Disease of sailors who only ate canned food during their crossing at sea, Beriberi disease is linked to a deficiency in vitamins B1. Indispensable to the body, this deficiency is at the origin of neurological and cardiovascular disorders, sometimes irreversible. Its early supplementation through food and treatment allows it to be treated. 

Deficiency disease known since in the East from the seventeenth century in Asian subjects who ate only white rice, it was also observed in sailors who ate only canned food during their long voyage at sea before understanding that their prevention went through a diet richer in vitamins, especially vitamin B1. Hence the name Beriberi for vitamin B. 

The human body is in fact not capable of synthesizing this vitamin and needs sufficient nutritional contributions for the metabolism to function in a balanced and efficient manner.

This vitamin is however present in many products of the usual diet such as whole grains, meat, nuts, legumes or potatoes.

Its deficiency still concerns today especially the developing countries which suffer from malnutrition and favor a diet based on refined carbohydrates (white rice, white sugar, white starches…). 

But it can also occur in unbalanced diets such as vegan diets, or in cases of anorexia nervosa in young adults. Certain diseases can also be the cause of vitamin B1 deficiency such as hyperthyroidism, prolonged intestinal absorption such as during chronic diarrhea or liver failure. It is found only in patients suffering from alcohol addiction and cirrhosis of the liver.

Vitamin B1 deficiency leads to degeneration of peripheral nerves (neuropathy), of certain regions of the brain (thalamus, cerebellum, etc.) and reduces cerebral circulation by increased resistance of the cerebral blood vessels to blood circulation. It also affects the heart, which dilates and does not perform well its pump function to allow blood circulation in the body (heart failure). 

Finally, this deficiency can cause a dilation of the vessels (vasodilation) causing edema (swelling) of the feet and legs.

When the deficiency is modest, only a few non-specific symptoms may occur such as fatigue (mild asthenia), irritability, memory impairment and sleep.

But when it is more pronounced, several symptoms are then present in the form of two tables:

In dry form with 

• symmetrical peripheral neuropathies (polyneuritis) on both sides of the lower limbs, with sensations of tingling, burning, cramping, pain in the legs;
• reduced sensitivity of the lower limbs (hypoaesthesia) especially to vibrations, a feeling of numbness;
• reduction in muscle mass (atrophy) and muscle strength causing difficulty in walking;
• reduction or even abolition of tendon reflexes (Achilles tendon, patellar tendon, etc.);
• difficulty rising from a squatting position to a standing position;
• neurological symptoms with paralysis of eye movements (Wernicke’s syndrome), difficulty walking, mental confusion, difficulty in taking initiatives (abulia), amnesia with false recognition (Korsakoff syndrome).

In the wet form

• heart damage with heart failure, increased heart rate (tachycardia), heart size (cardiomegaly);
• increased jugular vein pressure (in the neck);
• shortness of breath on exertion (dyspnea);
• edema of the lower limbs (feet, ankle, calf).

There are also digestive signs in these severe forms with abdominal pain, nausea, vomiting. 

Finally, in infants, the child loses weight, is hoarse or even voiceless (no longer screams or moans slightly), suffers from diarrhea and vomiting and has difficulty breathing.

Additional examinations are carried out in case of suspicion of Beriberi to confirm the diagnosis and take the measure of the deficiency (thiamine mono and diphosphate). Magnetic Resonance Imaging (MRI) of the brain may also be prescribed to visualize abnormalities linked to Vit B1 deficiency (bilateral lesions of the thalamus, cerebellum, cerebral cortex, etc.).

The treatment of Beriberi disease is vitamin B1 supplementation as early as possible to prevent possible irreversible sequelae. Drug prophylaxis can also be implemented in subjects at risk (subjects suffering from chronic alcoholism and cirrhosis, malnourished patients suffering from AIDS, malnutrition, etc.)

Finally, daily prevention consists in enriching a diversified diet with legumes (peas, beans, chickpeas, etc.), whole grains (rice, bread and whole wheat, etc.), yeasts rich in Vit B1 and seeds (walnuts, hazelnuts, glitches…). You have to avoid white rice and anything that is too refined like white sugar and ensure a preparation in the kitchen that does not destroy too much vitamins in general.