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Common Test-Ordering Errors
Part 5: Overordered Tests

Plasma Thiamin
Serum Folate
Zinc Protoporphyrin (ZPP)


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Thiamin (Vitamin B1)

Slide 5

August 2010

Plasma thiamin is a test that we believe should not be ordered. Thiamin (also known as vitamin B1) is an essential vitamin that is required for a variety of the body’s biochemical pathways, including those involved with metabolism of carbohydrates and fats, brain function, and peripheral nerve myelination.

Thiamin is obtained from the diet—body stores are limited—and deficiencies can develop quickly. Thiamin deficiency is most prevalent in chronic alcoholics due to poor nutrition, although it can occur in individuals with chronic gastrointestinal problems or those who are elderly, on cancer treatment, or receiving diuretic therapy. Severe thiamin deficiency causes congestive heart failure, peripheral neuropathy, Wernicke encephalopathy (which is a medical emergency that can progress to coma and death), and Korsakoff syndrome (which can follow Wernicke encephalopathy, resulting in memory loss that is often irreversible and dementia). Importantly, rapid treatment of Wernicke encephalopathy with thiamin can prevent Korsakoff syndrome.

(Vitamin B1)


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