A Case of Classic Beriberi in America

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thiamine deficiency beriberi in america
A desperate mother sent me an email about her 23-year-old son and it was easy to recognize that this young man had full-blown beriberi. You may or may not know that beriberi is well known as a vitamin B1 deficiency disease. Because the medical profession is convinced that this disease never occurs in America, it is usually not recognized for what it is. He had seen many physicians without success. I want to record the majority of his symptoms to show that they are surprisingly common and are usually ascribed to a “more modern” diagnosis. I have christened beriberi as the “great imitator” and I am sure that the reader will readily recognize the common nature of these symptoms, presented below in the form of a Table. It is important also to understand that these symptoms can occur for other reasons, but thiamine deficiency is widespread.

 

collapsing fatigue confusion
panic attacks loss of balance
blurred vision cluster headaches
hair loss jaundice at birth
infantile colic migraines
poor intestinal motility bloating
severe calf pain joint pains
weakness salt craving
cold extremities chemical sensitivity
POTS severe pain sensitivity

 

I want now to describe some of the features reported by this mother that were extremely important major clues. She described her son, when in good health, as 6’2”,  175 pounds, extremely athletic with “amazing hand-eye coordination and finishing college with high honors”.

As a result of his undiagnosed illness, his weight had dropped to 133 pounds. Because thiamine governs energy metabolism, an intelligent brain consumes a great deal. Of course, compromised energy production can occur for reasons other than thiamine deficiency. But there were very strong clues for beriberi. The mother described how her son

“…went out drinking with friends. The next day he could barely sit up in the car or stand. We were all commenting on why he was having such an extreme hangover”.

Alcohol would certainly exaggerate an existing thiamine deficiency. It is a well-known association. The symptoms were intermittent, rising and falling “for no apparent reason”. For example, she said that he was

“able to play sports, then lose his balance, become weak and complain of blurred vision”.

The reason for this is because the physical activity was demanding energy that could not be supplied because of the thiamine deficiency. He had jaundice at birth, now known to be because of inefficient oxygen utilization. This would indicate poor maternal diet in pregnancy or a genetic mechanism involving thiamine absorption. So-called panic attacks are common in the modern world and are absolute indicators of poor oxygen utilization in the brain. Under these conditions the reflex known as fight-or-flight would be initiated and this is what is being called panic attacks. The blurred vision would go along with this too.

Beriberi is a Form of Dysautonomia

We have two nervous systems. One maintains what we call willpower and is known as the voluntary system. The other one is known as autonomic and is entirely automatic and outside willpower. This system controls all the organs within the body. It explains why there are so many symptoms involving many parts of the body. This is because of the loss of signaling power between the organs and the brain. A lot of energy is required to run this system and explains why the autonomic nervous system is affected in beriberi. POTS is one variety of dysautonomia. This young man craved salt and that too is a form of dysautonomia is known as cerebral salt wasting syndrome, explaining the natural craving.

Thiamine deficiency beriberi in America

Is there a help from the laboratory?

The answer to this is no, as long as physicians refuse to recognize that beriberi is common in America. This unfortunate young man was diagnosed almost certainly as psychosomatic. The disease has a very long morbidity with symptoms shifting up and down according to the state of energy metabolism on a day-to-day, week-to-week and month-to-month basis. The laboratory has to look for it because the standard tests done only provide distant clues. It is the absence of the abnormal results that make it easy to conclude that this is “a psychologic disease”. For example, it was reported that this young man had an elevated vitamin B12 and a mildly elevated CRP. I cannot give the complex details here, but both are peculiarly related to energy metabolism and require understanding in order to fit them into the pattern of diagnostic clues. I have reported these facts elsewhere.

What is the hope of normal health in this person?

It stands to reason that the first thing is proper diagnosis and a knowledge of the widespread symptomatology, including their fluctuation. As long as he continues to take alcohol and sugar, he will never get his health back even if he supplements with thiamine. He is in danger of developing the classical brain disease known as Wernicke’s Encephalopathy. This state of the disease almost certainly involves cellular damage that cannot be repaired. It is therefore very urgent to understand the self-responsibility that is required. He has to learn that alcohol is potentially lethal for him. There is undoubtedly a genetic relationship between alcoholism and sugar craving and it is probably true that a search for the genetic relationship would at least be helpful in understanding the nature of this disease.

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4 Comments

  1. Dr. Lonsdale,

    I ordered your books this summer and found them to be the most important in my journey. Thank you!

    Two months ago I wrote about my air hunger, which went away after I mega dosed B1 but some more symptoms are showing up since I stopped mega dosing. My doctor emailed a list of supplements, and wanted me on a small dose then off for a month except for one week until, and plans 35 mg 6-12 months until we meet in Sept.

    I’m 53, and have had health issues since childhood. I was docile and low energy child, I remember my teacher had my hearing tested but it was never followed up on, I suppose this is when my ADD was showing up. In high school hormones imbalances from processed foods and chronic fatique started showing, I took antibiotics for acne. In 20’s, more antibiotics for strep, then yeast infections. At 35 I was on effexor for several years. A psychiatrist Dx with high frequency loss in my early 40’s.

    At 46, Dx with hashis, my antibodies were 60, and half the doctors said yes you have it, they other half said no. Antibodies are steady at 600, new doc says I might not have even have hashis. I tried Armour and it lifted my brain fog for a day and I saw vivid colors, then I got horrible side effects. Thyroid docs kept telling me to raise the grains even though my TSH goes too low, My shoulders are starting to curve. DHEA worked one week and then stopped working. I’m on estrodial/progesterone but I believe the HRT was fuel for the small fibroid. It grew to the size of a grapefruit in 3 years. B12 is always elevated in my Lab Corp labs.

    At 47, I was in DC the week of hurricane Katrina, went sight seeing in storm and felt normal. After I flew home, I lost my motor control. I was bed ridden for a month and broke a dish after I didn’t have the strengh to put away. I recovered fully after just resting. A few years later I began walking slow for no reason, accupuncture helped recover. At 50, I had wicked calf cramps and leg and edema in face and legs but ceased.

    In Feb, I had fibroid ablated. My bowels worked after I recovered from surgery then shut down after two months. I have IBS but I think I have gastroparesis. In Mar, I began taking ozone baths for a 3 months once a week (w/o functioning SOD enzymes) and I think the heat and oxidation caused air hunger and POTS in August. I’ve had insomnia for 10 years, it started when there when a bar was playing music too loud for about 6 months, then hot flashes, nocturnal itching on fingers, poor urine at night and day, dry mouth and now body heat. Being tested for MCAD and other related syndromes, GI thinks I have EoE. Lipids elevated for several years and I’m paleo. My handwriting lost form.

    The root is – I grew up on white rice – I’m Chinese. Mom is 81 high energy, low IQ, no chronic disease, her side has bad Alzheimers. Dad is 83 high energy, high IQ, sugar addict, moody, sleep issues. His dad had diabetes (in China it was a treat to get an extra bowl). Two ADD brothers are high energy, one had TC cancer at 42. I have ++SLC19A3, DHFR/MSH, FOLR2, SLC6A2 +-MTHFR 1298, SLC19A1 and a bunch of other bad ones. I look healthy, but people teased me all my life saying I have a blank stare.

    Since last Friday night I’ve been faint getting up from bed and sitting, my bpm raises by 30. After 6 days, I mega dosed 500 mg of B1 and magnesium and the dizziness and constipation went away in 24 hours. Having diarrhea though.

    I’m getting results I need from mega dosing B1 to function normal, but this is in conflict with the low and slow plan reconstituting with no immediate results.

    D-Ribose gave me an abundant amount of energy that was life changing. The energy I enjoyed for once, left my system by the fourth week and I can’t get it to work again. Genova labs from last August show I have no Mitochondria dysfunction. I’m in ketosis. Creatinine is 6.5 Pryuvic 17, and Lactic Acid 3.0. I had 6 Meyers cocktails this summer and they didn’t make me feel any better. I’m getting RBC tests run to see whats active, but trying to finesse treatments while waiting and getting accupuncture 3x’s a week.

    I eat meat, vegetables and fruit. stopped eating chocolate, but do I stop eating low sugar fruits too?

    Could a B1 tolerance develope?

    I suspect my supplements and hormones may not work because of the B1 deficiency and under methylation?

    Are there consequences with mega dosing B1, when folate snps occur?

    Sometimes I think I have wet and dry beri beri or maybe Wernickes?
    Should I see a cardiologist or neruologist at this point?

    Thoughts the blank stare, losing motor function, loss of high frequency hearing?

    1. You have classic beriberi. When you got such a result from “megadose B1”, why on earth did you cease using it? Resume your B1 and continue on a daily basis, and add magnesium.

  2. Dr. Lonsdale,

    Thanks for the post. The story above is very similar to mine and I appreciate you socializing the issue. I can relate to the waxing and waning of symptoms over days and weeks. I now have salt cravings, POTS/dysautonomia symptoms, fatigue, panic attacks, etc. I was 5’11’ 160 lbs before I became ill 3 years ago. I now weight 124 lbs. I shared some of my story in the comments field of the article Navigating Thiamine Supplements. I am trying to find a way out of this mess. I hope that Thiamine replenishment is the answer, but as stated previously, I continue to feel like I am flying blind due to lack of knowledge.

    1. Unfortunately, you are flying blind! This is because the physicians that you have been to have two biases.
      1. They absolutely refuse to believe that thiamin deficiency occurs in America in spite of the huge intake of sugar, carbonated beverages, alcohol, chocolate etc. We have known for years that this excess of carbohydrate junk induces thiamin deficiency.
      2. They do not recognize the polysymptomatic nature that results from energy deficiency. The customary laboratory studies, with some exceptions, are normal and they conclude that the symptoms are generated by the patient’s imagination and called psychosomatic.
      I advise you to look up my books on Amazon by typing in my name, Derrick Lonsdale. You will find the latest one very technical and much more expensive than “A Nutritional Approach to a Revised Model for Medicine”, written for the general reader.

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