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Thiamine deficiency

life science Maturity 7-9 Next article →

Thiamine deficiency is a medical condition caused by low levels of thiamine, also known as vitamin B1. When this deficiency becomes severe and chronic, it results in a disease known as beriberi. The name beriberi may have originated in the 18th century from the Sinhalese phrase "bæri bæri," which means "I cannot, I cannot." This name reflects the extreme physical weakness felt by those suffering from the condition.

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Thiochromes

To understand how this deficiency works, we must look at how cells produce energy. Thiamine is converted in the body into a derivative called thiamine pyrophosphate, or TPP. This TPP acts as a cofactor, which is a helper molecule, in the citric acid cycle. The citric acid cycle is a central metabolic pathway that regulates the metabolism of carbohydrates, lipids, and amino acids. When thiamine is low, this cycle is disrupted. This disruption inhibits the production of many vital molecules, including the neurotransmitters glutamic acid and GABA.

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Thiochromes

Beriberi is categorized into four distinct types based on which bodily systems are affected. Dry beriberi primarily targets the peripheral nervous system. It can cause wasting, partial paralysis, and difficulty walking. It may also result in sensory issues like numbness or tingling in the hands and feet. Wet beriberi affects the cardiovascular system and other bodily systems. This type can cause a fast heart rate and edema, which is the swelling of bodily tissues.

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Thiochromes

Two other types provide even more specific medical categories. Gastrointestinal beriberi was recognized in 2004 and specifically affects the digestive system, causing abdominal pain, nausea, and vomiting. Infantile beriberi occurs in babies, usually between two and six months of age. This often happens to children whose mothers had inadequate thiamine intake. In its acute form, infantile beriberi can cause a baby to develop cyanosis, a bluish skin color, and can lead to heart failure.

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Thiochromes

Dry beriberi is also closely linked to specific brain diseases. Wernicke's encephalopathy is a neuropsychiatric disorder characterized by abnormal eye movements, an abnormal gait, and deranged mental function. Korsakoff syndrome, sometimes called alcohol amnestic disorder, can occur as brain function deteriorates following Wernicke's encephalopathy. This syndrome is characterized by amnesia, which is a loss of memory, and a decrease in spontaneity or initiative.

Thiochromes
Thiochromes

History shows that thiamine deficiency has been described in Asia for thousands of years. However, it became more common in the late 1800s due to increased rice processing. This processing can remove the thiamine found in the grain. While rare in most of the developed world, the condition remains common in sub-Saharan Africa and in refugee camps. Alcoholism is a major risk factor because alcohol can interfere with how the body absorbs and uses thiamine.

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Thiochromes

Diagnosis involves looking for specific clinical signs and laboratory results. Doctors may check for high blood lactate or low levels of thiamine in the urine. One common test is the erythrocyte transketolase activation assay, which measures the activity of an enzyme in red blood cells. Treatment is straightforward and involves thiamine supplementation via oral doses or injections. Most symptoms generally resolve within a few weeks of starting treatment. On a larger scale, many populations prevent this through the fortification of food, which means adding thiamine back into common staples.

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Thiochromes
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