Jordan InessMichael GiovineHolly RoyerElsa C

Hypermesis Education and Research. “Neurological Conditions: Wernicke’s Encephalopathy.” Updated Apr. 9, 2009. http://www.helpher.org/health-professionals/complications/neurological.php (Apr. 14, 2009).

Kantor, D. MedlinePlus. “Wernicke-Korsakoff Syndrome.” Updated Sept. 10, 2006. . http://www.nlm.nih.gov/medlineplus/ency/article/000771.htm (Apr. 14, 2009).

Nguyen-Khoa. “Beriberi (Thiamine Deficiency).” Updated May 20, 2008. http://emedicine.medscape.com/article/116930-overview (Apr. 14, 2009).

Ehrlich, Steven D. “Vitamin B1 (thiamine).” Updated Aug. 28, 2007. http://www.umm.edu/altmed/articles/vitamin-b1-000333.htm (Apr. 14, 2009).

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Velma is excited about her first pregnancy, and her expected delivery next month. Her family and

friends are impressed by the fact that she has been in good spirits, despite the fact that she has

suffered from an acute case of hyperemesis gravidarum for her entire pregnancy. However, they

report that she has recently begun to “make up elaborate stories” and appears to be drunk at times.

This information combined with her unexpected poor weight gain leads her clinician to be very

concerned about malnutrition, especially thiamine deficiency. Explain the connections.

Definition: Hyperemesis gravidarum (HG) is marked by continuous nausea and vomiting which can lead to dehydration, malnutrition and weight loss. The malnutrition is due to the fact that

the woman is constantly throwing up and nutrients are not being absorbed

It is an essential nutrient(B1): the body does not produce thiamine naturally so it must be consumed through diet.

It is water soluble and the body does not store it so it must be replaced everyday (excess thiamine is easily flushed out)

Coenzyme that helps the body obtain energy from food

It is required for the body to form ATP

One of the most significant factors of malnutrition in HG is thiamine deficiency.

Some of the symptoms of thiamine deficiency (beriberi): can cause a person to feel fatigued, weak and have resting tachycardia Dry beriberi: effects the nerves and muscles;

memory loss and mental confusion, involuntary eye movements and trouble standing.

Potential result of thiamine deficiency Can develop after just a few weeks of vomiting. In up to 20% of cases, it was found to be fatal

and spontaneous abortion can occur. Symptoms: visual disturbances, confusion and

muscular weakness. Can lead to Wernicke-Korsakoff (alcoholic

encephalopathy): brain disorder resulting in the loss of specific brain functions and is the result of thiamine deficiency. Symptoms: double vision, eye movement

abnormalities, loss of muscle coordination (unsteady walking), loss of memory, inability to form new memories, confabulation (making up stories) and hallucinations.

Vitamin B injections into a vein or muscle

Take vitamin B1 supplements

Thiamine

Thiamine deficiency effects the central and peripheral nervous system- balance, coordination and cranial nerves that control eye movements

ATP is used as energy for muscle contraction

Thiamine deficiency decreases the production of ATP by disrupting the major pathway for glucose from the carbohydrates you take in.

Thiamine=moneyNeed money for gas for new car

(pregnancy)You lose your job (thiamine deficiency –

due to vomiting)Bills not paid (Wernicke’s Encephalopathy)Potentially lose your car

(death/spontaneous abortion)Or get a job ( B1 vitamin

supplements/injections)

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