Beriberi: Types, Causes, Symptoms, Treatment, Prevention & MCQs

What is Beriberi?

Beriberi is a nutritional disorder caused by a deficiency of thiamine (vitamin B1). It is considered a nutritional disease because it results from inadequate intake or absorption of thiamine, an essential nutrient, rather than from an infection or genetic condition. Thiamine is crucial for carbohydrate metabolism and energy production in cells. When there is a deficiency, cells cannot efficiently convert food into energy, leading to various symptoms affecting the nervous system, heart, and muscles.

Historical context of Beriberi

Beriberi was first documented and recognised and remained in the same contacts for centuries. Early Chinese and Japanese texts have provided some of the first detailed accounts of these conditions found in the human body. Modern scientific understanding says that thiamine deficiency was largely shaped during the late 19th and early 20th centuries. Some more historical context about Beriberi is discussed below:

• Ge Hong (3rd Century) first described beri beri as a symptom of swelling weakness and numbness in the feet.

• Takaki Kanehiro (1883) discovered that this disease has a high rate among Japanese sailors and was first discussed as a diverse disease due to diet.

• Later on in 1901, Beriberi was identified as having deficiency syndrome by Gerrit Grijns.

• In 1929 Sir Frederick Hopkins and Eijkman were awarded the Nobel Prize for their contribution and understanding of beriberi and its importance to the vitamins.

Signs and Symptoms of Beriberi

Beri beri is caused due to vitamin B1 deficiency that affects the nervous as well as cardiovascular systems of our body. It is found in different forms and each symptom has potentially life-threatening conditions.

• The general symptoms of beriberi include soreness, numbness, mental disorders, weight loss, and an increase in pyruvic acid levels.

• In dry beriberi, there is a fact on peripherals which leads to paralysis problems in walking and also cognitive difficulties.

• In brain beriberi, there are symptoms like mental instability, memory loss and impaired brain functions which particularly happens in alcoholics.

• Affects the cardiovascular system during wet beriberi and the symptoms include high heart rate heart failure and breathlessness.

• Due to beriberi in the gastrointestinal area, there are causes and abdominal pain vomiting and also lactic Acid reflux.

Types of Beriberi

Beriberi is of four major types:

Dry Beriberi

Dry neriberi develops when the diet contains slightly less than the thiamin requirement. The symptoms include fatigue, severe muscular weakness and pain on contact with skin.

Wet Beriberi

Wet beriberi affects the heart and circulatory system. It's called "wet" beriberi due to the fluid accumulation in tissues. It is characterised by edema of extremities, heart enlargement and cardiac insufficiency like tachycardia, bradycardia.

Cerebral Beriberi

It is also called Wernicke-Korsakoff's Syndrome. It is also caused due to severe deficiency of thiamine. It is seen commonly in alcoholics, the long term alcohol consumption interferes with the intestinal absorption of thiamin.

Infantile Beriberi

It is observed in breastfed infants born to mothers suffering from thiamin deficiency. The breast milk of the mothers is deficient in thiamin.

Causes of Beriberi

Beriberi is caused by deficiency of vitamin B1 which is important for energy metabolism. There can be several reasons and some of the common ones are genetics, alcoholism and medical conditions. A few of them have been discussed below in the table:

Treatment of Berberi

Thiamine is a commonly used standalone treatment for beriberi. The healing process is quick and dramatic when thiamine is administered intravenously and later orally. It may take several months of thiamine therapy for peripheral neuropathy to improve.

Prevention of Beriberi

An individual must include adequate Vitamin B1 in their diet to prevent beriberi. Generally speaking, thiamine deficiency is not a concern for someone who follows a a healthy, balanced diet that prioritises whole foods.

Natural sources of thiamine in food include:

• Meat

• Nuts and seeds

• Seafood,

• Dairy products,

• Beans and legumes

Additionally, producers fortify a variety of foods with vitamins, including thiamine, bread, morning cereals, and baked goods.

Exam Importance of Beriberi

During exam preparation, different types of questions about the Beriberi are asked. The table below contains the different patterns of questions asked in different exams.

Tips, Tricks, & Mnemonics for Beriberi

It takes effort to remember everything in a single go. We made the entire problem easy. Some of the tricks regarding Beriberi are given below which you can use to memorise the important points.

Causes of Beriberi

"PLANT: Polished rice, Lack of thiamine, Alcoholism, Nutrition deficiency, Thiamine malabsorption"

• P: Polished rice is a major dietary cause (low thiamine)

• L: Lack of thiamine in diet

• A: Alcoholism reduces thiamine absorption

• N: Nutrition deficiency or poor diet

• T: Thiamine malabsorption in gastrointestinal conditions

Symptoms of Beriberi

"WLN-HO: Weakness, Legs, Numbness, Heart, Oedema"

• W: Weakness (muscle weakness, paralysis)

• L: Legs and limb pain (numbness, tingling, trouble walking)

• N: Numbness and neurological signs

• H: Heart failure (high-output heart failure in wet beriberi)

• O: Oedema (swelling in wet beriberi)

Types of Beriberi

"WDI: Wet, Dry, Infantile"

• W: Wet beriberi (affects heart and circulatory system)

• D: Dry beriberi (affects nerves and muscles)

• I: Infantile beriberi (affects infants of malnourished mothers)

Diagnosis of Beriberi

"TET: Transketolase, Enzyme, Thiamine level"

• T: Transketolase enzyme activity test

• E: Enzyme activity to detect deficiency

• T: Thiamine levels in blood or urine

Prevention and Treatment of Beriberi

"TRI: Thiamine-rich foods, Rice unpolished, Injection or oral supplements"

• T: Thiamine-rich foods (meat, grains, vegetables)

• R: Rice unpolished (maintains thiamine content)

• I: Injection or oral supplements for treatment

Beriberi NEET MCQs

Q1. Beriberi is caused due to the deficiency of:

1. Vitamin B1

2. Vitamin B2

3. Vitamin B6

4. Vitamin B12

Correct answer: 1) Vitamin B1

Explanation:

Beriberi is caused by the deficiency of Vitamin B1 (Thiamine). Thiamine plays an essential role in carbohydrate metabolism and energy production through the citric acid cycle. Its deficiency leads to impaired ATP generation, accumulation of pyruvate and lactate, and malfunctioning of the nervous and cardiovascular systems. This condition manifests as either dry (neurological) or wet (cardiac) beriberi.

Hence, the correct answer is option 1) Vitamin B1.

Q2. Which type of beriberi primarily affects the nervous system?

1. Wet beriberi

2. Dry beriberi

3. Infantile beriberi

4. Gastrointestinal beriberi

Correct answer: 2) Dry beriberi

Explanation:

Dry beriberi affects the nervous system. It leads to degeneration of peripheral nerves, muscle wasting, numbness, tingling sensations, and difficulty in walking. The patient may suffer from paralysis and loss of reflexes if untreated. This occurs because the absence of thiamine hampers nerve impulse conduction and energy supply to muscles.

Hence, the correct answer is option 2) Dry Beriberi.

Q3. The main symptom of wet beriberi is:

1. Paralysis

2. Heart failure and edema

3. Mental confusion

4. Vomiting

Correct answer: 2) Heart failure and edema

Explanation:

Wet beriberi primarily affects the cardiovascular system. Its hallmark symptoms are edema (swelling due to fluid accumulation), rapid heartbeat, breathlessness, and heart failure. The deficiency of thiamine reduces ATP in cardiac cells, weakening the heart muscle and impairing blood circulation. If untreated, wet beriberi can lead to severe congestive heart failure.

Hence, the correct answer is option 2) Heart failure and edema.

Also Read:

• MCQs on Disorder of Digestive Tract

• Biological Functions of Proteins

• Amino Acids

FAQs on Beriberi

What is beriberi and its cause?

Beriberi is a nutritional deficiency disease caused by the lack of vitamin B₁ (thiamine) in the diet. Thiamine is essential for carbohydrate metabolism and normal functioning of the nervous system and heart. Its deficiency leads to low energy production, accumulation of pyruvate and lactate, and damage to nerves and muscles. It is most common in populations consuming polished rice as a staple food.

What are the symptoms of wet and dry beriberi?

• Dry beriberi: Develops when the diet contains slightly less than the thiamin requirement and affects the nervous system. Symptoms include fatigue, severe muscular weakness and pain on contact with skin.

• Wet beriberi: Develops when the thiamine deficiency is more severe and affects the cardiovascular system. Symptoms include edema of extremities, heart enlargement, rapid heartbeat, and congestive heart failure.

How is beriberi treated?

Treatment of beriberi involves thiamine supplementation either orally or by injection, depending on severity. Along with vitamin therapy, a nutritious diet rich in whole grains, legumes, milk, eggs, and meat is recommended. In wet beriberi, supportive care for heart failure (oxygen, diuretics, rest) is also given. Improvement in symptoms is usually seen within days to weeks after treatment.

How can beriberi be prevented?

Beriberi can be prevented by ensuring adequate thiamine intake through a balanced diet rich in whole grains, legumes, nuts, and fortified foods. In addition, avoiding overconsumption of polished rice or highly refined foods helps. In high-risk populations, thiamine supplementation or food fortification programs can be effective preventive measures.