Beriberi

Written by Chitra Badii and Matthew Solan | Published on July 18, 2012
Medically Reviewed by George Krucik, MD

Overview

Beriberi is a disease brought on by a Vitamin B-1 (thiamine) deficiency.

There are two types of the disease: wet beriberi and dry beriberi. Wet beriberi can effect heart function and, in the most extreme cases, heart failure. Dry beriberi damages the nerves and can lead to a loss of muscle strength and, eventually, muscle paralysis. If left unchecked and untreated, beriberi will cause death.

Yet, if you have access to foods rich in Vitamin B-1, your chances of developing beriberi are low. Meat, dairy products, and whole grains are all excellent sources of Vitamin B-1 that can prevent you from getting the disease.

What Causes Beriberi? Who is at Risk?

The primary cause of beriberi is a diet low in Vitamin B-1. The disease is very rare in regions with access to vitamin-enriched foods. Other dynamics can contribute:

  • Alcohol abuse can make it difficult for your body to absorb and store Vitamin B-1.
  • Genetic beriberi is a rare condition that prevents the body from absorbing Vitamin B-1.
  • Pregnant women and anyone with hyperthyroidism (over-active thyroid gland) need extra vitamin B-1.
  • Prolonged diarrhea can make it difficult for your body to absorb Vitamin B-1.
  • Some diseases (e.g., liver disease) impair your body’s ability to use Vitamin B-1.
  • Infants drinking breast milk or formula low in Vitamin B-1.
  • Kidney dialysis can increase your risk of beriberi.

What are the Symptoms of Beriberi?

The symptoms of beriberi vary depending on the type, wet or dry. The following are symptoms of wet beriberi:

  • shortness of breath during physical activity
  • rapid heart rate
  • swollen lower legs
  • waking up short of breath

The symptoms of dry beriberi are:

  • decreased muscle function, particularly in the lower legs
  • tingling or loss of feeling in the feet and hands
  • pain
  • mental confusion
  • difficulty speaking
  • vomiting
  • involuntary eye movement
  • paralysis

In extreme cases, the condition can cause Wernicke-Korsakoff syndrome. This is a type of brain damage that causes mental confusion and memory loss. This condition occurs most often in cases of alcoholism.

How is Beriberi Diagnosed?

You will need a series of medical tests to determine whether you have beriberi. A blood test will measure how much Vitamin B-1 is in your blood. A urine test will check the concentration level of thiamine. Any difficulty you body has absorbing thiamine will show up as a high concentrations of thiamin in your urine.

During a neurological exam, doctors look for signs of lack of coordination, walking difficulty, droopy eyelids, and impaired reflexes. Later stages of beriberi will show memory loss, confusion, or delusions.

A physical exam will alert your doctor to any heart problems. Rapid heartbeats, lower leg swelling, and/or difficulty breathing are all possible signs for beriberi.

How is Beriberi Treated?

Beriberi is treated with thiamine supplements. Your doctor might prescribe a thiamine shot or pill. Monitoring your progress is usually done with follow-up blood tests that show how well your body is absorbing the vitamin.

Your doctor may also put you on a specific diet of thiamine-enriched foods, including whole grains, eggs, meats, beets, nuts, seeds, and tomato or orange juice. Foods such as milled rice, shrimp and raw meat, make it harder for your body to absorb Vitamin B-1 and might need to be limited.

How to Prevent Beriberi

To prevent beriberi, eat a healthy, balanced diet that emphasizes foods rich in thiamine. Pregnant and nursing mothers should be check regularly for any vitamin deficiencies Infant formulas should also be checked for adequate thiamine. Anyone who abuses alcohol should be checked for Vitamin-B deficiencies.

What is the Long-Term Outlook for Someone With Beriberi?

The prognosis for beriberi is quite good if caught and treated early. Any nerve and/or heart damage from beriberi can also be reversed if caught early.

In cases of beriberi brought on by alcoholism, if allowed to advance to Wernicke-Korsakoff syndrome, the brain damage can be permanent.

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