Beriberi: Alternative names: thiamine deficiency; vitamin B1 deficiency

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From: "califpacific" Sat, 18 Sep 2004 06:55:51 -0000 Beriberi: Alternative names: thiamine deficiency; vitamin B1 deficiencyI think that this disease is more common than generaly thought toexist although most would be subclinical cases. F.http://www.healthcentral.com/mhc/top/000339.cfmBeriberiAlternative names: thiamine deficiency; vitamin B1 deficiencyDefinition: A vitamin deficiency disease, caused by a lack of vitaminB1 (thiamine); the most significant manifestations are damage to theheart and nervous system.Causes, incidence, and risk factors:Beriberi has become almost nonexistent in the United States since thediscovery of its

cause, thiamine deficiency. Most foods are vitaminenriched and a normal diet contains adequate amounts of thiamine.Beriberi can appear, however, in breast-fed infants when the motherhas an inadequate intake of thiamine or among people whose dietincludes certain types of fish that produce an enzyme whichinactivates thiamine.Early symptoms of beriberi are nonspecific and include fatigue,irritability, restlessness, loss of appetite, and vague abdominaldiscomfort.As the disease progresses, patients develop burning sensations,tingling in the extremities, and changes in sensation such asnumbness. Patients may develop psychosis. Heart manifestations arecaused by degeneration of the heart muscle and include heart failurewith shortness of breath (dyspnea) and cyanosis (bluish tinged skin).Neurologic symptoms are caused by degeneration of the nerve fiber andits insulation (myelin). Death is generally a result of heart

failure.Prevention:Adequate intake of thiamine will prevent beriberi. Nursing mothersshould insure that their diet is adequate in all vitamins.Symptoms:Early symptoms: * irritability * fatigue * restlessness * decreased appetiteLater symptoms: * complaints of tingling or burning in the extremities * numbness in the extremities * shortness of breath (dyspnea) * bluish coloration to the skin (cyanosis) * decreased mental ability * unusual behavior * seizures * loss of consciousnessSigns and tests:Physical examination may show signs of congestive heart failure,including difficulty breathing, bluish skin (cyanosis), and others.The person with late-stage beriberi

may be confused or psychotic.Neurological examination shows a loss of vibratory sensation (theperson is less able to sense vibration), loss of coordination, gaitchanges (ataxia), and other changes. The liver may be enlarged(hepatomegaly).Tests include: * ECG (to rule out other causes of seizures and neurologic changes) * clinical response to administered thiamine (symptoms improveafter the person is given thiamine supplements)Treatment:Administration of thiamine reverses the deficiency and symptomsimprove rapidly.Expectations (prognosis):Cardiac damage is reversible and is not permanent. Full recovery isexpected after treatment. Untreated, beriberi is often fatal.Complications: * seizures and subsequent injuries * psychosis * congestive heart

failure---------------------------http://www.sci.uidaho.edu/med532/wernicke_korsakoff.htmWernicke-Korsakoff SyndromeThis disease, notably frequent among chronic alcoholics, is due to adeficiency of vitamin B1 or thiamine. The poor diet of alcoholics whoare suffering from this syndrome leads to lesions and increasedmicrohemorrhages in the mammillary bodies, thalamus and brainstem.This syndrome can also be associated with diseases of the GI tractwhen there is inadequate thiamine absorption. Neurologic symptoms include confusion, memory loss, impaired movementsand peripheral neuropathy. Immediate administration of thiamine isusually successful in treating the symptoms, but sometimes permanentmemory loss occurs.http://www.healthcentral.com/mhc/top/000771.cfmAlternative names: Korsakoff psychosis; alcoholic encephalopathy;encephalopathy, alcoholic; Wernicke's diseaseDefinition: A brain disorder involving loss of specific brainfunctions, due to thiamine deficiency.Causes, incidence, and risk factors:Wernicke-Korsakoff syndrome usually affects people between 40 and 80years old. The onset is gradual.The syndrome is actually two disorders that may occur independently ortogether. Wernicke's disease involves damage to multiple nerves inboth the central nervous system (brain and spinal cord) and theperipheral nervous system (the rest of the body). It may also includesymptoms caused by alcohol withdrawal. The cause is generallyattributed to malnutrition, especially lack of vitamin B-1 (thiamine),which commonly accompanies habitual alcohol use or alcoholism.Korsakoff

syndrome, or Korsakoff psychosis, involves impairment ofmemory and intellect/cognitive skills such as problem solving orlearning, along with multiple symptoms of nerve damage. The mostdistinguishing symptom is confabulation (fabrication) where the personmakes up detailed, believable stories about experiences or situationsto cover the gaps in the memory. Korsakoff psychosis involves damageto areas of the brain.Prevention:Minimal or moderate alcohol use and adequate nutrition reduce the riskof developing Wernicke-Korsakoff syndrome.Symptoms: * vision changes o double vision o eye movements, uncontrollable or twitching of the eyes o eyelid drooping * loss of muscle

coordination o unsteady, uncoordinated walking o weakness o movement, dysfunctional o hand tremor * muscle contractions * muscle atrophy * facial paralysis * sensation changes o decreased sensation in the feet or hands, numbness o abnormal sensations, tingling * thin, malnourished appearance * loss of hair * dry skin * swallowing difficulty * speech impairment * hoarseness or changing voice * mood

changes, emotional changes, and behavior changes * loss of memory, can be profound * confabulation * decreased intellect/cognitive skills o decreased problem solving o loss of ability to think abstractly * autonomic disturbances: o orthostatic dizziness o constipation o inability to tolerate cold environmentNote: Symptoms that indicate alcohol withdrawal may also be present ormay develop.Signs and tests:History is significant for chronic alcohol use. Examination of thenervous/muscular system may show polyneuropathy (damage to multiplenerve systems). Reflexes may be decreased or of

abnormal intensity, orabnormal reflexes may be present. Testing of gait and coordinationindicate damage to portions of the brain that control musclecoordination. Muscles may be weak and may show atrophy (loss of tissuemass). Examination of the eyes shows abnormalities of eye movement.Blood pressure and body temperature measurement may be low; pulse(heart rate) may be rapid. The person may appear cachectic (malnourished).A nutritional assessment may confirm malnourished state, serum B-1levels may be low, pyruvate is elevated, and transhetolase activity isdecreased. Serum or urine alcohol levels may be elevated (seetoxicology screen).A cranial MRI rarely shows changes in the tissue of the brainindicating Wernicke-Korsakoff syndrome.Treatment:The goals of treatment are to control symptoms as much as possible andto prevent progression of the disorder. Hospitalization is requiredfor initial control of symptoms.

If the person is lethargic,unconscious, or comatose, monitoring and care appropriate to thecondition may be required. The airway should be monitored andprotected as appropriate.Thiamine (vitamin B-1) may improve symptoms of confusion or delirium,difficulties with vision and eye movement, and muscle incoordination.B-1 may be given by injection into a vein or a muscle, or by mouth.Thiamine does not generally improve loss of memory and intellectassociated with Korsakoff psychosis.Total abstinence from alcohol is required to prevent progressive lossof brain function and damage to peripheral nerves. A well-balanced,nourishing diet is recommended.Support groups:The stress of illness can often be helped by joining a support groupwhere members share common experiences and problems. See alcoholism -support group.Expectations (prognosis):Without treatment, Wernicke-Korsakoff syndrome progresses steadily

todeath. With treatment, symptoms such as incoordination and visiondifficulties may be controlled, and progression of the disorder may beslowed or stopped. Some of the symptoms, particularly the loss ofmemory and intellect/cognitive skills, may be permanent. There may bea need for custodial care if the loss of intellect/cognitive skills issevere. Other disorders related to the abuse of alcohol may also bepresent.Complications: * permanent loss of memory * permanent loss of cognitive/intellectual skills * injury caused by falls * difficulty with personal/social interaction * alcohol withdrawal state * permanent alcoholic neuropathy * shortened life spanCalling your health care provider:Call your health care provider if Wernicke-Korsakoff syndrome ispresent and symptoms worsen

or reappear. Also call if new symptomsdevelop, including symptoms of alcohol withdrawal: * delirium or confusion. * agitation. * jumpiness or nervousness * insomnia * hallucinations * palpitations * heart rate that is faster than normal without an observablecause such as: o increased activity. o pale skin o profuse sweating o muscle tremors o seizures o headache o

fever. o nausea/vomitingDiscuss the situation with your health care provider if you are unableto care for the person at home. Please pass this message or article on to someone else so that they may learn also.Community Newsletters.http://www.alternative-medicine-newsletter.infoCommunity Message Boards.http://www.alternative-medicine-message-boards.info"Do not let either the medical authorities or the politicians mislead you. Find out what the facts are, and make your own decisions about how to live a happy life and how to work for a better world." - Linus PaulingGetting well is done one step at a time, day by day, building health and well being..list or archives: :........ - post:............. alternative_Medicine_Forum digest form:...... -digest individual emails: -normal no email:......... -nomail moderator:........ -owner unsubscribe:...... -