Beriberi: Causes, Symptoms, Diagnosis, Treatment, and Prevention
When thiamine, also known as vitamin B-1, is lacking, beriberi occurs. Thiamine is a crucial nutrient that helps the body break down carbohydrates, maintain muscle function, and support nerve conduction. A lack of thiamine can lead to a variety of health problems in the heart, nervous system, and digestive system.
There are two main types of beriberi: wet and dry. Wet beriberi affects the cardiovascular system, causing poor blood circulation and fluid buildup in the tissues. Dry beriberi affects the nervous system, causing nerve damage and muscle weakness. The life-threatening effects of both types of beriberi cannot be ignored.
Causes of Beriberi
A diet low in thiamine is the main cause of beriberi. In countries where white rice and refined carbohydrates are the staple foods, thiamine is usually not present. Beriberi is rare in developed countries, where breads and cereals are fortified with thiamine.
However, some factors can increase the risk of beriberi, even in people who consume enough thiamine. These include:
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Alcohol use disorder, which can impair the absorption and storage of thiamine in the body
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Genetic beriberi, a rare condition that prevents the body from using thiamine effectively
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Hyperthyroidism, which can increase the metabolic demand for thiamine
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Extreme nausea and vomiting in pregnancy, which can cause thiamine loss
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Bariatric surgery, which can reduce the intake and absorption of thiamine
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HIV, which can affect the immune system and nutritional status
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Prolonged diarrhea or use of diuretics, which can increase the excretion of thiamine
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Kidney dialysis, which can remove thiamine from the blood
Symptoms of Beriberi
The symptoms of beriberi depend on the type and severity of the condition. Some common symptoms of wet beriberi are:
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Shortness of breath, especially during physical activity or at night
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Rapid heart rate
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Swelling of the lower legs
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Fatigue and weakness
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Chest pain
Some common symptoms of dry beriberi are:
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Tingling or numbness in the feet and hands
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Decreased muscle function, especially in the lower legs
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Muscle pain and cramps
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Difficulty walking or standing
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Mental confusion and memory loss
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Difficulty speaking or swallowing
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Involuntary eye movements
In extreme cases, beriberi can lead to Wernicke-Korsakoff syndrome, a form of brain damage caused by thiamine deficiency. This syndrome can cause:
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Vision problems, such as double vision or rapid eye movements
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Loss of muscle coordination and balance
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Hallucinations and delusions
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Inability to form new memories or recall past events
Diagnosis of Beriberi
To diagnose beriberi, a doctor will ask about the person’s medical history, dietary habits, and alcohol consumption. They will also perform a physical examination and check for signs of thiamine deficiency, such as:
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Enlarged heart
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Low blood pressure
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Edema (fluid retention)
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Muscle wasting
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Nerve damage
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Eye abnormalities
In addition to ordering blood tests for thiamine and its metabolites, the doctor can also order blood tests. However, these tests are not always reliable, since thiamine levels can vary depending on the time of day, food intake, and other factors. Therefore, the diagnosis of beriberi is usually based on the clinical symptoms and the response to thiamine supplementation.
Treatment of Beriberi
The treatment of beriberi involves restoring the normal level of thiamine in the body. This can be done by:
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Giving thiamine injections, usually for a few days or weeks, depending on the severity of the condition
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Taking oral thiamine supplements, usually for several months or longer, depending on the underlying cause of the deficiency
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Eating a balanced diet that includes foods rich in thiamine, such as whole grains, legumes, nuts, seeds, meat, fish, eggs, and dairy products
When beriberi is treated, most of the symptoms can be reversed and complications are prevented. However, if the condition is diagnosed late or left untreated, some damage to the heart or brain may be irreversible. If you suspect beriberi, it is imperative to seek medical attention as soon as possible.
Prevention of Beriberi
The prevention of beriberi is mainly based on ensuring adequate intake of thiamine. This can be done by:
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Eating a varied and nutritious diet that includes foods rich in thiamine, such as whole grains, legumes, nuts, seeds, meat, fish, eggs, and dairy products
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Choosing foods that are fortified with thiamine, such as breads and cereals, if available
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Avoiding excessive alcohol consumption, which can interfere with the absorption and storage of thiamine
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Taking thiamine supplements, if recommended by a doctor, especially for people who have a higher risk of beriberi, such as those with alcohol use disorder, genetic beriberi, hyperthyroidism, pregnancy, bariatric surgery, HIV, diarrhea, diuretics, or kidney dialysis
Beriberi is a serious condition that can affect the heart, nervous system, and digestive system. It is caused by a lack of thiamine, which is an essential nutrient for the body. Symptoms of Beriberi can be treated with injections of thiamine, supplements, and dietary changes. It is possible to prevent Beriberi by eating a balanced diet filled with foods rich in thiamine, avoiding excessive alcohol consumption, and taking thiamine supplements whenever necessary. These steps can reduce the risk of developing beriberi and its complications.
