Diuretics and Vitamin B,: Are Diuretics a Risk Factor for Thiamin Malnutrition?

Abstract

Despite modern pharmacologic agents in the therapy of heart failure, the prevalence of heart failure is increasing worldwide. In the vitamin B₁ deficiency disease beriberi, cardiac symptoms may represent the central feature. Two new studies confirmed that all diuretics lead to increased uri- nary thiamin excretion depending on the urinary flow rate. In a subject at risk, such as an elderly patient, chronic diuretic treatment may lead to a subclinical thiamin deficiency. Whether subclinical thiamin nutriture is a modulator of the prevalence andlor severity of heart failure is not known; however, it seems to be plausible from the metabolic point of view.