Beriberi
Getting Enough Thiamin
The legend goes something like this: A nineteenth-century Dutch shipboard physician, studying the effects of a strange disease in the Far East, calls for his next patient. But instead of seeing someone walking through the door, he hears a faint cry of "Beriberi!"
Roughly translated from Sinhalese, a language of the tiny country of Sri Lanka, the response means "I can't, I can't!" The would-be patient literally couldn't muster enough muscle to get up to see the doctor. And his response became the name of the mystery disease.
Years later, this disease, which involves a gradual decline in neuromuscular coordination, was linked to a deficiency of thiamin. Although rice and whole grains--dietary staples in that part of the world--naturally contain thiamin, the process of refining them for consumption removes the nutrient. The result: Those folks who live on the devitalized rice and grains become thiamin-deficient. The deficiency soon leads to symptoms such as leg swelling and numbness, fluid buildup in the heart, severe muscle wasting, irritability and nausea.
Adding thiamin to rice and flours has all but eliminated most forms of beriberi in the United States. "Even things such as white bread and doughnuts--foods you wouldn't consider very healthy at all--are of some benefit anyway, because they contain thiamin," says Robert Keith, R.D., Ph.D., professor in the Department of Nutrition and Food Science at Auburn University in Alabama.
| Prescriptions for Healing These days, cases of beriberi are rare in the Western world. When doctors do encounter patients with this thiamin-deficiency disease, they administer the vitamin intravenously or intramuscularly. Intravenous thiamin is given only in cases of severe deficiency. In less severe cases, doctors prescribe oral thiamin, along with other B-complex vitamins. Nutrient Daily Amount
Thiamin 50-100 milligrams, given intravenously or intramuscularly for 7-14 days
MEDICAL ALERT: If you have symptoms of beriberi, you should see a doctor for proper diagnosis and treatment. |
Dealing with Alcohol Abuse
But what fortification eliminates, alcohol precipitates. The most common cause of beriberi in the Western world is alcohol abuse. "Your body's thiamin stores are simply used up during the metabolism of ethanol," explains Dr. Keith.
As a result, some alcoholics go on to suffer from a beriberi-like disease known as Wernicke-Korsakoff syndrome, which includes symptoms such as severe memory loss, unsteady gait and loss of appetite, says Gary E. Gibson, Ph.D., professor of neuroscience at the Burke Medical Research Institute in White Plains, New York. "If you dramatically reduce thiamin intake, you reduce the ability of the brain to use glucose. And if you reduce that, you have impaired mental ability," he explains. Severe thiamin deficiency not only kills the brain cells responsible for memory but also may lead to an increase in a protein that has been linked to Alzheimer's disease, says Dr. Gibson.
When doctors encounter severe thiamin deficiency these days, they administer the vitamin intravenously or intramuscularly, usually in doses of 50 to 100 milligrams daily for 7 to 14 days. For the full details on using nutrients to treat alcoholism, see page 69.
