It is a clinical syndrome arises insidiously due to a severe and prolonged deficiency of thiamine (vitamin B1) in your daily dietary habits. It is manifested in the initial stages by malaise, anorexia and frequently with slight edema and palpitations) and paraesthesia (weakness of the legs). This disorder may persist in its chronic stage or may be at any time progress to an acute stage and is characterized either by cardiac involvement with edema or by peripheral neuropathy and formation of an intermediate between these two stages may also occur.
What are the Causes of Thiamine Deficiency?
- Thiamine deficiency is caused by less dietary intake and poor absorption of the dietary foods.
- Many other factors that cause breakdown of thiamine such as intake of alcohol, a combination of various chronic diseases such as HIV/AIDS diabetes, heart failure, and Alzheimer’s disease.
- Use of multiple medications is the most common cause of thiamine deficiency.
- It is also seen in people having high carbohydrate intake and low thiamine intake.
What are the Symptoms of Thiamine Deficiency?
The symptoms associated with thiamine deficiency are vague and they are attributed to other problems.
In infants the symptoms now a days are usually rare. The symptoms are often very rapid and in initial stages, there will be varying degrees of constipation, vomiting, restlessness, and crying. This condition presents with edema, dyspnoea (difficulty in breathing), low urination and cardiac disturbances. The common age for this deficiency particularly high prevalence of thiamine deficiency (38%) was found in infants aged6-12 months,. There will be a symptom of loss of voice due to the paralysis of vocal cords.
In older infants, the symptoms may manifest that can be mistaken for bacterial meningitis such as neck stiffness, meningeal irritation which is accompanied by sweating, nausea, vomiting, and convulsions.
In Adults, Symptoms Associated with this Disease are
The Deficiency with Peripheral Neuropathy
This condition is an acute form of thiamine deficiency which is characterized by the paraesthesia of the especially the lower extremities (legs), in which there are a reduced knee jerk and other tendon reflexes, and also progressive severe weakness and muscle wasting. Nowadays, the susceptibility to these infections is greatly increased.
Thiamine Deficiency with Cardiopathy
In this acute form of thiamine deficiency, there is a characterization of edema especially in the lower extremities (legs) that also involves trunk and the face, high cardiac output, dilatation of arterioles, ventricular failure, sinus rhythm along with pulmonary congestion with pleural effusion and death from congestive heart failure may also occur abruptly.
The clinical features of thiamine deficiency are usually divided into two types: a dry (neuritic) and a wet (cardiac). Whether the disease is wet or may be dry, it depends upon the amount of fluid which accumulates in the body due to factors like cardiac function. Main cases of thiamine (vitamin B1) deficiency show a mixture of these two features and are more mainly termed as thiamine deficiency with cardiomyopathy and peripheral neuropathy. There may be nutritional amblyopia in eyes which is associated with visual loss and central or cecocentral scotomas. The condition also manifests itself principally with changes in the nervous system, gastrointestinal tract as well as the cardiovascular system.
Changes in the Nervous System
The most important clinical features of thiamine (vitamin B1) deficiency are associated with the nervous system. The most predominating conditions are polyneuritis and paralysis of the peripheral nerves of the nervous system. These manifestations are commonly found in the sensory, motor and autonomic nervous system. In the sensory system, there will be tactile sensation which is firstly affected and after that, there will be pain and temperature sensitivity is altered. This also includes loss of vibratory sensation over the big toe as well as the ankle and there will be disturbances in peripheral sensory nerves such as tingling, burning, and numbness (paraesthesia) in the lower extremities (legs) and toes. There will be hyperesthesia (increased sensitivity) starting from the legs, then on the fingers tips and then lower abdomen, and this gradually expands. These sensory effects are usually symmetrical that although mainly occurs on the side that is in greater use.
Paralysis of the motor nervous system occurs after the disturbance of sensory system. This usually begins on the tips of the lower extremities and then occurs in the fingers, and ascends progressively. There is an increase in the weakness of muscles which is demonstrated when the person is unable to stand up from a squatting position without any assistance. As the disease started progressing, there is atrophy of the muscles of the legs. The tendon reflexes may also affect and there is a loss of knee and ankle jerks. Pain in calf muscles, foot drop and a symptom of wrist drop may also develop. These changes in the nervous system may result in difficulty in walking and even paralysis may also happen.
Changes in Cardiovascular System
Changes in the cardiovascular system may be more severe than other systems. There are clinical features of weakness, palpitation, and shortness of breath. Palpitation is associated with tachycardia (rapid heartbeat), and there may be a pain over the heart. All these symptoms may occur quite early and some electrocardiographic changes are also found. In chronic cases, the heart is enlarged to the right side, and there may be symptoms of dizziness and low blood pressure. Changes in the muscles of the heart and there may be an accumulation of fluid between the muscle fibers. Patients suffering from severe beriberi disease may die of a stroke or heart failure or exertion. The pulse is rapid and the diastolic pressure may drop. Lung congestion, nausea, and vomiting are also the symptoms associated with it.
Changes in the Gastrointestinal Tract
In the gastrointestinal tract, there may be symptoms of delayed emptying of the stomach and dilation of the colon. Other symptoms include anorexia, abdominal pain, constipation, nausea, and vomiting.
These are the health problems caused by vitamin B1 (thiamine) deficiency. Include a variety of fruits and vegetables, whole grains and low-fat milk to your diet. Avoid the intake of saturated and Trans fats, sodium and sugar in your diet.