{"id":4422603,"date":"2025-01-12T07:15:29","date_gmt":"2025-01-12T13:15:29","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/topics\/beriberi\/"},"modified":"2025-01-12T07:43:22","modified_gmt":"2025-01-12T13:43:22","slug":"beriberi","status":"publish","type":"oen_topic","link":"https:\/\/myendoconsult.com\/learn\/topics\/beriberi\/","title":{"rendered":"Beriberi"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">OVERVIEW OF B1 DEFICIENCY<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Vitamin B1 (thiamine)<\/strong> is water-soluble, comprised of a pyrimidine and a thiazole ring.<\/li>\n\n\n\n<li><strong>Dietary sources<\/strong>: Whole-grain cereals, whole-wheat bread, brown rice, legumes, yeast, fresh meats (especially pork).<\/li>\n\n\n\n<li><strong>Stability<\/strong>: Destroyed by high temperature and alkaline pH (cooking\/baking\/pasteurization can reduce bioactivity).<\/li>\n\n\n\n<li><strong>Absorption<\/strong>: Occurs in the <strong>jejunum and ileum<\/strong>; once in blood, thiamine binds <strong>albumin<\/strong> and enters cells by passive diffusion + active transport.<\/li>\n\n\n\n<li><strong>Tissue distribution<\/strong>: Heart, skeletal muscle, brain, liver, kidney.<\/li>\n\n\n\n<li><strong>Half-life &amp; storage<\/strong>: Biologic half-life 10\u201320 days; no large tissue depot \u2192 continuous dietary intake required.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">BIOCHEMICAL ROLE<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Cofactor<\/strong> for enzymes in carbohydrate and amino acid metabolism:\n<ul class=\"wp-block-list\">\n<li>Converts <strong>pyruvate<\/strong> to <strong>acetyl coenzyme A<\/strong>.<\/li>\n\n\n\n<li>Functions in the pentose phosphate pathway.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Essential for normal nerve conduction<\/strong>.<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">BERIBERI<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Cause<\/strong>: Nutritional deficiency in thiamine.<\/li>\n\n\n\n<li><strong>Populations<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Breastfed infants of thiamine-deficient mothers.<\/li>\n\n\n\n<li>Children\/adults consuming polished rice or high <a href=\"https:\/\/myendoconsult.com\/learn\/intravenous-thiamine-administration-prior-to-glucose-infusions-in-alcoholics\/\" data-wpil-monitor-id=\"299\">alcohol \u2192 poor thiamine<\/a> intake.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Clinical features<\/strong>:\n<ol class=\"wp-block-list\">\n<li><strong>Infantile beriberi (by ~2 months)<\/strong>:\n<ul class=\"wp-block-list\">\n<li>CNS issues: vomiting, nystagmus, purposeless movements, seizures.<\/li>\n\n\n\n<li>Cardiac disease: cardiomegaly, tachycardia, cyanosis.<\/li>\n\n\n\n<li>Sudden death if untreated.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Adult beriberi<\/strong>:\n<ul class=\"wp-block-list\">\n<li><strong>Dry beriberi<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Predominantly neurologic.<\/li>\n\n\n\n<li>Symmetric peripheral neuropathy (distal paresthesias), muscle weakness (foot\/wrist drop), muscle wasting, possible aphonia, emaciation.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Wet beriberi<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Predominantly cardiac.<\/li>\n\n\n\n<li>Cardiomegaly, congestive heart failure signs (dyspnea, orthopnea, edema, tachycardia).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<\/li>\n\n\n\n<li><strong>Treatment<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Supportive care + <strong>thiamine supplementation<\/strong>:\n<ul class=\"wp-block-list\">\n<li>IV or IM: 50\u2013100 mg daily for ~2 weeks.<\/li>\n\n\n\n<li>Then oral dose: ~10 mg\/day until full recovery.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Evaluate for coexisting <a href=\"https:\/\/myendoconsult.com\/learn\/topics\/vitamins\/\" data-wpil-monitor-id=\"297\">vitamin<\/a> deficiencies.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">WERNICKE-KORSAKOFF SYNDROME<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Most severe thiamine deficiency<\/strong> in adults.<\/li>\n\n\n\n<li><strong>Wernicke encephalopathy<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Ophthalmoplegia (6th <a href=\"https:\/\/myendoconsult.com\/learn\/mnemonic-cranial-nerves-dirty-surprise\/\" data-wpil-monitor-id=\"298\">cranial nerve<\/a> palsy), nystagmus, ataxia, confusion \u2192 may progress to coma.<\/li>\n\n\n\n<li>Commonly in alcoholics (poor thiamine intake + depletion).<\/li>\n\n\n\n<li>Requires urgent treatment: <strong>50 mg IV thiamine<\/strong> daily, then oral.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Korsakoff syndrome<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Chronic phase after Wernicke encephalopathy.<\/li>\n\n\n\n<li>Marked by impaired short-term memory, confabulation.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">DIAGNOSIS<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Blood thiamine measurement<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Reference range: 80\u2013150 nmol\/L.<\/li>\n\n\n\n<li>Levels &lt;80 nmol\/L suggest deficiency.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h2 class=\"wp-block-heading\">PREVENTION<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Recommended dietary allowance (RDA)<\/strong> for thiamine:\n<ul class=\"wp-block-list\">\n<li>Men: 1.2 mg\/day<\/li>\n\n\n\n<li>Women: 1.0 mg\/day (1.4 mg in pregnancy\/lactation)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Easy to obtain<\/strong> from a nutritionally balanced diet rich in:\n<ul class=\"wp-block-list\">\n<li>Whole grains<\/li>\n\n\n\n<li>Legumes<\/li>\n\n\n\n<li>Yeast<\/li>\n\n\n\n<li>Fresh meats<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>OVERVIEW OF B1 DEFICIENCY BIOCHEMICAL ROLE BERIBERI WERNICKE-KORSAKOFF SYNDROME DIAGNOSIS PREVENTION<\/p>\n","protected":false},"featured_media":0,"template":"","oen_topic_chapter":[689],"class_list":["post-4422603","oen_topic","type-oen_topic","status-publish","hentry","oen_topic_chapter-obesity-medicine","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422603","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/oen_topic"}],"version-history":[{"count":4,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422603\/revisions"}],"predecessor-version":[{"id":4422607,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic\/4422603\/revisions\/4422607"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=4422603"}],"wp:term":[{"taxonomy":"oen_topic_chapter","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/oen_topic_chapter?post=4422603"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}