Beriberi
Beriberi is vitamin B1 (Thiamine) deficiency. Thiamine hydrochloride is a white crystalline substance which is readily soluble in water but not in fats and is readily destroyed by heat in neutral and alkaline solutions. So, what are the functions of thiamine?
1. It is a coenzyme in carbohydrate metabolism
2. It is also required for the synthesis of acetylcholine and deficiency may produce impairment of nerve functions.
There are two classifications of beriberi.
1. Wet and Dry type – this is the one most widely occuring at the present time
2. Acute cardiac, occurring at 2-4 months of age; aphonic which is developing at ages 5 to 7 months, and; pseudomeningeal which occurs in slightly older infants at 8-10 months
Clinically, infants with Dry Beriberi have the following features:
– they appear well nourished but are pale, listless, flabby, cyanotic and dyspnic
– the heart rate is fast and the liver is enlarged
– there is numbness, tingling sensation, sensory loss and calf tenderness
– leg pains are exacerbated by assuming a squatting position
– there may be absence of deep tendon reflexes which later may result to flaccid paresis, foot drop, muscular wasting and muscular paralysis
In Wet Beriberi, the infant appears edematous, pale, undernourished, dyspneic with vomiting and fast heart rate
– deep tendon reflexes are also absent
– the wet type may have an acute onset in an apparently healthy older child or adult doing heavy work.
– during the initial phase of the wet type, edema is first noted around the ankles which disappears on lying down. This may progress to generalized anasarca with pleural, peritoneal and pericardial effusions. Patients with beriberi heart may have excessive fatigue, palpitation on exertion and shortness of breath.
It is important to mention that both types of beriberi are most likely to occur among women before and after delivery where rice is the main food eaten and among alcoholics.
It is very important to eat a well balanced diet to prevent beriberi. The following have a rich source of thiamine:
– germ of cereals
– peas
– nuts
– beans
– and yeasts
– all green vegetables
– roots
– fruits and
– dairy products
– pork has a higher content of thiamine than beef or lamb
The recommended daily allowance of thiamine is 0.4 mg for infants
0.6 mg to 1.2 mg for older children
1.0 mg to 1.3 mg for adults and 1.5 mg for nursing mothers