Thiamine supplementation Thiamine requirements
increase in pregnancy, so any depletion due to
vomiting must be reversed to ensure Wernicke’s
encephalopathy can be avoided (Bergin and
Harvey 1992). Thiamine can be administered as an
intravenous medication and certainly in those who
are vomiting this is the most appropriate route of
administration. It is recommended that thiamine
should be part of the standard care for any patient
with more than three weeks of vomiting. This
can be started with an initial intravenous dose
and then daily oral dosing for as long as needed
(Spruill and Kuller 2002).