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Our bodies need thiamine for multiple essential functions, the most important of which is to convert food into fuel that the body can use to produce energy. Thiamine — commonly called Vitamin B1 — also strengthens your immune system and helps your body endure stressful conditions.

Given the essential role thiamine plays, it stands to reason that medical doctors should be able to recognize and anticipate the circumstances that will put their patients at risk for this deficiency. Every physician understands from their training that if thiamine deficiency is allowed to go on to the point of developing symptoms, it may be too late for a complete recovery from those symptoms. The only chance for a meaningful recovery is for thiamine to be administered immediately and urgently. Unfortunately, failures to prevent and diagnose thiamine deficiency are all too common.

Dr. David Yousem, Johns Hopkins Medicine, discusses the importance of diagnosing thiamine deficiency before the patient develops an encephalopathy.


Thiamine deficiency is associated with a long list of serious medical problems, including Wernicke’s encephalopathy — a potentially fatal brain disease that neurologists say is underdiagnosed.

At Davis & Davis, Attorneys at Law, we are familiar with these cases, and we are committed to helping improve hospital protocol to ensure that medical professionals diagnose and treat thiamine deficiency before it is too late. As medical malpractice attorneys, we also stand up for the victims of delayed diagnosis of thiamine deficiency and Wernicke’s encephalopathy.


A dangerous lack of thiamine can occur before or after a patient is admitted for medical treatment, but patients who have undergone gastrointestinal surgery or bariatric surgery may be especially at risk. Even women who have severe, prolonged nausea and vomiting during pregnancy are at great risk for this nutritional deficiency. Diets rich in carbohydrates may also increase the need for thiamine.

Any patient who presents post-surgical signs of undernourishment, dehydration or prolonged nausea and vomiting should be evaluated for thiamine deficiency. If left untreated, acute thiamine deficiency can lead to lesions in vulnerable areas of the brain and permanent brain damage.

Signs of acute thiamine deficiency include:

  • Confusion
  • Loss of balance while walking
  • Visual disturbances
  • Inability to concentrate
  • Mental sluggishness and short-term memory issues
  • Apathy
  • Coma

We hold medical professionals to a high standard of care because medical mistakes can cause permanent harm to patients. That is certainly the case when thiamine deficiency and Wernicke’s encephalopathy go untreated. Patients presenting any of the symptoms mentioned here should seek immediate medical attention.

When determining whether or not a patient is thiamine-deficient, doctors tend to consider only a few known symptoms called the triad. Those three commonly recognized symptoms are confusion, dysfunction of the eye muscle and loss of balance. The reality, however, is that a patient with thiamine deficiency may not present any of the symptoms in the classic triad.

In our legal practice, we have also found that simple breakdowns in communication between medical professionals have resulted in failure to treat known cases of thiamine deficiency, resulting in devastating outcomes for patients.

The tragedy in the Wernicke’s cases we see is that, in every one, the treatment is simple, very fast-acting, cheap and without known complications: a simple shot of vitamin B1. The consequences when Wernicke’s is not detected and treated as it should be: severe, permanent disability.


Please call Davis & Davis at 713-364-0314 or toll free at 877-202-0835 for a complimentary consultation about thiamine deficiency and medical malpractice. We can also be reached by email for prompt and honest answers to your questions.

Davis & Davis, Attorneys at Law, proudly accepts referrals from Texas attorneys and law firms.