Beriberi is a debilitating disease having devastating effects over almost all the organ systems of the human body. Beriberi disease manifests as neurological disorders, peripheral paralysis, psychosis, weakened heart and impaired circulatory system and results in heart failure and death.
Causes for the occurrence of the Beriberi diseaseBeriberi disease is a disease caused by vitamin B1(thiamine) deficiency. Primary cause of the disease is malnutrition in the form of reduced intake of essential nutrients by the economically weaker sections of the society. Beriberi disease also occurs in populations who take polished white rice as main staple food.
Most of the cereals and grains have vitamin B1(thiamin) available in their outer skin. While refining and polishing them, the vitamin B1 is lost in the husk/bran. Food containing high levels thiaminase like polished rice, raw shellfish, raw freshwater fish, ferns may lead to depletion of thiamine. Betel nuts, tea and coffee which contain anti thiamine factors can cause deficiency of thiamin and beriberi disease.
In regions of famine when the available meagre food excludes vitamin B1 sources like whole grains, green vegetables, fruits, legumes and animal sources of food like meat and milk, the whole population may suffer from the deficiency and get affected by Beriberi. In alcoholics due to their careless food habits combined with poor absorption and/or poor utilisation of thiamin Beriberi can occur.
Patients who had gastric bypass surgery are predisposed to develop beriberi. Infants who are milk dependent and are nursed by vitamin B1 deficient mothers develop infantile beriberi. Severe diseases of the liver, chronic diarrhea, long spell of febrile illness, pregnancy and diseases of thyroid glands can lead to vitamin B1 deficiency and beriberi. Patients on dialysis loose thiamine considerably and have the risk of getting beriberi if supplements are not taken.
People taking diuretics are under the risk of developing deficiency of vitamin B1, as increased urination causes more loss of thiamine. Impaired digestive system (usually found in elderly persons), celiac disease and tropical sprue can lead to beriberi. Genetic beriberi (a hereditary disease) is a rare condition in which thiamin cannot be absorbed by the body. This condition sets in adults.
Symptoms and signs of BeriberiHuman body cannot produce vitamin B1. Thiamin being water soluble, in excess is excreted in urine. In the human body vitamin B1 is stored in small quantities in skeletal muscles, heart, kidneys, liver and brain. If thiamine intake is stopped totally, whole thiamin store will be depleted within a month.
Early symptoms are nonspecific like general weakness and fatigue and are followed by weight loss, pain and weakness in extremities, resting tachycardia (abnormally high heart beat rate even in resting condition), disturbed emotions, decreased reflex actions, peripheral neuropathy and edema. These symptoms of beriberi can start occurring just about ten days from the stopping of vitamin B1 intake in healthy persons.
Effects of Beriberi disease on healthIf not treated the end result of beriberi is failure of heart and death. Depending on the prominent body systems affected the terms dry beriberi and wet beriberi are used. In wet beriberi, the circulatory system and the renal system are affected. Initially in wet beriberi vasodilation occurs. This leads to high cardiac output. Renal system responds to this by salt and fluid retention. This in turn leads to edema of the extremities more particularly legs.
With the increased fluids the heart has high workload of pumping the increased volume of blood to reach out to all parts. This results in the weakening of heart, heart enlargement, fluids in the lungs, rapid heartbeat and heart muscle injury due to overuse. With the weakening of heart its output gets reduced. Due to lack of oxygenated blood, cyanosis (blue colouration due to lack of oxygenated blood) of the hands and legs occurs.
With poor level of oxygen in the blood heart muscles may stop functioning and heart failure may occur. In dry beriberi disease, which involves the nervous system, damage to the nerves and brain occurs.
Treatment for BeriberiThe immediate treatment for this disease is thiamine supplements as injections and/or oral tablets.A nutritive diet also should be given. Immediate improvement can be observed in the condition of the beriberi patient after administration of thiamin hydrochloride injections.
In the initial stages heart damage is reversible when treated properly. In the later stages even if the life is saved by the treatment, the patient may have to live with impaired heart function. The damage to the nervous system is reversible if treated early. However some effects like poor memory and memory loss may remain.
Prevention of BeriberiA balanced diet consisting of both animal and plant sources of food can prevent not only vitamin B1 deficiency caused disease like beriberi, but also all types of vitamin deficiency caused diseases. We should use whole cereals and whole wheat flour, as sufficient thiamin can be obtained from them. Regular intake of potatoes, oatmeal, oranges, eggs and liver can prevent beriberi in normal healthy person.
Alcoholics should give up alcohol and correct their food habits and take food rich in vitamin B1. Pregnant women should take food rich in thiamine and take vitamin B1 supplements as per doctor's advice. Lactating mothers also should take nutritive food and vitamin supplements. When infants are weaned care should be taken to ensure availability of vitamin B1 in the baby food to ward of beriberi disease.
Current topic: Vitamin B1 deficiency and beriberi disease.