CLINICAL APPLICATION OF THE THIOCHROME REACTION IN THE STUDY OF THIAMIN (VITAMIN B^1) DEFICIENCY

Abstract

By the use of a modification of the thiochrome method for the estimation of thiamin in urine, a simple procedure for the study of thiamin deficiency was developed. Subjects on normal diets excrete from 100 to 300 [gamma] of thiamin daily. Adm. of a standard test dose of 0.1 mg. of thiamin per kg. of body wt. is followed by excretion in the urine of 8 to 10% of the dose. Patients with severe thiamin deficiency disease excrete normal quantities after adm. of about 100 mg. of thiamin. Severe persistent diuresis increases the excretion of thiamin. In severe diffuse liver disease the excretion of thiamin is supernormal, indicating impairment of the phosphorylating function of the liver. Mild to moderate degrees of thiamin deficiency frequently occur in the course of chronic disease, resulting in symptoms erroneously attributed to the primary disease. Thus, clinical improvement resulting from thiamin adm. to patients with multiple sclerosis, central nervous system syphilis, myopathies, dorsolateral sclerosis, thyrotoxicosis, arthritis cannot be attributed to improvement of the primary disease. Diarrhea impairs the absorption of thiamin.