Beriberi – Understanding the Disease

Beriberi is a serious nutritional deficiency disorder caused primarily by inadequate levels of Vitamin B1 (Thiamine), an essential nutrient required for carbohydrate metabolism, nerve conduction, brain function, and energy production. When the body lacks sufficient thiamine over a continuous period, cells lose the ability to convert food into usable energy, resulting in exhaustion, nerve degeneration, muscle weakness, and cardiovascular instability. The disease is particularly common among individuals with chronic malnutrition, alcoholism, gastrointestinal absorption disorders, or those consuming polished rice as staple food.

There are two major types of Beriberi:

1. Dry Beriberi, which affects the nervous system

2. Wet Beriberi, which primarily affects the heart and circulatory system

A third form exists known as Infantile Beriberi, seen in breastfed infants whose mothers are thiamine-deficient.

As the deficiency worsens, the body’s tissues begin to deteriorate, nerve signals weaken, muscles shrink, blood circulation slows, and the heart becomes unable to pump efficiently. Without urgent correction, Beriberi can result in paralysis, respiratory failure, heart failure, coma, and death. Although medical science highlights nutrient deficiency, Ayurveda describes it as a deeper systemic imbalance affecting Vata and Rasa-Dhatu metabolism.

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Causes of Beriberi

The primary cause of Beriberi is prolonged Thiamine (Vitamin B1) deficiency, but underlying contributing factors differ depending on lifestyle, diet, medical disorders, and digestive impairment.

Major causes include:

Poor diet lacking whole grains, pulses, nuts, and seeds

Excess consumption of polished or white rice

Chronic alcoholism affecting nutrient absorption

Gastrointestinal diseases preventing thiamine absorption

Hyperthyroidism and high metabolic demand

Pregnancy and breastfeeding increasing nutritional requirement

Bariatric or gastrointestinal surgery reducing absorption

Prolonged diarrhea and malabsorption syndrome

HIV infection or immunocompromised state

Chronic liver disease damaging storage and conversion of thiamine

Use of diuretics increasing thiamine excretion

Dialysis patients losing water-soluble vitamins

Extreme starvation or eating disorders

Long-term consumption of junk food without micronutrients

Dry Beriberi is mainly associated with neurological degeneration due to Vata impairment, while Wet Beriberi results from circulatory and cardiac weakness due to Rasa-Ojas depletion.

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Signs & Symptoms of Beriberi

The symptoms of Beriberi depend on whether the disorder is affecting the nervous system (Dry Beriberi) or cardiovascular system (Wet Beriberi). As the deficiency progresses, several severe complications develop.

Symptoms of Dry Beriberi

Tingling sensation, numbness, burning in hands and feet

Muscle weakness and gradual paralysis

Difficulty walking, imbalance and loss of coordination

Reduced reflexes or absent knee reflex

Memory loss, confusion, difficulty concentrating

Severe fatigue with minimal activity

Nerve pain and sensitivity

Speech difficulty and emotional instability

Symptoms of Wet Beriberi

Shortness of breath on mild exertion

Rapid heartbeat and irregular pulse

Swelling of legs, ankles, and feet due to fluid retention

Enlarged heart and weak cardiac muscles

Chest discomfort and pressure

Sudden heart failure and collapse

Extreme exhaustion even after rest

Symptoms in Infants

Difficulty breathing and weak cry

Vomiting and irritability

Seizures and bluish skin due to low oxygen

Sudden cardiac failure

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Diagnostic Methods for Beriberi

Diagnosis of Beriberi involves evaluating nutritional history, neurological examination, cardiac assessment, and blood tests determining thiamine levels.

Major diagnostic tools include:

Blood measurement of Thiamine and Thiamine Pyrophosphate

Erythrocyte Transketolase Activity test

Complete Blood Count

Liver Function test

Electromyography (EMG) and Nerve Conduction velocity tests

ECG and Echocardiography for heart function

MRI scan in severe neurological involvement

Urine test for thiamine excretion

Clinical dietary assessment and physical examination

Response to thiamine supplementation as confirmation

In infants, diagnosis is often rapid due to severe cardiac distress symptoms.

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Beriberi – Ayurvedic View

In Ayurveda, Beriberi resembles a condition called Vatakshaya and Vatavritta Prameha, caused by Vata aggravation combined with Dhatu-kshaya, particularly Rasa, Majja, and Mamsa Dhatu depletion. Improper diet, weak digestion, and poor absorption lead to formation of Ama and obstruction of Srotas (microchannels). As Vata governs nerve impulses and muscle function, its imbalance results in neurological degeneration, muscle wasting, tremors, paralysis, breathlessness, and heart weakness.

Ayurveda explains Wet Beriberi as Hrid-Dourbalya or Hridroga, which arises from disturbance of Vyana Vata and Ojas depletion, causing weakened cardiac pumping and fluid retention. Infantile Beriberi is related to Stanya-Dushti (impure or deficient breast milk).

Ayurvedic management focuses on:

Restoring digestive fire (Agni)

Replenishing depleted dhatus (Tissue rejuvenation)

Calming aggravated Vata

Improving nerve conduction and heart strength

Nourishing Rasa Dhatu and improving circulation

Balancing metabolic function

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Herbal Remedies for Beriberi

Ayurvedic herbs help rebuild nerve strength, nourish muscles, boost heart function, and enhance metabolism to restore cellular vitality.

Powerful Ayurvedic Herbs for Beriberi

Ashwagandha – strengthens muscles and nervous system

Brahmi – enhances cognitive ability and nerve function

Shatavari – supports nourishment and tissue regeneration

Amla – powerful Rasayana, improves digestion and nutrient absorption

Giloy (Guduchi) – boosts immunity and cellular metabolism

Punarnava – reduces swelling and supports cardiac function

Arjun Chhal – strengthens heart muscles and improves circulation

Guggul – balances metabolism and clears Ama

Bala (Sida Cordifolia) – rejuvenates nerves and muscles

Jatamansi – stabilizes mind and controls stress

Dashmool – excellent for Vata pacification

Musta and Pippali – improve absorption of nutrients

Hingwashtak Churna – corrects digestion and gas problems

Ayurvedic Therapies

Abhyanga (medicated oil massage)

Basti (medicated enema) – primary Vata therapy

Shirodhara for neurological balance

Swedana (herbal steam)

Nasya for nervous rejuvenation

Diet and Lifestyle

Warm freshly cooked meals

Whole grains, millets, legumes, nuts, seeds, ghee

Avoid polished rice, alcohol, junk foods

Gentle yoga, pranayama, meditation

Adequate sleep and stress control

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Conclusion

Beriberi is a serious nutritional and metabolic disorder that must not be ignored. Early detection and thiamine supplementation can reverse the condition, while severe untreated cases may result in permanent nerve damage or heart failure. Ayurveda provides a comprehensive approach by restoring Vata balance, nourishing depleted tissues, improving digestion, and strengthening the heart and nervous system. A combination of herbal treatment, lifestyle correction, balanced diet, and regular monitoring supports complete healing and prevents recurrence.