Thiamine(Vitamin B1) rich food

Thiamine Deficiency(Beriberi)

Thiamine deficiency is a medical condition of low levels of thiamine (vitamin B1). A severe and chronic form is known as beriberi.

Symptoms of beriberi include weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate. Edema (swelling of bodily tissues) is common.

It may increase the amount of lactic acid and pyruvic acid within the blood. In advanced cases, the disease may cause high-output cardiac failure and death.

Types of Beriberi

There are different types of Thiamine deficiency(Beriberi) which are as follows:

There are two main types in adults: Dry Beriberi and Wet Beriberi

Dry Beriberi

Dry beriberi affects the nervous system resulting in numbness of hands and feet, confusion, trouble moving the legs, and pain. 

A form with loss of appetite and constipation may also occur.

It is characterized by:

  • Difficulty in walking
  • Tingling or loss of sensation (numbness) in hands and feet
  • Loss of tendon reflexes
  • Loss of muscle function or paralysis of the lower legs
  • Mental confusion/speech difficulties
  • Pain
  • Involuntary eye movements (nystagmus)
  • Vomiting

Wet Beriberi

It affects the cardiovascular system resulting in a fast heart rate, shortness of breath, and leg swelling.

 It is characterized by:

  • There is also a beriberi found in babies named as Acute Beriberi.

Acute Beriberi

Acute beriberi(Infantile beriberi), is found mostly in babies and presents with loss of appetite, vomiting, lactic acidosis, changes in heart rate, and enlargement of the heart.

These symptoms may be described in infantile beriberi:

  • Hoarseness, where the child makes moves to moan but emits no sound or just faint moans caused by nerve paralysis
  • Weight loss, becoming thinner and then marasmic as the disease progresses
  • Vomiting
  • Diarrhea
  • Pale skin
  • Edema
  • Ill temper
  • Alterations of the cardiovascular system, especially tachycardia (rapid heart rate)
  • Convulsions occasionally observed in the terminal stages

Gastrointestinal Beriberi

It causes abdominal pain.

It is characterized by:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Lactic acidosis

Brain disease

A deficiency of a single vitamin, B1 (thiamine), can cause a potentially fatal brain disorder called Wernicke encephalopathy.

Symptoms can include confusion, hallucinations, coma, loss of muscle coordination and vision problems such as double vision and involuntary eye movements.

Untreated, the condition can lead to irreversible brain damage and death.

Cause

A deficiency of vitamin B1 commonly leads to beriberi, a condition that features problems with the peripheral nerves and wasting. Weight loss and anorexia can develop.

There may be mental problems, including confusion and short-term memory loss.

Risk factors include a diet of mostly white rice, as well as alcoholism, dialysis, chronic diarrhea, and taking high doses of diuretics.

Rarely it may be due to a genetic condition which results in difficulties absorbing thiamine found in food. Wernicke encephalopathy and Korsakoff syndrome are forms of dry beriberi.

Beriberi may also be caused by shortcomings other than inadequate intake: diseases or operations on the digestive tract, alcoholism, dialysis, genetic deficiencies, etc.

All these causes mainly affect the central nervous system, and provoke the development of what is known as Wernicke’s disease or Wernicke’s encephalopathy.

Treatment

Many people with beriberi can be treated with thiamine alone. 

Given thiamine intravenously (and later orally), rapid and dramatic recovery can occur within hours.

If concentrated thiamine supplements are not available, thiamine-rich diets (e.g. whole grain brown bread) will lead to recovery, though at a much slower rate.

Following thiamine treatment, rapid improvement occurs, in general, within 24 hours. 

Improvements of peripheral neuropathy may require several months of thiamine treatment.

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