Thiamine deficiency is a medical condition of low levels of thiamine vitamin B 1. Risk factors include a diet of mostly white rice , as well as alcoholism , dialysis , chronic diarrhea , and taking high doses of diuretics. Treatment is by thiamine supplementation , either by mouth or by injection. Thiamine deficiency is rare in the United States.
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Thiamine deficiency is a medical condition of low levels of thiamine vitamin B 1. Risk factors include a diet of mostly white rice , as well as alcoholism , dialysis , chronic diarrhea , and taking high doses of diuretics. Treatment is by thiamine supplementation , either by mouth or by injection.
Thiamine deficiency is rare in the United States. Symptoms of beriberi include weight loss, emotional disturbances, impaired sensory perception , weakness and pain in the limbs, and periods of irregular heart rate.
Edema swelling of bodily tissues is common. It may increase the amount of lactic acid and pyruvic acid within the blood. In advanced cases, the disease may cause high-output cardiac failure and death. Symptoms may occur concurrently with those of Wernicke's encephalopathy , a primarily neurological thiamine-deficiency related condition.
Beriberi is divided into four categories as follows. The first three are historical and the fourth, gastrointestinal beriberi, was recognized in Dry beriberi causes wasting and partial paralysis resulting from damaged peripheral nerves.
It is also referred to as endemic neuritis. It is characterized by:. A selective impairment of the large proprioceptive sensory fibers without motor impairment can occur and present as a prominent sensory ataxia , which is a loss of balance and coordination due to loss of the proprioceptive inputs from the periphery and loss of position sense. Wernicke's encephalopathy WE , Korsakoff's syndrome alcohol amnestic disorder , Wernicke—Korsakoff syndrome are forms of dry beriberi. Korsakoff's syndrome is, in general, considered to occur with deterioration of brain function in patients initially diagnosed with WE.
Following improved nutrition and the removal of alcohol consumption, some impairments linked with thiamine deficiency are reversed, in particular poor brain functionality, although in more severe cases, Wernicke—Korsakoff syndrome leaves permanent damage.
See delirium tremens. Wet beriberi affects the heart and circulatory system. It is sometimes fatal, as it causes a combination of heart failure and weakening of the capillary walls, which causes the peripheral tissues to become edematous.
Wet beriberi is characterized by:. Infantile beriberi usually occurs between two and six months of age in children whose mothers have inadequate thiamine intake. It may present as either wet or dry beriberi. In the acute form, the baby develops dyspnea and cyanosis and soon dies of heart failure. These symptoms may be described in infantile beriberi:.
Beriberi may also be caused by shortcomings other than inadequate intake: diseases or operations on the digestive tract, alcoholism ,  dialysis , genetic deficiencies , etc.
All these causes mainly affect the central nervous system, and provoke the development of what is known as Wernicke's disease or Wernicke's encephalopathy. Wernicke's disease is one of the most prevalent neurological or neuropsychiatric diseases. In alcohol abusers , autopsy series showed neurological damages at rates of In addition, uncounted numbers of people can experience fetal damage and subsequent diseases. Genetic diseases of thiamine transport are rare but serious. Thiamine responsive megaloblastic anemia TRMA with diabetes mellitus and sensorineural deafness  is an autosomal recessive disorder caused by mutations in the gene SLC19A2 ,  a high affinity thiamine transporter.
TRMA patients do not show signs of systemic thiamine deficiency, suggesting redundancy in the thiamine transport system. This has led to the discovery of a second high-affinity thiamine transporter, SLC19A3.
Pathological similarities between Leigh disease and WE led to the hypothesis that the cause was a defect in thiamine metabolism. One of the most consistent findings has been an abnormality of the activation of the pyruvate dehydrogenase complex. Mutations in the SLC19A3 gene have been linked to biotin-thiamine responsive basal ganglia disease  , which is treated with pharmacological doses of thiamine and biotin , another B vitamin. Other disorders in which a putative role for thiamine has been implicated include subacute necrotising encephalomyelopathy , opsoclonic cerebellopathy a paraneoplastic syndrome , and Nigerian seasonal ataxia.
In addition, several inherited disorders of ThDP-dependent enzymes have been reported,  which may respond to thiamine treatment.
Thiamine in the human body has a half-life of 18 days and is quickly exhausted, particularly when metabolic demands exceed intake. A derivative of thiamine, thiamine pyrophosphate TPP , is a cofactor involved in the citric acid cycle , as well as connecting the breakdown of sugars with the citric acid cycle.
The citric acid cycle is a central metabolic pathway involved in the regulation of carbohydrate, lipid, and amino acid metabolism, and its disruption due to thiamine deficiency inhibits the production of many molecules including the neurotransmitters glutamic acid and GABA.
A positive diagnosis test for thiamine deficiency involves measuring the activity of the enzyme transketolase in erythrocytes Erythrocyte transketolase activation assay. Alternatively, thiamine and its phosphphosphorylated derivatives, can directly be detected in whole blood, tissues, foods, animal feed, and pharmaceutical preparations following the conversion of thiamine to fluorescent thiochrome derivatives Thiochrome assay and separation by high-performance liquid chromatography HPLC.
Many people with beriberi can be treated with thiamine alone. If concentrated thiamine supplements are not available, thiamine-rich diets e. Following thiamine treatment, rapid improvement occurs, in general, within 24 hours. Historically, beriberi was associated with a diet based on polished rice white rice. When the relationship between the polishing of rice and the disease became clear, the deficiency could be treated and prevented by including inexpensive rice bran in the diet, among other things.
Beriberi caused by inadequate nutritional intake of thiamine is rare today in developed countries [ citation needed ] because of quality of food and the fact that many foods are fortified with vitamins. Beriberi is a recurrent nutritional disease in detention houses, even in this century. In , an outbreak of beriberi occurred in a detention center in Taiwan.
Populations under extreme stress may be at higher risk for beriberi. Displaced populations , such as refugees from war, are susceptible to micronutritional deficiency, including beriberi. Earliest written descriptions of thiamine deficiency are from Ancient China in the context of chinese medicine.
Hong called the illness by the name jiao qi , which can be interpreted as "foot qi ". He described the symptoms to include swelling, weakness and numbness of the feet. He also acknowledged that the illness could be deadly, and claimed that it could be cured by eating certain foods such as fermented soybeans in wine.
Better known examples of early descriptions of "foot qi" are by Chao Yuanfang who lived during — in his book Zhu bing yuan hou lun Sources and Symptoms of All Diseases   and by Sun Simiao — in his book Bei ji qian jin yao fang Essential Emergency Formulas Worth a Thousand in Gold. In the late 19th century, beriberi was studied by Takaki Kanehiro , a British-trained Japanese medical doctor of the Imperial Japanese Navy.
The voyage lasted more than nine months and resulted in cases of sickness and 25 deaths on a ship of men. With the support of the Japanese Navy, he conducted an experiment in which another ship was deployed on the same route, except that its crew was fed a diet of meat, fish, barley, rice, and beans. At the end of the voyage, this crew had only 14 cases of beriberi and no deaths. This convinced Takaki and the Japanese Navy that diet was the cause. In , Christiaan Eijkman , a Dutch physician and pathologist , demonstrated that beriberi is caused by poor diet, and discovered that feeding unpolished rice instead of the polished variety to chickens helped to prevent beriberi.
The following year, Sir Frederick Hopkins postulated that some foods contained "accessory factors"—in addition to proteins, carbohydrates, fats, and salt—that were necessary for the functions of the human body.
Although according to the Oxford English Dictionary , the term "beriberi" comes from a Sinhalese phrase meaning "weak, weak" or "I cannot, I cannot", the word being duplicated for emphasis,  the origin of the phrase is questionable.
It has also been suggested to come from Hindi, Arabic and a few other languages, with many meanings like "weakness", "sailor" and even "sheep". Such suggested origins were listed by Heinrich Botho Scheube among others. Edward Vedder wrote in his book Beriberi that "it is impossible to definitely trace the origin of the word beriberi". Word berbere was used in writing at least as early as by Diogo do Couto , when he described the deficiency in India.
As most feedstuffs used in poultry diets contain enough quantities of vitamins to meet the requirements in this species, deficiencies in this vitamin do not occur with commercial diets. This was, at least, the opinion in the s. Mature chickens show signs three weeks after being fed a deficient diet. In young chicks, it can appear before two weeks of age. Onset is sudden in young chicks.
There is anorexia and an unsteady gait. Later on, there are locomotor signs, beginning with an apparent paralysis of the flexor of the toes. The characteristic position is called "stargazing", meaning a chick "sitting on its hocks and the head in opisthotonos ".
Response to administration of the vitamin is rather quick, occurring a few hours later. Differential diagnosis include riboflavin deficiency and avian encephalomyelitis. In riboflavin deficiency, the "curled toes" is a characteristic symptom. Muscle tremor is typical of avian encephalomyelitis.
A therapeutic diagnosis can be tried by supplementing thiamine only in the affected bird. If the animals do not respond in a few hours, thiamine deficiency can be excluded.
Polioencephalomalacia PEM is the most common thiamine deficiency disorder in young ruminant and nonruminant animals. Symptoms of PEM include a profuse, but transient, diarrhea, listlessness, circling movements, star gazing or opisthotonus head drawn back over neck , and muscle tremors.
These bacteria produce thiaminases that will cause an acute thiamine deficiency in the affected animal. Snakes that consume a diet largely composed of goldfish and feeder minnows are susceptible to developing thiamine deficiency.
This is often a problem observed in captivity when keeping garter and ribbon snakes that are fed a goldfish-exclusive diet, as these fish contain thiaminase, an enzyme that breaks down thiamine. Thiamine deficiency has been identified as the cause of a paralytic disease affecting wild birds in the Baltic Sea area dating back to It affects primarily 0.
Researches noted, "Because the investigated species occupy a wide range of ecological niches and positions in the food web, we are open to the possibility that other animal classes may suffer from thiamine deficiency as well. More recently, species of other classes seems to be affected. Lack of thiamine is the common denominator where analysis is done.
In April , the County Administrative Board of Blekinge found the situation so alarming that they asked the Swedish government to set up a closer investigation. From Wikipedia, the free encyclopedia. For the African ethnic group, see Kanuri people.
Beriberi is a disease of the nervous system caused by a person not getting enough thiamine vitamin B1 in the diet. Thiamine is needed to break down food such as glucose. It is also found on the membranes of neurons. Symptoms of beriberi include severe lethargy and tiredness. Beriberi may also cause problems that affect the cardiovascular system , the nervous system, muscles , and gastrointestinal systems. Wet beriberi mainly affects the cardiovascular system. There, some people only eat white rice.