Thiamin is vitamin B1, a water-soluble, nontoxic B vitamin that depletes within 2 weeks of not eating normally. Thiamin protects HG patients’ hearts and brains and babies’ development. Thiamin is not a treatment for Hyperemesis Gravidarum.
Why HG patients need more thiamin
- Malnutrition + vomiting + GI damage reduce absorption.
- High carbohydrate diet requires additional thiamin to metabolize, and reduced muscle mass impairs storage.
- Medications can eliminate or interfere with absorption of B1.
- Immobility, GI dysfunction, inflammation, limited diet, and stress increase need for thiamin.
Onset may occur within 2 weeks of vomiting or poor intake and mimics HG signs.
Severe Thiamin Deficiency or Wernicke’s encephalopathy can be present even if serum thiamin levels are normal and MRI negative.
Signs of Wernicke’s Encephalopathy in Hyperemesis Gravidarum
- Vision/ocular changes
- Change in LOC /somnolence
- Difficulty speaking
- Gait abnormality/weakness
- Pain (abdominal/head)
- Memory loss/confusion
- Tachycardia/arrhythmia
Prevent Wernicke’s Encephalopathy
100-250 mg B1 daily
PO/IV + 200 mg B1 with each IV bag of D5 or D10 or TPN
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- Participate in HG research.
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