Beriberi

Beriberi is a vitamin deficiency disease, caused by a lack of vitamin B1 (thiamine). Since thiamine is essential for proper carbohydrate and fat metabolism and for normal functioning of enzymes and nervous tissue, beriberi results in neurological and gastrointestinal disorders. In severe cases the heart may be affected; paralysis and death may occur. Thiamin, which is also known as vitamin B1, was the first B vitamin to be discovered. Scientists in the late 19th century noticed that animals fed a diet of polished rice developed the thiamin deficiency disease, beriberi, and that this could be cured by adding rice husks to the feed. In 1926, two Dutch scientists isolated pure thiamin, the active anti-beriberi agent in the rice. In the human body, thiamin is found in high concentrations in the muscles, heart, liver, kidneys and brain.

• Irritability 
• Fatigue 
• Restlessness 
• Decreased appetite 
• Complaints of tingling or burning in the extremities 
• Numbness in the extremities 
• Shortness of breath (dyspnea) 
• Bluish coloration to the skin (cyanosis) 
• Decreased mental ability 
• Unusual behavior 
• Seizures 
• Loss of consciousness

Beriberi can be prevented with an adequate intake of thiamine. Nursing mothers should insure that their diet is adequate in all vitamins.

Beriberi has become almost nonexistent in the United States since the discovery of thiamine deficiency as its cause. Most foods are vitamin enriched and a normal diet contains adequate amounts of thiamine. However, it can appear in breast-fed infants when the mother has an inadequate intake of thiamine or among people whose diet includes certain types of fish that produce an enzyme, which inactivates thiamine. 

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.

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: 
ECG (to rule out other causes of seizures and neurologic changes) 
Clinical response to administered thiamine (symptoms improve after the person is given thiamine supplements)

Avoid alcohol and smoking especially junk foods that deplete thiamine. Deficiency results in insomnia, fatigue confusion and poor memory and muscle coordination. Foods rich in thiamine include brewers yeast, whole grains, wild rice, mushrooms, yogurt, almonds and broccoli.

Alcoholics and binge drinkers are especially prone to thiamin deficiency as alcohol reduces absorption, alters metabolism and depletes body stores. Alcoholics also tend to have poor diets. Thiamin deficiency is associated with some of the symptoms of alcoholism such as mental confusion, visual disturbances and staggering gait. If thiamin deficiency is not corrected, permanent brain damage may result. This condition is known as Wernicke Korsakoff syndrome and is usually seen in people who have been addicted to alcohol for many years. It is best to avoid alcohol and smoking.

When having thiamine deficiency it is best to avoid stressful activities and to relax and adopt therapies that would help the body to relax.