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Thiamine

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We get vitamin levels at 6, 9, 12, 18, 24 months and every year thereafter. If anything is low, then we treat it therapeutically. No additional thiamin is needed unless we have a patient that has prolonged vomiting. Hope that helps.

For patients that do not tolerate pills, we recommend Bug Bunny Completes BID. We also have pharmaceutical grade vitamins we sell in the office that are highly bioavailable. Once they hit the intestine, they dissolve immediately. Patients have had no complaints.

Kate Alie MS, RD, LD

Re: thiamine

Kate,

Thank you so much for your response. I have read about the study from Mayo Clinic and found the same conclusion; that patients are at risk of developing thiamin deficiency under the conditions you described. There are cases of malnutrition that need thiamin to be given by injection (I had a patient recently that was admitted for malnutrition and received these injections daily). However, my question is about routinely giving thiamin supplements to all patients after gastric bypass. I was wondering if any studies concluded that this would be necessary to prevent deficiencies. We are all aware of the need for nutritional counseling to prepare for surgery and learn the essential nutrition requirements. Unfortunately, some practices are not adequate in the nutrition department, such as those in the recent study. I even spoke with a dietitian from the Mayo Clinic to ask her if she gives thiamin to all her patients and her answer was no, but patients presenting with symptoms are treated with additional thiamin.

I am finding that many patients have difficulty with the basic vitamin/mineral supplements that we recommend and adding the extra thiamin may not be necessary (since they are getting adequate amounts in their multivitamins). Do you routinely check thiamin status or only treat once patients present with symptoms?

I really appreciate being able to discuss this here and welcome any further discussion, comments or suggestions.

Thanks again to all!!

Royfe, MS, RD

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  • 6 months later...
Guest guest

My surgeon said that another program had started doing this and was

wondering if we should add thiamine to the discharge orders. Is anyone

sending pts home on thiamine supplements? If so what dose?

Thanks for the input.

Cheryl , R.D., L.D.

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Cheryl,

Our MDs prescribe a B complex w/ Folic acid to be taken QOD

Amy

Amy Long MS, RD

Clinical DietitianNorthridge Hospital Medical CanterNorthridge, CA818-885-8500 x3831Amy.Long@...

-----Original Message-----From: cljohnson72004 [mailto:cheryl.johnson@...]Sent: Tuesday, May 17, 2005 7:51 AM Subject: ThiamineMy surgeon said that another program had started doing this and was wondering if we should add thiamine to the discharge orders. Is anyone sending pts home on thiamine supplements? If so what dose? Thanks for the input.Cheryl , R.D., L.D.

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  • 2 years later...
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We also suggest a B50 complex once daily. Hosier <hosierj@...> wrote: I know this has been discussed before, but I still feel like there is noconsistent answers. Are there any good recommendations for maintenancethiamine doses? I have started to suggest B 50 complex. One of thedoctors I work with asked me and I didn't really have a solid answer.Thanks. Hosier, RD, LDClinical DietitianMember ASBS www.asbs.orgSt. Luke's Regional Medical Center381-1519"TWEF

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