Beriberi: Overview, Causes, Symptoms, Treatments, Topics
Beriberi is a disease caused by the deficiency of thiamine (Vitamin B1), affecting the nervous and cardiovascular systems. The major types of beriberi are wet, dry, cerebral and infantile beriberi. Lack of vitamin B1 causes diminished ability of the tissues to use some cellular nutrients. Other symptoms include weakness, numbness, and edema. In extreme cases, it can also cause heart failure. Treatment includes thiamine therapy and prevention through a thiamine-rich diet. Thiamine injections or oral supplements are also used as treatment. Symptoms typically go away with treatment in a few weeks.
This Story also Contains
- What is Beriberi?
- Historical context of Beriberi
- Signs and Symptoms of Beriberi
- Types of Beriberi
- Causes of Beriberi
- Treatment of Berberi
- Prevention of Beriberi
- Exam Importance of Beriberi
- Tips, Tricks, & Mnemonics for Beriberi
- Beriberi NEET MCQs
- FAQs on Beriberi
Berberi is a topic in Biology and they carry a significant weightage in NEET, CBSE and Paramedical Exams. This article includes signs and symptoms, types, causes, treatment and prevention of beriberi.
What is Beriberi?
Beriberi is a nutritional disorder caused by a deficiency of thiamine (vitamin B1). It is considered a nutritional disease because it results from inadequate intake or absorption of thiamine, an essential nutrient, rather than from an infection or genetic condition. Thiamine is crucial for carbohydrate metabolism and energy production in cells. When there is a deficiency, cells cannot efficiently convert food into energy, leading to various symptoms affecting the nervous system, heart, and muscles.
Historical context of Beriberi
Beriberi was first documented and recognised and remained in the same contacts for centuries. Early Chinese and Japanese texts have provided some of the first detailed accounts of these conditions found in the human body. Modern scientific understanding says that thiamine deficiency was largely shaped during the late 19th and early 20th centuries. Some more historical context about Beriberi is discussed below:
Ge Hong (3rd Century) first described beri beri as a symptom of swelling weakness and numbness in the feet.
Takaki Kanehiro (1883) discovered that this disease has a high rate among Japanese sailors and was first discussed as a diverse disease due to diet.
Later on in 1901, Beriberi was identified as having deficiency syndrome by Gerrit Grijns.
In 1929 Sir Frederick Hopkins and Eijkman were awarded the Nobel Prize for their contribution and understanding of beriberi and its importance to the vitamins.
Commonly Asked Questions
The industrial revolution led to increased consumption of refined grains, particularly polished white rice in Asia. This processing removes the thiamine-rich outer layers of the grain, leading to widespread thiamine deficiency and beriberi outbreaks in the late 19th and early 20th centuries.
Beriberi was a significant problem in naval and military history, particularly affecting sailors on long voyages who subsisted on preserved foods low in thiamine. It was a major cause of disability and death until its cause was discovered and prevention methods were implemented.
Signs and Symptoms of Beriberi
Beri beri is caused due to vitamin B1 deficiency that affects the nervous as well as cardiovascular systems of our body. It is found in different forms and each symptom has potentially life-threatening conditions.
The general symptoms of beriberi include soreness, numbness, mental disorders, weight loss, and an increase in pyruvic acid levels.
In dry beriberi, there is a fact on peripherals which leads to paralysis problems in walking and also cognitive difficulties.
In brain beriberi, there are symptoms like mental instability, memory loss and impaired brain functions which particularly happens in alcoholics.
Affects the cardiovascular system during wet beriberi and the symptoms include high heart rate heart failure and breathlessness.
Due to beriberi in the gastrointestinal area, there are causes and abdominal pain vomiting and also lactic Acid reflux.
Types of Beriberi
Beriberi is of four major types:
Dry Beriberi
Dry neriberi develops when the diet contains slightly less than the thiamin requirement. The symptoms include fatigue, severe muscular weakness and pain on contact with skin.
Wet Beriberi
Wet beriberi affects the heart and circulatory system. It's called "wet" beriberi due to the fluid accumulation in tissues. It is characterised by edema of extremities, heart enlargement and cardiac insufficiency like tachycardia, bradycardia.
Cerebral Beriberi
It is also called Wernicke-Korsakoff's Syndrome. It is also caused due to severe deficiency of thiamine. It is seen commonly in alcoholics, the long term alcohol consumption interferes with the intestinal absorption of thiamin.
Infantile Beriberi
It is observed in breastfed infants born to mothers suffering from thiamin deficiency. The breast milk of the mothers is deficient in thiamin.
Causes of Beriberi
Beriberi is caused by deficiency of vitamin B1 which is important for energy metabolism. There can be several reasons and some of the common ones are genetics, alcoholism and medical conditions. A few of them have been discussed below in the table:
Category | Details |
Dietary Causes | Diets that are not in vitamin B1 such as polished rice are responsible for BeriBeri. |
Other Causes | Digestive disorders, alcoholism dialysis or genetic abnormalities can lead to the deficiency of vitamin B1. |
Wernicke’s Encephalopathy | A kind of neural disorder which is caused due to thiamine deficiency leads to the disorder of the central nervous system and is common in alcoholic people. |
Genetic Disorders | A genetic condition where thiamine-responsive megaloblastic anaemia syndrome. This leads to gene mutation. |
Commonly Asked Questions
Beriberi is more prevalent in regions where the diet is heavily based on polished white rice or refined carbohydrates, which are low in thiamine. It's also more common in areas with widespread alcohol abuse, as alcohol interferes with thiamine absorption and utilization.
Alcohol interferes with thiamine absorption in the intestines and impairs thiamine storage in the liver. Chronic alcoholism often leads to poor nutrition, further increasing the risk of thiamine deficiency and beriberi.
Thiamine is a cofactor for enzymes involved in glucose metabolism, particularly in the conversion of pyruvate to acetyl-CoA in the citric acid cycle. Without sufficient thiamine, glucose metabolism is impaired, leading to energy deficits in cells.
Treatment of Berberi
Thiamine is a commonly used standalone treatment for beriberi. The healing process is quick and dramatic when thiamine is administered intravenously and later orally. It may take several months of thiamine therapy for peripheral neuropathy to improve.
Commonly Asked Questions
Treatment for beriberi primarily involves thiamine supplementation, usually given intravenously at first in severe cases, followed by oral supplements. Addressing the underlying cause (e.g., improving diet, treating alcoholism) is also crucial for long-term management.
In wet beriberi, thiamine deficiency leads to vasodilation and increased cardiac output. At the cellular level, impaired energy metabolism in heart muscle cells can lead to weakened heart contractions and eventual heart failure if left untreated.
The brain is highly dependent on glucose for energy. Thiamine deficiency impairs the brain's ability to metabolize glucose efficiently, leading to energy deficits in neurons. This can cause various neurological symptoms and, in severe cases, brain damage.
Thiamine pyrophosphate is a coenzyme for transketolase, an enzyme in the pentose phosphate pathway. This pathway is crucial for producing NADPH (used in biosynthetic reactions) and ribose (used in nucleic acid synthesis). Impairment of this pathway in beriberi can affect many cellular processes.
Beriberi can impact the endocrine system indirectly. Thiamine deficiency can lead to glucose intolerance, mimicking diabetes. It can also affect the hypothalamus and pituitary gland, potentially disrupting various hormonal pathways.
Prevention of Beriberi
An individual must include adequate Vitamin B1 in their diet to prevent beriberi. Generally speaking, thiamine deficiency is not a concern for someone who follows a a healthy, balanced diet that prioritises whole foods.
Natural sources of thiamine in food include:
Meat
Nuts and seeds
Seafood,
Dairy products,
Beans and legumes
Additionally, producers fortify a variety of foods with vitamins, including thiamine, bread, morning cereals, and baked goods.
Commonly Asked Questions
Yes, beriberi can be prevented by ensuring adequate thiamine intake through a balanced diet rich in whole grains, legumes, nuts, and fortified foods. In high-risk populations, thiamine supplementation or food fortification programs can be effective preventive measures.
The body doesn't store large amounts of thiamine. It's water-soluble and excess is excreted in urine. Thiamine must be consumed regularly through diet or supplements. It's quickly used up, especially during high-carbohydrate intake or increased metabolic demand.
Thiamine is crucial for maintaining the integrity of the blood-brain barrier. In thiamine deficiency, the barrier can become more permeable, potentially allowing harmful substances to enter the brain and contributing to neurological symptoms.
Thiamine is involved in the synthesis of acetylcholine, a crucial neurotransmitter for nerve signal transmission. Thiamine deficiency can lead to reduced acetylcholine production, contributing to neurological symptoms in beriberi.
Thiamine deficiency in beriberi can lead to increased oxidative stress. This is partly due to the impairment of the pentose phosphate pathway, which normally produces NADPH, an important cellular antioxidant. Increased oxidative stress can contribute to cellular damage and disease progression.
Exam Importance of Beriberi
During exam preparation, different types of questions about the Beriberi are asked. The table below contains the different patterns of questions asked in different exams.
Exam Type | Types of Questions Asked |
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Paramedical |
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Tips, Tricks, & Mnemonics for Beriberi
It takes effort to remember everything in a single go. We made the entire problem easy. Some of the tricks regarding Beriberi are given below which you can use to memorise the important points.
Causes of Beriberi
"PLANT: Polished rice, Lack of thiamine, Alcoholism, Nutrition deficiency, Thiamine malabsorption"
P: Polished rice is a major dietary cause (low thiamine)
L: Lack of thiamine in diet
A: Alcoholism reduces thiamine absorption
N: Nutrition deficiency or poor diet
T: Thiamine malabsorption in gastrointestinal conditions
Symptoms of Beriberi
"WLN-HO: Weakness, Legs, Numbness, Heart, Oedema"
W: Weakness (muscle weakness, paralysis)
L: Legs and limb pain (numbness, tingling, trouble walking)
N: Numbness and neurological signs
H: Heart failure (high-output heart failure in wet beriberi)
O: Oedema (swelling in wet beriberi)
Types of Beriberi
"WDI: Wet, Dry, Infantile"
W: Wet beriberi (affects heart and circulatory system)
D: Dry beriberi (affects nerves and muscles)
I: Infantile beriberi (affects infants of malnourished mothers)
Diagnosis of Beriberi
"TET: Transketolase, Enzyme, Thiamine level"
T: Transketolase enzyme activity test
E: Enzyme activity to detect deficiency
T: Thiamine levels in blood or urine
Prevention and Treatment of Beriberi
"TRI: Thiamine-rich foods, Rice unpolished, Injection or oral supplements"
T: Thiamine-rich foods (meat, grains, vegetables)
R: Rice unpolished (maintains thiamine content)
I: Injection or oral supplements for treatment
Beriberi NEET MCQs
Q1. Beriberi is caused due to the deficiency of:
Vitamin B1
Vitamin B2
Vitamin B6
Vitamin B12
Correct answer: 1) Vitamin B1
Explanation:
Beriberi is caused by the deficiency of Vitamin B1 (Thiamine). Thiamine plays an essential role in carbohydrate metabolism and energy production through the citric acid cycle. Its deficiency leads to impaired ATP generation, accumulation of pyruvate and lactate, and malfunctioning of the nervous and cardiovascular systems. This condition manifests as either dry (neurological) or wet (cardiac) beriberi.
Hence, the correct answer is option 1) Vitamin B1.
Q2. Which type of beriberi primarily affects the nervous system?
Wet beriberi
Dry beriberi
Infantile beriberi
Gastrointestinal beriberi
Correct answer: 2) Dry beriberi
Explanation:
Dry beriberi affects the nervous system. It leads to degeneration of peripheral nerves, muscle wasting, numbness, tingling sensations, and difficulty in walking. The patient may suffer from paralysis and loss of reflexes if untreated. This occurs because the absence of thiamine hampers nerve impulse conduction and energy supply to muscles.
Hence, the correct answer is option 2) Dry Beriberi.
Q3. The main symptom of wet beriberi is:
Paralysis
Heart failure and edema
Mental confusion
Vomiting
Correct answer: 2) Heart failure and edema
Explanation:
Wet beriberi primarily affects the cardiovascular system. Its hallmark symptoms are edema (swelling due to fluid accumulation), rapid heartbeat, breathlessness, and heart failure. The deficiency of thiamine reduces ATP in cardiac cells, weakening the heart muscle and impairing blood circulation. If untreated, wet beriberi can lead to severe congestive heart failure.
Hence, the correct answer is option 2) Heart failure and edema.
Also Read:
FAQs on Beriberi
What is beriberi and its cause?
Beriberi is a nutritional deficiency disease caused by the lack of vitamin B₁ (thiamine) in the diet. Thiamine is essential for carbohydrate metabolism and normal functioning of the nervous system and heart. Its deficiency leads to low energy production, accumulation of pyruvate and lactate, and damage to nerves and muscles. It is most common in populations consuming polished rice as a staple food.
What are the symptoms of wet and dry beriberi?
Dry beriberi: Develops when the diet contains slightly less than the thiamin requirement and affects the nervous system. Symptoms include fatigue, severe muscular weakness and pain on contact with skin.
Wet beriberi: Develops when the thiamine deficiency is more severe and affects the cardiovascular system. Symptoms include edema of extremities, heart enlargement, rapid heartbeat, and congestive heart failure.
How is beriberi treated?
Treatment of beriberi involves thiamine supplementation either orally or by injection, depending on severity. Along with vitamin therapy, a nutritious diet rich in whole grains, legumes, milk, eggs, and meat is recommended. In wet beriberi, supportive care for heart failure (oxygen, diuretics, rest) is also given. Improvement in symptoms is usually seen within days to weeks after treatment.
How can beriberi be prevented?
Beriberi can be prevented by ensuring adequate thiamine intake through a balanced diet rich in whole grains, legumes, nuts, and fortified foods. In addition, avoiding overconsumption of polished rice or highly refined foods helps. In high-risk populations, thiamine supplementation or food fortification programs can be effective preventive measures.
Frequently Asked Questions (FAQs)
Beriberi can impact the autonomic nervous system, leading to symptoms such as increased heart rate, changes in blood pressure, and gastrointestinal disturbances. This is due to the role of thiamine in maintaining proper nerve function and energy metabolism in autonomic neurons.
Thiamine is involved in the metabolism of neurotransmitters that play a role in regulating the circadian rhythm. Beriberi can potentially disrupt sleep-wake cycles and other circadian-regulated processes, contributing to symptoms like fatigue and sleep disturbances.
Recent research suggests that thiamine may play a role in DNA repair mechanisms. Thiamine deficiency in beriberi could potentially impair these repair processes, leading to increased DNA damage and potentially contributing to long-term cellular dysfunction.
Thiamine is important for the body's stress response. In beriberi, the impaired energy metabolism and potential impacts on hormone production can affect the body's ability to cope with physical and psychological stress, potentially exacerbating symptoms.
Thiamine plays a role in maintaining cellular osmotic balance. In beriberi, impaired energy metabolism and electrolyte imbalances can disrupt this balance, potentially leading to cell swelling or shrinkage, which can contribute to various symptoms.
Thiamine is important for myelin synthesis. In beriberi, reduced thiamine can lead to impaired myelin production and maintenance, contributing to the neurological symptoms and potentially causing long-term nerve damage if left untreated.
Thiamine is involved in the production of neurotrophic factors, which are crucial for neuronal growth, survival, and plasticity. Deficiency in beriberi can lead to reduced production of these factors, contributing to neurological symptoms and potential long-term nerve damage.
Beriberi impairs the body's antioxidant defenses. Thiamine is involved in the production of NADPH, a key molecule in many antioxidant processes. Its deficiency leads to reduced capacity to neutralize harmful free radicals, increasing oxidative damage.
Thiamine deficiency in beriberi can affect the function of glucose transporters, particularly in the brain. This can impair glucose uptake by cells, further exacerbating the energy deficit caused by impaired glucose metabolism.
In beriberi, the impaired breakdown of pyruvate due to thiamine deficiency leads to increased conversion of pyruvate to lactate. This can result in lactic acidosis, a condition where lactic acid builds up in the bloodstream faster than it can be removed.