Beriberi : Types, Symptoms, Diagnosis And Treatment

Overview

Healthy food nourishes our bodies. It protects us from diseases and illnesses. But, sometimes, people may not get the required nutrition for numerous reasons. A deficiency in vitamins, proteins, minerals, and other nutrients may lead to disorders. One such disorder is Beriberi – caused due to vitamin B-1 deficiency. 

The blog explains Beriberi, its types, causes, symptoms, risk factors, treatment options, and possible complications. 

What is Beriberi?

When the body does not get enough thiamine, more commonly known as Vitamin B-1, it causes Beriberi. Because thiamin is involved in many basic cell functions and a breakdown of the nutrients for energy, a deficiency can cause various problems in the heart and brain that need a constant energy supply. Severe vitamin B-1 deficiency can affect the cardiovascular and central nervous systems. 

It is relatively common in countries where the diet is primarily white rice or highly-refined carbohydrates. However, it is relatively rare in western countries. The treatment focuses on reintroducing thiamine into the diet, and in more severe cases, the patient may require medical intervention. However, a more advanced case of Beriberi may lead to heart failure or muscle paralysis.

The word Beriberi in Sinhalese means ‘extreme weakness,’ which leads to severe and sometimes life-threatening symptoms. 

What are the types of Beriberi?

Two  types of Beriberi affect different body parts. They are as follows:

• Wet Beriberi: It involves the heart and circulatory systems. As it affects the functioning of the heart, it is a medical emergency that needs immediate medical attention. In severe cases, it leads to heart failure.
• Dry Beriberi: It impairs the nerves and may lead to decreased muscle strength. Thus, gradually leading to muscle paralysis. It can be life-threatening as well if untreated. Dry Beriberi is easier to treat than wet Beriberi. 

What are the symptoms of Beriberi?

The symptoms of dry Beriberi are different than that of wet Beriberi. The symptoms of dry Beriberi are as follows:

1. Troubled walking
2. Loss of sensation in the hands and feet
3. Decrease muscle function or paralysis of the lower legs
4. Confusion or speech impairment
5. Extreme pain
6. Bizarre eye movements
7. Tingling sensations
8. Vomiting
9. paralysis

The symptoms of wet Beriberi include the following:

1. Suddenly getting up at night with shortness of breath
2. Increased heart rate
3. Shortness of breath when performing activities
4. Swollen lower legs

In severe cases, Beriberi is linked to Wernicke-Korsakoff syndrome, two different types of brain damage resulting from thiamine deficiency. 

Wernicke encephalopathy is responsible for damaging brain regions known as the thalamus and hypothalamus. It can lead to:

• Confusion
• Loss of memory
• Decreased muscle coordination
• Vision issues such as double vision or rapid eye movement

Korsakoff syndrome is due to the permanent damage caused to the region of the brain where memories are formed. It causes the following:

• Memory loss
• Inability to create and develop new memories
• hallucinations

When to seek medical attention?

If an individual knows or feels that their diet is not well-balanced or inadequate and notices symptoms, immediately seek medical help.

Request an appointment at Apollo Hospitals     

Who is at risk of developing Beriberi?

If a person eats a well-balanced diet, there is nothing to worry about .However, other risk factors may come into play for a person to develop Beriberi. They are as follows.

• Misuse of alcohol makes it hard for the body to absorb and store thiamine
• Genetic Beriberi is a rare condition that makes it challenging for the body to absorb thiamine
• Hyperthyroidism develops due to an overactive thyroid gland
• Severe nausea and vomiting during pregnancy
• Bariatric surgery
• AIDS
• Malnutrition
• Kidney dialysis
• Persistent diarrhoea or use of diuretics
• Diabetic patients
• Breastfed babies whose mother is  vitamin B-1 deficient 
• High carbohydrate diet
• People engaging in intense and high amounts of physical activity
• Digestive issues and high-stress levels

How is Beriberi diagnosed?

If the doctor suspects Beriberi, they may conduct a physical examination that may show signs of cognitive heart failure, such as 

• Troubled breathing with veins in the neck that stick out
• Enlarged heart
• Fluid in the lungs
• Increased heart rate
• Swelling in both the legs

The doctor may also conduct neurological exams as the patient with Beriberi may show signs of confusion, memory loss, delusion, or decreased sense of vibration. The exams may indicate the following:

• Change in gait and 
• Issues in coordination
• Decreased reflexes
• Eyelid drooping

Healthcare professionals also rely on blood and urine tests to determine if an individual is suffering from Beriberi. These tests measure the levels of thiamine in the body.

How is Beriberi treated?

When a person is diagnosed with Beriberi, it is easily treatable. The goal of treatment is to replace thiamine in the body.

Doctors prescribe a thiamine-rich diet as the first line of defence when the disease is in the initial stage. The diet should include the following:

• Thiamine-fortified cereals
• Thiamine-enriched rice or noodles
• Sunflower seeds
• Beans
• Pork
• Fish 
• Yoghurt 
• Green beans

A diet change may not be sufficient if the Beriberi disease is advanced. Therefore, doctors may administer thiamine supplements as a pill or injections, sometimes intravenously. The healthcare provider may also prescribe different types of vitamins. As a person gets treated for Beriberi disease, the doctor may conduct repeated blood tests to monitor the thiamine levels and check how the body responds to the medications.

If Beriberi is in its advanced stage when a medical emergency is needed, such as wet Beriberi, the disease can be controlled with immediate medical intervention. Patients may have to continue thiamine supplements or follow a thiamine-rich diet for a few months after the treatment to ensure that the disease does not reoccur. However, it is essential to note that with early treatment, damages caused to the heart and nerves can be reversible.. 

What are the possible complications of Beriberi?

The possible complications of Beriberi disease are as follows:

• Coma
• Congestive heart failure
• Psychosis
• Death 

How can one prevent developing Beriberi?

Preventing the development of Beriberi may require a balanced diet that includes food such as beans, legumes, seeds, meat, fish, whole grains, nuts, dairy, certain vegetables, and thiamine-rich cereals. 

It is important to check formula feed if the milk contains thiamine and should always  be purchased from a reliable source. Limiting alcohol also reduces the risk of developing Beriberi disease. Chronic alcoholics need regular blood checks to monitor  thiamine levels in the body.

Conclusion

Beriberi patients have a good prognosis if diagnosed and treated early. With early treatment, nerve and heart damage due to the disease can be reversed. The recovery is also quick as soon as the treatment begins. But if it progresses to Wernicke-Korsakoff syndrome, the outlook is not good. The damage caused due to these syndromes are permanent. 

Therefore, maintaining a healthy lifestyle and including a balanced diet is crucial for overall health. Talk to an expert for a well-balanced diet.

Frequently Asked Questions (FAQs)

Is Beriberi reversible?

With early detection and medical intervention, Beriberi is reversible. 

Who can get Beriberi?

People of any age with vitamin B-1 deficiency can develop Beriberi disease.