Not many vitamin-deficiency disorders occur in the U.S. any more. For all the faults in the American diet, most people escape such disorders as scurvy, rickets and beriberi. Beriberi is the disorder caused by a lack of thiamine, or Vitamin B1, in the diet. This vitamin helps convert carbohydrates into energy and aids in heart, muscle and nervous function.
Beriberi has probably been around for millennia, but has only been given a name in the past few hundred years. The name is Sinhalese for “I cannot, I cannot,” probably referring to the fatigue and lassitude often experienced by those with the disorder. Two Dutch physicians, Bontius and Nicolaas Tulp, wrote the first clinical descriptions of the disease in 1642. However, it was 200 or more years later that the disorder was recognized as related to diet.
Beriberi was first most commonly seen in Japan and in other countries where a diet of white rice was the staple food. Polishing the husks from rice destroys the B1 component. In that day and age, poor people mixed their rice with barley, and so escaped beriberi. It was largely a disease of the white-rice-eating upper class. Asian sailors ate mostly white rice every day, and they were also prey to beriberi. It wasn’t until the early 20th century that scientists and doctors understood that beriberi was the result of a vitamin deficiency and that it was easily treated.
Beriberi comes in two forms, “wet,” which affects the heart, and “dry,” which affects the nerves. Beriberi can cause heart failure and paralysis when left untreated. Happily, it is easy to add thiamine to the diet. Consumption of fresh vegetables and fruit, legumes and meat will all help to keep the disorder from developing. Vegetarians or vegans can easily add thiamine to their diets by eating brown rice.
Chronic alcoholics sometimes develop beriberi when their livers no longer process B1. These are about the only cases a U.S. physician will ever see, although the disease can be genetic as well. However, genetic beriberi is extremely rare.
Vitamin B1 supplements are available, but with thiamine-enriched cereals and bread on the market, to say nothing of the many fruits and vegetables available, supplements are not usually necessary. Beriberi is a condition that few doctors in developed countries ever treat.