From the Guidelines
Thiamine deficiency, also known as beriberi, is associated with metabolic lactic acidosis.
Relationship between Lactic Acidosis and Beriberi
- Thiamine plays a crucial role in carbohydrate and lipid metabolism, and its deficiency can lead to severe lactic acidosis, particularly in parenterally fed infants and children 1.
- Beriberi, a condition caused by thiamine deficiency, can manifest as neurological, psychiatric, and cardiovascular symptoms, including unexplained metabolic lactic acidosis 1.
- The involvement of thiamine in energy metabolism is critical, and its deficiency can disrupt this process, leading to the accumulation of lactic acid and resulting in lactic acidosis 1.
- The risk of lactic acidosis is particularly high in patients with thiamine deficiency, especially those with predisposing factors such as rapid weight loss, decreased consumption, and persistent vomiting 1.
- Early suspicion and recognition of thiamine deficiency are essential to enable immediate initiation of therapy and prevent complications such as lactic acidosis 1.
From the Research
Relationship between Lactic Acidosis and Beriberi (Thiamine Deficiency)
- Lactic acidosis has been found to be a complication of thiamine deficiency, also known as beriberi, in several studies 2, 3, 4, 5, 6.
- Thiamine plays a crucial role in cellular metabolism, and its deficiency can lead to impaired glucose metabolism, resulting in lactic acidosis 2, 3, 4.
- Studies have shown that thiamine administration can rapidly resolve lactic acidosis in patients with beriberi, even in critically ill patients with severe cardio-circulatory collapse 2, 5.
- The relationship between lactic acidosis and beriberi is not limited to alcoholic patients, as cases have been reported in non-alcoholic patients with thiamine deficiency 5.
- Thiamine deficiency should be considered in the differential diagnosis of lactic acidosis, especially in patients receiving parenteral nutrition or with unexplained recalcitrant lactic acidosis 3, 4.
- The correction of lactic acidosis with thiamine administration can occur rapidly, often within hours, and can be a lifesaving intervention in critically ill patients 2, 5, 6.