Everyone has heard that it’s important to get enough vitamins, but what happens if you don’t? Vitamin deficiencies can be severe, and one such deficiency is beriberi, a condition that can cause symptoms as severe as heart failure and brain damage if left unaddressed. It can also cause extreme weakness in the legs and other muscles, giving it its name — “beri” is a Sinhalese (Sri Lankan) word meaning “weakness.” Read on to find out more about this disease so you can learn how to identify, treat, and prevent it.

What Is Beriberi?

Beriberi is a condition that results from a lack of vitamin B1, also known as thiamine. Vitamin B1 "plays an important role in metabolic pathways," said Muneer Imam, MD, the medical director at The CIIT Medical Center, meaning that it is essential for the chemical reactions that take place within cells. Since the body cannot produce this vitamin on its own, you can only get it by making sure you get enough in your diet or by taking supplements. If you don’t get enough thiamine, or if you use excess thiamine, you are then at risk of developing this potentially fatal disease. However, with treatment, it is possible to recover from beriberi fully and undo its effects on your body.

Stages and Types of Beriberi

There are two main types of beriberi: wet beriberi and dry beriberi. Each of the two has different symptoms, but both can be life-threatening if gone untreated.

  • Wet beriberi, which gets its name because it causes a buildup of fluid in the body’s tissues, affects the heart and the rest of the cardiovascular symptom.
  • Dry beriberi affects the nervous system. It can also develop into more severe conditions such as Wernicke encephalopathy and Korsakoff syndrome, two often co-occurring disorders (known when they do as Wernicke-Korsakoff syndrome) that can cause permanent brain damage.

A less common form of beriberi is gastrointestinal beriberi, which, as the name suggests, affects the gastrointestinal system.

Symptoms and Causes

Beriberi is caused by a deficiency of vitamin B1. In some cases, the deficiency can be the result of the body being unable to absorb enough of this vitamin, a condition that can be passed down genetically. Babies can also develop beriberi if their mothers are not consuming adequate amounts of B1 while pregnant or breastfeeding.

Because beriberi comes in different forms, symptoms and their severity varies depending on which type a person has.

Symptoms of wet beriberi include:

  • Shortness of breath
  • Rapid heart rate
  • Swelling in the lower legs
  • In extreme cases, heart failure

Symptoms of dry beriberi include:

  • Confusion and/or trouble speaking
  • Vomiting
  • Numbness or tingling in extremities
  • Difficulty walking or inability to move lower legs
  • Involuntary eye movements

Should dry beriberi progress into Wernicke-Korsakoff syndrome, it has such symptoms as:

  • Loss of mental activity
  • Coma
  • Loss of memory or an inability to form memories
  • Hallucinations

Gastrointestinal beriberi causes abdominal pain, nausea, and vomiting.

According to Dr. Imam, possible complications of beriberi include a "change in mental states, [a] skin condition, [and] cardiovascular issues."

Prevention and Risks

The primary way to prevent beriberi is to make sure that you consume enough vitamin B1. Beriberi is uncommon in the United States because it is found in many foods that are easy to acquire.

Some risk factors for any type of beriberi are:

  • A genetic history of beriberi or an inability to adequately absorb thiamine
  • Abusing alcohol
  • A diagnosis of HIV/AIDS
  • Hyperemesis gravidarum (extreme vomiting while pregnant)
  • Dialysis treatment
  • Hyperthyroidism
  • Taking diuretics

Diagnosis and Tests

Doctors will typically start with a blood and/or urine test to determine the levels of thiamine in the body. These tests will reveal if there is a thiamine deficiency. In cases where beriberi is caused by the body’s inability to properly absorb this vitamin, a blood test will reveal a low level of thiamine, while a urine test will show a high level of thiamine.

Depending on the disease’s progression, a doctor may also need to perform neurological exams to determine its effects. Checking reflexes, memory, and coordination can all help lead to a beriberi diagnosis and can aid the doctor in determining how advanced the condition has become.

Treatment, Procedures, and Medication

Fortunately, though its effects can be severe, beriberi is an easy condition to treat. Thiamine supplements, taken via a pill, an injection, or in extreme cases, an IV, can reverse the symptoms of the condition. It is usually prescribed in "50-100 mg" doses, according to Dr. Imam. Once the body has built up a healthy supply of vitamin B1 again, it should return to a healthy functionality.

In cases where dry beriberi has led to Wernicke-Korsakoff syndrome, the symptoms can be more difficult to reverse and may require closer monitoring, but they are still sometimes reversible if caught in time.

Healthy Lifestyle Tips

If you have or are at risk of developing beriberi, the best way to stay healthy is to eat a diet rich in thiamine (see below), as well as cutting back on or quitting drinking alcohol. Taking B-complex vitamins or supplements can also help treat or prevent beriberi.

Food and Nutrition-Based Approaches to Prevention and Management

The best way to prevent or manage beriberi is to make sure that you are getting a sufficient amount of vitamin B1 in your diet. This vitamin is found in many foods, but some of the richest in B1 are:

  • Beef, pork, and fish
  • Beans
  • Nuts, especially macadamia nuts and pistachios
  • Brown rice
  • Seeds, especially sunflower seeds and flax seeds
  • Wheat bread
  • Peas
  • Acorn squash

What Type of Doctors to See

The first doctor you should see if you have any symptoms of beriberi is your primary care physician. A child showing signs of beriberi should be taken to their pediatrician. In either case, the necessary tests can be performed to diagnose beriberi, and treatment can begin. In more advanced cases, such as dry beriberi that has led to Wernicke-Korsakoff syndrome, it may be necessary to visit a neurologist for treatment and monitoring of its more advanced and severe symptoms.

Conclusion

While it can have dangerous symptoms and effects when gone untreated, it is important to remember that beriberi is a condition that can be reversed. See a doctor if you think you may be at risk of developing beriberi, and be sure to eat a diet rich in vitamin B1 to avoid becoming deficient in it.

About the Expert Contributor:

Muneer Imam, MD, is the medical director at The CIIT Medical Center, a multi-modality health care treatment center for chronic illness on Long Island. The center uses both traditional and functional medicine to take an integrative approach to treatment. He works extensively with IV therapy including cutting-edge detoxification methods. Dr. Imam focuses on treating chronic illness.