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Polyneuropathy from thiamin deficiency associated with thyrotoxicosis
Panitha Jindahra1, Charungthai Dejthevaporn, Surat Komindr
1Division of Neurology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Summary
Thiamin deficiency can cause polyneuropathy, especially in individuals with hypermetabolic conditions like thyrotoxicosis. A young fisherman developed polyneuropathy due to a diet low in thiamin, insufficient for his condition.
Area of Science:
- Neurology
- Endocrinology
- Nutritional Science
Background:
- Thiamin (vitamin B1) deficiency can lead to polyneuropathy.
- Hypermetabolic states, such as thyrotoxicosis, increase thiamin requirements.
- Diets low in thiamin, like those based on polished rice, are common in some regions.
Observation:
- A 17-year-old fisherman presented with a 3-month history of polyneuropathy symptoms.
- Clinical signs of thyrotoxicosis were present and confirmed by thyroid function tests.
- His diet primarily consisted of polished rice and fish, both low in thiamin.
Findings:
- The patient's hypermetabolic state from thyrotoxicosis exceeded his thiamin intake.
- This imbalance resulted in severe thiamin deficiency.
- The deficiency manifested as polyneuropathy.
Implications:
- This case highlights the risk of thiamin deficiency polyneuropathy in hypermetabolic conditions.
- Dietary thiamin intake must be adequate to meet increased metabolic demands.
- Awareness is crucial for early diagnosis and prevention in at-risk populations.
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