From the Guidelines
Beriberi should be treated with immediate thiamine supplementation, typically 100mg intravenously for severe cases, followed by 50-100mg daily orally until symptoms resolve, as recommended by the most recent guidelines 1. The disease presents in two main forms: wet beriberi, which affects the cardiovascular system causing heart failure and edema, and dry beriberi, which damages the peripheral nerves leading to muscle weakness and sensory disturbances. Key points to consider in the treatment of beriberi include:
- The dose and route of thiamine administration, with intravenous administration being the most efficient in severe cases 1
- The importance of early treatment to prevent permanent neurological damage or heart failure 1
- The need for maintenance therapy with oral thiamine, typically 50-100mg daily 1
- The recommendation to maintain a thiamine-rich diet including whole grains, legumes, nuts, and pork after treatment Beriberi commonly affects people with alcoholism, those with malabsorption conditions, or populations relying on polished rice as a dietary staple, and the disease occurs because thiamine is essential for carbohydrate metabolism and nerve function, and the body cannot produce it naturally 1. In cases of suspected chronic deficiency without acute disease, the oral route is adequate, but in cases of acute disease or suspicion of inadequate intake, even short-term, the intravenous route should be used 1.
From the FDA Drug Label
Indications and Usage Thiamine hydrochloride injection is effective for the treatment of thiamine deficiency or beriberi whether of the dry (major symptoms related to the nervous system) or wet (major symptoms related to the cardiovascular system) variety
- Thiamine hydrochloride injection is used to treat beriberi, which can be of the dry or wet variety.
- The treatment is indicated for thiamine deficiency and is effective for rapid restoration of thiamine in certain conditions, including Wernicke’s encephalopathy and infantile beriberi 2.
From the Research
Definition and Causes of Beri Beri
- Beri beri is a disease caused by thiamine deficiency (TD) 3, which may lead to heart problems, including heart failure.
- Thiamine deficiency can be caused by various factors, including dietary deficiency, chronic alcohol consumption, and certain medical conditions such as gastric surgery 4.
Symptoms and Diagnosis of Beri Beri
- The symptoms of beri beri can be non-specific, making diagnosis challenging 3, 5.
- Wet beriberi is characterized by haemodynamic and biochemical features, including hypotension, high cardiac output, low peripheral vascular resistance, lactic acidosis, and high mixed venous content 6.
- Diagnosis of beri beri can be made by measuring serum thiamine concentration and responding to thiamine administration 5.
Treatment and Prevention of Beri Beri
- Treatment of beri beri involves administration of thiamine, which can remarkably reverse the symptoms of the disease 6, 5.
- Prevention of beri beri can be achieved through dietary education and long-term follow-up to determine nutritional status, including vitamin and mineral assessment, especially in patients who undergo gastric surgery 4.
- Prompt recognition and administration of supplemental thiamine can decrease morbidity and mortality in patients with beriberi 4.