What is beriberi?
Beriberi is a disease caused by a vitamin B-1 deficiency, also known as 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 decreased 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, your chances of developing beriberi are low. Today, beriberi mostly occurs in people with an alcohol use disorder. Beriberi from other causes are rare in the United States. Still, the disease can be seen in women who have extreme nausea and vomiting in pregnancy (hyperemesis gravidarum), in people with AIDS, and after bariatric surgery.
What are the symptoms of beriberi?
The symptoms of beriberi vary depending on the type.
Wet beriberi symptoms include:
- shortness of breath during physical activity
- waking up short of breath
- rapid heart rate
- swollen lower legs
Dry beriberi symptoms 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 thalamus and hypothalamus. This condition can cause:
- memory loss
- loss of muscle coordination
- 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. It can cause:
- loss of memory
- inability to form new memories
What causes beriberi?
The main cause of beriberi is a diet low in thiamine. The disease is very rare in regions with access to vitamin-enriched foods, such as certain breakfast cereals and breads. Beriberi is most common in regions of the world where the diet includes unenriched, processed white rice, which only has a tenth of the amount of thiamine as brown rice.
Who is at risk?
Other factors may cause thiamine deficiency, as well. These include:
- alcohol abuse, which can make it hard for your body to absorb and store thiamine
- genetic beriberi, a rare condition that prevents the body from absorbing thiamine
- hyperthyroidism (overactive thyroid gland)
- extreme nausea and vomiting in pregnancy
- bariatric surgery
- prolonged diarrhea or use of diuretics (medication that makes you urinate more)
- undergoing kidney dialysis
Breastfeeding mothers need daily thiamine in their diet. Infants drinking breast milk or formula low in thiamine are at risk for thiamine deficiency.
How is beriberi diagnosed?
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 thiamine in your body. 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. People with 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.
How is beriberi treated?
Your progress will be monitored with follow-up blood tests to see how well your body is absorbing the vitamin.
How to prevent beriberi
To prevent beriberi, eat a healthy, balanced diet that includes foods rich in thiamine. These include:
- beans and legumes
- whole grains
- certain vegetables, such as asparagus, acorn squash, brussels sprouts, spinach, and beet greens
- breakfast cereals that are enriched with thiamine
Cooking or processing any of the foods listed above decreases their thiamine content.
If you give your infant formula, you should also check that it contains enough thiamine.
Always be sure to purchase infant formula from a reliable source.
Limiting alcohol consumption will reduce your risk of developing beriberi. Anyone who abuses alcohol should be checked routinely for a B-1 vitamin deficiency.
What is the long-term outlook for someone with beriberi?
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 progresses 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. 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.