Beriberi
Beriberi is a nutritional disease caused by a deficiency of thiamine (vitamin B1), which is essential for energy production and tissue building. It primarily affects the gastrointestinal system, heart, muscles, and nervous system. The condition can arise from various factors, including chronic alcoholism, malnutrition, excessive diuresis or dialysis, and high carbohydrate intake. Symptoms of beriberi include weakness, irritability, nausea, vomiting, and tingling sensations, particularly in the hands and feet. If left untreated, the condition can lead to severe complications, including mental confusion, difficulty in movement, coma, and potentially death.
There are two main forms of beriberi: wet beriberi, which primarily affects the cardiovascular system, and dry beriberi, which impacts the nervous system. Treatment typically involves thiamine hydrochloride supplementation and dietary changes to restore thiamine levels. Recovery is possible with prompt treatment and a balanced diet rich in thiamine-containing foods such as whole grains, legumes, and vegetables. Awareness of thiamine deficiency and proper nutritional intake is essential for preventing beriberi and promoting overall health.
Beriberi
ALSO KNOWN AS: Thiamine deficiency, vitamin B1 deficiency
ANATOMY OR SYSTEM AFFECTED: Gastrointestinal system, heart, muscles, nervous system
DEFINITION: A nutritional disease resulting from thiamine deficiency.
CAUSES: Thiamine deficiency from chronic alcoholism, malnutrition, diuresis, dialysis, high carbohydrate intake
SYMPTOMS: Weakness, irritability, nausea, vomiting, tingling, loss of sensation in hands and feet, confusion, difficulty speaking or walking; may progress to coma and death
DURATION: Chronic, sometimes fatal
TREATMENTS: Thiamine hydrochloride, dietary changes
Causes and Symptoms
Thiamine, one of the B vitamins, plays an important role in energy and tissue building. When there is not enough thiamine in the diet, these basic energy functions are disturbed, leading to problems throughout the body. There are two major manifestations of thiamine deficiency, disease (wet beriberi) and disease (dry beriberi). Each can be caused by chronic alcoholism, malnutrition, diuresis, dialysis, and high carbohydrate intake.
The accompanying symptoms of thiamine deficiency may include weakness, irritability, nausea, vomiting, tingling, or loss of sensation in the hands and feet (peripheral neuropathy). Progressed symptoms include mental confusion and difficulties speaking or walking; these are often the precursor symptoms leading to and/or death.
Treatment and Therapy
Thiamine hydrochloride is the initial treatment of choice for beriberi. Successful treatment reverses the deficiency and alleviates most of the symptoms. Severe deficiencies may be treated with high doses of thiamine given by muscular injection.
Alternative treatments stress a diet rich in foods that provide thiamine and other B vitamins, such as brown rice, whole grains, raw fruits and vegetables, legumes, nuts and seeds, and yogurt. Additional supplements of B vitamins, a multivitamin and mineral complex, and vitamin C are also recommended. A balanced diet containing all essential will prevent thiamine deficiency and the development of beriberi. People who consume large quantities of soda, pretzels, chips, candy, and high-carbohydrate foods made with unenriched flours may also need vitamin supplements to avoid thiamine deficiency.
Perspective and Prospects
The first clinical descriptions of beriberi were conducted by the Dutch physician Nicolaes Tulp around 1652. Tulp treated a young Dutchman who, upon returning from the East Indies, suffered from what the natives of the Indies called beriberi, or “the lameness.” Not until the early twentieth century did scientists discover that rice bran, the outer covering of white rice, actually contains something that prevents the disease, thiamine. In the 1920s, extracts of rice polishings were used to treat the disease.
Beriberi is fatal if left untreated. Most symptoms can be reversed, and full recovery is possible when thiamine levels are returned to normal and maintained with a balanced diet and vitamin supplements as needed.
Bibliography:
Anderson, Jean, and Barbara Deskins. The Nutrition Bible. New York: William Morrow, 1997.
Bouraghda. M.A. et al. "Beriberi Diease: Forgotten But Not Gone!" Scholars Journal of Medical Case Reports, 17 Feb. 2023, DOI: 10.36347/sjmcr.2023.v11i02.021. Accessed 28 Mar. 2024.
Kliegman, Robert, and Waldo E. Nelson, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Saunders/Elsevier, 2011.
Johnson, Larry E. "Thiamin." Merck Manual Home Health Handbook, Feb. 2013.
Rivlin, Richard. “Vitamin Deficiency.” In Conn’s Current Therapy, edited by Robert E. Rakel and Edward T. Bope. Philadelphia: Saunders/Elsevier, 2007.
"Thiamin (Vitamin B1)." MedlinePlus, 15 Oct. 2024, medlineplus.gov/druginfo/meds/a682586.html. Accessed 28 Mar. 2024.
Vorvick, Linda J., and David Zieve. "Beriberi." MedlinePlus, medlineplus.gov/ency/article/000339.htm. Accessed 31 July 2023.
Williams, Sue Rodwell, and Eleanor D. Schlenker. Essentials of Nutrition and Diet Therapy. 9th ed. St. Louis, Mo.: Mosby/Elsevier, 2007.