Vitamin deficiencies

Definition

Vitamin deficiencies are the decrease in levels of vitamins than the optimum levels required for the metabolic processes in the body.

Various disorders can be caused due to vitamin deficiencies.

Alternative names

Causes, incidence and risk factors

Vitamin deficiencies may be caused due to inadequate intake of diet containing vitamins, alcohol intake, malabsorption syndrome or due to certain diseases like diarrhea, giardiasis, cystic fibrosis, obstructive jaundice, tuberculosis, nephritis, pneumonia, urinary tract infections, pancreatitis, celiac disease, Crohn’s disease, biliary obstruction, fistulas, colitis, hemolytic anemia and conditions like pregnancy, lactation and prolonged intake of antibiotics or anticoagulants.

Symptoms

Night blindness, dry scaly skin, follicular hyperkeratosis, shrinking and hardening of mucous membrane, infections of urinogenital or respiratory tract or eyes are the symptoms of vitamin A deficiency. In infants, dry skin, failure to thrive and corneal changes are the symptoms of vitamin A deficiency.

Polyneuritis, Wernicke’s encephalopathy, Korsakoff’s psychosis, cardiomegaly, palpitations, dyspnea, trachycardia, circulatory collapse, indigestion, constipation, ophthalomoplegia, nystagmus and ataxia may be caused due to thiamin deficiency. In infants edema, abdominal pain, irritability, vomiting, loss of voice, pallor and rarely seizures are caused due to thiamin deficiency.

Lip cracking, cracking of corners of mouth; glossitis; sore throat; seborrheic dermatitis in the nasolabial folds, vulva, scrotum; generalized dermatitis; burning and itching of eyes; light sensitivity; tearing and vascularization of cornea are the symptoms of riboflavin deficiency. In later stages of riboflavin deficiency there may be mild anemia and neuropathy. In children riboflavin deficiency can cause growth retardation.

Headache, backache, fatigue, anorexia, indigestion, muscle weakness, mild skin eruptions and weight loss are the symptoms of niacin deficiency. In advanced stages there may be scaly dermatitis particularly of uncovered skin. Reddening of mouth, tongue and lips; nausea; vomiting; diarrhea; disorientation; confusion; neuritis; dementia; dermatitis or diarrhea may be there due to niacin deficiency.

The symptoms of pyridoxine deficiency in infants are abdominal pain, vomiting, ataxia, dermatitis, rarely cheilosis or glossitis, no effect of riboflavin therapy or seizures. Pyridoxine deficiency can cause disturbances in central nervous system.

Deficiency of cobalamine can cause pernicious anemia.

Vitamin C deficiency in adults can cause anemia, anorexia, painful limbs and joints, swelling and bleeding of the gums, weakness, pallor, lethargy, insomnia, loose teeth, poor healing of wound, fractures, hemorrhage in eyes, depression, hysteria, irritability and hypochondriasis. In children vitamin C deficiency may cause fever, vomiting, diarrhea, tenderness and pain in legs.

Symptoms of initial stage of vitamin D deficiency are restlessness, irritability and sweating. In later stages it can cause bone malformations, poor development of muscles and tetanus in infants.

Vitamin E deficiency in adults can cause muscle weakness or sporadic claudications. In infants it can cause skin lesions and edema. In premature neonates it can cause hemolytic anemia, thrombocythemia and erythematous popular skin eruptions.

Tendency to bleed abnormally is the sign if vitamin K deficiency.

Signs and tests

Vitamin A deficiency is diagnosed based on dietary history, physical examination and blood test (for serum level of vitamin A).

Thiamin, riboflavin, niacin and pyridoxine deficiencies are diagnosed by urine tests. Cobalamine deficiency is diagnosed by blood test.

Vitamin C deficiency is diagnosed by dietary history and blood test (serum level of ascorbic acid).

Vitamin D deficiency is diagnosed by physical examination, dietary history and blood test (for plasma calcium level and serum level of inorganic phosphorous, citrate and alkaline phosphataase) and the diagnosis is confirmed by X-ray (to check for bone deformities).

Vitamin E deficiency is diagnosed by physical examination, dietary history and blood tests (for serum level of alpha-tocopherol).

A blood test (for prothrombin time) is done to diagnose vitamin K deficiency.

Treatment

Treatment depends on the deficiency of particular vitamin. For vitamin A deficiency cod liver oil, halibut liver oil and vitamin A solution; for vitamin B deficiency B complex vitamins and foods containing it like peas, pork, wheat bran, oatmeal, milk, dairy products, meat, fish, brewer’s yeast,  green leafy vegetables, cereals, eggs, and liver;  for vitamin C deficiency synthetic vitamin C, ascorbic acid or consumption of orange juice; for vitamin D deficiency oral doses of vitamin D or fish, processed milk and liver; for vitamin E deficiency intake of water soluble supplements and for vitamin K deficiency intravenous or intramuscular administration of vitamin K are recommended.

Expectations (Prognosis)

If the deficiency of a particular vitamin is diagnosed in early stage then it can be corrected by supplements in the synthetic or natural form.

Complications

Vitamin deficiencies can cause complications like metabolic neuropathies, vitamin deficiency anemia, splenomegaly, optic atrophy, ophthalmoplegia, brain failure and many others.

Calling your health care provide

If there are symptoms of vitamin deficiencies then it is advised to call the health care provider.

Prevention

Intake of well balanced diet can prevent vitamin deficiencies.

Reference

Nih.gov, wikipedia.com, wrongdiagnosis.com