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Encyclopedia -> Disease -> B -> Beriberi Alternate Names: Thiamin deficiency; Vitamin B1 deficiency Causes and Risks: Beriberi has become almost nonexistent in the United States since the discovery of its cause, thiamin deficiency. Most foods are now vitamin enriched, which means that a normal diet contains adequate amounts of thiamin. Beriberi, although uncommon, can be found among alcoholics. Alcohol-related thiamin deficiency is caused by inadequate intakes of thiamin as well as impaired absorption and storage. Beriberi can also appear, in breast-fed infants when the mother has an inadequate intake of thiamin or if the infant is fed unusual formulas without thiamin supplements. Deficiencies may also be found in people whose diet includes certain types of fish that produce an enzyme that inactivates thiamin. Early symptoms of beriberi are nonspecific and include fatigue, irritability, restlessness, loss of appetite, and vague abdominal discomfort. As the disease progresses, patients develop burning sensations, tingling in the extremities, and changes in sensation such as numbness. Patients may develop mental confusion and psychosis. Heart manifestations are caused by degeneration of the heart muscle and include heart failure with shortness of breath (dyspnea) and cyanosis (bluish tinged skin). Neurologic symptoms are caused by degeneration of the nerve fiber and its insulation (myelin). Death is generally a result of heart failure. There are two kinds of beriberi: "dry" and "wet". Dry beriberi is associated with energy deprivation and inactivity characterized by mental confusion, peripheral neuropathy, muscular wasting with loss of function or paralysis of the lower extremities. Wet beriberi is resultant of high carbohydrate intake along with strenuous exercise characterized by edema, tachycardia, pulmonary congestion, and enlarged heart. Prevention: Adequate intake of thiamin will prevent beriberi. Nursing mothers should insure that their diet is adequate in all vitamins and be sure that infant formulas contain thiamin. Alcoholics, the elderly, people in stress, and elite athletes also need to focus on well-balanced diet and may require B-vitamin supplementation to ensure appropriate intake and utilization of thiamin. Symptoms: Early symptoms:
Later symptoms:
Signs and Tests: Physical examination may show signs of congestive heart failure, including difficulty breathing, bluish skin (cyanosis), and others. The person with late-stage beriberi may be confused or psychotic. Neurological examination shows a loss of vibratory sensation (the person is less able to sense vibration), loss of coordination, gait changes (ataxia), and other changes. The liver may be enlarged (hepatomegaly). Tests include:
Treatment: Administration of thiamin reverses the deficiency and symptoms improve rapidly. Because most patients suffer from multiple deficiencies a vitamin B-complex is often given. Prognosis: Cardiac damage is reversible and is not permanent. Full recovery is expected after treatment. Untreated, beriberi is often fatal. If acute heart failure has occurred outlook is poor. If damage to the nervous system is not too great response to treatment is usually good. Complications:
Beriberi is extremely rare in the United States. However, if you feel your family’s diet is inadequate or poorly balanced and you or your children have any of the described symptoms, call your health care provider.
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