Beriberi is a disease caused by a vitamin B1 (thiamine) deficiency. There are two types of the disease: wet beriberi and dry beriberi. Wet beriberi affects the heart and circulatory system. In extreme cases, wet beriberi can cause heart failure. Dry beriberi damages the nerves and can lead to a loss of muscle strength and eventually, muscle paralysis. Beriberi can be life-threatening if it isn’t treated.
If you have access to foods rich in thiamine, such as beans, vegetables, meat, and whole grains, your chances of developing beriberi are low. Today, beriberi mostly occurs in people with an alcohol use disorder (alcoholism).
The main cause of beriberi is a diet low in thiamine. The disease is very rare in regions with access to vitamin-enriched foods (e.g., breakfast cereals and breads). Beriberi is most common in regions of the world where the diet includes a lot of unenriched white rice, which only has a tenth of the amount of thiamine as brown rice.
There are a number of other factors may cause thiamine deficiency as well. These include:
- Alcohol abuse can make it hard for your body to absorb and store thiamine.
- Genetic beriberi is a rare condition that prevents the body from absorbing thiamine.
- Pregnant women, breast-feeding mothers, and anyone with hyperthyroidism (over-active thyroid gland) need extra thiamine.
- Prolonged diarrhea or use of diuretics (medication that makes you urinate more) can lead to depletion of thiamine.
- Infants drinking breast milk or formula low in thiamine are at risk for thiamine deficiency.
- Kidney dialysis can increase your risk of beriberi by depleting your body’s stores of thiamine more quickly.
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
- waking up short of breath
- rapid heart rate
- swollen lower legs
The symptoms of dry beriberi include:
- decreased muscle function, particularly in the lower legs
- tingling or loss of feeling in the feet and hands
- mental confusion
- difficulty speaking
- involuntary eye movement
In extreme cases, beriberi is associated with Wernicke-Korsakoff syndrome. Wernicke encephalopathy and Korsakoff syndrome are two forms of brain damage caused by thiamine deficiency. Wernicke encephalopathy damages regions of the brain called the thymus and hypothalamus. This condition can cause confusion, memory loss, loss of muscle coordination, and visual problems such as rapid eye movement and double vision. Korsakoff syndrome is the result of permanent damage to the region of the brain where memories form. This can cause loss of memory, the inability to form new memories, and hallucinations.
You will need a series of medical tests to determine whether or not you have beriberi. Blood and urine tests will measure the levels of vitamin B1 or thiamine in your body, specifically erythrocyte transketolase activity. If your body has trouble absorbing thiamine, you will have a low concentration of thiamine in your blood and a high concentration in your urine.
Doctors will also perform a neurological exam to look for lack of coordination, difficulty walking, droopy eyelids, and weak reflexes. Later stages of beriberi will show memory loss, confusion, or delusions.
A physical exam will alert your doctor to any heart problems. Rapid heartbeat, swelling of the lower legs, and difficulty breathing are all symptoms of beriberi.
While the symptoms can be severe, beriberi is easily treated with thiamine supplements. Your doctor may prescribe a thiamine shot or pill. For severe cases, intravenous thiamine will be administered. Your progress will be monitored with follow-up blood tests to see how well your body is absorbing the vitamin.
To prevent beriberi, eat a healthy, balanced diet that includes foods rich in thiamine. These include:
- beans and legumes
- whole grains
Many breakfast cereals come enriched with 100 percent of your daily thiamine.
Pregnant and nursing mothers should be checked regularly for vitamin deficiencies. Infant formulas should also be checked to be sure they contain enough thiamine.
Limiting alcohol consumption will reduce your risk of developing beriberi. Anyone who abuses alcohol should be checked routinely for B1 vitamin deficiencies.
If beriberi is caught and treated early, the outlook is good. Nerve and heart damage from beriberi is usually reversible when it’s caught in the early stages. Recovery is often quick once you begin treatment.
If beriberi is allowed to progress to Wernicke-Korsakoff syndrome, the outlook is poor. While treatment can control symptoms of Wernicke encephalopathy, brain damage from Korsakoff syndrome is often permanent.
Maintaining a healthy, balanced diet is important for your health, so talk to your doctor if you think you are showing signs of a thiamine deficiency or if you need advice on how to get the nutrients you need.