Should We Measure Thiamine Levels or Should We Send a Transketolase?

One of my passions is acid-based disorders and we recently had a patient who had a significant lactic acidosis. I said let's just give him some thiamine and we knew he had an alcohol use disorder and everything cleared up right away. We also describe that same pattern in patients with Wernicke so they actually can get this distinctive mixed acid-based disorder where they have lactic acidosi and then on top of that they actually have an overcompensation from respiratorySo it's kind of an interesting pattern. The other thing that sometimes comes up is should we measure thiamine levels or should we send a transketolase? For all those reasons I would say