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<ul id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Dry_beriberi" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Dry_beriberi"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Dry beriberi</span> </div> </a> <ul id="toc-Dry_beriberi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Brain_disease" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Brain_disease"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Brain disease</span> </div> </a> <ul id="toc-Brain_disease-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Wet_beriberi" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Wet_beriberi"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.3</span> <span>Wet beriberi</span> </div> </a> <ul id="toc-Wet_beriberi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Gastrointestinal_beriberi" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Gastrointestinal_beriberi"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Gastrointestinal beriberi</span> </div> </a> <ul id="toc-Gastrointestinal_beriberi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Infants" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Infants"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5</span> <span>Infants</span> </div> </a> <ul id="toc-Infants-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Cause" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Cause"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Cause</span> </div> </a> <button aria-controls="toc-Cause-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Cause subsection</span> </button> <ul id="toc-Cause-sublist" class="vector-toc-list"> <li id="toc-Genetics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Genetics</span> </div> </a> <ul id="toc-Genetics-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Pathophysiology</span> </div> </a> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Treatment</span> </div> </a> <ul id="toc-Treatment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Successful_prevention_and_identification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Successful_prevention_and_identification"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Successful prevention and identification</span> </div> </a> <ul id="toc-Successful_prevention_and_identification-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Japanese_Army_denialism" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Japanese_Army_denialism"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>Japanese Army denialism</span> </div> </a> <ul id="toc-Japanese_Army_denialism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Etymology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Etymology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3</span> <span>Etymology</span> </div> </a> <ul id="toc-Etymology-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Other animals</span> </div> </a> <button aria-controls="toc-Other_animals-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Other animals subsection</span> </button> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> <li id="toc-Poultry" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Poultry"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>Poultry</span> </div> </a> <ul id="toc-Poultry-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Ruminants" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ruminants"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.2</span> <span>Ruminants</span> </div> </a> <ul id="toc-Ruminants-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Snakes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Snakes"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.3</span> <span>Snakes</span> </div> </a> <ul id="toc-Snakes-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Wild_birds_and_fish" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Wild_birds_and_fish"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.4</span> <span>Wild birds and fish</span> </div> </a> <ul id="toc-Wild_birds_and_fish-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Thiamine deficiency</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 64 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-64" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">64 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Afrikaans" lang="af" hreflang="af" data-title="Beri-beri" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%86%D9%82%D8%B5_%D8%A7%D9%84%D8%AB%D9%8A%D8%A7%D9%85%D9%8A%D9%86" title="نقص الثيامين – Arabic" lang="ar" hreflang="ar" data-title="نقص الثيامين" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Azerbaijani" lang="az" hreflang="az" data-title="Beri-beri" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A8%D8%A6%D8%B1%DB%8C-%D8%A8%D8%A6%D8%B1%DB%8C" title="بئری-بئری – South Azerbaijani" lang="azb" hreflang="azb" data-title="بئری-بئری" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AC%E0%A7%87%E0%A6%B0%E0%A6%BF%E0%A6%AC%E0%A7%87%E0%A6%B0%E0%A6%BF" title="বেরিবেরি – Bangla" lang="bn" hreflang="bn" data-title="বেরিবেরি" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D1%8B-%D0%B1%D0%B5%D1%80%D1%8B" title="Беры-беры – Belarusian" lang="be" hreflang="be" data-title="Беры-беры" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8-%D0%B1%D0%B5%D1%80%D0%B8" title="Бери-бери – Bulgarian" lang="bg" hreflang="bg" data-title="Бери-бери" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Catalan" lang="ca" hreflang="ca" data-title="Beri-beri" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Czech" lang="cs" hreflang="cs" data-title="Beri-beri" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Beriberi" title="Beriberi – Danish" lang="da" hreflang="da" data-title="Beriberi" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Beriberi" title="Beriberi – German" lang="de" hreflang="de" data-title="Beriberi" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Beribeeri" title="Beribeeri – Estonian" lang="et" hreflang="et" data-title="Beribeeri" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Beriberi" title="Beriberi – Spanish" lang="es" hreflang="es" data-title="Beriberi" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Beribero" title="Beribero – Esperanto" lang="eo" hreflang="eo" data-title="Beribero" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Beriberi" title="Beriberi – Basque" lang="eu" hreflang="eu" data-title="Beriberi" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A8%D8%B1%DB%8C%E2%80%8C%D8%A8%D8%B1%DB%8C" title="بری‌بری – Persian" lang="fa" hreflang="fa" data-title="بری‌بری" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fo mw-list-item"><a href="https://fo.wikipedia.org/wiki/Beriberi" title="Beriberi – Faroese" lang="fo" hreflang="fo" data-title="Beriberi" data-language-autonym="Føroyskt" data-language-local-name="Faroese" class="interlanguage-link-target"><span>Føroyskt</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/B%C3%A9rib%C3%A9ri" title="Béribéri – French" lang="fr" hreflang="fr" data-title="Béribéri" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Irish" lang="ga" hreflang="ga" data-title="Beri-beri" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Beriberi" title="Beriberi – Galician" lang="gl" hreflang="gl" data-title="Beriberi" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B0%81%EA%B8%B0%EB%B3%91" title="각기병 – Korean" lang="ko" hreflang="ko" data-title="각기병" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B2%D5%A5%D6%80%D5%AB-%D5%A2%D5%A5%D6%80%D5%AB" title="Բերի-բերի – Armenian" lang="hy" hreflang="hy" data-title="Բերի-բերի" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AC%E0%A5%87%E0%A4%B0%E0%A5%80%E0%A4%AC%E0%A5%87%E0%A4%B0%E0%A5%80" title="बेरीबेरी – Hindi" lang="hi" hreflang="hi" data-title="बेरीबेरी" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Croatian" lang="hr" hreflang="hr" data-title="Beri-beri" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Beriberio" title="Beriberio – Ido" lang="io" hreflang="io" data-title="Beriberio" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Indonesian" lang="id" hreflang="id" data-title="Beri-beri" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Taugakr%C3%B6m" title="Taugakröm – Icelandic" lang="is" hreflang="is" data-title="Taugakröm" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Beriberi" title="Beriberi – Italian" lang="it" hreflang="it" data-title="Beriberi" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%91%D7%A8%D7%99%D7%91%D7%A8%D7%99" title="בריברי – Hebrew" lang="he" hreflang="he" data-title="בריברי" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%91%E1%83%94%E1%83%A0%E1%83%98-%E1%83%91%E1%83%94%E1%83%A0%E1%83%98" title="ბერი-ბერი – Georgian" lang="ka" hreflang="ka" data-title="ბერი-ბერი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8-%D0%B1%D0%B5%D1%80%D0%B8" title="Бери-бери – Kazakh" lang="kk" hreflang="kk" data-title="Бери-бери" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Ber%C3%AEber%C3%AE" title="Berîberî – Kurdish" lang="ku" hreflang="ku" data-title="Berîberî" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Beriberi" title="Beriberi – Latin" lang="la" hreflang="la" data-title="Beriberi" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Hungarian" lang="hu" hreflang="hu" data-title="Beri-beri" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8-%D0%B1%D0%B5%D1%80%D0%B8" title="Бери-бери – Macedonian" lang="mk" hreflang="mk" data-title="Бери-бери" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%97%E1%80%9A%E1%80%BA%E1%80%9B%E1%80%AE_%E1%80%97%E1%80%9A%E1%80%BA%E1%80%9B%E1%80%AE" title="ဗယ်ရီ ဗယ်ရီ – Burmese" lang="my" hreflang="my" data-title="ဗယ်ရီ ဗယ်ရီ" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Beriberi" title="Beriberi – Dutch" lang="nl" hreflang="nl" data-title="Beriberi" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%84%9A%E6%B0%97" title="脚気 – Japanese" lang="ja" hreflang="ja" data-title="脚気" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Beriberi" title="Beriberi – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Beriberi" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Beriberi" title="Beriberi – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Beriberi" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%A5%E0%AC%BF%E0%AC%86%E0%AC%AE%E0%AC%BF%E0%AC%A8_%E0%AC%85%E0%AC%AD%E0%AC%BE%E0%AC%AC" title="ଥିଆମିନ ଅଭାବ – Odia" lang="or" hreflang="or" data-title="ଥିଆମିନ ଅଭାବ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Beriberi" title="Beriberi – Uzbek" lang="uz" hreflang="uz" data-title="Beriberi" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Beri-beri" title="Beri-beri – Polish" lang="pl" hreflang="pl" data-title="Beri-beri" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Berib%C3%A9ri" title="Beribéri – Portuguese" lang="pt" hreflang="pt" data-title="Beribéri" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-rue mw-list-item"><a href="https://rue.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8-%D0%B1%D0%B5%D1%80%D0%B8" title="Бери-бери – Rusyn" lang="rue" hreflang="rue" data-title="Бери-бери" data-language-autonym="Русиньскый" data-language-local-name="Rusyn" class="interlanguage-link-target"><span>Русиньскый</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8-%D0%B1%D0%B5%D1%80%D0%B8" title="Бери-бери – Russian" lang="ru" hreflang="ru" data-title="Бери-бери" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sco mw-list-item"><a href="https://sco.wikipedia.org/wiki/Beriberi" title="Beriberi – Scots" lang="sco" hreflang="sco" data-title="Beriberi" data-language-autonym="Scots" data-language-local-name="Scots" class="interlanguage-link-target"><span>Scots</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Beriberi" title="Beriberi – Simple English" lang="en-simple" hreflang="en-simple" data-title="Beriberi" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Beriberi" title="Beriberi – Slovenian" lang="sl" hreflang="sl" data-title="Beriberi" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%A8%DB%8E%D8%B1%DB%8C%D8%A8%DB%8E%D8%B1%DB%8C" title="بێریبێری – Central Kurdish" lang="ckb" hreflang="ckb" data-title="بێریبێری" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8%D0%B1%D0%B5%D1%80%D0%B8" title="Берибери – Serbian" lang="sr" hreflang="sr" data-title="Берибери" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Beriberi" title="Beriberi – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Beriberi" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Beriberi" title="Beriberi – Finnish" lang="fi" hreflang="fi" data-title="Beriberi" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Beriberi" title="Beriberi – Swedish" lang="sv" hreflang="sv" data-title="Beriberi" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Manas" title="Manas – Tagalog" lang="tl" hreflang="tl" data-title="Manas" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AA%E0%AF%86%E0%AE%B0%E0%AE%BF%E0%AE%AA%E0%AF%86%E0%AE%B0%E0%AE%BF" title="பெரிபெரி – Tamil" lang="ta" hreflang="ta" data-title="பெரிபெரி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%AC%E0%B1%86%E0%B0%B0%E0%B0%BF%E0%B0%AC%E0%B1%86%E0%B0%B0%E0%B0%BF" title="బెరిబెరి – Telugu" lang="te" hreflang="te" data-title="బెరిబెరి" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B9%82%E0%B8%A3%E0%B8%84%E0%B9%80%E0%B8%AB%E0%B8%99%E0%B9%87%E0%B8%9A%E0%B8%8A%E0%B8%B2" title="โรคเหน็บชา – Thai" lang="th" hreflang="th" data-title="โรคเหน็บชา" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D0%B8-%D0%B1%D0%B5%D1%80%D0%B8" title="Бери-бери – Tajik" lang="tg" hreflang="tg" data-title="Бери-бери" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Beriberi" title="Beriberi – Turkish" lang="tr" hreflang="tr" data-title="Beriberi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%91%D0%B5%D1%80%D1%96-%D0%B1%D0%B5%D1%80%D1%96" title="Бері-бері – Ukrainian" lang="uk" hreflang="uk" data-title="Бері-бері" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Thi%E1%BA%BFu_vitamin_B1" title="Thiếu vitamin B1 – Vietnamese" lang="vi" hreflang="vi" data-title="Thiếu vitamin B1" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E8%84%9A%E6%B0%94%E7%97%85" title="脚气病 – Wu" lang="wuu" hreflang="wuu" data-title="脚气病" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%84%9A%E6%B0%94%E7%97%85" title="脚气病 – Chinese" lang="zh" hreflang="zh" data-title="脚气病" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q184084#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav aria-label="Namespaces"> <div id="p-associated-pages" class="vector-menu vector-menu-tabs mw-portlet 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For the African ethnic group, see <a href="/wiki/Kanuri_people" title="Kanuri people">Kanuri people</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Thiamine deficiency<sup id="cite_ref-GARD2015_1-0" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Beriberi, vitamin B<sub>1</sub> deficiency, thiamine-deficiency syndrome<sup id="cite_ref-GARD2015_1-1" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ad2017_2-0" class="reference"><a href="#cite_note-Ad2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Beriberi_USNLM.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/en/thumb/7/72/Beriberi_USNLM.jpg/220px-Beriberi_USNLM.jpg" decoding="async" width="220" height="310" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/7/72/Beriberi_USNLM.jpg/330px-Beriberi_USNLM.jpg 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/7/72/Beriberi_USNLM.jpg/440px-Beriberi_USNLM.jpg 2x" data-file-width="727" data-file-height="1024" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Sufferer of beriberi in Southeast Asia beginning of the 20th Century</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Neurology" title="Neurology">Neurology</a>, <a href="/wiki/Cardiology" title="Cardiology">cardiology</a>, <a href="/wiki/Pediatrics" title="Pediatrics">pediatrics</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"><ul><li><i>Wet:</i> Fast heart rate, shortness of breath, leg swelling<sup id="cite_ref-GARD2015_1-2" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li><li><i>Dry:</i> Numbness, confusion, trouble moving the legs, pain<sup id="cite_ref-GARD2015_1-3" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label">Types</th><td class="infobox-data">Wet, dry, gastrointestinal,<sup id="cite_ref-Fer2018_3-0" class="reference"><a href="#cite_note-Fer2018-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> infantile,<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> cerebral<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Not enough <a href="/wiki/Thiamine" title="Thiamine">thiamine</a><sup id="cite_ref-GARD2015_1-4" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Diet of mostly <a href="/wiki/White_rice" title="White rice">white rice</a>; <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a>, <a href="/wiki/Kidney_dialysis" title="Kidney dialysis">dialysis</a>, chronic <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, <a href="/wiki/Diuretics" class="mw-redirect" title="Diuretics">diuretics</a><sup id="cite_ref-GARD2015_1-5" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2012_6-0" class="reference"><a href="#cite_note-CDC2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data"><a href="/wiki/Food_fortification" title="Food fortification">Food fortification</a>, Food diversification<sup id="cite_ref-GARD2015_1-6" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Thiamine_supplementation" class="mw-redirect" title="Thiamine supplementation">Thiamine supplementation</a><sup id="cite_ref-GARD2015_1-7" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">Uncommon (USA)<sup id="cite_ref-GARD2015_1-8" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> <p><b>Thiamine deficiency</b> is a medical condition of low levels of <a href="/wiki/Thiamine" title="Thiamine">thiamine</a> (vitamin B<sub>1</sub>).<sup id="cite_ref-GARD2015_1-9" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> A severe and chronic form is known as <b>beriberi</b>.<sup id="cite_ref-GARD2015_1-10" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Hermann_7-0" class="reference"><a href="#cite_note-Hermann-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The name beriberi was possibly borrowed in the 18th century from the <a href="/wiki/Sinhala_language" title="Sinhala language">Sinhalese</a> phrase <span title="Sinhala-language text"><span lang="si">බැරි බැරි</span></span> (bæri bæri, “I cannot, I cannot”), owing to the weakness caused by the condition. The two main types in adults are wet beriberi and dry beriberi.<sup id="cite_ref-GARD2015_1-11" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Wet beriberi affects the <a href="/wiki/Cardiovascular_system" class="mw-redirect" title="Cardiovascular system">cardiovascular system</a>, resulting in a <a href="/wiki/Tachycardia" title="Tachycardia">fast heart rate</a>, <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a>, and <a href="/wiki/Pedal_edema" class="mw-redirect" title="Pedal edema">leg swelling</a>.<sup id="cite_ref-GARD2015_1-12" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Dry beriberi affects the <a href="/wiki/Nervous_system" title="Nervous system">nervous system</a>, resulting in <a href="/wiki/Peripheral_neuropathy" title="Peripheral neuropathy">numbness of the hands and feet</a>, confusion, trouble moving the legs, and pain.<sup id="cite_ref-GARD2015_1-13" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> A form with loss of appetite and <a href="/wiki/Constipation" title="Constipation">constipation</a> may also occur.<sup id="cite_ref-Fer2018_3-1" class="reference"><a href="#cite_note-Fer2018-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Another type, acute beriberi, found mostly in babies, presents with loss of appetite, vomiting, <a href="/wiki/Lactic_acidosis" title="Lactic acidosis">lactic acidosis</a>, changes in heart rate, and enlargement of the heart.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>Risk factors include a diet of mostly <a href="/wiki/White_rice" title="White rice">white rice</a>, <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a>, <a href="/wiki/Kidney_dialysis" title="Kidney dialysis">dialysis</a>, chronic <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, and taking high doses of <a href="/wiki/Diuretics" class="mw-redirect" title="Diuretics">diuretics</a>.<sup id="cite_ref-GARD2015_1-14" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC2012_6-1" class="reference"><a href="#cite_note-CDC2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> In rare cases, it may be due to a <a href="/wiki/Genetics" title="Genetics">genetic</a> condition that results in difficulties absorbing thiamine found in food.<sup id="cite_ref-GARD2015_1-15" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Wernicke_encephalopathy" title="Wernicke encephalopathy">Wernicke encephalopathy</a> and <a href="/wiki/Korsakoff_syndrome" title="Korsakoff syndrome">Korsakoff syndrome</a> are forms of dry beriberi.<sup id="cite_ref-CDC2012_6-2" class="reference"><a href="#cite_note-CDC2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Diagnosis is based on symptoms, low levels of thiamine in the urine, high blood <a href="/wiki/Lactic_acid" title="Lactic acid">lactate</a>, and improvement with <a href="/wiki/Thiamine_supplementation" class="mw-redirect" title="Thiamine supplementation">thiamine supplementation</a>.<sup id="cite_ref-Sw2017_9-0" class="reference"><a href="#cite_note-Sw2017-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Treatment is by thiamine supplementation, either by mouth or by injection.<sup id="cite_ref-GARD2015_1-16" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> With treatment, symptoms generally resolve in a few weeks.<sup id="cite_ref-Sw2017_9-1" class="reference"><a href="#cite_note-Sw2017-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The disease may be prevented at the population level through the <a href="/wiki/Fortification_of_food" class="mw-redirect" title="Fortification of food">fortification of food</a>.<sup id="cite_ref-GARD2015_1-17" class="reference"><a href="#cite_note-GARD2015-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>Thiamine deficiency is rare in the United States.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> It remains relatively common in <a href="/wiki/Sub-Saharan_Africa" title="Sub-Saharan Africa">sub-Saharan Africa</a>.<sup id="cite_ref-Ad2017_2-1" class="reference"><a href="#cite_note-Ad2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Outbreaks have been seen in <a href="/wiki/Refugee_camps" class="mw-redirect" title="Refugee camps">refugee camps</a>.<sup id="cite_ref-CDC2012_6-3" class="reference"><a href="#cite_note-CDC2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Thiamine deficiency has been described for thousands of years in Asia, and became more common in the late 1800s with the increased processing of rice.<sup id="cite_ref-Lan2010_11-0" class="reference"><a href="#cite_note-Lan2010-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Symptoms of beriberi include weight loss, <a href="/wiki/Emotion" title="Emotion">emotional</a> disturbances, impaired <a href="/wiki/Sensory_perception" class="mw-redirect" title="Sensory perception">sensory perception</a>, <a href="/wiki/Muscle_weakness" title="Muscle weakness">weakness</a> and <a href="/wiki/Pain" title="Pain">pain</a> in the limbs, and periods of irregular <a href="/wiki/Heart_rate" title="Heart rate">heart rate</a>. <a href="/wiki/Edema" title="Edema">Edema</a> (swelling of bodily tissues) is common. It may increase the amount of <a href="/wiki/Lactic_acid" title="Lactic acid">lactic acid</a> and <a href="/wiki/Pyruvic_acid" title="Pyruvic acid">pyruvic acid</a> within the blood. In advanced cases, the disease may cause <a href="/wiki/High-output_cardiac_failure" class="mw-redirect" title="High-output cardiac failure">high-output cardiac failure</a> and death. </p><p>Symptoms may occur concurrently with those of <a href="/wiki/Wernicke%27s_encephalopathy" class="mw-redirect" title="Wernicke's encephalopathy">Wernicke's encephalopathy</a>, a primarily neurological <a href="/wiki/Wernicke_encephalopathy" title="Wernicke encephalopathy">thiamine deficiency-related condition.</a> </p><p>Beriberi is divided into four categories. The first three are historical and the fourth, gastrointestinal beriberi, was recognized in 2004: </p> <ul><li>Dry beriberi especially affects the peripheral nervous system.</li> <li>Wet beriberi especially affects the cardiovascular system and other bodily systems.</li> <li>Infantile beriberi affects the babies of malnourished mothers.</li> <li>Gastrointestinal beriberi affects the digestive system and other bodily systems.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Dry_beriberi">Dry beriberi</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=2" title="Edit section: Dry beriberi"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Dry beriberi causes wasting and partial <a href="/wiki/Paralysis" title="Paralysis">paralysis</a> resulting from damaged peripheral <a href="/wiki/Nerve" title="Nerve">nerves</a>. It is also referred to as endemic neuritis. It is characterized by: </p> <ul><li>Difficulty with walking</li> <li>Tingling or loss of sensation (<a href="/wiki/Paresthesia" title="Paresthesia">numbness</a>) in hands and feet</li> <li>Loss of tendon reflexes<sup id="cite_ref-Katsura_12-0" class="reference"><a href="#cite_note-Katsura-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>Loss of muscle function or paralysis of the lower legs</li> <li>Mental confusion/speech difficulties</li> <li>Pain</li> <li>Involuntary eye movements (<a href="/wiki/Pathologic_nystagmus" class="mw-redirect" title="Pathologic nystagmus">nystagmus</a>)</li> <li>Vomiting</li></ul> <p>A selective impairment of the large proprioceptive sensory fibers without motor impairment can occur and present as a prominent sensory <a href="/wiki/Ataxia" title="Ataxia">ataxia</a>, which is a loss of balance and coordination due to loss of the proprioceptive inputs from the periphery and loss of position sense.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Brain_disease">Brain disease</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=3" title="Edit section: Brain disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Wernicke%27s_encephalopathy" class="mw-redirect" title="Wernicke's encephalopathy">Wernicke's encephalopathy</a> (WE), <a href="/wiki/Korsakoff_syndrome" title="Korsakoff syndrome">Korsakoff syndrome</a> (also called alcohol amnestic disorder), and <a href="/wiki/Wernicke%E2%80%93Korsakoff_syndrome" title="Wernicke–Korsakoff syndrome">Wernicke–Korsakoff syndrome</a> are forms of dry beriberi.<sup id="cite_ref-CDC2012_6-4" class="reference"><a href="#cite_note-CDC2012-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p><p>Wernicke's encephalopathy is the most frequently encountered manifestation of thiamine deficiency in Western society,<sup id="cite_ref-Kril_14-0" class="reference"><a href="#cite_note-Kril-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> though it may also occur in patients with impaired nutrition from other causes, such as gastrointestinal disease,<sup id="cite_ref-Kril_14-1" class="reference"><a href="#cite_note-Kril-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> those with <a href="/wiki/HIV/AIDS" title="HIV/AIDS">HIV/AIDS</a>, and with the injudicious administration of <a href="/wiki/Route_of_administration#Local_or_systemic_effect" title="Route of administration">parenteral</a> glucose or <a href="/wiki/Hyperalimentation" class="mw-redirect" title="Hyperalimentation">hyperalimentation</a> without adequate B-vitamin supplementation.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> This is a striking neuro-psychiatric disorder characterized by paralysis of eye movements, abnormal stance and gait, and markedly deranged mental function.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Korsakoff_syndrome" title="Korsakoff syndrome">Korsakoff syndrome</a>, in general, is considered to occur with deterioration of brain function in patients initially diagnosed with WE.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> This is an amnestic-confabulatory syndrome characterized by <a href="/wiki/Retrograde_amnesia" title="Retrograde amnesia">retrograde</a> and <a href="/wiki/Anterograde_amnesia" title="Anterograde amnesia">anterograde amnesia</a>, impairment of conceptual functions, and decreased spontaneity and initiative.<sup id="cite_ref-Butterworth_RF._Thiamin_2006_19-0" class="reference"><a href="#cite_note-Butterworth_RF._Thiamin_2006-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>Alcoholics may have thiamine deficiency because of: </p> <ul><li>Inadequate nutritional intake: Alcoholics tend to intake less than the recommended amount of thiamine.</li> <li>Decreased uptake of thiamine from the GI tract: Active transport of thiamine into enterocytes is disturbed during acute alcohol exposure.</li> <li>Liver thiamine stores are reduced due to hepatic steatosis or fibrosis.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li>Impaired thiamine utilization: Magnesium, which is required for the binding of thiamine to thiamine-using enzymes within the cell, is also deficient due to chronic alcohol consumption. The inefficient use of any thiamine that does reach the cells will further exacerbate the thiamine deficiency.</li> <li>Ethanol <i>per se</i> inhibits thiamine transport in the gastrointestinal system and blocks phosphorylation of thiamine to its cofactor form (ThDP).<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup></li></ul> <p>Following improved nutrition and the removal of alcohol consumption, some impairments linked with thiamine deficiency are reversed, in particular poor brain functionality, although in more severe cases, Wernicke–Korsakoff syndrome leaves permanent damage. (See <a href="/wiki/Delirium_tremens" title="Delirium tremens">delirium tremens</a>.) </p> <div class="mw-heading mw-heading3"><h3 id="Wet_beriberi">Wet beriberi</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=4" title="Edit section: Wet beriberi"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Wet beriberi affects the <a href="/wiki/Heart" title="Heart">heart</a> and circulatory system. It is sometimes fatal, as it causes a combination of <a href="/wiki/Congestive_heart_failure" class="mw-redirect" title="Congestive heart failure">heart failure</a> and weakening of the <a href="/wiki/Capillary" title="Capillary">capillary</a> walls, which causes the peripheral tissues to become edematous. Wet beriberi is characterized by: </p> <ul><li>Increased heart rate</li> <li><a href="/wiki/Vasodilation" title="Vasodilation">Vasodilation</a> leading to decreased systemic vascular resistance, and high-output heart failure<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></li> <li>Elevated <a href="/wiki/Jugular_venous_pressure" title="Jugular venous pressure">jugular venous pressure</a><sup id="cite_ref-twomodes_23-0" class="reference"><a href="#cite_note-twomodes-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup></li> <li>Dyspnea (shortness of breath) on exertion</li> <li>Paroxysmal nocturnal <a href="/wiki/Dyspnea" class="mw-redirect" title="Dyspnea">dyspnea</a></li> <li>Peripheral <a href="/wiki/Oedema" class="mw-redirect" title="Oedema">edema</a><sup id="cite_ref-twomodes_23-1" class="reference"><a href="#cite_note-twomodes-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> (swelling of lower legs) or <a href="/wiki/Anasarca" title="Anasarca">generalized edema</a><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> (swelling throughout the body)</li> <li><a href="/wiki/Dilated_cardiomyopathy" title="Dilated cardiomyopathy">Dilated cardiomyopathy</a></li></ul> <div class="mw-heading mw-heading3"><h3 id="Gastrointestinal_beriberi">Gastrointestinal beriberi</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=5" title="Edit section: Gastrointestinal beriberi"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Gastrointestinal beriberi causes abdominal pain. It is characterized by: </p> <ul><li>Abdominal pain</li> <li>Nausea</li> <li>Vomiting</li> <li>Lactic acidosis<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Infants">Infants</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=6" title="Edit section: Infants"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Infantile beriberi usually occurs between two and six months of age in children whose mothers have inadequate thiamine intake. It may present as either wet or dry beriberi.<sup id="cite_ref-Ad2017_2-2" class="reference"><a href="#cite_note-Ad2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>In the acute form, the baby develops <a href="/wiki/Dyspnea" class="mw-redirect" title="Dyspnea">dyspnea</a> and <a href="/wiki/Cyanosis" title="Cyanosis">cyanosis</a> and soon dies of heart failure. These symptoms may be described in infantile beriberi: </p> <ul><li>Hoarseness, where the child makes moves to moan, but emits no sound or just faint moans<sup id="cite_ref-latham_30-0" class="reference"><a href="#cite_note-latham-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> caused by nerve paralysis<sup id="cite_ref-Katsura_12-1" class="reference"><a href="#cite_note-Katsura-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>Weight loss, becoming thinner and then <a href="/wiki/Marasmic" class="mw-redirect" title="Marasmic">marasmic</a> as the disease progresses<sup id="cite_ref-latham_30-1" class="reference"><a href="#cite_note-latham-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></li> <li>Vomiting<sup id="cite_ref-latham_30-2" class="reference"><a href="#cite_note-latham-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></li> <li>Diarrhea<sup id="cite_ref-latham_30-3" class="reference"><a href="#cite_note-latham-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></li> <li>Pale skin<sup id="cite_ref-Katsura_12-2" class="reference"><a href="#cite_note-Katsura-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>Edema<sup id="cite_ref-Katsura_12-3" class="reference"><a href="#cite_note-Katsura-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-latham_30-4" class="reference"><a href="#cite_note-latham-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></li> <li>Ill temper<sup id="cite_ref-Katsura_12-4" class="reference"><a href="#cite_note-Katsura-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li>Alterations of the cardiovascular system, especially <a href="/wiki/Tachycardia" title="Tachycardia">tachycardia</a> (rapid heart rate)<sup id="cite_ref-Katsura_12-5" class="reference"><a href="#cite_note-Katsura-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Convulsions" class="mw-redirect" title="Convulsions">Convulsions</a> occasionally observed in the terminal stages<sup id="cite_ref-latham_30-5" class="reference"><a href="#cite_note-latham-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=7" title="Edit section: Cause"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Beriberi is often caused by eating a diet with a very high proportion of calorie rich <a href="/wiki/White_rice" title="White rice">polished rice</a> (common in Asia) or <a href="/wiki/Cassava" title="Cassava">cassava root</a> (common in sub-Saharan Africa), without much if any <a href="/wiki/Thiamine#Sources" title="Thiamine">thiamine-containing animal products or vegetables</a>.<sup id="cite_ref-Ad2017_2-3" class="reference"><a href="#cite_note-Ad2017-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>It may also be caused by shortcomings other than inadequate intake – <a href="/wiki/Digestive_disease" class="mw-redirect" title="Digestive disease">diseases</a> or operations on the digestive tract, <a href="/wiki/Alcoholism" title="Alcoholism">alcoholism</a>,<sup id="cite_ref-twomodes_23-2" class="reference"><a href="#cite_note-twomodes-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Kidney_dialysis" title="Kidney dialysis">dialysis</a> or <a href="/wiki/Genetic_deficiencies" class="mw-redirect" title="Genetic deficiencies">genetic deficiencies</a>. All those causes mainly affect the central nervous system, and provoke the development of Wernicke's encephalopathy. </p><p>Wernicke's disease is one of the most prevalent neurological or neuropsychiatric diseases.<sup id="cite_ref-Cernicchiaro_2007_31-0" class="reference"><a href="#cite_note-Cernicchiaro_2007-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> In <a href="/wiki/Autopsy" title="Autopsy">autopsy</a> series, features of Wernicke lesions are observed in approximately 2% of general cases.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> Medical record research shows that about 85% had not been diagnosed, although only 19% would be asymptomatic. In children, only 58% were diagnosed. In <a href="/wiki/Alcohol_abuse" title="Alcohol abuse">alcohol abusers</a>, autopsy series showed neurological damages at rates of 12.5% or more. Mortality caused by Wernicke's disease reaches 17% of diseases, which means 3.4/1000 or about 25 million contemporaries.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Harper1979_34-0" class="reference"><a href="#cite_note-Harper1979-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> The number of people with Wernicke's disease may be even higher, considering that early stages may have dysfunctions prior to the production of observable lesions at necropsy. In addition, uncounted numbers of people can experience fetal damage and subsequent diseases. </p> <div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=8" title="Edit section: Genetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Genetic diseases of thiamine transport are rare but serious. <a href="/wiki/Thiamine_responsive_megaloblastic_anemia_syndrome" title="Thiamine responsive megaloblastic anemia syndrome">Thiamine responsive megaloblastic anemia syndrome</a> (TRMA) with <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a> and <a href="/wiki/Sensorineural_deafness" class="mw-redirect" title="Sensorineural deafness">sensorineural deafness</a><sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> is an autosomal recessive disorder caused by mutations in the gene <a href="/wiki/SLC19A2" class="mw-redirect" title="SLC19A2">SLC19A2</a>,<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> a high affinity <a href="/wiki/Thiamine_transporter" title="Thiamine transporter">thiamine transporter</a>. TRMA patients do not show signs of systemic thiamine deficiency, suggesting redundancy in the thiamine transport system. This has led to the discovery of a second high-affinity thiamine transporter, <a href="/wiki/SLC19A3" class="mw-redirect" title="SLC19A3">SLC19A3</a>.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Leigh_disease" class="mw-redirect" title="Leigh disease">Leigh disease</a> (subacute necrotising encephalomyelopathy) is an inherited disorder that affects mostly infants in the first years of life and is invariably fatal. Pathological similarities between Leigh disease and WE led to the hypothesis that the cause was a defect in thiamine metabolism. One of the most consistent findings has been an abnormality of the activation of the <a href="/wiki/Pyruvate_dehydrogenase" title="Pyruvate dehydrogenase">pyruvate dehydrogenase</a> complex.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p><p>Mutations in the <i><a href="/wiki/SLC19A3" class="mw-redirect" title="SLC19A3">SLC19A3</a> </i>gene have been linked to <a href="/wiki/Biotin-thiamine-responsive_basal_ganglia_disease_(BTBGD)" class="mw-redirect" title="Biotin-thiamine-responsive basal ganglia disease (BTBGD)">biotin-thiamine responsive basal ganglia disease</a>,<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> which is treated with pharmacological doses of thiamine and <a href="/wiki/Biotin" title="Biotin">biotin</a>, another <a href="/wiki/B_vitamin" class="mw-redirect" title="B vitamin">B vitamin</a>. </p><p>Other disorders in which a putative role for thiamine has been implicated include <a href="/wiki/Subacute_necrotising_encephalomyelopathy" class="mw-redirect" title="Subacute necrotising encephalomyelopathy">subacute necrotising encephalomyelopathy</a>, <a href="/wiki/Opsoclonus_myoclonus_syndrome" title="Opsoclonus myoclonus syndrome">opsoclonus myoclonus syndrome</a> (a paraneoplastic syndrome), and <a href="/wiki/Nigerian_seasonal_ataxia" class="mw-redirect" title="Nigerian seasonal ataxia">Nigerian seasonal ataxia</a> (or African seasonal ataxia). In addition, several inherited disorders of ThDP-dependent enzymes have been reported,<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> which may respond to thiamine treatment.<sup id="cite_ref-Butterworth_RF._Thiamin_2006_19-1" class="reference"><a href="#cite_note-Butterworth_RF._Thiamin_2006-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=9" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Thiamine in the human body has a half-life of 17 days and is quickly exhausted, particularly when metabolic demands exceed intake. A derivative of thiamine, <a href="/wiki/Thiamine_pyrophosphate" title="Thiamine pyrophosphate">thiamine pyrophosphate</a> (TPP), is a cofactor involved in the <a href="/wiki/Citric_acid_cycle" title="Citric acid cycle">citric acid cycle</a>, as well as connecting the <a href="/wiki/Glycolysis" title="Glycolysis">breakdown of sugars</a> with the citric acid cycle. The citric acid cycle is a central metabolic pathway involved in the regulation of carbohydrate, lipid, and amino acid metabolism, and its disruption due to thiamine deficiency inhibits the production of many molecules including the neurotransmitters <a href="/wiki/Glutamic_acid" title="Glutamic acid">glutamic acid</a> and <a href="/wiki/GABA" title="GABA">GABA</a>.<sup id="cite_ref-Sechi_42-0" class="reference"><a href="#cite_note-Sechi-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> Additionally, thiamine may also be directly involved in <a href="/wiki/Neuromodulation_(biology)" class="mw-redirect" title="Neuromodulation (biology)">neuromodulation</a>.<sup id="cite_ref-Hirsch_43-0" class="reference"><a href="#cite_note-Hirsch-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=10" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Thiochromes.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/23/Thiochromes.jpg/250px-Thiochromes.jpg" decoding="async" width="220" height="74" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/23/Thiochromes.jpg/330px-Thiochromes.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/23/Thiochromes.jpg/500px-Thiochromes.jpg 2x" data-file-width="1418" data-file-height="478" /></a><figcaption>Oxidation of thiamine derivatives to fluorescent thiochromes by potassium ferricyanide under alkaline conditions</figcaption></figure> <p>A positive diagnosis test for thiamine deficiency involves measuring the activity of the enzyme <a href="/wiki/Transketolase" title="Transketolase">transketolase</a> in <a href="/wiki/Erythrocyte" class="mw-redirect" title="Erythrocyte">erythrocytes</a> (Erythrocyte transketolase activation assay). Alternatively, thiamine and its phosphorylated derivatives can directly be detected in whole blood, tissues, foods, animal feed, and pharmaceutical preparations following the conversion of thiamine to <a href="/wiki/Fluorescent" class="mw-redirect" title="Fluorescent">fluorescent</a> thiochrome derivatives (thiochrome assay) and separation by <a href="/wiki/High-performance_liquid_chromatography" title="High-performance liquid chromatography">high-performance liquid chromatography</a> (HPLC).<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> Capillary electrophoresis (CE) techniques and in-capillary enzyme reaction methods have emerged as alternative techniques in quantifying and monitoring thiamine levels in samples.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> The normal thiamine concentration in EDTA-blood is about 20–100 μg/L. </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=11" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Many people with beriberi can be treated with thiamine alone.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> Given thiamine intravenously (and later orally), rapid and dramatic<sup id="cite_ref-twomodes_23-3" class="reference"><a href="#cite_note-twomodes-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> recovery occurs, generally within 24 hours.<sup id="cite_ref-Tanphaichitr_49-0" class="reference"><a href="#cite_note-Tanphaichitr-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> </p><p>Improvements of peripheral neuropathy may require several months of thiamine treatment.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=12" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Beriberi is a recurrent nutritional disease in detention houses, even in this century. In 1999, an outbreak of beriberi occurred in a detention center in Taiwan.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> High rates of illness and death from beriberi in overcrowded Haitian jails in 2007 were traced to the traditional practice of washing rice before cooking; this removed a nutritious coating which had been applied to the rice after processing (enriched <a href="/wiki/White_rice" title="White rice">white rice</a>).<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> In the <a href="/wiki/Ivory_Coast" title="Ivory Coast">Ivory Coast</a>, among a group of prisoners with heavy punishment, 64% were affected by beriberi. Before beginning treatment, prisoners exhibited symptoms of dry or wet beriberi with neurological signs (tingling: 41%), cardiovascular signs (dyspnoea: 42%, thoracic pain: 35%), and edemas of the lower limbs (51%). With treatment, the rate of healing was about 97%.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </p><p>Populations under extreme stress may be at higher risk for beriberi. <a href="/wiki/Forced_displacement" title="Forced displacement">Displaced populations</a>, such as <a href="/wiki/Refugee" title="Refugee">refugees</a> from war, are susceptible to micronutritional deficiency, including beriberi.<sup id="cite_ref-prinzo2009_54-0" class="reference"><a href="#cite_note-prinzo2009-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> The severe nutritional deprivation caused by <a href="/wiki/Famine" title="Famine">famine</a> also can cause beriberis, although symptoms may be overlooked in clinical assessment or masked by other famine-related problems.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> An extreme weight-loss <a href="/wiki/Dieting" title="Dieting">diet</a> can, rarely, induce a famine-like state and the accompanying beriberi.<sup id="cite_ref-twomodes_23-4" class="reference"><a href="#cite_note-twomodes-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>Workers on Chinese squid ships are at elevated risk of beriberi due to the cheap refined grain and raw fish diet they are fed and the long period of time between shoring. Between 2013 and 2021, 15 workers on 14 ships have died with symptoms of beriberi.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=13" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Earliest written descriptions of thiamine deficiency are from ancient China in the context of <a href="/wiki/Chinese_medicine" class="mw-redirect" title="Chinese medicine">Chinese medicine</a>. One of the earliest is by <a href="/wiki/Ge_Hong" title="Ge Hong">Ge Hong</a> in his book <i>Zhou hou bei ji fang</i> (<i>Emergency Formulas to Keep up Your Sleeve</i>) written sometime during the third century. Hong called the illness by the name <i>jiao qi</i>, which can be interpreted as "foot <a href="/wiki/Qi" title="Qi">qi</a>". He described the symptoms to include swelling, weakness, and numbness of the feet. He also acknowledged that the illness could be deadly, and claimed that it could be cured by eating certain foods, such as fermented soybeans in wine. Better known examples of early descriptions of "foot qi" are by <a href="/wiki/Chao_Yuanfang" title="Chao Yuanfang">Chao Yuanfang</a> (who lived during 550–630) in his book <i>Zhu bing yuan hou lun</i> (<i>Sources and Symptoms of All Diseases</i>)<sup id="cite_ref-:0_57-0" class="reference"><a href="#cite_note-:0-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_58-0" class="reference"><a href="#cite_note-:1-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> and by <a href="/wiki/Sun_Simiao" title="Sun Simiao">Sun Simiao</a> (581–682) in his book <i>Bei ji qian jin yao fang</i> (<i>Essential Emergency Formulas Worth a Thousand in Gold</i>).<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:1_58-1" class="reference"><a href="#cite_note-:1-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p><p>In the mid-19th century, interest in beriberi steadily rose as the disease became more noticeable with changes in diet in East and Southeast Asia. There was a steady uptick in medical publications, reaching one hundred and eighty-one publications from 1880 and 1889, and hundreds more in the following decades. The link to white rice was clear to Western doctors, but a confounding factor was that some other foods like meat failed to prevent beriberi, so it could not be easily explained as a lack of known chemicals like carbon or nitrogen. With no knowledge of <a href="/wiki/Vitamin" title="Vitamin">vitamins</a>, the <a href="/wiki/Etiology" title="Etiology">etiology</a> of beriberi was among the most hotly debated subjects in Victorian medicine.<sup id="cite_ref-19th_62-0" class="reference"><a href="#cite_note-19th-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Successful_prevention_and_identification">Successful prevention and identification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=14" title="Edit section: Successful prevention and identification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The first successful preventative measure against beriberi was discovered by <a href="/wiki/Takaki_Kanehiro" title="Takaki Kanehiro">Takaki Kanehiro</a>, a British-trained Japanese medical doctor of the <a href="/wiki/Imperial_Japanese_Navy" title="Imperial Japanese Navy">Imperial Japanese Navy</a>, in the mid-1880s.<sup id="cite_ref-Takaki_63-0" class="reference"><a href="#cite_note-Takaki-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> Beriberi was a serious problem in the Japanese navy; sailors fell ill an average of four times a year in the period 1878 to 1881, and 35% were cases of beriberi.<sup id="cite_ref-Takaki_63-1" class="reference"><a href="#cite_note-Takaki-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> In 1882, Takaki learned of a very high incidence of beriberi among cadets on a training mission from Japan to Hawaii, via New Zealand and South America. The voyage lasted more than nine months and resulted in 169 cases of sickness and 25 deaths on a ship of 376 men. Takaki observed that beriberi was common among low-ranking crew who were often provided free rice, thus ate little else, but not among crews of Western navies, nor among Japanese officers who consumed a more varied diet. With the support of the Japanese Navy, he conducted an experiment in which another ship was deployed on the same route, except that its crew was fed a diet of meat, fish, barley, rice, and beans. At the end of the voyage, this crew had only 14 cases of beriberi and no deaths.<sup id="cite_ref-Takaki_63-2" class="reference"><a href="#cite_note-Takaki-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> This emphasis on varied diet contradicted observations by other doctors, and Takaki's carbon-based etiology was just as incorrect as similar theories before him, but the results of his experiment impressed the Japanese Navy, which adopted his proposed solution. By 1887 beriberi had been completely eliminated on Navy ships.<sup id="cite_ref-19th_62-1" class="reference"><a href="#cite_note-19th-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p><p>In the same year, Takaki's experiment was described favorably in <i><a href="/wiki/The_Lancet" title="The Lancet">The Lancet</a></i>,<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> but his incorrect etiology was not taken seriously.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> In 1897, <a href="/wiki/Christiaan_Eijkman" title="Christiaan Eijkman">Christiaan Eijkman</a>, a <a href="/wiki/Netherlands" title="Netherlands">Dutch</a> <a href="/wiki/Physician" title="Physician">physician</a> and <a href="/wiki/Pathologist" class="mw-redirect" title="Pathologist">pathologist</a>, published his mid-1880s experiments showing that feeding unpolished rice (instead of the polished variety) to chickens helped to prevent beriberi.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> This was the first experiment to show that not a major chemical but some minor nutrient was the true cause of beriberi. The following year, Sir <a href="/wiki/Frederick_Hopkins" class="mw-redirect" title="Frederick Hopkins">Frederick Hopkins</a> postulated that some foods contained "accessory factors"—in addition to proteins, carbohydrates, fats, and salt—that were necessary for the functions of the human body.<sup id="cite_ref-Challem_67-0" class="reference"><a href="#cite_note-Challem-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup> In 1901, <a href="/wiki/Gerrit_Grijns" title="Gerrit Grijns">Gerrit Grijns</a>, a Dutch physician and assistant to <a href="/wiki/Christiaan_Eijkman" title="Christiaan Eijkman">Christiaan Eijkman</a> in the Netherlands, correctly interpreted beriberi as a deficiency syndrome,<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> and between 1910 and 1913, <a href="/wiki/Edward_Bright_Vedder" title="Edward Bright Vedder">Edward Bright Vedder</a> established that an extract of <a href="/wiki/Rice_bran" class="mw-redirect" title="Rice bran">rice bran</a> is a treatment for beriberi.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2012)">citation needed</span></a></i>]</sup> In 1929, Eijkman and Hopkins were awarded the <a href="/wiki/Nobel_Prize_for_Physiology_or_Medicine" class="mw-redirect" title="Nobel Prize for Physiology or Medicine">Nobel Prize for Physiology or Medicine</a> for their discoveries. In 1935, <a href="/wiki/Robert_R._Williams" title="Robert R. Williams">Robert R. Williams</a> isolated and cheaply synthesized thiamine from rice bran, based on discoveries he had made as a researcher in Manila's Bureau of Science in 1910. Williams assigned the patents to a fund that worked to promote thiamine-enriched rice in Asia, and in <a href="/wiki/Bataan" title="Bataan">Bataan</a> in particular.<sup id="cite_ref-Time_1951_70-0" class="reference"><a href="#cite_note-Time_1951-70"><span class="cite-bracket">[</span>70<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Japanese_Army_denialism">Japanese Army denialism</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=15" title="Edit section: Japanese Army denialism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although the identification of beriberi as a deficiency syndrome was proven beyond a doubt by 1913, a Japanese group headed by <a href="/wiki/Mori_%C5%8Cgai" title="Mori Ōgai">Mori Ōgai</a> and backed by <a href="/wiki/Tokyo_Imperial_University" class="mw-redirect" title="Tokyo Imperial University">Tokyo Imperial University</a> continued to deny this conclusion until 1926. In 1886, Mori, then working in the Japanese Army Medical Bureau, asserted that white rice was sufficient as a diet for soldiers. Simultaneously, Navy surgeon general Takaki Kanehiro published the groundbreaking results described above. Mori, who had been educated under German doctors, responded that Takaki was a "fake doctor" due to his lack of prestigious medical background, while Mori himself and his fellow graduates of Tokyo Imperial University constituted the only "real doctors" in Japan and that they alone were capable of "experimental induction", although Mori himself had not conducted any beriberi experiments.<sup id="cite_ref-71" class="reference"><a href="#cite_note-71"><span class="cite-bracket">[</span>71<span class="cite-bracket">]</span></a></sup> </p><p>The Japanese Navy sided with Takaki and adopted his suggestions. In order to prevent himself and the Army from losing <a href="/wiki/Face_(sociological_concept)" title="Face (sociological concept)">face</a>, Mori assembled a team of doctors and professors from Tokyo Imperial University and the Japanese Army who proposed that beriberi was caused by an unknown pathogen, which they described as <i>etowasu</i> (from the German <i>Etwas</i>, meaning "something"). They employed various social tactics to denounce vitamin deficiency experiments and prevent them from being published, while beriberi ravaged the Japanese Army. During the <a href="/wiki/First_Sino-Japanese_War" title="First Sino-Japanese War">First Sino-Japanese War</a> and <a href="/wiki/Russo-Japanese_War" title="Russo-Japanese War">Russo-Japanese War</a>, Army soldiers continued to die in mass numbers from beriberi, while Navy sailors survived. In response to this severe loss of life, in 1907, the Army ordered the formation of a Beriberi Emergency Research Council, headed by Mori. Its members pledged to find the cause of beriberi.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">[</span>72<span class="cite-bracket">]</span></a></sup> By 1919, with most Western doctors acknowledging that beriberi was a deficiency syndrome, the Emergency Research Council began conducting experiments using various vitamins, but stressed that "more research was necessary". During this period, more than 300,000 Japanese soldiers contracted beriberi and over 27,000 died.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">[</span>73<span class="cite-bracket">]</span></a></sup> </p><p>Mori died in 1922. The Beriberi Research Council disbanded in 1925, and by the time Eijkman and Hopkins were awarded the Nobel Prize, all of its members had acknowledged that beriberi was a deficiency syndrome. </p> <div class="mw-heading mw-heading3"><h3 id="Etymology">Etymology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=16" title="Edit section: Etymology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although according to the <i><a href="/wiki/Oxford_English_Dictionary" title="Oxford English Dictionary">Oxford English Dictionary</a></i>, the term "beriberi" comes from a <a href="/wiki/Sinhala_language" title="Sinhala language">Sinhalese</a> phrase meaning "weak, weak" or "I cannot, I cannot", the word being <a href="/wiki/Reduplication" title="Reduplication">duplicated</a> for emphasis,<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">[</span>74<span class="cite-bracket">]</span></a></sup> the origin of the phrase is questionable. It has also been suggested to come from Hindi, Arabic, and a few other languages, with many meanings like "weakness", "sailor", and even "sheep". Such suggested origins were listed by <a href="/wiki/Heinrich_Botho_Scheube" title="Heinrich Botho Scheube">Heinrich Botho Scheube</a>, among others. <a href="/wiki/Edward_Vedder" class="mw-redirect" title="Edward Vedder">Edward Vedder</a> wrote in his book <i>Beriberi</i> (1913) that "it is impossible to definitely trace the origin of the word beriberi". The word <i>berbere</i> was used in writing at least as early as 1568 by <a href="/wiki/Diogo_do_Couto" title="Diogo do Couto">Diogo do Couto</a>, when he described the deficiency in India.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">[</span>75<span class="cite-bracket">]</span></a></sup> </p><p><i>Kakke</i><span style="font-weight: normal"> (<span title="Japanese-language text"><span lang="ja">脚気</span></span>)</span>, which is a Japanese synonym for thiamine deficiency, comes from the way "jiao qi" is pronounced in Japanese.<sup id="cite_ref-:2_76-0" class="reference"><a href="#cite_note-:2-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> "<i>Jiao qi</i><span style="padding-left:.15em;">"</span> is an old word used in Chinese medicine to describe beriberi.<sup id="cite_ref-:0_57-1" class="reference"><a href="#cite_note-:0-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> "<i>Kakke</i><span style="padding-left:.15em;">"</span> is supposed to have entered into the Japanese language sometime between the sixth and eighth centuries.<sup id="cite_ref-:2_76-1" class="reference"><a href="#cite_note-:2-76"><span class="cite-bracket">[</span>76<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Other_animals">Other animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=17" title="Edit section: Other animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Poultry">Poultry</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=18" title="Edit section: Poultry"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Mature chickens show signs three weeks after being fed a deficient diet. In young chicks, it can appear before two weeks of age. Onset is sudden in young chicks, with anorexia and an unsteady gait. Later on, locomotor signs begin, with an apparent paralysis of the flexor of the toes. The characteristic position is called "stargazing", with the affected animal sitting on its hocks with its head thrown back in a posture called <a href="/wiki/Opisthotonos" class="mw-redirect" title="Opisthotonos">opisthotonos</a>. Response to administration of the vitamin is rather quick, occurring a few hours later.<sup id="cite_ref-77" class="reference"><a href="#cite_note-77"><span class="cite-bracket">[</span>77<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">[</span>78<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Ruminants">Ruminants</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=19" title="Edit section: Ruminants"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Polioencephalomalacia" title="Polioencephalomalacia">Polioencephalomalacia</a> (PEM) is the most common thiamine deficiency disorder in young ruminant and nonruminant animals. Symptoms of PEM include a profuse, but transient, diarrhea, listlessness, circling movements, stargazing or opisthotonus (head drawn back over neck), and muscle tremors.<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">[</span>79<span class="cite-bracket">]</span></a></sup> The most common cause is high-carbohydrate feeds, leading to the overgrowth of thiaminase-producing bacteria, but dietary ingestion of thiaminase (e.g., in <a href="/wiki/Bracken" title="Bracken">bracken</a> fern), or inhibition of thiamine absorption by high sulfur intake are also possible.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">[</span>80<span class="cite-bracket">]</span></a></sup> Another cause of PEM is <i>Clostridium sporogenes</i> or <i>Bacillus aneurinolyticus</i> infection. These bacteria produce <a href="/wiki/Thiaminase" title="Thiaminase">thiaminases</a> that can cause an acute thiamine deficiency in the affected animal.<sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">[</span>81<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Snakes">Snakes</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=20" title="Edit section: Snakes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Snakes that consume a diet largely composed of goldfish and feeder minnows are susceptible to developing thiamine deficiency. This is often a problem observed in captivity when keeping garter and ribbon snakes that are fed a goldfish-exclusive diet, as these fish contain thiaminase, an enzyme that breaks down thiamine.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">[</span>82<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Wild_birds_and_fish">Wild birds and fish</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=21" title="Edit section: Wild birds and fish"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Thiamine deficiency has been identified as the cause of a paralytic disease affecting wild birds in the Baltic Sea area dating back to 1982.<sup id="cite_ref-Balk_83-0" class="reference"><a href="#cite_note-Balk-83"><span class="cite-bracket">[</span>83<span class="cite-bracket">]</span></a></sup> In this condition, there is difficulty in keeping the wings folded along the side of the body when resting, loss of the ability to fly and voice, with eventual paralysis of the wings and legs and death. It affects primarily 0.5–1 kg-sized birds such as the <a href="/wiki/European_herring_gull" title="European herring gull">European herring gull</a> (<i>Larus argentatus</i>), <a href="/wiki/Common_starling" title="Common starling">common starling</a> (<i>Sturnus vulgaris</i>), and <a href="/wiki/Common_eider" title="Common eider">common eider</a> (<i>Somateria mollissima</i>). Researchers noted, "Because the investigated species occupy a wide range of ecological niches and positions in the food web, we are open to the possibility that other animal classes may develop thiamine deficiency, as well."<sup id="cite_ref-Balk_83-1" class="reference"><a href="#cite_note-Balk-83"><span class="cite-bracket">[</span>83<span class="cite-bracket">]</span></a></sup><sup>p. 12006</sup> </p><p>In the counties of <a href="/wiki/Blekinge" title="Blekinge">Blekinge</a> and <a href="/wiki/Sk%C3%A5ne" class="mw-redirect" title="Skåne">Skåne</a>, mass deaths of several bird species, especially the European herring gull, have been observed since the early 2000s. More recently, species of other classes seems to be affected. High mortality of <a href="/wiki/Atlantic_Salmon" class="mw-redirect" title="Atlantic Salmon">salmon</a> (<i>Salmo salar</i>) in the river <a href="/wiki/M%C3%B6rrums%C3%A5n" title="Mörrumsån">Mörrumsån</a> is reported, and mammals such as the <a href="/wiki/Moose" title="Moose">Eurasian elk</a> (<i>Alces alces</i>) have died in unusually high numbers. Lack of thiamine is the common denominator where analysis is done. In April 2012, the County Administrative Board of Blekinge found the situation so alarming that they asked the Swedish government to set up a closer investigation.<sup id="cite_ref-Länsstyrelsen_Blekinge_län_84-0" class="reference"><a href="#cite_note-Länsstyrelsen_Blekinge_län-84"><span class="cite-bracket">[</span>84<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=22" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-GARD2015-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-GARD2015_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-GARD2015_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-GARD2015_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-GARD2015_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-GARD2015_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-GARD2015_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-GARD2015_1-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-GARD2015_1-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-GARD2015_1-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-GARD2015_1-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-GARD2015_1-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-GARD2015_1-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-GARD2015_1-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-GARD2015_1-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-GARD2015_1-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-GARD2015_1-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-GARD2015_1-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-GARD2015_1-17"><sup><i><b>r</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output 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Retrieved <span class="nowrap">11 November</span> 2017</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Genetic+and+Rare+Diseases+Information+Center+%28GARD%29+%E2%80%93+an+NCATS+Program&rft.atitle=Beriberi&rft.date=2015&rft_id=https%3A%2F%2Frarediseases.info.nih.gov%2Fdiseases%2F9948%2Fberiberi&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-Ad2017-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Ad2017_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Ad2017_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Ad2017_2-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Ad2017_2-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFAdamolekunHiffler2017" class="citation journal cs1">Adamolekun B, Hiffler L (24 October 2017). <a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fnyas.13509">"A diagnosis and treatment gap for thiamine deficiency disorders in sub-Saharan Africa?"</a>. <i>Annals of the New York Academy of Sciences</i>. <b>1408</b> (1): <span class="nowrap">15–</span>19. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2017NYASA1408...15A">2017NYASA1408...15A</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fnyas.13509">10.1111/nyas.13509</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29064578">29064578</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Annals+of+the+New+York+Academy+of+Sciences&rft.atitle=A+diagnosis+and+treatment+gap+for+thiamine+deficiency+disorders+in+sub-Saharan+Africa%3F&rft.volume=1408&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E15-%3C%2Fspan%3E19&rft.date=2017-10-24&rft_id=info%3Apmid%2F29064578&rft_id=info%3Adoi%2F10.1111%2Fnyas.13509&rft_id=info%3Abibcode%2F2017NYASA1408...15A&rft.aulast=Adamolekun&rft.aufirst=B&rft.au=Hiffler%2C+L&rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fnyas.13509&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-Fer2018-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-Fer2018_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Fer2018_3-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFFerri2017" class="citation book cs1">Ferri FF (2017). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=wGclDwAAQBAJ&pg=PA1368"><i>Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1</i></a>. Elsevier Health Sciences. p. 1368. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-323-52957-0" title="Special:BookSources/978-0-323-52957-0"><bdi>978-0-323-52957-0</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20171111204713/https://books.google.ca/books?id=wGclDwAAQBAJ&pg=PA1368">Archived</a> from the original on 2017-11-11.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Ferri%27s+Clinical+Advisor+2018+E-Book%3A+5+Books+in+1&rft.pages=1368&rft.pub=Elsevier+Health+Sciences&rft.date=2017&rft.isbn=978-0-323-52957-0&rft.aulast=Ferri&rft.aufirst=Fred+F.&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DwGclDwAAQBAJ%26pg%3DPA1368&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/984721-clinical">"Pediatric Beriberi Clinical Presentation: History, Physical Examination"</a>. <i>emedicine.medscape.com</i><span class="reference-accessdate">. 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Elsevier Health Sciences. p. e929. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-323-37481-1" title="Special:BookSources/978-0-323-37481-1"><bdi>978-0-323-37481-1</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20171111204954/https://books.google.ca/books?id=PJ9tDgAAQBAJ&pg=SL5-PA929">Archived</a> from the original on 2017-11-11.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Swaiman%27s+Pediatric+Neurology+E-Book%3A+Principles+and+Practice&rft.pages=e929&rft.pub=Elsevier+Health+Sciences&rft.date=2017&rft.isbn=978-0-323-37481-1&rft.aulast=Swaiman&rft.aufirst=Kenneth+F.&rft.au=Ashwal%2C+Stephen&rft.au=Ferriero%2C+Donna+M.&rft.au=Schor%2C+Nina+F.&rft.au=Finkel%2C+Richard+S.&rft.au=Gropman%2C+Andrea+L.&rft.au=Pearl%2C+Phillip+L.&rft.au=Shevell%2C+Michael&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DPJ9tDgAAQBAJ%26pg%3DSL5-PA929&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://ods.od.nih.gov/factsheets/Thiamin-Consumer/">"Thiamine Fact Sheet for Consumers"</a>. 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Vol. 95. pp. <span class="nowrap">445–</span>76. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0072-9752%2808%2902130-1">10.1016/S0072-9752(08)02130-1</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-444-52009-8" title="Special:BookSources/978-0-444-52009-8"><bdi>978-0-444-52009-8</bdi></a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19892133">19892133</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Chapter+30+Historical+aspects+of+the+major+neurological+vitamin+deficiency+disorders%3A+The+water-soluble+B+vitamins&rft.btitle=History+of+Neurology&rft.series=Handbook+of+Clinical+Neurology&rft.pages=%3Cspan+class%3D%22nowrap%22%3E445-%3C%2Fspan%3E76&rft.date=2010&rft_id=info%3Apmid%2F19892133&rft_id=info%3Adoi%2F10.1016%2FS0072-9752%2808%2902130-1&rft.isbn=978-0-444-52009-8&rft.aulast=Lanska&rft.aufirst=DJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-Katsura-12"><span class="mw-cite-backlink">^ <a href="#cite_ref-Katsura_12-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Katsura_12-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Katsura_12-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Katsura_12-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Katsura_12-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Katsura_12-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFKatsuraOiso1976" class="citation journal cs1">Katsura E, Oiso T (1976). Beaton G, Bengoa J (eds.). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110708000808/http://whqlibdoc.who.int/monograph/WHO_MONO_62_(chp9).pdf">"Chapter 9. Beriberi"</a> <span class="cs1-format">(PDF)</span>. <i>World Health Organization Monograph Series No. 62: Nutrition in Preventive Medicine</i>. Geneva: <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a>. Archived from <a rel="nofollow" class="external text" href="http://whqlibdoc.who.int/monograph/WHO_MONO_62_(chp9).pdf">the original</a> <span class="cs1-format">(PDF)</span> on 2011-07-08.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=World+Health+Organization+Monograph+Series+No.+62%3A+Nutrition+in+Preventive+Medicine&rft.atitle=Chapter+9.+Beriberi&rft.date=1976&rft.aulast=Katsura&rft.aufirst=E.&rft.au=Oiso%2C+T.&rft_id=http%3A%2F%2Fwhqlibdoc.who.int%2Fmonograph%2FWHO_MONO_62_%28chp9%29.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFSpinazziAngeliniPatrini2010" class="citation journal cs1">Spinazzi M, Angelini C, Patrini C (2010). "Subacute sensory ataxia and optic neuropathy with thiamine deficiency". <i>Nature Reviews Neurology</i>. <b>6</b> (5): <span class="nowrap">288–</span>93. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnrneurol.2010.16">10.1038/nrneurol.2010.16</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20308997">20308997</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:12333200">12333200</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Reviews+Neurology&rft.atitle=Subacute+sensory+ataxia+and+optic+neuropathy+with+thiamine+deficiency&rft.volume=6&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E288-%3C%2Fspan%3E93&rft.date=2010&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A12333200%23id-name%3DS2CID&rft_id=info%3Apmid%2F20308997&rft_id=info%3Adoi%2F10.1038%2Fnrneurol.2010.16&rft.aulast=Spinazzi&rft.aufirst=Marco&rft.au=Angelini%2C+Corrado&rft.au=Patrini%2C+Cesare&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-Kril-14"><span class="mw-cite-backlink">^ <a href="#cite_ref-Kril_14-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Kril_14-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFKril1996" class="citation journal cs1">Kril JJ (1996). "Neuropathology of thiamine deficiency disorders". <i>Metab Brain Dis</i>. <b>11</b> (1): <span class="nowrap">9–</span>17. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2FBF02080928">10.1007/BF02080928</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/8815394">8815394</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:20889916">20889916</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Metab+Brain+Dis&rft.atitle=Neuropathology+of+thiamine+deficiency+disorders&rft.volume=11&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E9-%3C%2Fspan%3E17&rft.date=1996&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A20889916%23id-name%3DS2CID&rft_id=info%3Apmid%2F8815394&rft_id=info%3Adoi%2F10.1007%2FBF02080928&rft.aulast=Kril&rft.aufirst=JJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-15">^</a></b></span> <span class="reference-text">For an interesting discussion on thiamine fortification of foods, specifically targetting beer, see <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="http://www.mja.com.au/public/issues/jun1/drew/drew.html">"Wernicke's encephalopathy and thiamine fortification of food: time for a new direction?"</a>. <i>Medical Journal of Australia</i>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110831104941/http://www.mja.com.au/public/issues/jun1/drew/drew.html">Archived</a> from the original on 2011-08-31.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medical+Journal+of+Australia&rft.atitle=Wernicke%27s+encephalopathy+and+thiamine+fortification+of+food%3A+time+for+a+new+direction%3F&rft_id=http%3A%2F%2Fwww.mja.com.au%2Fpublic%2Fissues%2Fjun1%2Fdrew%2Fdrew.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFButterworthGaudreauVincelette1991" class="citation journal cs1">Butterworth RF, Gaudreau C, Vincelette J, et al. (1991). "Thiamine deficiency and Wernicke's encephalopathy in AIDS". <i>Metab Brain Dis</i>. <b>6</b> (4): <span class="nowrap">207–</span>12. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2FBF00996920">10.1007/BF00996920</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/1812394">1812394</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:8833558">8833558</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Metab+Brain+Dis&rft.atitle=Thiamine+deficiency+and+Wernicke%27s+encephalopathy+in+AIDS&rft.volume=6&rft.issue=4&rft.pages=%3Cspan+class%3D%22nowrap%22%3E207-%3C%2Fspan%3E12&rft.date=1991&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A8833558%23id-name%3DS2CID&rft_id=info%3Apmid%2F1812394&rft_id=info%3Adoi%2F10.1007%2FBF00996920&rft.aulast=Butterworth&rft.aufirst=RF&rft.au=Gaudreau%2C+C&rft.au=Vincelette%2C+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFHarper1979" class="citation journal cs1">Harper C (1979). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC490724">"Wernicke's encephalopathy, a more common disease than realised (a neuropathological study of 51 cases)"</a>. <i>J Neurol Neurosurg Psychiatry</i>. <b>42</b> (3): <span class="nowrap">226–</span>231. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fjnnp.42.3.226">10.1136/jnnp.42.3.226</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC490724">490724</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/438830">438830</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=J+Neurol+Neurosurg+Psychiatry&rft.atitle=Wernicke%27s+encephalopathy%2C+a+more+common+disease+than+realised+%28a+neuropathological+study+of+51+cases%29&rft.volume=42&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E226-%3C%2Fspan%3E231&rft.date=1979&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC490724%23id-name%3DPMC&rft_id=info%3Apmid%2F438830&rft_id=info%3Adoi%2F10.1136%2Fjnnp.42.3.226&rft.aulast=Harper&rft.aufirst=C.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC490724&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text">McCollum EV <i>A History of Nutrition</i>. Cambridge, MA: Riverside Press, Houghton Mifflin; 1957.</span> </li> <li id="cite_note-Butterworth_RF._Thiamin_2006-19"><span class="mw-cite-backlink">^ <a href="#cite_ref-Butterworth_RF._Thiamin_2006_19-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Butterworth_RF._Thiamin_2006_19-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Butterworth RF. Thiamin. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern Nutrition in Health and Disease, 10th ed. Baltimore: Lippincott Williams & Wilkins; 2006.</span> </li> <li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFButterworth1993" class="citation journal cs1">Butterworth RF (1993). 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=East+Asian+Science%2C+Technology+and+Society&rft.atitle=Efficacy+vs.+Ideology%3A+The+Use+of+Food+Therapies+in+Preventing+and+Treating+Beriberi+in+the+Japanese+Army+in+the+Meiji+Era&rft.volume=17&rft.issue=2&rft.pages=%3Cspan+class%3D%22nowrap%22%3E201-%3C%2Fspan%3E21&rft.date=2023-04&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A251484808%23id-name%3DS2CID&rft.issn=1875-2160&rft_id=info%3Adoi%2F10.1080%2F18752160.2022.2071191&rft.aulast=Padilla&rft.aufirst=Roberto+Ramon&rft_id=https%3A%2F%2Fwww.tandfonline.com%2Fdoi%2Ffull%2F10.1080%2F18752160.2022.2071191&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-73"><span class="mw-cite-backlink"><b><a href="#cite_ref-73">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFBay2011" class="citation journal cs1">Bay A (2011). <a rel="nofollow" class="external text" href="https://muse.jhu.edu/article/465090">"Ōgai Mori rintarō to kakkefunsō 鴎外森林太郎と脚気紛争 [Mori Ōgai and the Beriberi Dispute] (review)"</a>. <i>East Asian Science, Technology and Society</i>. <b>5</b> (4): <span class="nowrap">573–</span>79. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1215%2F18752160-1458784">10.1215/18752160-1458784</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1875-2152">1875-2152</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:222093508">222093508</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=East+Asian+Science%2C+Technology+and+Society&rft.atitle=%C5%8Cgai+Mori+rintar%C5%8D+to+kakkefuns%C5%8D+%E9%B4%8E%E5%A4%96%E6%A3%AE%E6%9E%97%E5%A4%AA%E9%83%8E%E3%81%A8%E8%84%9A%E6%B0%97%E7%B4%9B%E4%BA%89+%5BMori+%C5%8Cgai+and+the+Beriberi+Dispute%5D+%28review%29&rft.volume=5&rft.issue=4&rft.pages=%3Cspan+class%3D%22nowrap%22%3E573-%3C%2Fspan%3E79&rft.date=2011&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A222093508%23id-name%3DS2CID&rft.issn=1875-2152&rft_id=info%3Adoi%2F10.1215%2F18752160-1458784&rft.aulast=Bay&rft.aufirst=Alexander&rft_id=https%3A%2F%2Fmuse.jhu.edu%2Farticle%2F465090&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-74"><span class="mw-cite-backlink"><b><a href="#cite_ref-74">^</a></b></span> <span class="reference-text"><a href="/wiki/Oxford_English_Dictionary" title="Oxford English Dictionary">Oxford English Dictionary</a>: "Beri-beri ... a Cingalese word, f. <i>beri</i> weakness, the reduplication being intensive ...", page 203, 1937</span> </li> <li id="cite_note-75"><span class="mw-cite-backlink"><b><a href="#cite_ref-75">^</a></b></span> <span class="reference-text">HA Smith, p. 118-119</span> </li> <li id="cite_note-:2-76"><span class="mw-cite-backlink">^ <a href="#cite_ref-:2_76-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:2_76-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">HA Smith, p. 149</span> </li> <li id="cite_note-77"><span class="mw-cite-backlink"><b><a href="#cite_ref-77">^</a></b></span> <span class="reference-text">R.E. 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Washington, D.C.: National Academy Press.</span> </li> <li id="cite_note-80"><span class="mw-cite-backlink"><b><a href="#cite_ref-80">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFMichel_Lévy2015" class="citation web cs1">Michel Lévy, ed. (March 2015). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160303233122/http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm%2Fbc%2F102000.htm">"Overview of Polioencephalomalacia"</a>. <i>Merck Veterinary Manual</i>. Archived from <a rel="nofollow" class="external text" href="http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm%2Fbc%2F102000.htm">the original</a> on 2016-03-03<span class="reference-accessdate">. Retrieved <span class="nowrap">2023-02-16</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Merck+Veterinary+Manual&rft.atitle=Overview+of+Polioencephalomalacia&rft.date=2015-03&rft_id=http%3A%2F%2Fwww.merckvetmanual.com%2Fmvm%2Findex.jsp%3Fcfile%3Dhtm%252Fbc%252F102000.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-81"><span class="mw-cite-backlink"><b><a href="#cite_ref-81">^</a></b></span> <span class="reference-text"><a rel="nofollow" class="external text" href="http://www.aces.edu/pubs/docs/U/UNP-0065/">Polioencephalomacia: Introduction</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20100528043219/http://www.aces.edu/pubs/docs/U/UNP-0065/">Archived</a> 2010-05-28 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a>, "ACES Publications"</span> </li> <li id="cite_note-82"><span class="mw-cite-backlink"><b><a href="#cite_ref-82">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.researchgate.net/publication/264981292">"Update on Common Nutritional Disorders of Captive Reptiles"</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20170913231717/https://www.researchgate.net/publication/264981292_Update_on_Common_Nutritional_Disorders_of_Captive_Reptiles">Archived</a> from the original on 2017-09-13<span class="reference-accessdate">. Retrieved <span class="nowrap">2017-09-13</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Update+on+Common+Nutritional+Disorders+of+Captive+Reptiles&rft_id=https%3A%2F%2Fwww.researchgate.net%2Fpublication%2F264981292&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-Balk-83"><span class="mw-cite-backlink">^ <a href="#cite_ref-Balk_83-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Balk_83-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFBalkHägerrothAkermanHanson2009" class="citation journal cs1">Balk L, Hägerroth PA, Akerman G, Hanson M, Tjärnlund U, Hansson T, Hallgrimsson GT, Zebühr Y, Broman D, Mörner T, Sundberg H, et al. (2009). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715476">"Wild birds of declining European species are dying from a thiamine deficiency syndrome"</a>. <i>Proc Natl Acad Sci U S A</i>. <b>106</b> (29): <span class="nowrap">12001–</span>12006. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2009PNAS..10612001B">2009PNAS..10612001B</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1073%2Fpnas.0902903106">10.1073/pnas.0902903106</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2715476">2715476</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19597145">19597145</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Proc+Natl+Acad+Sci+U+S+A&rft.atitle=Wild+birds+of+declining+European+species+are+dying+from+a+thiamine+deficiency+syndrome&rft.volume=106&rft.issue=29&rft.pages=%3Cspan+class%3D%22nowrap%22%3E12001-%3C%2Fspan%3E12006&rft.date=2009&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2715476%23id-name%3DPMC&rft_id=info%3Apmid%2F19597145&rft_id=info%3Adoi%2F10.1073%2Fpnas.0902903106&rft_id=info%3Abibcode%2F2009PNAS..10612001B&rft.aulast=Balk&rft.aufirst=L&rft.au=H%C3%A4gerroth%2C+PA&rft.au=Akerman%2C+G&rft.au=Hanson%2C+M&rft.au=Tj%C3%A4rnlund%2C+U&rft.au=Hansson%2C+T&rft.au=Hallgrimsson%2C+GT&rft.au=Zeb%C3%BChr%2C+Y&rft.au=Broman%2C+D&rft.au=M%C3%B6rner%2C+T.&rft.au=Sundberg%2C+H.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2715476&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-Länsstyrelsen_Blekinge_län-84"><span class="mw-cite-backlink"><b><a href="#cite_ref-Länsstyrelsen_Blekinge_län_84-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFBlekinge_län2013" class="citation web cs1">Blekinge län L (2013). <a rel="nofollow" class="external text" href="http://www.lansstyrelsen.se/blekinge/SiteCollectionDocuments/Sv/nyheter/2013/500-1380-2013.pdf">"2012-04-15 500-1380-13 Förhöjd dödlighet hos fågel, lax og älg"</a> <span class="cs1-format">(PDF)</span>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20131202222034/http://www.lansstyrelsen.se/blekinge/SiteCollectionDocuments/Sv/nyheter/2013/500-1380-2013.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on 2013-12-02.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=2012-04-15+500-1380-13+F%C3%B6rh%C3%B6jd+d%C3%B6dlighet+hos+f%C3%A5gel%2C+lax+og+%C3%A4lg&rft.date=2013&rft.aulast=Blekinge+l%C3%A4n&rft.aufirst=L%C3%A4nsstyrelsen&rft_id=http%3A%2F%2Fwww.lansstyrelsen.se%2Fblekinge%2FSiteCollectionDocuments%2FSv%2Fnyheter%2F2013%2F500-1380-2013.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=23" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFArnold2010" class="citation journal cs1">Arnold D (2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2889456">"British India and the beri-beri problem"</a>. <i>Medical History</i>. <b>54</b> (3): <span class="nowrap">295–</span>314. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1017%2FS0025727300004622">10.1017/S0025727300004622</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2889456">2889456</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20592882">20592882</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Medical+History&rft.atitle=British+India+and+the+beri-beri+problem&rft.volume=54&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E295-%3C%2Fspan%3E314&rft.date=2010&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2889456%23id-name%3DPMC&rft_id=info%3Apmid%2F20592882&rft_id=info%3Adoi%2F10.1017%2FS0025727300004622&rft.aulast=Arnold&rft.aufirst=D&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2889456&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFChisholm1911" class="citation encyclopaedia cs1"><a href="/wiki/Hugh_Chisholm" title="Hugh Chisholm">Chisholm H</a>, ed. (1911). <span class="cs1-ws-icon" title="s:1911 Encyclopædia Britannica/Beri-Beri"><a class="external text" href="https://en.wikisource.org/wiki/1911_Encyclop%C3%A6dia_Britannica/Beri-Beri">"Beri-Beri" </a></span>. <i><a href="/wiki/Encyclop%C3%A6dia_Britannica_Eleventh_Edition" title="Encyclopædia Britannica Eleventh Edition">Encyclopædia Britannica</a></i>. Vol. 03 (11th ed.). Cambridge University Press. pp. <span class="nowrap">774–</span>775.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Beri-Beri&rft.btitle=Encyclop%C3%A6dia+Britannica&rft.pages=%3Cspan+class%3D%22nowrap%22%3E774-%3C%2Fspan%3E775&rft.edition=11th&rft.pub=Cambridge+University+Press&rft.date=1911&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFSmith2017" class="citation book cs1">Smith HA (2017). <i>Forgotten Disease: Illnesses Transformed in Chinese Medicine</i>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjhmas%2Fjry029">10.1093/jhmas/jry029</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-5036-0350-9" title="Special:BookSources/978-1-5036-0350-9"><bdi>978-1-5036-0350-9</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/993877848">993877848</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Forgotten+Disease%3A+Illnesses+Transformed+in+Chinese+Medicine&rft.date=2017&rft_id=info%3Aoclcnum%2F993877848&rft_id=info%3Adoi%2F10.1093%2Fjhmas%2Fjry029&rft.isbn=978-1-5036-0350-9&rft.aulast=Smith&rft.aufirst=HA&rfr_id=info%3Asid%2Fen.wikipedia.org%3AThiamine+deficiency" class="Z3988"></span></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Thiamine_deficiency&action=edit&section=24" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/20px-Commons-logo.svg.png" decoding="async" width="12" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/40px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></a></span> Media related to <a href="https://commons.wikimedia.org/wiki/Category:Beriberi" class="extiw" title="commons:Category:Beriberi">Beriberi</a> at Wikimedia Commons</li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox 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.navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}</style><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q184084" class="extiw" title="d:Q184084">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/E51">E51</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=265.0">265.0</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D001602">D001602</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb14107.htm">14107</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000339.htm">000339</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/ped/229-overview">ped/229</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/med/topic221.htm#">med/221</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/beriberi">Thiamine deficiency</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Malnutrition190" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Nutritional_pathology" title="Template:Nutritional pathology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Nutritional_pathology" title="Template talk:Nutritional pathology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Nutritional_pathology" title="Special:EditPage/Template:Nutritional pathology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Malnutrition190" style="font-size:114%;margin:0 4em"><a href="/wiki/Malnutrition" title="Malnutrition">Malnutrition</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Protein%E2%80%93energy_malnutrition" title="Protein–energy malnutrition">Protein-energy<br />malnutrition</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ascites" title="Ascites">Ascites</a></li> <li><a href="/wiki/Emaciation" title="Emaciation">Emaciation</a></li> <li><a href="/wiki/Kwashiorkor" title="Kwashiorkor">Kwashiorkor</a></li> <li><a href="/wiki/Marasmus" title="Marasmus">Marasmus</a></li> <li><a href="/wiki/Catabolysis" title="Catabolysis">Catabolysis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Vitamin_deficiency" title="Vitamin deficiency">Vitamin deficiency</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/B_vitamins" title="B vitamins">B vitamins</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>B<sub>1</sub> <ul><li><a href="/wiki/Beriberi" class="mw-redirect" title="Beriberi">Beriberi</a></li> <li><a href="/wiki/Wernicke%E2%80%93Korsakoff_syndrome" title="Wernicke–Korsakoff syndrome">Wernicke–Korsakoff syndrome</a></li> <li><a href="/wiki/Wernicke%27s_encephalopathy" class="mw-redirect" title="Wernicke's encephalopathy">Wernicke's encephalopathy</a></li> <li><a href="/wiki/Korsakoff_syndrome" title="Korsakoff syndrome">Korsakoff syndrome</a></li></ul></li> <li>B<sub>2</sub> <ul><li><a href="/wiki/Riboflavin#Deficiency" title="Riboflavin">Riboflavin deficiency</a></li></ul></li> <li>B<sub>3</sub> <ul><li><a href="/wiki/Pellagra" title="Pellagra">Pellagra</a></li></ul></li> <li>B<sub>6</sub> <ul><li><a href="/wiki/Pyridoxine_deficiency" class="mw-redirect" title="Pyridoxine deficiency">Pyridoxine deficiency</a></li></ul></li> <li>B<sub>7</sub> <ul><li><a href="/wiki/Biotin_deficiency" title="Biotin deficiency">Biotin deficiency</a></li></ul></li> <li>B<sub>9</sub> <ul><li><a href="/wiki/Folate_deficiency" title="Folate deficiency">Folate deficiency</a></li></ul></li> <li>B<sub>12</sub> <ul><li><a href="/wiki/Vitamin_B12_deficiency" title="Vitamin B12 deficiency">Vitamin B<sub>12</sub> deficiency</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>A: <a href="/wiki/Vitamin_A_deficiency" title="Vitamin A deficiency">Vitamin A deficiency</a> <ul><li><a href="/wiki/Bitot%27s_spots" title="Bitot's spots">Bitot's spots</a></li></ul></li> <li>C: <a href="/wiki/Scurvy" title="Scurvy">Scurvy</a></li> <li>D: <a href="/wiki/Vitamin_D_deficiency" title="Vitamin D deficiency">Vitamin D deficiency</a> <ul><li><a href="/wiki/Rickets" title="Rickets">Rickets</a></li> <li><a href="/wiki/Osteomalacia" title="Osteomalacia">Osteomalacia</a></li> <li><a href="/wiki/Harrison%27s_groove" title="Harrison's groove">Harrison's groove</a></li></ul></li> <li>E: <a href="/wiki/Vitamin_E_deficiency" title="Vitamin E deficiency">Vitamin E deficiency</a></li> <li>K: <a href="/wiki/Vitamin_K_deficiency" title="Vitamin K deficiency">Vitamin K deficiency</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mineral_deficiency" title="Mineral deficiency">Mineral deficiency</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrolyte_imbalance" title="Electrolyte imbalance">Electrolyte imbalance</a> <ul><li><a href="/wiki/Hypocalcemia" title="Hypocalcemia">Calcium</a></li> <li><a href="/wiki/Hypochloremia" title="Hypochloremia">Chloride</a></li> <li><a href="/wiki/Magnesium_deficiency_(medicine)" class="mw-redirect" title="Magnesium deficiency (medicine)">Magnesium</a></li> <li><a href="/wiki/Hypophosphatemia" title="Hypophosphatemia">Phosphate</a></li> <li><a href="/wiki/Hypokalemia" title="Hypokalemia">Potassium</a></li> <li><a href="/wiki/Hyponatremia" title="Hyponatremia">Sodium</a></li></ul></li> <li><a href="/wiki/Iron_deficiency" title="Iron deficiency">Iron</a></li> <li><a href="/wiki/Zinc_deficiency" title="Zinc deficiency">Zinc</a></li> <li><a href="/wiki/Manganese_deficiency_(medicine)" title="Manganese deficiency (medicine)">Manganese</a></li> <li><a href="/wiki/Copper_deficiency" title="Copper deficiency">Copper</a></li> <li><a href="/wiki/Iodine_deficiency" title="Iodine deficiency">Iodine</a></li> <li><a href="/wiki/Chromium_deficiency" title="Chromium deficiency">Chromium</a></li> <li><a href="/wiki/Molybdenum_deficiency" title="Molybdenum deficiency">Molybdenum</a></li> <li><a href="/wiki/Selenium_deficiency" title="Selenium deficiency">Selenium</a> <ul><li><a href="/wiki/Keshan_disease" title="Keshan disease">Keshan disease</a></li></ul></li> <li><a href="/wiki/Fluorine_deficiency" title="Fluorine deficiency">Fluorine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_development_(biology)" class="mw-redirect" title="Human development (biology)">Growth</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Deformity" title="Deformity">Deformity</a></li> <li><a href="/wiki/Delayed_milestone" title="Delayed milestone">Delayed milestone</a></li> <li><a href="/wiki/Failure_to_thrive" title="Failure to thrive">Failure to thrive</a></li> <li><a href="/wiki/Short_stature" title="Short stature">Short stature</a> <ul><li><a href="/wiki/Idiopathic_short_stature" title="Idiopathic short stature">Idiopathic</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">Anorexia</a></li> <li><a href="/wiki/Cachexia" title="Cachexia">Cachexia</a></li> <li><a href="/wiki/Deficiency_(medicine)" title="Deficiency (medicine)">Deficiency (medicine)</a></li> <li><a href="/wiki/Dehydration" title="Dehydration">Dehydration</a></li> <li><a href="/wiki/Epidemiology_of_malnutrition" title="Epidemiology of malnutrition">Epidemiology of malnutrition</a></li> <li><a href="/wiki/Famine" title="Famine">Famine</a></li> <li><a href="/wiki/Food_fortification" title="Food fortification">Food fortification</a></li> <li><a href="/wiki/Hunger" title="Hunger">Hunger</a></li> <li><a href="/wiki/Human_right_to_water_and_sanitation" title="Human right to water and sanitation">Human right to water and sanitation</a></li> <li><a href="/wiki/Micronutrient_deficiency" title="Micronutrient deficiency">Micronutrient deficiency</a></li> <li><a href="/wiki/Right_to_health" title="Right to health">Right to health</a></li> <li><a href="/wiki/Starvation" title="Starvation">Starvation</a></li> <li><a href="/wiki/Starvation_(crime)" title="Starvation (crime)">Starvation (crime)</a></li> <li><a href="/wiki/Terminal_dehydration" title="Terminal dehydration">Terminal dehydration</a></li> <li><a href="/wiki/Undernutrition_in_children" title="Undernutrition in children">Undernutrition in children</a></li> <li><a href="/wiki/Weight_loss" title="Weight loss">Weight loss</a></li> <li><a href="/wiki/Underweight" title="Underweight">Underweight</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link 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