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Beriberi

Thiamine Vitamin B-1

Thiamine deficiency

Thiamin (vitamin B1) is widely available in the diet. Thiamin is involved in carbohydrate, fat, amino acid, glucose, and alcohol metabolism. Thiamin is essentially nontoxic Thiamine deficiency happens when people eat mostly white rice, and they get heart failure with swollen legs, cough, difficulty breathing. People also get weakness and numbness of feet a disease called polyneuropathy.It is commonly due to a diet of highly refined carbohydrates (eg, polished rice, white flour, white sugar) in developing countries. It also develops when intake of other nutrients is inadequate, as may occur in young adults with severe anorexia; it often occurs with other B vitamin deficiencies.

Symptoms and Signs

Early symptoms are nonspecific: fatigue, irritability, poor memory, sleep disturbances, precordial pain, anorexia, and abdominal discomfort.In the average person, thiamine (vitamin B1) deficiency can lead to a disease called beriberi. This can occur within 7 -12 weeks  of a thiamin deficient diet. There are 2 main forms of beriberi: wet and dry. Both types cause peripheral neuropathy (numbness and tingling of the hands and feet). Dry beriberi also has the symptoms of weakness, nerve degeneration, irritability, poor arm/leg coordination, and loss of nerve transmission. Wet beriberi has the signs of edema, enlarged heart and heart failure, and occurs in more wet, humid climates.Thiamin deficiency in alcoholics leads to a disease called Wernicke-Korsakoff (memory disorder) syndrome/encephalopathy, which leads to many symptoms and signs which mimick drunkenness. These include double vision, staggering, poor muscle coordination, and mental confusion

Thiamine deficiency is not common. However, people with Crohn;s disease or anorexia, those undergoing kidney dialysis and people with alcoholism are at risk of having low thiamine levels. A severe deficiency, which is rare in the United States, makes digesting carbohydrates difficult and causes a buildup of pyruvic acid in your blood. That situation can lead to problems with the nervous system, like confusion, loss of feeling in hands and feet and even paralysis of the lower legs. It can also cause breathing difficulties and heart damage.Thiamine is a water-soluble vitamin stored primarily in the liver; however, storage only lasts up to 18 days

SYMPTOMS

First signs include depression, anorexia and/or diarrhea which may appear suddenly or over a period of several days. Other signs include head elevation while standing, excitability, drowsiness, circling, muscular tremors and apparent loss of vision which causes goats to walk in circles. If symptoms occur, contact your veterinarian immediately. Rigidity and convulsions occur in later stages of the disease.

TREATMENT / PREVENTION

A study by Isenberg-Grzeda et al indicated that thiamine deficiency may be a frequent occurrence among inpatients with cancer, even in those who are of normal weight or overweight, lack other vitamin deficiencies, and are receiving multivitamin supplements. The single-center study found thiamine deficiency in 55.3%

Thiamine is deficient inpatients with heart failure and helps improve cardiac pumping ability. The cause may be diuretic use and poor dietPersons with chronic alcoholism have low thiamine intake, impaired thiamine uptake and storage, accelerated destruction of thiamine diphosphate, and varying degrees of energy expenditure. Alcohol is a direct neurotoxin. The effects on the body;s supply of thiamine and on brain tissue are detrimental. Persons with known alcoholism should be administered parenteral thiamine as a routine action when they present to a medical facility.

In suspected cases of thiamine deficiency, prompt administration of parenteral thiamine is indicated. The recommended dose is 50 mg given intramuscularly for several days. The duration of therapy depends on the symptoms, and therapy is indicated until all symptoms have disappeared. Maintenance is recommended at 2.5-5 mg per day orally unless a malabsorption syndrome is suspected.

The only treatment for thiamine deficiency is thiamine supplementation and changes to any underlying dietary habits that may have caused the deficiency. Thiamine supplementation can be given orally or by injection, depending on the type and cause of thiamine deficiency you have.

The natural ways to take thiamine-rich foods in everyday diet. Food sources of thiamine include beef, liver, dried milk, nuts, oats, oranges, eggs, seeds, legumes, peas and yeast.
When someone is thiamine deficient, oral thiamine will never be able to replenish effectively. Ask the doctor to give the patient intravenous or intramuscular thiamine several times daily for at least three days.

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