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  • 4 years later...
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Hi Jeanne,

Thanks for all of the great info. I tried to order a erythrocyte transketolase enyme to determine thiamine deficiency and our lab stated that they do not do this test. The MD from the lab said he looked it up and it is not commonly done anywhere in our area. Is a serum thiamine level accurate? We have a 28 year old pt who is 3 months post op RYGB with numbness and weakness in her legs. She denies vomiting and claims she takes one Centrum per day (not chewable) and one Vitamin B complex. It looks as if the Guillian Barre diagnosis has been ruled out. The Vitamin B12 and folate levels are normal. The neurologist ordered thiamine but it was not done. Any assistance would be appreciated.

Thanks.

a Serafino-Cross, MS, RD, LDN

Baystate Medical CEnter

Springfield, MA

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Serum thiamin should at least give you an estimate of status, it is odd that it wasn't done despite an order. There is also restless leg syndrome to consider...and "burning feet" syndrome. Has she improved with supplementation? Were her levels checked pre-op? Not sure I have helped much, I will think about it a bit more.

Jeanne

-------------- Original message from Humnut413@...: --------------

Hi Jeanne,

Thanks for all of the great info. I tried to order a erythrocyte transketolase enyme to determine thiamine deficiency and our lab stated that they do not do this test. The MD from the lab said he looked it up and it is not commonly done anywhere in our area. Is a serum thiamine level accurate? We have a 28 year old pt who is 3 months post op RYGB with numbness and weakness in her legs. She denies vomiting and claims she takes one Centrum per day (not chewable) and one Vitamin B complex. It looks as if the Guillian Barre diagnosis has been ruled out. The Vitamin B12 and folate levels are normal. The neurologist ordered thiamine but it was not done. Any assistance would be appreciated.

Thanks.

a Serafino-Cross, MS, RD, LDN

Baystate Medical CEnter

Springfield, MA

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A couple more thoughts. If it truly is dry beriberi, you would expect to see elevated blood pyruvate and decreased urinary thiamine exretion (<50 ug/day).

Have you checked Mg levels? Magnesium is a cofactor for transketolase and can be given to correct thiamine resistance.

Jeanne

Re: Article of Interest

Hi Jeanne,

Thanks for all of the great info. I tried to order a erythrocyte transketolase enyme to determine thiamine deficiency and our lab stated that they do not do this test. The MD from the lab said he looked it up and it is not commonly done anywhere in our area. Is a serum thiamine level accurate? We have a 28 year old pt who is 3 months post op RYGB with numbness and weakness in her legs. She denies vomiting and claims she takes one Centrum per day (not chewable) and one Vitamin B complex. It looks as if the Guillian Barre diagnosis has been ruled out. The Vitamin B12 and folate levels are normal. The neurologist ordered thiamine but it was not done. Any assistance would be appreciated.

Thanks.

a Serafino-Cross, MS, RD, LDN

Baystate Medical CEnter

Springfield, MA

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  • 11 months later...
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  • 1 year later...

This is in this week's Medscape Gasto issue, and thought it might be of

interest:

Clinical Insights Into Autoimmune Hepatitis: An Expert Interview With

L. Flamm, MD

http://www.medscape.com/viewarticle/563821?src=mp

> Autoimmune hepatitis is a nonresolving inflammation of the liver of

> unknown etiology, characterized by the presence of interface hepatitis

> on histologic examination, hypergammaglobulinemia, and autoantibodies.

more...............

Jeannette OR PBC/AIH

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