Beriberi: Overview, Causes, Symptoms, Treatments, Topics

Edited By Irshad Anwar | Updated on Jul 02, 2025 05:21 PM IST

Low quantities of thiamine cause the medical disease known as thiamine deficiency (Vitamin B1). Beriberi is the name of a severe and persistent variation. Thiamine injections or oral supplements are used as treatment. Symptoms typically go away with treatment in a few weeks. Berberi is a topic in Biology and they carry a weightage of 2-3% in NEET and 4-5% in CBSE and other Paramedical Exams.

This Story also Contains

Historical context of Beriberi
Signs and Symptoms
Causes of Beriberi
Treatment of Berberi
Prevention of Beriberi
Types of Questions Asked from Beriberi
Tips, Tricks, and Strategies for Berberi

Historical context of Beriberi

Thiamine deficiency is known as beriberi commonly. This 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.

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Signs and Symptoms

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, a regular heartbeat 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.

Causes of Beriberi

Beriberi is caused by to deficiency of vitamin B1 which is important for energy metabolism. There can be several reasons for this syndrome and some of the common ones hour 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.

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.

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 balanced, healthy 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.

Types of Questions Asked from 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	Weightage
CBSE	Causes of beriberi (thiamine deficiency, poor diet). Symptoms of beriberi (wet and dry forms, cardiovascular and nervous system impacts). Dietary sources of thiamine (meat, grains, vegetables). Treatment and prevention of beriberi (diet modification, thiamine supplements).	4%
NEET	Types of beriberi (wet, dry, infantile, gastrointestinal) Pathophysiology of beriberi (thiamine role in the citric acid cycle, metabolism). Symptoms and complications of Wernicke's encephalopathy and Korsakoff syndrome in relation to thiamine deficiency. Role of thiamine in energy metabolism (carbohydrate metabolism, neurotransmitter synthesis).	3%
Paramedical	Thiamine deficiency in alcoholism (causes, complications). Treatment of beriberi (thiamine administration, dietary changes). Clinical presentation and diagnosis of wet and dry beriberi. Genetic factors related to thiamine transport and metabolism (TRMA, Leigh disease).	2%

Tips, Tricks, and Strategies for Berberi

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

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Frequently Asked Questions (FAQs)

1. Which part of the body is affected by beriberi?

Beriberi can be divided into two main categories: Cardiovascular system affected by wet beriberi. Wernicke-Korsakoff syndrome and dry beriberi: Both have an impact on the neurological system.

2. How long will beriberi last?

Thiamine has an approximate 9–18-day half-life. The kidney removes it. Thiamine deficiency can occur when a person consumes insufficient amounts of vitamin B1 in their diet or when they use too much of it, which can happen when a person has a fever, hyperthyroidism, is pregnant, is nursing, or is lactating.

3. Is beriberi a viral disease?

No, beriberi is caused by a vitamin B1 deficiency, also known as thiamine deficiency.

4. Is there a long-lasting treatment for beriberi?

The majority of issues can be resolved with thiamine supplements if discovered early. To avoid recurrence, it is recommended to consume a diet high in vitamin B1.

5. Which medical professional should I consult for beriberi?

A physician might be able to identify and handle beriberi cases. However, it could be important to see a neurologist or cardiologist in the event of neurological or cardiac issues.

6. What is beriberi and why is it considered a nutritional disease?

Beriberi is a nutritional disorder caused by a deficiency of thiamine (vitamin B1). It's 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.

7. How does thiamine deficiency lead to beriberi?

Thiamine is crucial for carbohydrate metabolism and energy production in cells. When there's a deficiency, cells can't efficiently convert food into energy, leading to various symptoms affecting the nervous system, heart, and muscles.

8. Why is beriberi more common in certain parts of the world?

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.

9. How does alcohol consumption contribute to beriberi?

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.

10. What role does thiamine play in glucose metabolism?

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.

11. What is the connection between beriberi and the industrial revolution?

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.

12. What is the historical significance of beriberi in naval and military history?

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.

13. Can beriberi be prevented?

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.

14. How does the body store and use thiamine?

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.

15. What is the role of thiamine in maintaining the blood-brain barrier?

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.

16. What is the role of thiamine in neurotransmitter synthesis?

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.

17. What is the connection between beriberi and oxidative stress?

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.

18. What are the early symptoms of beriberi that people might overlook?

Early symptoms of beriberi can be subtle and easily overlooked. They may include fatigue, irritability, poor memory, sleep disturbances, loss of appetite, and mild numbness or tingling in the extremities.

19. How does beriberi affect the nervous system?

In dry beriberi, thiamine deficiency leads to nerve damage (neuropathy). This can cause symptoms like numbness and tingling in the extremities, muscle weakness, difficulty walking, and in severe cases, paralysis.

20. What cardiovascular symptoms are associated with wet beriberi?

Wet beriberi affects the heart and circulatory system. Symptoms include rapid heart rate, shortness of breath, swelling in the lower legs (edema), and in severe cases, heart failure. It's called "wet" beriberi due to the fluid accumulation in tissues.

21. How does beriberi impact the digestive system?

Thiamine deficiency can affect the digestive system, leading to symptoms such as loss of appetite, nausea, vomiting, and constipation. In severe cases, it may cause abdominal pain and difficulty absorbing nutrients.

22. How does beriberi impact muscle function?

Beriberi can cause muscle weakness and wasting due to impaired energy metabolism in muscle cells. In severe cases, it can lead to paralysis, particularly affecting the lower limbs first.

23. How is beriberi diagnosed?

Diagnosing beriberi involves assessing symptoms, medical history, and dietary habits. Blood tests can measure thiamine levels or the activity of thiamine-dependent enzymes. In some cases, nerve conduction studies or heart function tests may be necessary.

24. What are the potential long-term consequences of untreated beriberi?

If left untreated, beriberi can lead to severe complications including heart failure, permanent nerve damage, muscle wasting, and in the case of Wernicke-Korsakoff syndrome, irreversible brain damage and memory loss.

25. How does cooking affect thiamine content in food?

Thiamine is heat-sensitive and water-soluble. Cooking, especially boiling, can significantly reduce the thiamine content of foods. Steaming or microwaving foods can help retain more thiamine compared to boiling.

26. Why are infants sometimes at risk for beriberi?

Infants can be at risk for beriberi if their mothers are thiamine deficient during pregnancy and breastfeeding. Breast milk from a thiamine-deficient mother may not provide enough of the vitamin for the rapidly growing infant.

27. How does beriberi affect the body's ability to metabolize carbohydrates?

In beriberi, the body's ability to metabolize carbohydrates is severely impaired. Without sufficient thiamine, enzymes involved in breaking down glucose for energy don't function properly, leading to a build-up of pyruvate and lactate, and inefficient energy production.

28. How is beriberi treated?

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.

29. How does beriberi affect the cardiovascular system at the cellular level?

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.

30. How does thiamine deficiency affect the brain's glucose metabolism?

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.

31. What is the role of thiamine in the pentose phosphate pathway?

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.

32. How does beriberi affect the endocrine system?

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.

33. What are the main types of beriberi?

There are two main types of beriberi: wet beriberi, which primarily affects the cardiovascular system, and dry beriberi, which mainly impacts the nervous system. A third type, called cerebral beriberi or Wernicke-Korsakoff syndrome, affects the brain.

34. How does beriberi affect energy production at the cellular level?

Thiamine pyrophosphate, the active form of thiamine, is a crucial coenzyme in several steps of cellular energy production. In beriberi, the lack of this coenzyme impairs the citric acid cycle and the pentose phosphate pathway, leading to decreased ATP production and cellular energy deficits.

35. What populations are at highest risk for developing beriberi?

High-risk populations include chronic alcoholics, people with eating disorders, those on fad diets, individuals with malabsorption syndromes (like Crohn's disease), and populations relying heavily on polished rice or refined carbohydrates as staple foods.

36. What is Wernicke-Korsakoff syndrome and how is it related to beriberi?

Wernicke-Korsakoff syndrome is a severe form of cerebral beriberi. It's characterized by confusion, memory loss, and eye movement disorders (Wernicke's encephalopathy), often followed by severe memory impairment and confabulation (Korsakoff's psychosis). It's most commonly seen in chronic alcoholics with severe thiamine deficiency.

37. What role does thiamine play in the nervous system beyond energy metabolism?

Besides its role in energy metabolism, thiamine is crucial for maintaining the myelin sheath around nerves and for the production of neurotransmitters. This explains why thiamine deficiency can lead to neurological symptoms even before severe energy deficits occur.

38. What is the relationship between beriberi and lactic acidosis?

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.

39. How does beriberi affect protein metabolism?

While thiamine is primarily associated with carbohydrate metabolism, its deficiency in beriberi can indirectly affect protein metabolism. Impaired energy production can lead to muscle protein breakdown for energy, contributing to muscle wasting seen in severe cases.

40. How does beriberi affect the immune system?

Thiamine deficiency can impair immune function. It affects the production of antibodies and can reduce the body's ability to fight infections. This is one reason why individuals with beriberi may be more susceptible to other diseases.

41. What is the relationship between beriberi and inflammation?

Chronic thiamine deficiency in beriberi can lead to increased inflammation in the body. This is partly due to increased oxidative stress and the body's impaired ability to regulate inflammatory responses, which can contribute to various symptoms and complications.

42. How does beriberi affect lipid metabolism?

While thiamine is primarily involved in carbohydrate metabolism, its deficiency can indirectly affect lipid metabolism. Impaired glucose utilization can lead to increased reliance on fat metabolism, potentially leading to changes in lipid profiles and fat storage.

43. How does beriberi affect mitochondrial function?

Beriberi significantly impacts mitochondrial function. Thiamine is essential for several mitochondrial enzymes involved in energy production. Its deficiency leads to impaired ATP production, increased oxidative stress, and potential mitochondrial damage.

44. What is the connection between beriberi and glutamate excitotoxicity?

In severe thiamine deficiency, there can be an accumulation of glutamate in the brain due to impaired energy metabolism. This can lead to glutamate excitotoxicity, where excessive glutamate causes damage to neurons, contributing to the neurological symptoms of beriberi.

45. How does beriberi affect the body's electrolyte balance?

Beriberi, particularly wet beriberi, can disrupt electrolyte balance. The cardiovascular effects can lead to fluid retention and edema. Additionally, impaired cellular energy metabolism can affect the function of ion pumps, potentially leading to electrolyte imbalances.

46. What is the role of thiamine in gene expression?

Recent research suggests that thiamine may play a role in gene expression regulation. Thiamine deficiency in beriberi could potentially alter the expression of genes involved in metabolism, neurological function, and other cellular processes.

47. How does beriberi affect the autonomic nervous system?

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.

48. What is the connection between beriberi and glucose transporter function?

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.

49. How does beriberi affect the body's ability to handle oxidative stress?

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.

50. What is the role of thiamine in neurotrophic factor production?

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.

51. How does beriberi affect the synthesis of myelin?

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.

52. What is the connection between beriberi and cellular osmotic balance?

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.

53. How does beriberi affect the body's response to stress?

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.

54. What is the role of thiamine in DNA repair mechanisms?

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.

55. How does beriberi affect the circadian rhythm?

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.