What is Beriberi?
People who are deficient in Vitamin B1, commonly known as thiamine, experience a combination of symptoms known as the Beriberi syndrome. Therefore, it typically affects undernourished people, especially in developing nations. There are two popular beriberi varieties. Dry beriberi causes necrosis and the degeneration of the neurological system, whereas wet beriberi causes cardiovascular failure. It could result in heart failure, nerve necrosis, or Wernicke's Korsakoff syndrome if untreated.
Beriberi subtypes
Beriberi mostly comes in three varieties:
Wet Beriberi, which affects a person's heart since it influences the circulatory system, can occasionally be fatal because it causes heart failure and weakens capillary walls.
Dry Beriberi affects the nervous system of the body and is sometimes referred to as endemic neuritis which causes paralysis and other conditions.
Infantile Beriberi occurs to the children of Thiamine deficient mothers who are breast feeding them. It usually occurs in the first year of the child’s life and if not treated immediately can prove to be fatal.
History behind the discovery of Beriberi and its symptoms
Christiaan Eijkman (1858-1930) discovered that not all diseases were caused by microorganisms like bacteria and viruses, but that some were due to dietary deficiencies, particularly deficiencies of certain vitamins. Born in the Netherlands in 1858, Eijkman received his medical degree from the University of Amsterdam in 1883, then went to Germany to study under the famous bacteriologist, Heinrich Robert Koch (1843-1910). Encouraged by Koch, Eijkman joined a commission sent to the Dutch East Indies (now Indonesia) in 1887 to investigate the disease beriberi and begin the work that was to make him famous.
Eijkman had discovered a dietary deficiency disease. At first, he did not fully understand the meaning of his findings, assuming that there must be a toxin (poison) in rice grains that could be neutralized by something in the hulls. But others would quickly clarify his results.
A younger colleague, Gerrit Grijns, took over the nutrition studies when an illness forced Eijkman to go home in 1896. In 1901 Grijns proposed that beriberi was caused not by germs, but by the lack of some natural substance present in rice hulls and other foods (this substance turned out to be thiamine, a vitamin.
Over the next decade, a number of investigators—most notably, England’s Frederick Gowland Hopkins (1861-1947)—came to similar conclusions about a number of diseases and a new era in medicine was launched. Eijkman, whose work served as the basis for the modern theory of vitamins, shared the Nobel Prize in medicine with Hopkins in 1929.
Prevalence
The prevalence of beriberi is much higher in East Asian countries because of the consumption of milled rice. Thiamine is contained in the outer coat of rice, and polishing destroys it. In the same countries, the custom of eating raw fish further increases the potential for deficiency.
Breastfed infants whose mothers have thiamine deficiency develop an infantile form of beriberi.
The same socioeconomic factors that yield beriberi in the West do so with much greater prevalence in East Asia. A study done in Indonesia revealed the prevalence of thiamine deficiency among low-income families to be as high as 66%. A study conducted in a group of Karen women from a refugee camp on the Thailand-Burma border revealed that up to 58% of these women were thiamine deficient 3 months postpartum, despite what appeared to be adequate dietary thiamine supplements.
Outbreaks have been described in prisons, drug rehabilitation centers, rural, agrarian communities, and in ships kept out at sea too long.
A familial form of thiamine deficiency with mitochondrial myopathy has been described in Japan.
Causes and risk factors of Beriberi
These factors may cause thiamine deficiency, as well.
Alcohol abuse, which can make it hard for your 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
Fad Diets
Malnutrition
AIDS
Prolonged diarrhea or use of diuretics (medication that makes you urinate more)
Undergoing kidney dialysis
Feeding mothers, lacking the vitamin may pass on the deficiency to their young ones via breast feeding.
What are the symptoms of beriberi?
The symptoms of beriberi vary depending on the type.
Wet beriberi symptoms include:
Shortness of breath during physical activity
Waking up short of breath
Rapid heart rate
Swollen lower legs
Dry beriberi symptoms include:
Decreased muscle function, particularly in the lower legs
Tingling or loss of feeling in the feet and hands
Pain
Mental confusion
Difficulty speaking
Vomiting
Involuntary eye movement
Paralysis
In extreme cases, beriberi is associated with Wernicke-Korsakoff syndrome. Wernicke encephalopathy and Korsakoff syndrome are two forms of brain damage caused by thiamine deficiency.
Wernicke encephalopathy damages regions 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 movement and double vision
Korsakoff syndrome is the result of permanent damage to the region of the brain where memories form. It can cause:
Loss of memory
Inability to form new memories
Hallucinations
Complications of Beriberi
The following systems are most affected by beriberi:
Gastrointestinal system. When the cells of the smooth muscles in the digestive system and glands do not get enough energy from glucose, they are unable to produce more glucose from the normal digestion of food. There is a loss of appetite, indigestion, severe constipation, and a lack of hydrochloric acid in the stomach.
Nervous System. Glucose is essential for the central nervous system to function normally. Early deficiency symptoms are fatigue, irritability, and poor memory. If the deficiency continues, there is damage to the peripheral nerves that causes loss of sensation and muscle weakness, which is called peripheral neuropathy. The legs are most affected. The toes feel numb and the feet have a burning sensation; the leg muscles become sore and the calf muscles cramp. The individual walks unsteadily and has difficulty getting up from a squatting position. Eventually, the muscles shrink (atrophy) and there is a loss of reflexes in the knees and feet; the feet may hang limp (foot drop).
Cardiovascular system. There is a rapid heartbeat and sweating. Eventually the heart muscle weakens. Because the smooth muscle in the blood vessels is affected, the arteries and veins relax, causing swelling, known as edema, in the legs.
Musculoskeletal system. There is widespread muscle pain caused by the lack of TPP in the muscle tissue.
Infants who are breastfed by a thiamine-deficient mother usually develop symptoms of deficiency between the second and fourth month of life. They are pale, restless, unable to sleep, prone to diarrhea, and have muscle wasting and edema in their arms and legs. They have a characteristic, sometimes silent, cry and develop heart failure and nerve damage.
Exams and Tests
A physical examination may show signs of congestive heart failure, including:
Difficulty breathing with neck veins that stick out
Enlarged heart
Fluid in the lungs
Rapid heartbeat
Swelling in both lower legs
A person with late-stage beriberi may be confused or have memory loss and delusions. The person may be less able to sense vibrations. A neurological exam may show signs of:
Changes in the walk
Coordination problems
Decreased reflexes
Drooping of the eyelids
The following tests may be done:
Blood tests to measure the amount of thiamine in the blood
Urine tests to see if thiamine is passing through the urine.
Treatments & home remedies
The goal of treatment is to replace the thiamine your body is lacking. This is done with thiamine supplements. Thiamine supplements are given through a shot (injection) or taken by mouth. The intake of Vitamin B1-rich pills prove to be highly advantageous and are observed to lend relief to the patient within a short span of time. Except for in extreme cases, a proper diet comprising of more thiamine than needed must be supplied while the body is in the recovering state. Excess thiamine is never harmful to the body.
Brown Rice
Brown or husked rice is considered to be the best source of thiamine, and therefore should be made a part of our regular diet. Try avoiding polished or dehusked rice as they lack vitamin B1. A healthy diet that is rich in rice can always help you from contracting beriberi.
Rice Bran
This is the best of all the known home remedies for beriberi. It has been practiced for hundreds of years. Rice is boiled in an excess of water and the water containing the rice extract is drained and collected in a vessel. This water can is drinkable, and has significant quantities of Vitamin B1.
Legumes
Most of the legumes, seeds and nuts contain thiamine in their outer covering. These can be used frequently, if not regularly.
Milk
Milk is a rich source of vitamins and other mineral nutrients and should be consumed on regular basis.
Whole Grain Brown Bread
Grains that contains outer layer are very rich in thiamine. Feeding individuals with thiamine-rich brown bread can also contribute to the overall vitamin content in the body.
Alagau
Alagau is a herb found only in the Philippines and has been found to be effective in treating this thiamine deficiency disease. Individuals with thiamine-rich brown bread can also contribute to the overall vitamin content in the body.
Protection against Beriberi
Avoid Drinking After Meals: Since vitamin B1 is a water-soluble substance, drinking too much after meals can cause the body to lose some of its supply.
Avoid Fish: Raw animal tissue, shellfish, clams, mussels, shrimp, and mussels all contain the enzyme thiaminase, which degrades thiamine. In order to preserve the vitamin B1 that is already present in the body, eating fish must be avoided.
Eat a healthy, balanced diet that include foods high in vitamin B1 to avoid beriberi (thiamine). These consist of:
legumes and beans
Seeds
Meat
Fish
whole grains
Nuts
Dairy
Several vegetables, including beet greens, acorn squash, brussels sprouts, asparagus, and breakfast foods that have been thiamine-enriched.
Cooking or processing any of the foods listed above decreases their thiamine content. If you give your infant formula, you should also check that it contains enough thiamine.
Always be sure to purchase infant formula from a reliable source.
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