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Diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

If the diagnosis of thiamine deficiency is in doubt, then treat. There should be a high index of suspicion in areas of endemic thiamine deficiency.

In cases of suspected wet beri-beri, a rapid improvement in the cardiac function following thiamine administration is diagnostic.

Blood biochemistry is deranged in thiamine deficiency states:

  • lactate and pyruvate concentrations are raised
  • transketolase activity of erythrocytes is low in the absence of added thiamine pyrophosphate but increases by more than 30% upon addition of thiamine pyrophosphate to the patient
  • reduced urinary thiamine excretion

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