I lost my legs out from underneath of me late monday night/tuesday morning. I lost all motor control, but I could still feel them. I was justifiably scared. This is the first time I’ve called the EMS. I had no idea if I was having a stroke or something serious. I spent nine hours in the emergency department while they tested, confirmed kidney failure, and didn’t even try to identify the nature of my transient paralysis. They popped me into the CT doughnut and ruled out gross brain abnormalities. I was hospitalized primarily for renal support, and a secondary full neurological workup or as much of a workup as time allowed.
Thanks to the timing of being daylight hours at the beginning of my admission, I got some real doctoring done immediately. Within 4 hours, I had a diagnosis. I know….what the fuck? That NEVER happens to me. I was shocked. What’s the dx?
Thiamine deficiency. Vitamin B1. Beriberi. I supplement B12, since my diet is mostly free of meat and animal products, and I don’t have many good sources of natural B12. But all of the other B vitamins are readily available in just about all foods, and only tiny amounts are needed to meet the RDA. B1, for example, only 1.5mg is needed. I get at least 5 times that without trying with a combo of nuts, beans, and vegetables. B1 is a common nutritional deficiency in severe alcoholism. Too bad I’m not an alcoholic. What I do have is inflamed bowels that don’t soak up all of the nutrients I throw at them.
When they told me I was to be on thiamine infusions 3x/day for 3 days, I was so confused. I had so many questions, and of course I didn’t get any actual answers. First and foremost was the theory that GI overlooked gastric Crohn’s related to my last endoscopy (chronic gastritis with features of ulceration on histology) because they were so concerned with my LOWER GI tract. Fortunately, I’m already back in the boat with those circle-jerks so we’ll see what input they have other than, “we swear your IBD isn’t bad enough to cause malabsorption!” As for the neuro stuff, there are a few things that fall outside of the B1 deficiency spectrum and they want to do a full workup outpatient with sleep studies, swallow studies, and emg’s. Sounds interesting. Whatever the case may be, symptoms improved drastically after only 1 day of infusions. My legs work again!
What are the symptoms of Beriberi? (ripped off from NIH)
Symptoms of dry beriberi include (neurological, the kind I had):
- Difficulty walking
- Loss of feeling (sensation) in hands and feet
- Loss of muscle function or paralysis of the lower legs
- Mental confusion/speech difficulties
- Strange eye movements (nystagmus)
Symptoms of wet beriberi include (cardiac manifestation):
- Awakening at night short of breath
- Increased heart rate
- Shortness of breath with activity
- Swelling of the lower legs