Thiamin functions as the coenzyme thiamin pyrophosphate (TPP) in the metabolism of carbohydrate and in conduction of nerve impulses. Thiamin deficiency causes beri-beri, which is frequently seen in parts of the world where polished (white) rice or unenriched white flour are predominantly eaten. There are three basic expressions of beriberi: childhood, wet, and dry. Childhood beriberi stunts growth in infants and children. Wet beriberi is the classic form, with swelling due to fluid retention (edema) in the lower limbs that spreads to the upper body, affecting the heart and leading to heart failure. Dry beriberi affects peripheral nerves, initially causing tingling or burning sensations in the lower limbs and progressing to nerve degeneration, muscle wasting, and weight loss. Thiamine-deficiency disease in North America commonly occurs in people with heavy alcohol consumption and is called Wernicke-Korsakoff syndrome. It is caused by poor food intake and by decreased absorption and increased excretion caused by alcohol consumption.
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