Thiamine Deficiency and Wernicoff-Korsakoff Syndrome

Prevention and Treatment

• The American College of Nutrition recommends thiamine must be administered immediately in any at-risk patient, such as those with chronic alcohol use, malnutrition, prolonged vomiting, post-bariatric surgery, or hyperemesis gravidarum, with a recommended dose of 500 mg thiamine IV three times daily for 3-5 days, followed by 250 mg IV daily for at least 3-5 additional days 1, 2
• Thiamine should always be given before any glucose-containing solutions, as glucose can precipitate or worsen Wernicke-Korsakoff syndrome 1, 2, 4, 5

Patient Management

• Prophylactic thiamine supplementation should be given liberally to all at-risk patients rather than waiting for diagnostic confirmation, to prevent permanent cognitive impairment 5