Beriberi is a disease caused by a deficiency of vitamin B1 or thiamine. This condition is common in developing countries, especially for people with a diet consisting mostly of white rice or refined carbohydrates.
There are two types of beriberi, namely wet beriberi and dry beriberi. For wet beriberi, it will affect the heart and circulatory system. In extreme cases, wet beriberi can cause heart failure. Meanwhile, dry beriberi can damage nerves which can lead to decreased muscle strength and eventually muscle paralysis. Beriberi can also be life-threatening if left untreated.
If you have access to foods rich in thiamine, your risk of developing this disease will be lower. This disease also occurs mostly in people who are addicted to alcohol and it can also occur as a complication of weight loss surgery.
Symptoms of Beri-Beri
Symptoms of this disease vary depending on the type. For wet beriberi, symptoms include:
- Shortness of breath during physical activity;
- Shortness of breath upon waking;
- Rapid heartbeat;
- Swelling in the lower legs.
Meanwhile, dry beriberi symptoms include:
- Decreased muscle function, especially in both lower legs;
- Tingling or loss of feeling in the feet and hands on both sides;
- Painful;
- Mental confusion;
- Difficulty speaking;
- Vomit;
- Involuntary eye movements;
- Paralysis.
In extreme cases, beriberi is associated with Wernicke-Korsakoff syndrome. Wernicke’s encephalopathy and Korsakoff’s syndrome are two forms of brain damage caused by thiamine deficiency. Wernicke’s encephalopathy damages areas of the brain called the thalamus and hypothalamus. This condition can cause:
- Confusion;
- Memory loss;
- Loss of muscle coordination;
- Visual problems such as rapid eye movements and double vision.
Korsakoff’s syndrome is the result of permanent damage to the part of the brain where memories are formed. It can cause:
- Memory loss;
- Inability to form new memories;
- Hallucinations.
Causes of Beri-Beri
The main cause of this disease is low thiamine intake. This disease is very rare in areas where people often eat foods rich in the vitamins, such as certain breakfast cereals and breads.
The disease is most common in areas where people eat processed, unenriched white rice, which typically contains only a tenth of the amount of thiamine needed.
Beriberi Risk Factors
Other factors can also cause thiamine deficiency. These include:
- Alcohol abuse, which can make it harder for the 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;
- Having AIDS;
- Prolonged diarrhea or use of diuretics (drugs that make a person urinate more);
- Undergoing kidney dialysis or blood washing;
- Malnutrition;
- Diabetes.
Breastfeeding mothers need daily thiamine in their diet. Babies who are breastfed or formula-fed are at risk for thiamine deficiency. Thiamine deficiency is also more common in people with cancer. Restrictive diets, eating disorders, and inflammatory bowel disease can also cause thiamine deficiency or beriberi.
Beriberi Diagnosis
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. Your doctor will also perform a neurological exam to look for poor coordination, difficulty walking, drooping eyelids, and weak reflexes. People with later stages of beriberi may show memory loss, confusion, or delusions.
A physical exam will alert your doctor to any heart problems. Rapid heartbeat, swelling in the lower legs, and difficulty breathing are all symptoms of beriberi.
Beriberi Complications
If beriberi is diagnosed and treated early, the patient’s condition can improve. The outlook is good. Nerve and heart damage from beriberi can usually be prevented when detected early. Recovery is often rapid once treatment begins.
If beriberi progresses to Wernicke-Korsakoff syndrome, it can make the condition worse. While treatment can manage the symptoms of Wernicke’s encephalopathy, the brain damage from Korsakoff syndrome is often permanent.
Maintaining good health and eating a healthy, balanced diet are important steps to staying healthy. Talk to your doctor if you think you may be showing signs of thiamine deficiency or if you need advice on how to get the nutrients you need.
Beriberi Treatment
The goal of beriberi treatment is to increase the levels of thiamine in the body. Your doctor may recommend supplements or injections to provide thiamine. Your doctor may suggest taking other supplements to support your treatment.
During treatment, your doctor may also ask you to have regular blood tests to check your thiamine levels until they return to normal. You may need to continue taking thiamine supplements at a lower dose or make changes to your diet after treatment to ensure that beriberi does not return.
A doctor can also treat complications that arise from beriberi, such as long-term nerve or heart damage. With early treatment, damage to the heart and nervous system from beriberi can be reversed. If a person has had the deficiency for a longer period, some symptoms may persist even after treatment.
Prevention of Beriberi
To prevent this disease, a person must consume enough thiamine in their diet. Typically, a person who eats a healthy, balanced diet with a focus on whole foods does not need to worry about thiamine deficiency. Foods that naturally contain thiamine include:
- Meat;
- Nuts, seeds, and legumes;
- Seafood;
- Milk and other processed products.
There are also many foods, such as bread, breakfast cereals, and baked goods, that manufacturers fortify with added vitamins including thiamine.
Pregnant or breastfeeding women should pay attention to their thiamine intake. Also, anyone using formula to feed their baby should check that the formula contains enough thiamine.
Heavy alcohol consumption is a risk factor for beriberi. So drinking less alcohol can help reduce the risk of beriberi by making thiamine more easily absorbed by the body. Someone who drinks heavily may also want to consider taking a vitamin B1 or B-complex supplement.
When to See a Doctor?
If someone experiences one or more of the above symptoms of beriberi, which are felt continuously or do not improve, they should immediately see a doctor for further examination and treatment.