Thiamine is a water soluble, B-complex vitamin also known as vitamin B-1, which is essential in carbohydrate metabolism and neural function. Deficiency of thiamine results in nerve and heart disease 'Beriberi,' termed as dry, wet or cerebral depending on which systems are affected in the body. Severe thiamine deficiency affects the cardiovascular, nervous, muscular, and gastrointestinal systems.
Dry Beriberi
Dry beriberi also known as paralytic or nervous beriberi is characterized by peripheral neuropathy, with burning feet syndrome as the earliest sign. Other symptoms include abnormal reflexes, diminished sensation, weakness in legs and arms followed by muscle pain and tenderness. Severe deficiency may result in seizures.
Wet Beriberi
Wet or Cardiac beriberi is symbolized by cardiac signs such as rapid heart rate, enlargement of the heart, edema-severe swelling, difficulty breathing and ultimately congestive heart failure.
Cerebral Beriberi
Cerebral beriberi leads to Wernicke-Korsakoff syndrome, seen in chronic alcoholics who derive more than half of their daily calories from ethanol and not seen in binge drinkers. In the book ''Vitamins: Their Role In The Human Body," author G. Ball describes, that the disease is characterized by clinical signs such as eye abnormalities, in coordination and altered state of consciousness. The eye signs are caused by paralysis of one or more of the eye muscles leading to photophobia, nystagmus-oscillation of eyeballs, crossed eyes, and double vision. In advanced cases, there may be complete loss of eye movement and the pupils may become non-reactive. The disorder of coordination is seen as broad based stance and staggering gait. Korsakoff's amnesia includes mental signs such as listlessness, inattentiveness, apathy, confusion, and delirium. In extreme cases, it may lead to stupor and coma.
Causes of Deficiency
Inadequate intake of thiamine is the main cause of thiamine deficiency especially in low-income population whose diets are low in carbohydrates and thiamin, with consumption of polished rice. Breast-fed infants and alcoholics are also vulnerable to deficiency due to low intakes of thiamine. Conditions resulting in increased requirement for thiamin such as physical exertion, fever, infections, pregnancy, and breast-feeding, or excessive loss of thiamine from the body as seen in kidney failure and use of diuretics and alcohol may also exacerbate deficiency. Certain plant foods contain anti-thiamine factors that react with thiamine and render it inactive. Excessive consumption of tea, coffee, and chewing tea leaves and betel nut are associated with depletion of thiamine.
Sources of Thiamine
Excellent sources of thiamine are brewers yeast, pork chop, ham, oatmeal, wheat germ, and enriched cereals, brown rice, Brazil nuts, lentils, peas, potato, orange, and cantaloupe, respectively.
References
- ''Vitamins: Their Role in the Human Body''; G. F. M. Ball; 2004
- ''An evidence-based approach to vitamins and minerals''; Jane Higdon, Ph.D.; 2003
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