Nutritional Deficiencies

Some Common Nutritional Deficiencies

  • Korsakoff’s Disease – related to thiamine deficiency
  • Folic acid/folate deficiency – implicated in a progressive condition of mental deterioration with concomitant cerebral atrophy. It is also implicated in spina bifida/neural tube defects.
  • Vitamin deficiencies – affect anorexic young women (who show subtle neuropsychological deficits), and in the elderly (whose intake of nutrients falls below recommended standards) who show similar deficits. In the elderly undernourishment with regard to vitamins B12, B6, and folate may occur.
  • Malabsorption of vitamins, fats and other critical substances – usually related to starvation, gastrectomy, gastric bypass surgery and inflammatory bowel disease leads to neuropathies.
  • Niacin deficiency – pellagra (dementia, dermatitis, diarrhea – the three D’s)
  • Combined System Disease (pernicious anemia, or B12 deficiency) – causes a neuropathy overshadowed by spinal cord impairment.
  • Fat-soluble vitamin deficiencies and clinical signs
    • Vitamin A – Night blindness, hyperkeratosis, skin changes
    • Vitamin D – Hypocalcemia, osteomalacia, rickets, hypophosphatemia
    • Vitamin E – Neuropathy, hemolytic anemia
    • Vitamin K – Prolongation of prothrombin time, easy bruising
  • Alcohol provides 7 kcal/g, but lacks in vitamins and minerals, can result in Wernicke’s encephalopathy and macrocytic anemia, respectively. Patients who do not respond to oral supplements may require subcutaneous injections of vitamins. If a diuretic is being taken, serum potassium, zinc and magnesium levels should be closely monitored.

Sources of Vitamins and Minerals

  • Thiamine (Vitamin B1)
    • Found abundantly in all varieties of food stuffs and is rapidly destroyed with cooking. Deficiency occurs in alcoholics, patients undergoing peritoneal dialysis, long administration of Glucose. Deficiency symptoms can be “Tingling and numbness” of fingers and toes.
  • Riboflavin (Vitamin B2)
    • Found in milk, meat, fish, leafy vegetables and is also destroyed with cooking. Deficiency causes sore mouth, apthous ulcers, anaemia.
  • Niacin (Vitamin B5)
    • Found in whole grain cereals, nuts, fish, meat. Deficiency can be associated with a high intake of maize. Symptoms are rapid loss of weight, diarrhea, fatigue and sometimes even severe loss of memory (dementia).
  • Pyridoxin (Vitamin B6)
    • Found in meat, vegetables, whole grain cereals. Deficiency can occur in alcoholics, pregnancy, intake of certain drugs like Isoniazid (Anti T.B. drug), oral contraceptives. Symptoms of deficiency are Seborrhoeic dermatitis ( a dandruff-like condition of scalp, eyebrows), cuts on the lips (Chelitis), burning sensation of the tongue, tingling and numbness of hands and legs.
  • Cobalamine (Vitamin B12)
    • Found in kidney, eggs and milk. Cobalamin is an essential intrinsic factor required for the formation of Hemoglobin.
    • Deficiency can be found in patients with impaired gastric absorption, pancreatic diseases. Symptoms are anaemia, low B.P., tingling and numbness of extremities, redness and burning of tongue (glossitis).
  • Vitamin C (Ascorbic Acid)
    • Found in fresh vegetables , citrus fruits. Deficiency can cause bleeding gums, delayed healing of colds, Pupura (bleeding disorder).
  • Folic Acid
    • Found in green, leafy vegetables. Defective absorption in cases with chronic gastric problem can lead to deficiency. Also in patients undergoing Dialysis, Hyperthyroidism, pregnancy. Deficiency symptoms include Megaloblastic Anaemia, Glossitis, Chelitis.
  • Vitamin A
    • Found in animal food, carrot etc. Deficiency causes dryness of eyes and skin, night blindness, corneal ulcers.
  • Vitamin D
    • Found in milk, fish, eggs, butter. Inadequate exposure to sunlight also can cause deficiency.In children it causes rickets and Osteomalacia (softening of bones) in adults, muscle weakness and muscular cramps.

Additional Resources

The following web sites are also useful resources.