In the management of Wernicke-Korsakoff syndrome, what is replenished after thiamine administration?

• A. Glucose and folate
• B. Iron and calcium
• C. Vitamin C and Vitamin D
• D. Vitamin A and Vitamin E

Answer: (A)

Thiamine is needed for carbohydrate metabolism in the brain. When thiamine deficiency is corrected, the brain’s ability to utilize glucose improves, restoring energy production and preventing ongoing neuronal injury. In chronic alcohol use, folate deficiency is also common due to poor nutrition, so addressing thiamine deficiency is typically accompanied by replenishing folate to correct other nutritional gaps. Therefore, after thiamine administration, replenishment of glucose (through restored glucose metabolism) and folate (to correct concurrent deficiency) fits the clinical approach. Remember that glucose should be given after thiamine, not before, to avoid precipitating Wernicke’s.