Thiamine Deficiency

Thiamine was the first vitamin identified (vitamin B1) many years ago. It serves as a cofactor for several enzymes involved in energy metabolism. The thiamine-dependent enzymes are important for the biosynthesis of neurotransmitters and for the production of reducing substances used in oxidant stress defenses, as well as for the synthesis of pentose used as nucleic acid precursors.

There are 2 major manifestations of thiamine deficiency: cardiovascular disease (wet beriberi) and nervous system disease (dry beriberi and Wernicke–Korsakoff syndrome).

The most striking clinical signs of thiamine deficiency are related to the nervous system. Polyneuritis and paralysis of the peripheral nerves predominate. Manifestations are seen in the autonomic, the sensory, and the motor systems. In the sensory system tactile sensation is first affected, then there is pain, and finally temperature sensitivity is altered.

The disease beriberi (which means ‘‘sheep’’) was first described by Jacobus Bonitus, a Dutch physician, in Java, in 1630. He described patients ‘‘with their knees shaking and legs raised up, walk like sheep. It is a kind of paralysis, or rather tremor ...’’ The first insight into the real cause of beriberi came in the 1880s in the Japanese Navy, when a correlation between the sailors’ diet and beriberi was noted.
Thiamine Deficiency