Due to the fortification of foods, cases of nutritional thiamine deficiency in the United States are extremely rare. However, it remains common in parts of Africa and outbreaks occur in refugee camps. While thiamine deficiency has been described in historical records for thousands of years, it only became common in the late nineteenth century with the increased processing of grains, particularly rice in the eastern hemisphere and wheat in the western hemisphere. As researchers observed increasing incidences of disease in populations that consumed more white rice and white flour, governments mandated the addition of essential vitamins back into these foods that processing had stripped away.
Mild to moderate thiamine deficiency is marked by malaise, weight loss, irritability, and confusion. Risk factors for thiamine deficiency in a functioning society include dialysis, bariatric surgery, diabetes, large numbers of diuretics, and alcoholism.
But what happens when our society is no longer functioning? What are the risk factors? How quickly will thiamine deficiency and beriberi (Sinhalese phrase meaning “I can’t, I can’t”), return when our society collapses?
Ten days. The human body doesn't store thiamine. Symptoms of mild to moderate deficiency may occur in just ten days.
Diagnosis of beriberi in a collapsed society without access to laboratory blood tests is going to be based on symptoms and improvement with good nutrition, specifically whole grain bread, because conventional treatment with thiamine administered intravenously also won't likely be an option.
Unfortunately for caretakers, beriberi is expressed in different forms, which could make diagnosis difficult. Common symptoms include impaired reflexes, droopy eyelids, lack of coordination, and difficulty walking.
Wet beriberi affects the cardiovascular system and is marked by an increased heart rate, shortness of breath, and swelling of the legs due to vasodilation.
Dry beriberi affects the nervous system and is exhibited by confusion, numbness in the limbs, trouble moving the feet, and pain.
Gastrointestinal beriberi causes abdominal pain, nausea, vomiting, and lactic acidosis.
Infantile beriberi occurs primarily in infants two to six months in age whose mothers are deficient in thiamine as well. It may present in either the wet or dry forms, and in addition to an increased heart rate, edema, and vomiting, the infant may also have diarrhea and pale skin. Shortness of breath and convulsions are noted in the terminal stages.
There are also some genetic conditions that make thiamine absorption from food difficult, but they're beyond the scope of this post and the ability to treat post-collapse.
So how to we ensure that we are getting enough thiamine in our diet on a daily basis? Building up a generous supply of supplemental vitamins is one way, but when that supply is exhausted, what next? What foods are high in thiamine?
- Whole grains, especially brown rice (which doesn't have a long shelf-life)
- Beef, pork, fish, liver, eggs, dairy (food from animal sources is only a good source of thiamine if their diet has adequate thiamine)
- Legumes
- Vegetables such as acorn squash, asparagus, spinach, beet greens, and Brussels sprouts
Links to related posts:
Dietary Deficiency and Consequences--Vitamin A
Vitamin B2
Vitamin B3
Vitamin B5, B6, B7
Vitamin B9
Vitamin B12
Vitamin C
Vitamin D
Calcium
Iodine
Iron
Magnesium
Potassium
Zinc
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