Beriberi literally means ‘I cannot, I cannot’ in the native language of Sri Lanka, Sinhalese. It is a disorder of the nervous system caused by the deficiency of Thiamine or Vitamin B1 in the diet. It also affects the heart, digestive system and muscles. The disease was often seen in Asian countries in the 19th century due to their dependence on white or polished rice.
There are two major types of beriberi, dry and wet. It is caused by the lack of Vitamin B1 or Thiamine, which occurs naturally and is easily available in unrefined cereals, green vegetables, legumes, whole grain breads, fresh fruits and meats. Hence, beriberi occurs in people whose daily diet does not include these foods, mostly in areas affected by droughts or famines. Beriberi is also found to occur in people who mainly eat polished rice as the thiamine rich husk has been removed. Another high-risk group is alcoholics and is rarely seen as a side effect of gastric bypass surgery. The child of a woman suffering from Thiamine deficiency may also develop beriberi if the child is mainly fed on breast milk.
The symptoms depend upon which system of the body is affected. The nervous system – symptoms include fatigue, poor memory and irritability in case of early deficiency. Continued deficiency of Thiamine will lead to damaged peripheral nerves, cause loss of sensation and weak muscles mainly affecting the legs. There is numbness in the toes and a burning sensation in the feet. The muscles eventually shrink and lead to atrophy and a condition where the feet hang limply called ‘footdrop’. Heart – symptoms include rapid heartbeat and sweating followed by weakening of the heart muscles eventually leading to edema in the legs. Digestive system – symptoms include loss of appetite, constipation, indigestion and lack acid in the stomach. Muscles – symptoms include severe muscular pain due to the lack of TPP.
The condition can be detected on a physical examination, which reveals the early symptoms. Information regarding the diet may reveal the deficiency and blood tests will show the Thiamine levels. Severe deficiency of the Vitamin can be treated rapidly with intramuscular or intravenous injections with high doses of Thiamine followed by smaller doses in the form pills or injections until the person recovers completely. Diuretics may also be given to remove the excess fluid in case of wet beriberi. Physical therapy will help recovery in dry beriberi.