beriberi

beriberi or Beriberi is a deficiency disease that is based on an insufficient intake of thiamine. Thiamine is the essential vitamin B1 for the body. It is triggered by an improper or poor diet, persistent alcoholism and, in rare cases, a congenital form of beriberi.

What is beriberi?

Beriberi has been known as a classic deficiency disease for several centuries. Vitamin B1 is an indispensable part of the human diet.Thiamine is needed for the conversion of carbohydrates and sugar. It supports the energy supply of the metabolism.

If you don't get enough thiamine, one of the different forms of beriberi can develop. The two main groups of moist beriberi and the dry variant are known. In wet beriberi, the cardiovascular system and internal organs are affected.

In dry beriberi, on the other hand, the disease manifests itself through failures of the nervous system. A special form is the Wernicke-Korsakoff syndrome as a result of longstanding alcoholism. As with many deficiency diseases, the symptoms of beriberi can be treated and almost always completely cured by giving high doses of thiamine. Permanent damage can only be expected with beriberi if the damage has progressed too far.

causes

Beriberi always occurs when the diet shows a lack of vitamin B1 or thiamine cannot be converted by the body. The vitamin is necessary for nerve cells and glucose metabolism.

If there is a deficiency, failure of the nervous system or functional disorders of the internal organs follow. The introduction of husked and polished rice has increased the incidence of beriberi in parts of Asia. Economically weaker sections of the population live there on a one-sided diet made of rice.

Industrial processing removes the peel that contains thiamine and the vitamin deficiency causes beriberi. Alcoholics often suffer from the special form of beriberi, as alcohol makes it difficult for thiamine to be absorbed. Infants who are fed exclusively with breast milk can develop beriberi if the mother herself suffers from a vitamin B1 deficiency.

Symptoms, ailments & signs

In addition to nausea, vomiting, loss of appetite, abdominal pain or loss of body weight, first possible, unspecific symptoms of beriberi are fatigue, irritability, memory disorders or sleep disorders.

Severe thiamine deficiency is associated with symptoms that suggest serious physical changes. These mainly relate to tissue and muscles, nerves and brain, and the heart. Indications of abnormalities in muscles and nerves may include cramps or pain in the legs, tingling sensation in the toes, burning of the feet, especially during the night.

Weak muscles, muscle paralysis, or atrophy, a gradual breakdown of muscle tissue, are also possible serious symptoms of severe thiamine deficiency. Changes in the heart caused by beriberi lead to fluid retention in the body. Any resulting edema in the legs or congestion in the lungs may indicate the presence of a thiamine deficiency.

Serious changes in the brain show up through states of confusion, loss of memory, especially in relation to recent events, but also difficulties with voluntary eye movements or eye paralysis. Infants three to four weeks of age whose nursing mothers are affected by thiamine deficiency may show lack of certain reflexes and, to some extent, loss of voice.

Diagnosis & course

The diagnosis of beriberi is not without its problems due to the variety of symptoms. In addition, when muscle and nerve diseases, memory disorders or heart diseases occur, people rarely think of the consequences of malnutrition in western industrialized nations.

The attending physician first draws up a detailed anamnesis and questions the patient's exact eating habits. Beriberi as Wernicke-Korsakow syndrome in strong alcoholics is recognized more often, since the memory disorders and brain diseases that occur can be considerable.

Depending on the form of beriberi, severe heart problems, swelling of the internal organs and edema occur. In dry beriberi, the gait pattern deteriorates and the coordination of the extremities decreases. The ability to speak is impaired, memory disorders and impaired consciousness can be observed. Cramps can also occur with beriberi.

Complications

The deficiency disease beriberi is always due to an inadequate supply of the body's metabolism with thiamine or vitamin B1. The same effects can have an increased body requirement or a metabolic disorder that prevents the vitamin B1 from being used in sufficient form. If the vitamin is continuously inadequate, there are initially mild, unspecific and then serious health complications.

In dry beriberi, the nervous system is mainly affected. In addition to muscle weakness and muscle breakdown, the CNS in particular is affected. Concentration, short-term memory and speech are noticeably reduced, and apathy and impaired consciousness occur. Immediately life-threatening complications occur with the moist or wet form of beriberi.

The heart and circulatory system are primarily affected. The increasing heart failure provokes secondary complications such as edema and breathing difficulties. In the case of persistent insufficient supply of thiamine, severe forms of disease became known that led to heart failure and thus death. Another serious form of the disease is so-called Wernicke encephalopathy, a complication that leads to edematous accumulations of fluid in the brain with corresponding effects.

As a rule, there are complications and problems in the autonomic nervous system that affect hypotension, speech disorders, sleep disorders, the regulation of the heat balance and much more. As long as the threshold of irreversibility is not exceeded, the symptoms and complications recede automatically as soon as sufficient availability of vitamin B1 is ensured.

When should you go to the doctor?

Beriberi can usually be cured without any problems and without long-term effects with a sufficient dose of thiamine (vitamin B1). However, diagnosis is not always easy. In any case, with congenital forms of beriberi, it is necessary to consult a doctor. Regular examinations are usually required.

Even if lifestyle is the cause of beriberi, over-the-counter vitamin supplements should not be consumed. A diagnosis by the doctor is important in any case, as many of the symptoms can also be triggered by other diseases, especially other deficiency symptoms. A doctor can identify and treat other deficiencies that are often associated with vitamin B1 deficiency.

Risk groups should definitely consult a doctor if beriberi is suspected. The risk groups include people who have a very one-sided diet, who regularly follow weight-reducing diets or who suffer from an eating disorder. Even with severe alcohol abuse, there is an increased risk of developing beriberi.

In infants who are breastfed, a vitamin B1 deficiency is always likely if the breastfeeding woman herself is not adequately supplied with thiamine. In the case of infants and toddlers, under no circumstances should self-medication be carried out; instead, a doctor should be consulted, since development disorders can be expected if there is insufficient care.

Doctors & therapists in your area

Treatment & Therapy

Depending on the severity of the symptoms of beriberi, the administration of concentrated vitamin B1 in tablet form is sufficient. This treatment can be carried out on an outpatient basis with regular medical observation of the patient. If those affected already show stronger symptoms of beriberi, they are hospitalized and treated with high-dose vitamins in the form of infusions.

The symptoms usually regress quickly with the administration of thiamine. Only when the disease is further advanced does beriberi cause permanent damage. These often consist of heart disease and poor performance of the internal organs. Supportive medication therapy is required.

In the event of damage to the motor skills, physiotherapy together with the administration of vitamins can heal the impaired movement more quickly. The treatment of beriberi in alcoholics is problematic. Significant memory damage is often left behind. Those affected are predominantly impaired in the area of ​​short-term memory. In addition to withdrawal therapy, they also need permanent care and support.

Outlook & forecast

In many cases, beriberi can be treated relatively well. This is especially true if the disease occurs due to an incorrect or insufficient diet.

Vitamin B1 can be reabsorbed through a healthy diet or by taking supplements, so that the symptoms also disappear. If beriberi is not treated, most of those affected suffer from severe abdominal pain, tiredness and also from depression or inner restlessness. The symptoms will not go away on their own if the disease is not treated.

This can lead to impaired memory or concentration. If the illness is triggered by a very high consumption of alcohol, the affected person is in most cases dependent on withdrawal, which can also be carried out in a closed clinic. Clinical treatment may also be necessary for eating disorders.

If the disease is congenital, the patients are permanently dependent on the intake of supplements. However, this completely alleviates and restricts the symptoms, so that there is no reduced life expectancy or impaired quality of life for the person affected.

prevention

The prevention of beriberi is not a problem as long as the necessary food is available. A balanced diet that includes untreated foods such as whole grain rice, beans or animal dairy products is sufficient. Otherwise, beriberi can be prevented by taking vitamin tablets.

Regardless of the reasons that led to beriberi symptoms, the affected people usually still need observation. One reason for this is possible damage to health that has occurred as a result of the thiamine deficiency. Another reason is to monitor nutritional and vitamin status. It must be ensured that the causes of the thiamine deficiency are permanently eliminated.

Aftercare

Deficient supply of thiamine is more common in modern societies than it used to be. It is also possible that vitamin deficiency diseases are only correctly diagnosed more often. A poor supply of vitamins in the case of chronic alcoholism not only requires a withdrawal treatment, but also monitoring for possible organ damage.

Alcoholic relapses are also a risk. That being said, chronic alcoholics are often poorly fed. To what extent a doctor can actually monitor the affected people and provide follow-up care often depends on their willingness to cooperate. Follow-up measures are also required for the surgical insertion of gastric bands and similar measures after an obesity finding.

Here it is not only possible to develop beriberi symptoms through one-sided malnutrition. Those affected can also suffer from other sequelae after the operation. They must be monitored quarterly and require regular doctor's appointments. Thanks to the metabolic or possible surgical complications, such patients must have lifelong follow-up visits.

You can do that yourself

The typical symptoms of the vitamin B1 deficiency disease beriberi can be quite clear, but are unspecific, so that it is not always immediately recognized that it is a B1 vitaminosis and thus a deficiency in thiamine - as vitamin B1 is also called - acts. If beriberi and thus the thiamine deficiency are recognized as the cause of the symptoms occurring at an early stage, self-help consists of a change in diet to foods that contain as much vitamin B1 as possible.

If husked and polished rice is on the menu, it should be replaced by unpeeled rice, because the thiamine is in the husk of the rice grain and retains its physiological abilities even after cooking and is absorbed by the body. In addition to unpeeled rice, wheat germ, whole grains and oatmeal and peas as well as pork and heart are also suppliers of thiamine. This means that affected vegetarians and even vegans normally do not need to fear beriberi if their main diet does not consist primarily of peeled rice.

If the vitamin B1 supply is secured through a change in diet, the typical motor and cognitive symptoms and problems disappear by themselves. If beriberi is only diagnosed at an advanced stage, some of the symptoms remain irreversible and become chronic. This is especially true for those affected who are also dependent on alcohol.