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    BeriBeri Metabolism

    What is keeping people alive when they have Beriberi? Since they cannot go through glycolysis or the citric acid cycle, what other process do they use to get energy? I think it has something to do with lactate
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    FYI: the usually cause is dietary deficiency of vitamin B1.
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    Registered User bartolomei's Avatar
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    Originally Posted by Francis333 View Post
    What is keeping people alive when they have Beriberi? Since they cannot go through glycolysis or the citric acid cycle, what other process do they use to get energy? I think it has something to do with lactate
    I can't answer directly, but even some people who have severe vitamin B1 deficiency, not only they stay alive but also have no symptoms directly related to vitamin B1.
    http://www.nutrientsreview.com/vitam...-thiamine.html
    http://emedicine.medscape.com/article/116930-clinical

    If these people have no symptoms, then I assume they can go through glycolysis with the help of other vitamins or just with minimal vitamin B1 amounts...Also, vitamin B1 needs increase with carbohydrate intake and physical activity. So, those on low-carb diets and less physically active need less vitamin B1.
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    Originally Posted by bartolomei View Post
    I can't answer directly, but even some people who have severe vitamin B1 deficiency, not only they stay alive but also have no symptoms directly related to vitamin B1.
    http://www.nutrientsreview.com/vitam...-thiamine.html
    http://emedicine.medscape.com/article/116930-clinical

    If these people have no symptoms, then I assume they can go through glycolysis with the help of other vitamins or just with minimal vitamin B1 amounts...Also, vitamin B1 needs increase with carbohydrate intake and physical activity. So, those on low-carb diets and less physically active need less vitamin B1.
    Hmm so a deficiency in Vitamin b1 means a deficiency in thiamine pyrophosphate. Thiamine pyrophosphate is the cofactor in the reaction of pyruvate to acetyl CoA (pyruvate dehydrogenase). So less conversion of pyruvate, means it accumulates and eventually turns into lactate.

    How is someone with beriberi going to get energy if they can't move past the pyruvate dehydrogenase step? Like what role does an accumulation of lactate play here
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    Gif King Francis333's Avatar
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    Registered User bartolomei's Avatar
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    When pyruvate cannot be sufficiently converted to acetyl CoA, it can be converted to lactate
    http://www.namrata.co/subjective-que...iamine-solved/

    Lactate production in beriberi can actually be increased.
    http://emedicine.medscape.com/article/116930-workup
    "Metabolic acidosis can be seen in thiamine deficiency. This is due to increased lactic acid production from thiamine deficiency. Thiamine pyrophosphate (thiamine derivative) is the coenzyme for the conversion of pyruvate to acetyl coenzyme A. Without it, pyruvate is under used and converts to lactate. It is important to consider thiamine deficiency in the presence of unexplained metabolic acidosis, specifically, lactic acidosis...Gastrointestinal beriberi is a condition in which patients report abdominal pain due to lactic acidosis."

    Lactate can be converted into energy without thiamine, but the amount of energy produced exclusively this way would not likely be sufficient to maintain life and would be associated with severe lactic acidosis resulting in abdominal pain and increased breathing rate.

    Since most people with thiamine deficiency do not have these symptoms, my explanation is that less vitamin B1 does not necessary mean less conversion to acetyl CoA but in some people the conversion requires very little vitamin B1.
    Last edited by bartolomei; 09-30-2014 at 03:37 AM.
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