Table of Vitamin Deficiency Symptoms
In 1997, the CDC recognized that patients receiving TPN without MVI supplementation were at risk for life-threatening complications due to certain micronutrient deficiencies.3 As nutritional science has expanded its understanding of additional physiologic functions of micronutrients, the concept of deficiency has been redefined.1 Originally based on a disease entity that occurred as a result of deficiency of the nutrient, the definition of deficiency today has been broadened to include the fact that micronutrients serve important functions in a wide variety of biochemical systems.1 The following table identifies deficiencies by signs and symptoms.1,2
|
NUTRIENT |
SIGNS AND SYMPTOMS OF DEFICIENCY
|
|
Fat-Soluble Vitamins |
|
Vitamin A (retinol) |
Nightblindness, xerosis, Bitot’s spot, keratomalacia, perifollicular hyperkeratosis, anorexia, bone changes.
|
|
Vitamin D |
Osteomalacia in adults; rickets in children. Deformity of bone and pathologic fractures.
|
|
Vitamin E |
Neurologic syndromes including areflexia, gait disturbances, paresis of gaze. May contribute to hemolytic anemia and retrolental fibroplasia in premature infants.
|
|
Vitamin K |
Hypothrombinemia and hemorrhagic disease.
|
Water-Soluble Vitamins |
|
Vitamin C |
Scurvy. In adults, fatigue, aching bones, joints, and muscles, perifollicular hemorrhages, bleeding gums, failed wound healing. In infants and elderly, bone changes, bleeding gums, anemia.
|
|
Thiamine (vitamin B1 ) |
CV (wet) beriberi: edema, heart failure. Neurologic (dry) berberi: Wernicke’s encephalopathy, peripheral neuropathies, lactic acidosis with carbohydrate loading.
|
|
Riboflavin (vitamin B2 ) |
Reddened, greasy scaly, puritic skin in the oroaculogenital areas; seborrheic dermatitis, dyssebacea (shark skin), angular stomatitis, cheilosis, magenta tongue.
|
|
Niacin |
Pellagra, photosensitive dermatitis, diarrhea, mucosal inflammation, dementia, beefy red tongue.
|
|
Vitamin B6 |
Seborrheic dermatitis, glossitis, cheilosis, angular stomatitis, peripheral neuropathy. In infants, convulsions.
|
|
Folate |
Megaloblastic anemia, glossitis, diarrhea.
|
|
Vitamin B12 (cobalamin) |
Megaloblastic anemia, glossitis, anorexia, sensory neuropathy, dementia.
|
|
Biotin |
Scaly dermatitis, alopecia.
|
|
Pantothenic acid |
Burning feet syndrome, fatigue, abdominal pain and vomiting, insomnia.
|
References:
1. Goldman, ed. (2000). Cecil Textbook of Medicine, 21st ed., pp. 1172-1178. Philadelphia: W.B. Saunders Company.
2. Rakel, ed (2002) Textbook of Family Practice, 6th ed., p. 1111. Philadelphia: W.B. Saunders Company
3. US Centers for Disease Control (1997). Lactic Acidosis Traced to Thiamine Deficiency Related to Nationwide Shortage of Multivitamins for Total Parenteral Nutrition. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00047949.htm. Accessed January 2004.
[PRINTER FRIENDLY VERSION]
|
|
|
