Which Vitamin Deficiency Causes Beriberi?

November 20, 2025 •

3 min read

Beriberi is a historical disease that became increasingly common in Asia in the late 1800s with the rise of polished white rice, which stripped the staple food of essential nutrients. The specific vitamin deficiency that causes beriberi is thiamine, or vitamin B1.

Quick Summary

A severe lack of thiamine, also known as vitamin B1, leads to beriberi, a condition affecting the nervous and cardiovascular systems. The disease presents in two main forms, wet and dry, with distinct symptoms related to heart failure or nerve damage. Risk factors include poor diet, alcohol misuse, and certain medical conditions.

Key Points

Thiamine Deficiency: Beriberi is caused by a severe deficiency of thiamine, also known as vitamin B1.
Wet Beriberi: Affects the heart and circulatory system, causing symptoms like a rapid heart rate, fluid retention, and heart failure.
Dry Beriberi: Impacts the nervous system, leading to peripheral neuropathy, muscle weakness, and potential paralysis.
At-Risk Groups: Alcohol use disorder, poor diet (especially polished rice), bariatric surgery, and certain medical conditions increase the risk.
Prevention: A balanced diet rich in whole grains, meat, fish, legumes, and nuts can prevent the deficiency.
Treatment: Involves thiamine supplementation, either orally or intravenously, with symptoms improving rapidly upon correction of the deficiency.

Understanding the Role of Thiamine (Vitamin B1)

Thiamine, or vitamin B1, is a water-soluble vitamin vital for metabolism, helping convert carbohydrates into energy for muscles, nerves, and the heart. The body cannot produce it and stores little, requiring regular dietary intake. A significant, consistent deficiency triggers beriberi.

The Two Primary Forms of Beriberi

Beriberi mainly appears as wet or dry forms, though symptoms can overlap.

Wet Beriberi

Wet beriberi primarily impacts the cardiovascular system, hindering the heart's pumping ability and leading to heart failure symptoms.

Cardiovascular Effects: Thiamine is crucial for heart muscle energy. Its deficiency weakens the heart, causing enlargement and rapid heartbeat.
Fluid Accumulation: Weakened circulation leads to fluid retention and swelling (edema), often in the legs and lungs.
Breathing Issues: Shortness of breath, especially with activity or lying down, is common due to lung fluid.

Dry Beriberi

Dry beriberi affects the nervous system, causing nerve damage.

Peripheral Neuropathy: Damage to peripheral nerves results in tingling, numbness, and burning in hands and feet.
Motor Function Impairment: Decreased muscle function, particularly in legs, can cause difficulty walking and paralysis.
Cognitive Issues: Mental confusion, memory problems, and irritability are frequent due to brain function impact.

Causes and Risk Factors for Thiamine Deficiency

A low-thiamine diet is the direct cause, but several factors increase risk.

Risk Factors List:

Alcohol Use Disorder: Impairs thiamine absorption and storage. Poor diet in alcoholics worsens deficiency.
Dietary Imbalances: Diets high in refined carbohydrates like polished white rice, lacking nutrients, contribute to deficiency.
Malabsorption Conditions: Disorders causing chronic diarrhea or bariatric surgery complications hinder thiamine absorption.
Increased Metabolic Need: Conditions such as hyperthyroidism, pregnancy, lactation, and fever increase the body's thiamine requirement.
Infantile Beriberi: Occurs in breastfed infants whose mothers are thiamine deficient.
Medications: High doses of diuretics can increase thiamine excretion.

Comparison of Wet vs. Dry Beriberi


Feature	Wet Beriberi	Dry Beriberi
Primary System Affected	Cardiovascular system (heart and circulatory)	Nervous system
Key Symptom	Fluid accumulation (edema) and heart failure	Peripheral neuropathy and muscle weakness
Cardiovascular Symptoms	Rapid heart rate, shortness of breath, swollen legs	Not typically present, though some overlap can occur
Neurological Symptoms	Confusion, potentially from heart failure's effect on the brain	Tingling, numbness, difficulty walking, muscle loss
Progression	Can be acute and life-threatening, requiring immediate medical attention	Develops more gradually over time

Prevention and Treatment

Preventing beriberi requires adequate dietary thiamine. Treatment is effective, especially early on.

Dietary Prevention

Eat thiamine-rich foods: whole grains, enriched products, lean meats, fish, legumes, seeds, nuts, and vegetables like asparagus and spinach.

Medical Treatment

Treating diagnosed beriberi involves quickly restoring thiamine under medical care.

Thiamine Supplements: Oral supplements for mild cases.
Intravenous Thiamine: For severe cases or Wernicke-Korsakoff syndrome.
Monitoring and Recovery: Blood tests track progress. Prompt treatment can reverse heart and nerve damage, but delays may result in permanent effects.

Conclusion

Beriberi results from severe thiamine (vitamin B1) deficiency, preventable and treatable with proper nutrition and medical intervention. Though rare in developed nations due to food fortification, it still threatens populations with alcohol use disorders, malabsorption issues, or poor diets. Recognizing the specific vitamin deficiency that causes beriberi is key to identifying symptoms and implementing preventive and corrective measures for cardiovascular and neurological health.

Frequently Asked Questions

The primary cause of beriberi is a severe and prolonged deficiency of thiamine, which is also known as vitamin B1.

There are two main types: wet beriberi, which affects the cardiovascular system, and dry beriberi, which damages the nervous system.

Excessive alcohol consumption interferes with the body's ability to absorb and store thiamine, and it is often associated with poor nutrition, further depleting vitamin B1 levels.

If left untreated, beriberi can be fatal, especially the wet form, which can lead to acute heart failure within a short period.

Early symptoms can be vague and include fatigue, irritability, loss of appetite, and a tingling sensation in the hands and feet.

Diagnosis is based on symptoms, physical examination, and blood or urine tests to measure thiamine levels. Response to thiamine supplementation can also confirm the diagnosis.

Thiamine-rich foods include whole grains, enriched breads and cereals, pork, fish, nuts, seeds, and legumes.