Beriberi, White Rice, and Vitamin B

Beriberi is a disease caused by a deficiency of thiamine (vitamin B1) that affects many systems of the body, including the muscles, heart, nerves, and digestive system. Beriberi literally means "I can't, I can't" in Sing-halese, which reflects the crippling effect it has on its victims.

 It is common in parts of southeast Asia, where white rice is the main food. In the United States, beriberi is primarily seen in people with chronic alcoholism.

Causes   

There is usually only one main cause of beri beri:

•    Lack of vitamin B1 (thiamin) in the diet

There can also be other reason for this condition:

•    Alcohol abuse - people who drink heavily may not be getting enough vitamin B1 (thiamin)
•    Baby formula - there may be some odd baby formula which may not contain enough vitamin B1 (thiamin)
•    Dialysis - can often cause a deficiency in all nutrients but especially of the water soluble ones like vitamin B1 (thiamin)
•    Diuretics - long term use of diuretic drugs can cause a deficiency in all nutrients but especially of the water soluble ones like vitamin B1 (thiamin)
•    Genetic factors - people with this rare genetic condition lose the ability to absorb vitamin B1 (thiamin) from their food
•    Malnutrition - if not enough food is being eaten to get all the different vital nutrients required (like vitamin B1), then beri beri can ensue
•    Mother to child - if a pregnant woman has a deficiency of vitamin B1 (thiamin), it can cause beri beri in the child

Symptoms   

Symptoms of dry beriberi include:

•    Pain
•    Tingling
•    Loss of feeling (sensation) in hands and feet
•    Muscle damage with loss of muscle function or paralysis of the lower legs
•    Vomiting
•    Strange eye movements (nystagmus)
•    Mental confusion/speech difficulties
•    Difficulty walking
•    Coma
•    Death

Symptoms of wet beriberi include:

•    Swelling of the lower legs
•    Increased heart rate
•    Lung congestion
•    Enlarged heart related to congestive heart failure
•    Shortness of breath with activity
•    Awakening at night short of breath

Treatment of beri beri:

Medical Care: Monitor patients with cardiac failure in an intensive care unit. Because beriberi often presents with other B-complex deficiencies, administer all other vitamins of the B complex.

Consultations:

Cardiologic evaluation with 2-dimensional echocardiography is necessary.
Essential for diagnosis and management of beriberi

Documents congestive heart failure (CHF) and the poor ventricular function observed in beriberi

Neurologic and psychiatric consultations are often necessary.

Diet: Patients with lethargy, confusion, and severe heart failure need to fast to prevent aspiration.

Treatment is also with thiamine hydrochloride either in tablet form or injection. A rapid and dramatic recovery within hours can be made when this is administered to patients with beriberi, and their health can be transformed within an hour of administration of the treatment. Thiamine occurs naturally in unrefined cereals and fresh foods, particularly fresh meat, legumes green vegetables , fruit, and milk.

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