| In developed nations, Thiamine deficiency occurs in
alcoholics or food faddists and in special clinical situations. In developing countries,
the deficiency is due to consumption of milled rice or foods containing thiaminases. Causes
Thiamine deficiency in alcoholics is due to low thiamine intake due to loss of
appetite, impaired thiamine absorption and storage and varying degrees of energy
expenditure.
Signs and symptoms
Severe thiamine deficiency leads to a condition known as beriberi. The major symptoms
are related to the nervous system (dry beriberi) and the cardiovascular system (wet
beriberi).
Many of the neurological signs and symptoms are characteristic of peripheral neuritis,
with sensory disturbances in the extremities. Muscle strength is lost gradually and may
result in wrist drop or complete paralysis of a limb. Personality disturbances,
depression, lack of initiative and poor memory may also result. In extreme cases Wernicke
Korsakoff's Syndrome - characterised by vomiting, palsies of the rectal muscles, fever,
failure of muscle coordination, and progressive mental deterioration that eventuates in a
global confusion state and may progress to coma and death - may occur.
Cardiovascular symptoms can include dyspnea* on exertion, palpitation, tachycardia**, and
other cardiac abnormalities characterized by abnormal ECG and cardiac failure of the
high-input type.
* Laboured breathing
** Abnormally rapid heart rate
Prevention and Treatment
Alcoholic neuritis patients should receive doses of oral Thiamine daily and in extreme
cases, appropriate doses should be administered intravenously.
Vitamin B1
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