Beriberi is a diseased condition caused due to insufficient amount of thiamine (Vitamin B1) in the body. The condition may be caused either due to inadequate supply of the vitamin in the food taken or the body’s inability to absorb thiamine efficiently.
Vitamin B1 or Thiamine plays a major role in the breakdown of complex molecules into simpler ones, in the metabolism of carbohydrates that release energy for the body functions. Thiamine is also related to the functioning of the neurons in the nervous system. The vitamin is hence inevitable for the efficient functioning of the body systems especially the cardio-vascular system and the nervous system. Prolonged deficiency of Thiamine will have serious consequences. In the same note, with timely care and treatment, the symptoms can be reversed and normal health restored in patients.
Types of Beriberi
Depending on the system affected, there are two major types of Beriberi as given below:
• Wet Beriberi that affects cardiovascular system
• Dry Beriberi that affects the nervous system.
Apart from these two major types, infantile beriberi that affects infants and gastro-intestinal beriberi that affects the digestive system are also reported. A significant offshoot of dry beriberi namely Wernicke-Korsakoff syndrome involves loss of memory and cognition and the situation is mostly driven by genetic disorders.
Causes of Beriberi
Beriberi is caused due to insufficient dietary supply of Vitamin B1 or thiamine. As the vitamin is involved in the energy metabolism of the body, deficiency of the vitamin leads to disrupted functioning of the body systems like cardiovascular system, nervous system, gastrointestinal system and muscular system. Though this disease was prevalent for over a millennium, it is only about 200 years ago that the causative factor and clinical description of the disease were identified and treated.
The disease was noted in Asians who took to having white polished rice for their staple food. While de-husking, the grains lose the vitamin content and hence intake of white polished rice was found to be a major reason for lack of vitamin in the diet.
There is also a rare occurrence of genetic inheritance of the disease. In such cases the patients will have an inherited problem of impaired absorption of thiamine from the food. The symptoms develop over a period of time and the disease is obviously felt in adulthood when the patient will lose the ability of thiamine absorption.
Treatment for Beriberi
The primary objective of the treatment methodology is to bring back the thiamine levels of the body within the normal range. Diagnosis of this disease is done based on the symptoms, which is further confirmed by a blood and urine test.
Thiamine is supplied to the body either as oral pills or injections, which helps to reverse the deficiency symptoms. When the deficiency is severe, intravenous or intramuscular injections are given for a prescribed number of days, followed by oral pills, until the patient recovers.
Treating Wet Beriberi
In case of wet beriberi that affects cardio vascular system, the patient is administered drugs that will strengthen the heart muscles and prevent heart failure.
Treating Dry Beriberi
When the deficiency affects the nervous system as in dry beriberi, in addition to administering drugs patient is also given physical therapy which is necessary for complete recovery. However, recovery from dry beriberi takes place gradually over a period of time.
Infantile beriberi is treated by encouraging the babies to be breast fed and putting the mothers on a thiamine rich diet. Physicians also advise dietary supplements of thiamine and the patient is advised to take a nutritious diet containing sources of the vitamin namely unrefined cereals, brown rice, fresh meat, legumes, green leafy vegetables like spinach, lettuce, cabbage, fruits and milk.
Symptoms of Beriberi
As thiamine is essential for the energy metabolism in the body deficiency leads to disturbed bodily functions that affect the various systems of the body.
When the nervous system is affected as in dry beriberi, symptoms like fatigue, nausea and irritability are noticed. When deficiency is severe there is loss of sensation and muscle weakness, as thiamine deficiency damages the peripheral nerves. The condition is called peripheral neuropathy. The condition affects the leg muscles badly as there is numbness, burning sensation and muscle cramps. Eventually there is loss of reflex and difficulty in walking. In general the patient will have loss of memory and lack of muscular co-ordination while moving.
Cardio Vascular System
In case of wet beriberi, the smooth cardio muscles are affected, which leads to swelling of legs and arms called edema. The patient will experience increased rate of heart beat, shortness of breath and also accumulation of fluid around the lungs.
Due to impaired glucose metabolism, the smooth muscles lining the gastrointestinal tract runs out of enough energy for digestion which leads to lack of appetite, indigestion and also constipation.
Infants affected will be irritated and found crying persistently , but not loudly. Interestingly, such infants are noticed crying without tears.
Incidences of beriberi are on the high in developing and under-developed countries. In developed countries like the US, nutritional supply of Thiamine is ensured as most people can afford to take nutrient rich food. Whereas in poorly developed countries, people are mostly under nourished which causes thiamine deficiency.
If occurrence of beriberi is directly related to malnutrition and poverty, one might wonder as to why cases of beriberi are reported from developed countries too. The answer is excess use of alcohol. Alcohol intake prevents the body from absorbing and storing thiamine for its metabolic activities and hence prolonged or regular intake of alcohol is a major factor leading to beri-beri.
Formula Fed Infants
Unlike breast fed infants, those fed only on baby formula do not get adequate supply of Thiamine as the formula feeds do not provide the needed dosage of the vitamin. Hence formula fed infants are at risk of having the deficiency symptoms.
Conditions like persistent diarrhea, liver, kidney disorders etc hinder with the absorption and use of thiamine by the body.