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Last updated July 17, 2018

Approved by: Maulik P. Purohit MD, MPH

Beriberi (or Beri Beri) is a disease state caused by a deficiency of vitamin B1, also known as thiamine. Thiamine sources include liver, eggs, rice, whole grain cereal, and wheat.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Beri Beri
  • Thiamine Deficiency
  • Vitamin B1 Deficiency

What is Beriberi? (Definition/Background Information)

  • Beriberi (or Beri Beri) is a disease state caused by a deficiency of vitamin B1, also known as thiamine. Thiamine sources include liver, eggs, rice, whole grain cereal, and wheat
  • Apart from thiamine deficiency, Beriberi may be caused by chronic alcohol consumption, positive family history of the condition, or high intake of diuretics
  • The clinical presentations of Beriberi include neurological symptoms, heart-related symptoms, loss of muscle function, paralysis, and even respiratory problems
  • If Beriberi is not diagnosed early and treated appropriately, it could give rise to complications, which could even lead to death
  • With suitable early treatment using vitamin B1 supplementation (oral or intravenous), the prognosis for Beriberi is generally good
  • There are two categories of Beriberi:
    • Wet Beriberi, associated with the cardiovascular system
    • Dry Beriberi, associated with the nervous system

Who gets Beriberi? (Age and Sex Distribution)

  • Beriberi occurs in individuals, who have a decreased intake/absorption of the vitamin thiamine. This is seen with consumption of non-enriched rice (such as taking place in some underdeveloped or developing countries) and with chronic alcoholism
  • Beriberi can be linked genetically, where the disease state can be passed down through generations. In such a case, the onset of this deficiency disorder is usually slow and observed predominantly in adulthood
  • Infants fed with breast milk/formula milk deficient in thiamine can develop this Beriberi

What are the Risk Factors for Beriberi? (Predisposing Factors)

Following are the risk factors for Beriberi:

  • Excessive alcohol consumption
  • Genetic transmission of the condition
  • Decreased thiamine intake
  • Intake of diuretics at high doses
  • Longstanding dialysis
  • Surgery of the gastrointestinal system

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Beriberi? (Etiology)

Beriberi may be caused by the following factors:

  • Decreased thiamine intake and decreased thiamine absorption by the body
  • Chronic alcoholism
  • Vertical transmission by a genetic component: This means Beriberi can be caused by a genetic condition wherein an individual cannot utilize vitamin B1
  • Dietary deficiency caused  by a decreased uptake, seen in certain impoverished regions of the world
  • Individuals taking high doses of diuretics

What are the Signs and Symptoms of Beriberi?

Beriberi signs and symptoms are associated with whether the type of Beriberi is wet or dry.

Wet Beriberi signs and symptoms include:

  • Increased in heart rate
  • Shortness of breath observed with physical activity, during nocturnal hours
  • Edema of the lower extremities

Dry Beriberi signs and symptoms include:

  • Dysthesia in hands/feet
  • Pain (in the legs)
  • Vomiting
  • Weight loss
  • Pain in the anus
  • Nystagmus
  • Mental confusion
  • Loss of muscle function
  • Paralysis of the lower legs

How is Beriberi Diagnosed?

Beriberi may be diagnosed in the following manner:

Physical exam with medical history evaluation: The physical examination can show indications of a congestive heart failure with the following signs and symptoms.

  • Cardiomegaly
  • Difficulty breathing with neck veins being observed
  • Bilateral edema in the legs
  • Fluid present in the lungs
  • Rapid heart rate or tachycardia

The physical examination can also show some neurological symptoms. These symptoms manifest themselves in the following manner:

  • Drooping of the eyelid (dyplopia)
  • Decrease in the reflexes
  • Change in the individual’s walk
  • Loss of coordination

When either cardiovascular or neurological signs are observed upon a physical exam in individuals with Beriberi, the following confirmatory tests are initiated:

  • Measurement of thiamine levels in blood
  • Urinalysis for evidence of thiamine
  • Blood lactic acid level
  • Blood pyruvic acid level

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Beriberi?

Complications of Beriberi can include the following:

  • Congestive heart failure (CHF)
  • Coma
  • Psychosis called Wernicke’s disease

Death may occur in severe Beriberi, if the condition is not promptly treated.

How is Beriberi Treated?

  • The main treatment for Beri Beri is thiamine (vitamin B1) replacement therapy
  • This is done via thiamine supplementation either by mouth (PO) or through injections

How can Beriberi be Prevented?

Beriberi is a deficiency disorder that can be prevented. The following measures may be considered:

  • Regular consumption of foods containing thiamine, such as liver, eggs, rice, whole grain cereal, and wheat
  • Alcoholics should cease drinking alcohol or limit alcohol consumption to a minimum
  • Mothers, who are thiamine deficient, should begin thiamine supplementation prior to breast feeding

What is the Prognosis of Beriberi? (Outcomes/Resolutions)

  • Beriberi is a vitamin B1 deficiency disorder that can be treated to full recovery. Although, untreated Beriberi can eventually lead to death
  • Commencing thiamine supplementation can cause an improvement in the symptoms
  • If congestive heart failure occurs, the prognosis is poor. Longstanding congestive heart failure can make the prognosis worse
  • Nervous system signs and symptoms usually improves with early treatment

Additional and Relevant Useful Information for Beriberi:

  • If Beriberi occurs in infants, it is called Infantile Beriberi
  • If Beriberi occurs in the GI system, it is called Gastrointestinal Beriberi

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Dec. 16, 2015
Last updated: July 17, 2018