What is Beriberi Disease?
Beriberi is a disease caused due to deficiency of thiamine. Thiamine or vitamin B1 is a water-soluble vitamin, which acts as a coenzyme for several metabolic pathways. The recommended daily intake of vitamin B1 is 1.2 mg.
The human body cannot produce thiamine and depends on external sources. Only 30 mg can be stored in the tissues. Thiamine is mostly concentrated in the skeletal muscles. It is also found in the heart, liver and kidneys. Thiamine is excreted through the kidney.
Causes and Risk Factors
Beriberi is mostly found in developing countries where people may not be able to access a diet rich in vitamin B1. Certain foods are known to destroy thiamine. Tea, coffee, betel nuts and processed foods contain anti-thiamine factor, which destroys thiamine.Other conditions that cause beriberi include:
- Excessive alcohol usage, which results in inadequate intake in the diet as well as prevents the body from absorbing and storing vitamin B1.
- Genetic beriberi, which is an inherited condition where people lose the ability to absorb thiamine from foods. Symptoms usually present during adulthood.
- Pregnancy; pregnant women often present with vitamin B1 deficiency. Breastfeeding infants can suffer from vitamin B1 deficiency if the mother is deficient.
- People with endocrine disorders like hyperthyroidism who require extra vitamin B1.
- Chronic liver disease, which prevents the body from absorbing sufficient vitamin B1.
- Kidney dialysis, which leads to a loss of vitamin B1.
- A prolonged bout of diarrhea, which also leads to a loss of vitamin B1.
What are the Symptoms of Beriberi Disease?
A mild deficiency of vitamin B1 can cause symptoms like fatigue and increased irritability.
Beriberi is of two types, wet beriberi and dry beriberi.
Wet beriberi can affect the heart and in serious cases cause heart failure. Symptoms of wet beriberi include:
- Shortness of breath during nighttime while lying down or during physical activity
- Increased heart rate
- Swelling of feet
Dry beriberi affects the musculoskeletal and nervous system. It damages the nerves and leads to loss of muscle strength eventually leading to muscle paralysis. Symptoms of dry beriberi include:
- Trouble with walking
- Paralysis in the lower limbs
- Loss of sensation in hands and feet
- Tingling sensation in hands and feet
- Abnormal eye movements
- Nausea and vomiting
In extreme cases of dry beriberi, a brain damaging condition called Wernicke Korsakoff syndrome can occur. This can lead to permanent mental impairment if not treated on time.
How to Diagnose Beriberi Disease?
Diagnosis of beriberi is based on the history and physical features of the patient, and diagnostic tests. Signs in a patient with beriberi include:
- Breathing difficulty
- Enlarged heart
Patients in late stage beriberi often display neurological signs like:
- Fluid collection in the lungs
- Tachycardia or rapid heartbeat
- Edema or swelling in the lower limbs
Tests that may be required to confirm the diagnosis include:
- Changes in the gait
- Difficulties in coordination
- Slower reflexes
- Droopy eyelids
- Measurement of blood thiamine levels
- In case Wernicke’s encephalopathy is suspected, an MRI and CSF (cerebrospinal fluid analysis) may be done
- EEG (electroencephalogram)
- ECG (echocardiogram)
What are the Treatments for Beriberi Disease?
Doctors usually prescribe thiamine in either tablet/injection form depending on the severity. In some cases, intravenous thiamine may be needed.
Repeated blood tests may be required to measure the level of the vitamin to check if the body is absorbing the vitamin. Doctors also recommend a thiamine-rich diet, which includes whole grains, eggs, nuts, seeds, and tomato or orange juice.
Often other vitamins like B12 are also given as supplements.
Prognosis of Beriberi Disease
If treated early, the prognosis is usually good with patients recovering and integrating into normal life activities. Though heart damage is reversible, acute heart failure has low chances of recovery.
If caught early, damage to the nervous system is reversible. However, issues like memory loss and confusion may remain when treated late.
If beriberi progresses to Wernicke Korsakoff syndrome, brain damage can be permanent.
Beriberi if untreated or severe can lead to death.
How to Prevent Beriberi Disease?
A balanced, healthy diet rich in whole grains and legumes is helpful to maintain vitamin levels. Pregnant and lactating mothers should check their vitamin B1 levels from time to time. People who consume alcohol in excess should also keep a check on their vitamin levels.