in frequency, especially among wildlife, where it is linked with changing environments and climate change. Thiamine deficiency should be considered whenever neurological or cardiological disease of unknown aetiology presents, especially in any patient presenting with lactic acidosis.

  • general medicine
  • nutrition & dietetics
  • cardiology
  • nephrology

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  • Contributors TS and RJJ drafted the original manuscript and further critiqued and edited the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.