Beriberi: What It Is, Types, Symptoms, Causes & Treatment

What is Beriberi?

Beriberi is a condition caused by the deficiency of thiamin (vitamin B1) in the body.

Thiamin is essential for digestion and the maintenance of metabolism. It also plays a vital role in the functioning of the musculoskeletal system and nervous systems. A deficiency of this vitamin can result in various symptoms.

Severe thiamin deficiency can also prove fatal as it may cause heart failure or muscle paralysis. It is very important to treat thiamin deficiency in the early stages. 

Types of Beriberi

Beriberi can be categorized into two types based on the different organs it affects. These types are:

• Wet Beriberi

It can affect your circulatory and cardiovascular systems. Due to its impact on your heart, this type of beriberi is often more severe and requires immediate treatment.

• Dry Beriberi

It affects your nervous system and can result in weakened muscles or muscle paralysis. There may also be impaired reflexes and numbness in the hands and feet. Dry beriberi is easier to treat than wet beriberi.

What are The Symptoms of Beriberi?

The symptoms of beriberi vary based on the type.

Symptoms of wet beriberi are:

• Breathlessness, especially with physical activity
• Shortness of breath when waking up
• Palpitations 
• Rapid heart beats
• Chest pain
• Swelling in the extremities, especially the legs

Symptoms of wet beriberi include:

• Muscle weakness, often in the lower legs
• Difficulty in walking and maintaining balance
• Tingling and numbness in the hands and feet
• Neuropathic pain (pain caused because of damage to nerves)
• Difficulty in speaking
• Difficulty in swallowing
• Mental confusion
• Involuntary muscle movements
• Vomiting
• Muscle paralysis

The symptoms are easy to treat in the initial stages. Without prompt treatment, the condition can progress to a type of encephalopathy called the Wernicke-Korsakoff syndrome. This syndrome is a type of brain damage caused due to thiamin deficiency. 

It can damage vital parts of the nervous system - the thalamus and hypothalamus. These sections of the brain are responsible for monitoring various functions and can result in

• Mental confusion
• Loss of control over emotions
• Memory issues
• Short-term memory loss
• Loss of coordination and balance
• Difficulty with vision
• Double vision
• Hallucinations

The syndrome may permanently damage the nervous system.

What Causes Beriberi?

The primary cause of beriberi is a lack of thiamin in the diet. The condition is rare in developed regions where people have access to vitamin-enriched foods, like whole-grain cereals, bread and pasta.

Beriberi is very common in India as the diet chiefly includes unenriched, refined white rice low in thiamin.

Who is at Risk For Beriberi?

Eating a healthy diet with food rich in thiamin can reduce the chances of beriberi. Thiamin deficiency is higher in people who drink large amounts of alcohol. Excess alcohol consumption can inhibit your body's capability of absorbing thiamin from food.

Other vulnerabilities that prone you to develop beriberi include:

1. Hyperemesis gravidarum - extreme vomiting during pregnancy 

1. Breastfed babies whose mothers have a vitamin B1 deficiency

1. Infants on formula with low thiamin levels

1. Bariatric surgery can reduce the digestive tract and interfere with vitamin absorption

1. Engaging in stressful physical activity and exercise

1. Hyperthyroidism can limit thiamin absorption

1. High levels of stress 

1. If you use diuretics or are on dialysis

1. History of medical conditions such as diabetes or AIDS

1. Cancer patients

1. People who have dietary restrictions due to eating disorders or irritable bowel syndrome (IBS)

How is Beriberi Diagnosed?

Your healthcare provider may recommend several medical tests to diagnose you with beriberi. Blood and urine tests are the main tests that can indicate thiamin levels.

Depending on the extent of the condition, your doctor may also recommend a detailed assessment to ascertain neurological and cardiovascular function. They will perform a physical exam to check for impaired coordination, muscle weakness, reduced reflexes, heart rate irregularities, swelling in extremities and walking difficulties. In advanced stages of this condition, symptoms include memory loss, confusion or hallucinations.

How Can Beriberi Be Prevented?

Beriberi is easily preventable with a healthy, well-balanced diet. Your body stores thiamin in the liver. However, the stores are limited and require replenishment through diet to avoid deficiency. Consuming thiamin-fortified cereals and meals can prevent beriberi.

The Recommended Dietary Allowance (RDA) for thiamin in healthy adults is

• 1.2 mg daily for males
• 1.1 mg daily for females
• 1.4 mg daily during pregnancy

A serving of 100 grams of sunflower seeds contains about 1.5 mg of thiamin which can quickly fulfill the body's need for thiamin.

How is Beriberi Treated?

Beriberi is easily treatable with thiamin supplementation through food. Including thiamin-rich food in your diet is the best way to correct the deficiency. In the early stages of vitamin deficiency, your doctors will often recommend consuming the following food:

• Thiamin fortified cereals
• Whole grain bread and pasta
• Beans and lentils
• Green peas
• Pork
• Fish
• Sunflower seeds
• Tofu
• Asparagus
• Yoghurt

In the advanced stages of beriberi, mere dietary supplements will not be enough. Your doctor may prescribe medicines. Thiamin supplements are available in oral and intravenous forms. For severe deficiency, injecting thiamin directly into the blood can help improve the symptoms faster.

Wet beriberi is a case of medical emergency and requires prompt treatment. Treating this type of beriberi is tricky but still possible with immediate intervention. Your doctors will observe your progress and perform routine follow-up blood tests to ensure effective treatment. 

Conclusion

Beriberi is a thiamin deficiency disorder. Early detection of thiamin deficiency is the key to treatment. The nervous and cardiovascular system changes can correct in the early stages.

As the symptoms progress, the condition may become difficult to treat.

Consuming a diet rich in all vital nutrients, including thiamin, is very important. If you have any symptoms of beriberi, consult your doctor immediately for early diagnosis and treatment.