What is thiamine deficiency?
Thiamine, also known as vitamin b1, is one of the eight essential b vitamins that have many important functions throughout the body. It is used by almost all cells, and it is responsible for helping to convert food into energy. Since the human body cannot produce thiamine, it must be consumed through various thiamine-rich foods, such as meat, nuts, and whole grains. It is quite rare in developed countries. However, several factors can increase your risk, including:
- Alcohol dependence
- Old age
- HIV AIDS
- Bariatric surgery
- Use of high-dose diuretics
Many people don’t realize that they have a thiamine deficiency, as many of the symptoms are subtle and often overlooked.
Signs and symptoms of thiamine deficiency
The first symptoms are nonspecific: Fatigue, irritability, poor memory, sleep disturbances, chest pain, anorexia, and abdominal discomfort.
Different forms of beriberi cause different symptoms.
Dry beriberi refers to peripheral neurological deficits due to thiamine deficiency. These deficits are bilateral and approximately symmetric and occur in a sock-glove distribution. They predominantly affect the lower extremities, start with paresthesias in the toes, burning feet (especially severe at night), muscle cramps in the calves, leg pain, and plantar dysesthesias. The first signs are tenderness of the calf muscles, effort getting up from a squatting position, and decreased vibratory sensation in the toes. Muscle atrophy occurs. Ongoing deficiency worsens polyneuropathy, which can eventually affect the arms.
Wernicke-Korsakoff syndrome, which combines Wernicke encephalopathy and Korsakoff psychosis, occurs in some alcoholics who do not eat foods fortified with thiamine. Wernicke encephalopathy consists of psychomotor slowing or apathy, nystagmus, ataxia, ophthalmoplegia, altered consciousness, and if left untreated, it leads to coma and death. It is probably due to a severe acute deficiency superimposed on a chronic deficiency. Korsakoff psychosis contains mental confusion, dysphonia, and confabulation with impaired memory of recent events. It is probably due to a chronic shortage and can develop after recurrent episodes of Wernicke encephalopathy.
Cardiovascular (wet) beriberi is a myocardial disease due to thiamine deficiency. The first effects are vasodilation, tachycardia, wide pulse pressure, sweating, hot skin, and lactic acidosis. Later, heart failure develops causing orthopnea and peripheral and pulmonary edema. Vasodilation can continue, sometimes resulting in shock.
Infant beriberi occurs in babies (usually between 3 and 4 weeks of age) who are breastfed by mothers with thiamine deficiency. Heart failure (which can occur suddenly), aphonia, and the absence of deep tendon reflexes are characteristic.
Because thiamine is essential for glucose metabolism, glucose infusions can precipitate or worsen deficiency symptoms in people with thiamine deficiency.
Thiamine deficiency causes
To function properly, your body needs vitamin thiamine. Without enough thiamine, a variety of symptoms can occur, ultimately leading to death if the deficiency is severe or left untreated.
This is caused by lack of thiamine. This can happen in two ways: Lack of thiamine is consumed, or too much thiamine is lost. Most diets in the developed world are supplemented with thiamine, making dietary deficiency of this vitamin very rare. In people with incredibly poor or unbalanced diets, such as alcoholics or people in the developing world, it is possible to consume a diet that is deficient in thiamine. In other cases, a genetic condition or kidney condition can result in the loss of too much thiamine.
Most people with risk factors will not develop, because it is very rare, especially in the developed world. Risk factors may include:
- Bariatric surgery
- Genetic beriberi
- Living in an impoverished or underdeveloped nation
- Low socioeconomic status
- Poor diet
Reduce your risk of thiamine deficiency
Beriberi is rare in the developed world because supplemental thiamine is added to many foods. Although the disease is rare, you can reduce your risk of thiamine deficiency by following a healthy and varied diet.
The only treatment is thiamine supplementation and changes in 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 your thiamine deficiency.
If identified early and treated early, most of the symptoms associated with thiamine deficiency should go away. People who are deficient in thiamine should have long-term monitoring of their thiamine levels to ensure that the deficiency does not return.
- Relief of symptoms when taking thiamine supplements
- The diagnosis of thiamine deficiency is based on the symptoms.
- Tests to confirm the diagnosis are not readily available. Blood tests are usually done to measure electrolyte levels to exclude other possible causes.
- The diagnosis is confirmed if thiamine supplements relieve symptoms.
Following a balanced diet is the best option to prevent beriberi. To get your fill of thiamine, load up on the following foods:
- Beans and legumes
- Dairy products (like yogurt)
- Meat, poultry, and fish
- Nuts and seeds
- Thiamine-fortified breakfast cereals
- Whole grains
The following vegetables are also high in thiamine:
- Acorn squash
- Beet greens
- Brussels sprouts
It should be noted that several foods contain thiamine, which are enzymes that inactivate thiamine. These foods include:
- White rice
Limiting your intake of these foods can also help prevent.