Beriberi is a disease in which the body does not have enough thiamine (vitamin B1).

Thiamine deficiency; Vitamin B1 deficiency

There are two major types of beriberi:

• Wet beriberi affects the cardiovascular system.
• Dry beriberi and Wernicke-Korsakoff syndrome affect the nervous system.

Beriberi is rare in the United States because most foods are now vitamin-enriched. If you eat a normal, healthy diet you should get enough thiamine. Today, beriberi occurs mostly in patients who abuse alcohol. Drinking heavily can lead to poor nutrition, and excess alcohol makes it harder for the body to absorb and store thiamine.

A rare condition known as genetic beriberi is inherited (passed down through families). People with genetic beriberi lose the ability to absorb thiamine from foods. This can happen slowly over time and symptoms occur when the person is an adult. However, because doctors may not consider beriberi in non-alcoholics, this diagnosis is often missed.

Beriberi can occur in breast-fed infants when the mother's body is lacking in thiamine. The condition can also affect infants who are fed unusual formulas that don't have enough thiamine.

Getting dialysis and taking high doses of diuretics raise your risk of beriberi.

Symptoms of dry beriberi include:

• Difficulty walking
• Loss of feeling (sensation) in hands and feet
• Loss of muscle function or paralysis of the lower legs
• Mental confusion/speech difficulties
• Pain
• Strange eye movements (nystagmus)
• Tingling
• Vomiting

Symptoms of wet beriberi include:

• Awakening at night short of breath
• Increased heart rate
• Shortness of breath with activity
• Swelling of the lower legs

A physical examination may show signs of congestive heart failure, including:

• Difficulty breathing with neck veins that stick out
• Enlarged heart
• Fluid in the lungs
• Rapid heartbeat
• Swelling in both lower legs

A person with late-stage beriberi may be confused or have memory loss and delusions. The person may be less able to sense vibrations.

A neurological exam may show signs of:

• Changes in the walk
• Coordination problems
• Decreased reflexes
• Drooping of the eyelids

The following tests may be done:

• Blood tests to measure the amount of thiamine in the blood
• Urine tests to see if thiamine is passing through the urine