Thiamine deficiency in congestive heart failure patients receiving long term furosemide therapy

Can J Clin Pharmacol. 2003 Winter;10(4):184-8.


Objective: To assess the presence of thiamine deficiency in congestive heart failure patients receiving furosemide therapy.

Design: Prospective, biochemical analysis of thiamine status was performed in outpatients and inpatients of the University of Ottawa Heart Institute.

Subjects: Thirty-two patients with congestive heart failure who received at least 40 mg/day of furosemide were included. Patients were then separated into two groups depending on whether the dose of furosemide was greater than or equal to 80 mg/day.

Methods: The primary measure was actual thiamine status as assessed by the erythrocyte transketolase enzyme activity and the degree of thiamine pyrophosphate effect.

Results: Biochemical evidence of severe thiamine deficiency was found in 98% (24 of 25) patients receiving at least 80 mg/day of furosemide and in 57% (four of seven) of patients taking 40 mg furosemide daily, odds ratio (OR) 19.0 (1.13<OR<601.29). Thiamine status was not associated with any other clinical variables.

Conclusions: These findings suggest that thiamine deficiency occurs in a substantial proportion of congestive heart failure patients being treated with furosemide.

MeSH terms

  • Aged
  • Diuretics / administration & dosage
  • Diuretics / adverse effects*
  • Female
  • Furosemide / administration & dosage
  • Furosemide / adverse effects*
  • Heart Failure / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Thiamine Deficiency / chemically induced
  • Thiamine Deficiency / epidemiology*


  • Diuretics
  • Furosemide