What Is Beriberi (Thiamine Deficiency)

Beriberi is a life-threatening condition caused by dangerously low levels of vitamin B-1, also known as thiamine. Thiamine is an essential nutrient obtained through food. It is responsible for several bodily functions.

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Some of which include:

  • Muscle contraction
  • Production of acids that aid digestion
  • Muscle contraction 
  • Breakdown of carbohydrate
  • Conduction in nerve cells

A deficiency in thiamine can result in the impaired functioning of these bodily functions. Beriberi causes thiamine levels in the body to deplete quickly (within 2-3 weeks) and must be replenished by consuming foods rich in thiamine. This makes beriberi particularly dangerous in people who are thiamine deficient. 

Diagnosis of the condition is based on symptoms. Urine samples typically reveal low levels of thiamine; lactate levels in the blood become high. Treating beriberi would involve administering thiamine supplements, either by mouth or injection to the patient. Symptoms generally resolve within a few weeks. 

Beriberi is common in sub-Saharan Africa. It has also been observed in women who have extreme nausea and vomiting during pregnancy, a condition known as hyperemesis gravidarum.

People with AIDS and those who have had bariatric surgery can be affected with beriberi.

Table of Contents

Types of Beriberi

  • Wet beriberi: mainly affects the cardiovascular system, resulting in poor circulation, fast heart rate, shortness of breath, leg swelling, and fluid buildup in the tissues.
  • Dry beriberi: primarily affects the nervous system, causing the degeneration of the nerves. This declinetypically begins in the legs and arms, resulting in numbness of the hands and feet, difficulty moving the legs, pain, and confusion. Loss of appetite and constipation may also occur. 
  • Acute beriberi: This is commonly found in babies. Symptoms include vomiting, loss of appetite, changes in heart rate, lactic acidosis, and enlargement of the heart. 

Causes and Risk Factors of Beriberi

The main cause of beriberi is either a thiamine-deficient diet or an inability for the body to absorb and process thiamine. 

Beriberi is uncommon in developed countries. Daily foods people consume, such as cereals and bread, are often fortified with Vitamin B-1. In developed countries with easy access to a thiamine-rich diet, the primary cause of beriberi is alcohol abuse disorder. 

According to the Department of Health and Human Services, about 80% of people who abuse alcohol will develop thiamine deficiency. Excess intake of alcohol makes it more difficult for the body to process and absorb vitamin B-1. 

Beriberi in babies occurs as a result of thiamine deficiency in breast milk or baby formula. 

In rare cases, a genetic condition may block the body’s ability to absorb and process the vitamin properly.

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Other people with a higher risk of beriberi include:

  • Older adults
  • People living with HIV
  • People who have had bariatric surgery
  • People with diabetes

Signs and Symptoms of Beriberi

The signs of the condition may vary depending on its type.

Symptoms of wet beriberi include:

  • Severe lack of energy or constant fatigue
  • Increased heart rate
  • Waking at night due to difficulty breathing
  • Shortness of breath
  • Swelling in the legs and feet

Symptoms of dry beriberi include:

  • Vomiting
  • General pain and body aches
  • Confusion
  • Difficulty walking
  • Paralysis in the lower legs
  • Numbness in the hands or feet

In rare and extreme cases, beriberi may result in a condition called Wernicke-Korsakoff syndrome. This condition is a form of brain damage caused by a severe lack of thiamine.

Wernicke-Korsakoff syndrome may causes a person to experience other symptoms, including:

  • General confusion
  • Memory loss
  • Inabilty to form new memories
  • Involuntary eye movement
  • Rapid eye movement
  • Loss of muscle coordination
  • Blurred or double vision
  • Hallucinations

Diagnosis

The patient will require a series of medical tests to determine the presence of beriberi. Doctors rely on blood and urine tests to measure thiamine levels in the body in order to diagnose the condition. 

Neurological exams would also be performed to check for difficulty walking, lack of coordination, weak reflexes, and droopy eyelids.

A physical exam will also be used to detect any heart problems. Swelling in the limbs, difficulty breathing, and rapid heart rate are all symptoms of beriberi.

Treatment

Treatment for the condition aims to increase thiamine levels in the body. The doctor may recommend oral supplements or injections to deliver vitamin B-1. They may also recommend taking other supplements to support treatment.

The doctor may also order regular blood tests to check the patient’s thiamine levels until they return to normal. A person might need to continue taking vitamin B-1 supplements at a lower dosage or make changes to their diet following treatment to ensure that beriberi does not reoccur.

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Damage to the heart and nervous system may be reversed if beriberi is treated early. Thiamine deficiency for extended periods may cause some symptoms to remain long after treatment. 

Prevention

A healthy, balanced diet that includes foods rich in thiamine can be used to prevent beriberi. These include:

  • Beans and legumes
  • Meat
  • Seeds
  • Whole grains
  • Fish
  • Dairy
  • Nuts
  • Vegetables like brussel sprouts, beet greens, sprouts, spinach asparagus, and acorn squash 
  • Breakfast cereals enriched with thiamine

Cooking or processing any of the foods listed above decreases their thiamine content. If you give your infant formula, you should also check that it contains enough thiamine. Always be sure to purchase infant formula from a reliable source.

Limiting alcohol consumption will reduce the risk of developing beriberi. People who abuse alcohol should be checked routinely for a B-1 vitamin deficiency.

Sources

Beriberi (Thiamine Deficiency)

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