Beriberi is a vitamin deficiency disease in which the body does not have enough thiamine (vitamin B1).

There are two major types of beriberi:

• Wet beriberi affects the cardiovascular system.
• Dry beriberi and Wernicke-Korsakoff syndrome affect the nervous system.

Beriberi is now rare in the United States because most foods are now vitamin-enriched, which means that if you eat a normal, healthy diet you get enough thiamine. Today, beriberi occurs mostly in patients who abuse alcohol, because drinking heavily can lead to bad nutrition and makes it harder for the body to absorb and store thiamine.

There is a rare condition known as genetic beriberi. This condition is inherited (passed down through families). People with genetic beriberi lose the ability to absorb thiamine from foods. This can happen slowly over time and symptoms occur when the person is an adult. However, since beriberi may not be considered in non-alcoholics, this diagnosis is often missed.

Beriberi can also occur in breast-fed infants when the mother's body is lacking in thiamine. The condition can also affect infants who are fed unusual formulas with inadequate thiamine supplements.

Dialysis and high doses of diuretics raise your risk of beriberi.

Symptoms of dry beriberi include:

• Pain
• Tingling
• Loss of feeling (sensation) in hands and feet
• Muscle damage with loss of muscle function or paralysis of the lower legs
• Vomiting
• Strange eye movements (nystagmus)
• Mental confusion/speech difficulties
• Difficulty walking
• Coma
• Death

Symptoms of wet beriberi include:

• Swelling of the lower legs
• Increased heart rate
• Lung congestion
• Enlarged heart related to congestive heart failure
• Shortness of breath with activity
• Awakening at night short of breath

A physical examination may show signs of congestive heart failure, including swelling in both the lower legs, fluid in the lungs, rapid heartbeat, and difficulty breathing with neck veins that stick out.

A person with late-stage beriberi may be confused or have memory loss and delusions. The person may be less able to sense vibration. A neurological exam may show signs of decreased reflexes, changes in the person's walk, coordination problems, drooping of the eyelids, and other changes.

The following tests may be done:

• Blood tests to measure the amount of thiamine in the blood
• Urine tests to see if thiamine is passing through urine