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Beriberi can result from a variety of factors that affect the amount of thiamine (vitamin B1) in the body, including behaviors or other medical conditions. It occurs as the result of prolonged thiamine deficiency, but dietary intake is rarely the only factor causing deficiency in Western nations.

Most cases of beriberi in the United States are related to alcohol abuse. Alcohol creates chemical barriers that reduce the ability of tissues and cells to absorb and utilize thiamine. Alcohol also increases the rate the body excretes thiamine, further preventing its absorption. Compounding this, alcoholics often substitute alcohol for food and therefore consume insufficient nutrients, including thiamine. Furthermore, some studies have suggested that a combination of alcoholism and beriberi may cause more seious symptoms than the sum of the two conditions.

In addition to alcohol, other factors increase the risk of inadequate thiamine intake, including:

• Eating disorders. Patients who suffer from eating disorders are also likely to be malnourished with little to no thiamine intake.
  
  
• Processed diets. People whose diets consisting largely of white rice or highly processed foods may not receive sufficient thiamine. Thiamine is often removed during processing.
  
  
• Breast or formula-feeding. Infants breast-fed by malnourished mothers or given formula without proper vitamins may not receive enough thiamine resulting in infantile beriberi.
  
  
• Chronic vomiting, appetite loss or diarrhea. Any medical treatment or condition that causes these symptoms can potentially result in malnourishment and thiamine deficiency.
  
  
• Intestinal surgeries. Certain intestinal procedures (e.g., gastric bypass surgery) have been known to contribute to malnutrition.

Some factors impact the body’s ability to absorb or use thiamine. When compounded with other causes they may lead to beriberi. These include:

• Dialysis. Treatments to remove waste products from the blood of patients with kidney failure. They may also remove thiamine before the body can use it.
  
  
• Diuretics. Medications that increase urine output. These have the potential to decrease the amount of time certain nutrients, including thiamine, are in the body and available for use.
  
  
• Genetic disorders. In some cases, genetic conditions prevent the body from absorbing thiamine from food.
  
  
• Certain foods, such as coffee, tea, and raw shellfish and freshwater fish. These foods contain chemicals that destroy thiamine before it can be used by the body. However, they must be consumed in extremely large amounts to cause thiamine deficiency.

Certain conditions increase the body’s need for thiamine and failing to ingest the increased amount can lead to beriberi. These factors include:

• Pregnancy and breastfeeding. Pregnant or breastfeeding mothers require more thiamine than other women of their age group.
  
  
• Hyperthyroidism (overactive thyroid). Having too much thyroid hormone in the body causes nutrients to metabolize more quickly, including thiamine. Therefore, greater amounts are needed than in the typical diet.
  
  
• Severe diseases. Conditions that cause the body to consume large amounts of energy result in a need for additional thiamine. Examples of these conditions include malaria, cancer, severe liver disease and HIV infection.
  
  
• Intravenous feeding (total parenteral nutrition [TPN]). Patients receiving intravenous feeding for more than 7 days without a multivitamin or dietary thiamin are at an increased risk for thiamine deficiency.