With a lack of vitamin B1, the body develops. Vitamin B1 (Thiamin)

(thiamine). Hypovitaminosis and vitamin B deficiency (beriberi, alimentary polyneuritis) occur when there is a lack of this vitamin in food (predominant diet of polished rice in the countries of Eastern and South-East Asia), violation of its absorption in the intestines and assimilation (with severe lesions intestines, occurring with malabsorption, persistent vomiting, prolonged diarrhea etc.).Pregnancy and lactation, heavy physical labor, febrile diseases, thyrotoxicosis, predispose to the development of the disease. Daily requirement An adult's vitamin B content is about 2 mg. Vitamin B. is part of a number of enzymes involved in carbohydrate metabolism; in the body it turns into cocarboxylase, which is a prosthetic group of enzymes involved in carbohydrate metabolism. In the development of the full clinical picture of vitamin B deficiency, concomitant deficiency of other B vitamins is also important.
Clinical picture. The disease is characterized by widespread lesions peripheral nerves(polyneuritis), of cardio-vascular system and swelling. The first complaints are general weakness, fatigue, shortness of breath and palpitations during physical activity. Then the phenomena of polyneuritis are added:
paresthesia and depression skin sensitivity lower limbs, and later in other parts of the body, a feeling of heaviness and weakness in the legs, fatigue when walking, lameness. Calf muscles become hard and painful on palpation. The gait of beriberi patients is characteristic: they step on the heel and then the outer edge of the foot, sparing the toes. Then they fade away tendon reflexes, arise muscle atrophy. Disruption of the cardiovascular system is manifested by tachycardia, dystrophic changes in the heart muscle with circulatory failure, decreased blood pressure, mainly diastolic. Symptoms of dystrophic lesions and organ dysfunctions are also observed. digestive system, visual impairments, mental disorders. According to the prevailing symptoms, the edematous form is distinguished (with more pronounced lesions cardiovascular system and edema) and dry (with a predominant lesion nervous system), as well as an acute, malignant “fulminant” form, often ending in death. It is difficult to recognize beriberi in young children childhood.
Diagnosis established on the basis of anamnesis data (nature of nutrition, presence of diseases contributing to the manifestation of thiamine deficiency), characteristic changes in the cardiovascular and nervous systems; the diagnosis is confirmed by biochemical studies: there is evidence of a decrease in the thiamine content in daily urine below 100 mcg, in hourly (fasting) urine - below 10 mcg, the content of cocarboxylase in erythrocytes is below 20-40 mcg/l. Characterized by an increase in content pyruvic acid in plasma (above 0.01 g/l) and increased excretion in urine (more than 25 mg/day). Recently, a number of more complex modern methods have also been used for this purpose.
Differential diagnosis with infectious (poliomyelitis, diphtheria, etc.) and toxic polyneuritis (mercury poisoning, methyl alcohol, phosphorus, etc.) is based on taking into account the epidemic situation, medical history, as well as the results biochemical research thiamine metabolism. The differential diagnosis of the edematous form of beriberi with myocarditis and myocardial dystrophies is facilitated by the presence of symptoms of polyneuritis.
Treatment in severe and moderate severity inpatient cases. Bed rest. Prescribe vitamin B, 30-50 mgv/m or subcutaneously, followed by switching to oral administration;
At the same time, nicotinic acid (25 i;v), riboflavin (10-20 mg), and vitamin B6 are prescribed. Symptomatic therapy: cardiovascular drugs, diuretics, to increase the tone of the nervous system - injections of strychnine (1:1000, 1-1.5 mg). With endogenous vitamin B deficiency caused by chronic diseases intestines - their treatment.
Prevention. Full, rich in vitamin B, food, timely diagnosis and treatment of diseases in which the absorption of vitamin B1 is impaired.

Our expert says - endocrinologist-nutritionist, creator of the author's nutrition program Vadim Krylov.

Vitamin B₁ is the most important player in the functioning of the brain and the entire nervous system. It can also be called the “Minister of Energy”, since it is part of several enzymes that play a key role in energy metabolism in a cage. And when there is not enough of it, enzymes stop working and a lack of energy appears. Research shows that B₁ deficiency develops quite quickly and can lead to very negative consequences in the body, and in severe cases and to death.

Emperors disease

A condition associated with severe deficiency of vitamin B₁ is called beriberi, or Chinese emperors' disease. The fact is that aristocrats in China, Japan and other countries in this region ate only white refined rice, which was considered noble. But when the rice was peeled, the shells of the grains were lost. useful material, including vitamin B₁. Due to a very monotonous diet, there were no other sources of thiamine in these countries, which led to its severe deficiency.

Vitamin B₁ is water soluble. It does not accumulate in the body, and excess is excreted in the urine. This feature is typical of all B vitamins. Therefore, they must be consumed every day to avoid deficiency. It is important that there is no overdose of vitamin B₁, even if you consume it many times more than the recommended daily intake. The body will take everything it needs, and the rest will be excreted through the kidneys.

First of all, thiamine is needed for the synthesis of acetylcholine - one of the most important neurotransmitters of the nervous system, on which the conduction of signals to the brain and nerves depends. Therefore, with a lack of thiamine, the nervous system and psyche are primarily affected: weakness, fatigue, and memory deterioration occur. In severe deficiency, as in beriberi, nerve conduction is disrupted, paralysis of the legs occurs, people stop walking, and death can occur.

Alcohol and vitamin B1

The last major outbreak of beriberi was 65 years ago in the Philippines. Now they have learned to prevent this disease, so it does not occur even in those countries where rice still remains the main food. However, a peculiar analogue of this disease is often found even in highly developed countries. It's called Wernicke-Korsakoff syndrome, a brain disorder caused by thiamine deficiency. For alcohol lovers who drink a lot and constantly, a deficiency of vitamin B₁ leads to damage to the nerves, the legs begin to tremble and do not obey well, then the person stops walking altogether. The fact is that when drinking alcohol, the need for vitamin B₁ increases significantly, and its supply due to poor nutrition, typical for alcoholics, falls.

A similar situation happens with those with a sweet tooth. A large number of requires carbohydrates in food increased amount thiamine, but in sweets and baked goods, which are usually made from refined wheat flour, this vitamin is not available. It is present in the shells of grains, and if they are removed, vitamin B₁ is lost. Therefore, choose bread only from whole grain flour, and choose unpolished porridges that have retained their grain shells.

Deficiency Symptoms

None at first specific symptoms No. Weakness, fatigue, shortness of breath and palpitations during physical activity - all this happens with a host of other diseases. How can we determine what caused these symptoms: a lack of vitamin or something else? First, think about whether there is real reasons such problems. Secondly, analyze your diet - does it contain enough foods with vitamin B₁ (see table). If there is no reason, and the composition of the products is not ideal, most likely the problem is in the vitamin.

Important

Requirement for vitamin B1 (mg)
For children

• up to 12 months - from 0.3 to 0.5
• 1-3 years - 0.8
• 3-7 years - 0.9
• 7-11 years - 1.1
• 11-14 years old - 1.3
• 14-18 years old:
• boys - 1.5,
• girls - 1.3

For adults

• Men and women - 1.5
• Pregnant women - 1.7
• Nursing mothers - 1.8

Where is there a lot of thiamine?

The disease is characterized by widespread damage to the peripheral nerves (polyneuritis), the cardiovascular system and edema. The first complaints are general weakness, fatigue, headache, shortness of breath and palpitations during exercise. Then the phenomena of polyneuritis are added: paresthesia and decreased skin sensitivity of the lower extremities, and later other parts of the body, a feeling of heaviness and weakness in the legs, fatigue when walking, lameness. The calf muscles become hard and painful on palpation. The gait of beriberi patients is characteristic: they step on the heel and then the outer edge of the foot, sparing the toes. Next, tendon reflexes fade and muscle atrophy occurs. Disruption of the cardiovascular system is manifested by tachycardia, dystrophic changes in the heart muscle with circulatory failure, and a decrease in blood pressure, mainly diastolic. Symptoms of dystrophic lesions and dysfunctions of the digestive system, visual disturbances, and mental disorders are also observed. According to the prevailing symptoms, there is an edematous form (with more pronounced damage to the cardiovascular system and edema) and a dry form (with predominant damage to the nervous system), as well as an acute, malignant “fulminant” form, often ending in death. It is difficult to recognize beriberi in young children.

Diagnostics

The diagnosis is established on the basis of anamnesis data (nature of nutrition, the presence of diseases that contribute to the manifestation of thiamine deficiency), characteristic changes in the cardiovascular and nervous systems; the diagnosis is confirmed by biochemical studies: there is evidence of a decrease in the thiamine content in daily urine below 100 mcg, in hourly (fasting) urine - below 10 mcg, the content of cocarboxylase in erythrocytes is below 20-40 mcg/l. Characterized by an increase in the content of pyruvic acid in plasma (above 0.01 g/l) and increased excretion in the urine (more than 25 mg/day). Recently, a number of more complex modern methods have also been used for this purpose.

Differential diagnosis with infectious (poliomyelitis, diphtheria, etc.) and toxic polyneuritis (poisoning with mercury, methyl alcohol, phosphorus, etc.) is based on taking into account the epidemic situation, medical history, as well as on the results of biochemical studies of thiamine metabolism. The differential diagnosis of the edematous form of beriberi with myocarditis and myocardial dystrophies is facilitated by the presence of symptoms of polyneuritis.

Treatment

Treatment in severe and moderate cases is inpatient. Bed rest. Vitamin B1 is prescribed at 30-50 mg IM or SC followed by transition to oral administration; At the same time, nicotinic acid, riboflavin, and vitamin B6 are prescribed. Symptomatic therapy: cardiovascular drugs, diuretics. For endogenous vitamin B1 deficiency caused by chronic intestinal diseases - their treatment.

Prevention

Complete nutrition rich in vitamin B1, timely diagnosis and treatment of diseases in which the absorption of vitamin B1 is impaired.

Great Medical Encyclopedia

Today we'll talk:

- how they manifest themselves. What to do if symptoms of vitamin B1 deficiency are detected.

Thus, the symptoms of vitamin B1 deficiency are diverse: at the same time, signs of damage appear different organs and systems. The clinical picture is extensive due to the fact that thiamine hypovitaminosis rarely occurs in isolation. It is usually combined with a reduced intake of other vitamins of this group - pyridoxine, nicotinic acid, riboflavin.

The objective status shows weight loss, pulse lability against the background of general emotional lability. Decrease in blood pressure numbers.

Prevention and treatment of vitamin B1 deficiency

When severe irritability, arising at the slightest provocation, weakness, unmotivated fatigue, insomnia, decreased appetite, you need to exclude a lack of thiamine, reconsider your diet, and, on the recommendation of a doctor, undergo a course of vitamin therapy. The best option treatment is a comprehensive intake of all B vitamins, since their effects on the body are interconnected.

Most effective drugs are:

• Aneurin (thiamine);
• brewer's yeast in tablets;
• hepatoprotectors, Essliver, where vitamin B1 is included as a coenzyme in carbohydrate metabolism processes;
• complex B vitamins: Neurovitan, Neuromidin, Milgamma Compositum;
• multivitamins: Alphabet (vitamin B1 along with iron is included in tablet No. 1), Vitrum, Complivit, Multitabs.

But in order not to make a mistake with your choice, you must first consult with your doctor, who will suggest the most suitable drug.

TO early symptoms Vitamin B1 deficiency include fatigue, irritability, memory loss, loss of appetite, sleep disturbances, abdominal discomfort and weight loss. Ultimately, severe vitamin B1 deficiency (beriberi) may develop, characterized by disorders of the nervous system, brain and heart function. In all forms of beriberi, they are violated metabolic processes in red blood cells, and the content of vitamin B 1 in the blood and urine decreases markedly.

Nerve damage (dry beriberi) begins with tingling sensations in the toes, a burning sensation in the feet that gets worse at night, calf muscle cramps, and pain in the legs and feet. These symptoms are more pronounced if vitamin B1 deficiency is combined with a deficiency pantothenic acid. The calf muscles are painful. Rising from a squatting position may become difficult; Special studies reveal that the vibration sensitivity of the toes is often reduced. Eventually, because the nerves and muscles do not function properly, the muscles in the calves and thighs atrophy, the feet or toes become droopy, and the hands may also become droopy.

Brain disorders(cerebral beriberi; Wernicke-Korsakoff syndrome) manifest themselves in acute severe deficiency of vitamin B 1, which can be caused by binge drinking or severe vomiting during pregnancy and aggravates chronic deficiency of this vitamin.

Early symptoms of cerebral beriberi include confusion, laryngitis, and double vision. The patient may make up facts and events (confabulation) to fill memory gaps. If brain disorders associated with Wernicke–Korsakoff syndrome are not treated, symptoms may worsen; coma occurs, possible fatal outcome. This emergency treated with vitamin B1. It is administered intravenously at 100 times the recommended daily dose for several days, and then taken orally at 10 times the recommended daily dose. daily dose until the symptoms subside. Recovery is often incomplete, as in some cases partially irreversible brain damage occurs.

Heart damage (wet beriberi) is characterized by increased blood ejection from the heart, increased heart rate reductions and expansion blood vessels, causing the skin to become warm and moist. Due to a deficiency of vitamin B1, the heart cannot maintain this high output for long, and heart failure develops with swelling of the veins, shortness of breath and fluid retention in the lungs and peripheral tissues.

Neonatal beri-beri occurs in children of the first year of life who are on breastfeeding if the mother has a deficiency of vitamin B 1. The disease is characterized by heart failure, loss of voice and damage to peripheral nerves; usually develops between 2 and 4 months of life. Cardiac disorders quickly and completely disappear after treatment with vitamin B1.