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Potential Consequences of Delayed Diagnosis of Thiamine Deficiency

What Is Thiamine Deficiency?

Thiamine deficiency is a condition where one’s thiamine level is too low.  Thiamine, also known as vitamin B1, is one of the B vitamins and is considered an essential vitamin.  Thiamine is necessary for the growth and function of certain cells in the body, particularly nerve cells.  The human body does not make thiamine, so we have to rely on absorbing it through the food that we eat.  Thiamine helps the body and brain to metabolize fats, proteins and carbohydrates to fuel our hearts, brains and nerves.  The body can usually only store enough thiamine to last one to two weeks before a thiamine deficiency begins to cause problems.

Thiamine deficiency can cause heart failure or problems with the central nervous system (brain) and the peripheral nervous system (arms and legs).  Thiamine deficiency is a reversible condition if it is quickly recognized.  However, thiamine deficiency is considered a medical emergency because a delay in diagnosing and adequately treating thiamine deficiency can result in irreversible injury.

What Are The Signs And Symptoms of Thiamine Deficiency?

Thiamine deficiency can cause a wide variety of symptoms depending on the type of thiamine deficiency.  Symptoms may start out minor and become more serious the longer thiamine deficiency is untreated.  When thiamine deficiency causes heart symptoms it is called wet beriberi. Patients with wet beriberi may have symptoms similar to congestive heart failure, including trouble breathing and swelling in the lower legs.

When thiamine deficiency affects the central nervous system (brain function) and/or the peripheral nervous system (function of arms and legs), it is called dry beriberi.  Common signs and symptoms of dry beriberi can include difficulty walking, weakness of the lower extremities, decreased or absent muscle reflex responses, numbness or tingling, fatigue, mental confusion, slowed thinking and speech difficulties.

Who Is At Risk Of Developing Thiamine Deficiency?

Most people in the U.S. do not have to worry about having a thiamine deficiency because we naturally take in adequate thiamine from the foods we eat, including cereal, yogurt, pork, beans, fish and peas.

However, people who are malnourished or who are unable to absorb vitamins and minerals from food (malabsorption)  have a higher risk of not getting enough thiamine.  Risk factors include alcoholism, bariatric surgery, repeated vomiting, kidney disease, poor diet and food restriction.  Bariatric surgery patients are at increased risk for thiamine deficiency not only because they may become malnourished but also because the surgery can disrupt the portion of the stomach that absorbs thiamine. A recent study revealed that 3.5% of bariatric surgery patients had thiamine levels below the lower limit of normal and an additional 14% were at risk for thiamine deficiency.   Prevalence of thiamine deficiency is significant in patients undergoing primary bariatric surgery – ScienceDirect.

What Treatment Is Required For Thiamine Deficiency?

Thiamine deficiency requires immediate treatment with daily high doses of IV and oral thiamine until there is clinical improvement.

If a health care provider has any suspicion at all that a patient may be suffering from thiamine deficiency, treatment with high dose thiamine should be given.  There is no risk to giving thiamine for presumed or suspected thiamine deficiency because thiamine is a water-soluble vitamin, and the body will simply eliminate whatever it cannot use.  Conversely, there is great risk in not treating suspected thiamine deficiency because any delay in treating a thiamine deficiency carries a great risk of permanent neurologic injury.

How Does Delay In Diagnosis Of Thiamine Deficiency Cause Harm?

Untreated thiamine deficiency can cause heart failure or permanent neurological damage.  Prolonged thiamine deficiency and depletion impair the nervous system’s ability to metabolize carbohydrates and glucose which damages certain cells in the body, starting with those areas of the brain and nervous system with the highest thiamine content and turnover.  Prolonged severe thiamine deficiency can present as several related neurologic disorders including wet beriberi, dry beriberi, Wernicke’s encephalopathy and Korsakoff syndrome. If left untreated, thiamine deficiency can cause coma, heart failure, brain damage and/or permanent peripheral nerve damage.

Do I Have A Legal Claim For A Delayed Diagnosis Of Thiamine Deficiency?

If a physician or other health care provider failed to recognize and treat thiamine deficiency under circumstances where most doctors exercising reasonable care would have made the diagnosis and started treatment, this is negligence (or medical malpractice).  If you or someone you love suffered serious harm as a result of the negligent delay in diagnosis of thiamine deficiency in the Philadelphia area, you should contact an attorney to discuss a potential legal claim and the compensation to which you may be entitled under Pennsylvania law.

The Philadelphia medical malpractice attorneys at Youman & Caputo have successfully handled cases involving a delay in diagnosis of thiamine deficiency and have obtained substantial compensation for their clients in such cases.  Call for a free consultation.