Thiamine deficiency


Thiamine deficiency types

Clinical Features

Differential Diagnosis

Vitamin deficiencies


  • Clinical diagnosis


  • Thiamine 50–100 mg IV for first few days, followed by 5-10mg PO daily
  • Replete other vitamins/electrolytes that may also be depleted (i.e. banana bag)
  • Replete thiamine before giving IV dextrose!


Vitamin Prophylaxis for Chronic alcoholics

  • At risk for thiamine deficiency, but no symptoms: thiamine 100mg PO q day
  • Give multivitamin PO; patient at risk for other vitamin deficiencies

Banana bag

The majority of chronic alcoholics do NOT require a banana bag[1][2]

  • Thiamine 100mg IV
  • Folate 1mg IV (cheaper PO)
  • Multivitamin 1 tab IV (cheaper PO)
  • Magnesium sulfate 2mg IV
  • Normal saline as needed for hydration

See Also


  1. Krishel, S, et al. Intravenous Vitamins for Alcoholics in the Emergency Department: A Review. The Journal of Emergency Medicine. 1998; 16(3):419–424.
  2. Li, SF, et al. Vitamin deficiencies in acutely intoxicated patients in the ED. The American Journal of Emergency Medicine. 2008; 26(7):792–795.



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