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Nutritional deficiencies

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Related Terms
  • Achlorhydria, appetite stimulant, B12 absorption, beriberi, biotin deficiency, cachexia, copper deficiency, familial hypophosphatemia, folate deficiency, hypercalciuria, hypocalcemia, hypophosphatemia, iodine deficiency, iron absorption enhancement, iron deficiency, Korsakoff's psychosis, Kwashiorkor, malnutrition, marasmus, nutritional deficiencies, nutritional support (TPN), pantothenic acid deficiency, pellagra, pyridoxine deficiency, riboflavin deficiency, rickets, scurvy, thiamin deficiency, total parenteral nutrition, TPN, vitamin A, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K, Wernicke-Korsakoff syndrome, Wernicke's encephalopathy.

Background
  • Nutrition is a science that examines the relationship between diet and health. Nutrition includes the foods that provide energy and health, including proteins, carbohydrates, fats, vitamins, minerals and water. A nutritional deficiency is a state where an individual's intake of nutrients is insufficient for the body's normal functioning. The body's needs for nutrition change as it grows. So, for example, babies have different nutritional needs than a pregnant woman or an elderly person.
  • The body needs a regular intake of many nutrients such as protein, fat, carbohydrates, vitamins, and minerals for the health of bones, nerves, organs, and other body functions. Proteins help build body tissue (such as muscle and organs), carbohydrates provide energy, and fats are a component of all cell membranes and are an important source of stored energy in the body.
  • Vitamins are important for the cellular functions of the body. They are chemical substances that help the body use energy, build proteins, make cells, and repair injuries. Vitamins are divided into two general categories: fat soluble and water soluble. The fat soluble vitamins are A, D, and E. Vitamin A is necessary for eyes, bones, and skin. Vitamin D is necessary to make bones and teeth, and it allows the body to use calcium from the diet. Vitamin E is important for the immune system and for the cardiovascular system.
  • The water soluble vitamins are vitamin C and the B vitamins. Vitamin C is important for fighting infection and for using the stored energy in the body. Vitamin C is generally found in citrus fruits and other vegetables like tomatoes and peppers. The B vitamins are important for building blood cells, nerve cells, and are vital for many of the body's chemical reactions. These are found in many meats and vegetables.
  • Minerals, such as calcium, iron, zinc, and magnesium, are also essential for health.
  • Deficiencies, excesses, and imbalances in the diet can produce negative impacts on health, which may lead to diseases such as cardiovascular disease, birth defects, diabetes, scurvy, obesity, seizures, or osteoporosis.
  • Many common diseases and their symptoms can often be prevented or alleviated with better nutrition; nutritional deficiencies are very common worldwide.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. American Academy of Family Physicians. . Accessed May 19, 2009.
  2. American Academy of Pediatrics. . Accessed May 19, 2009.
  3. American Dietetic Association. . Accessed May 19, 2009.
  4. Arnold M, Barbul A. Nutrition and wound healing. Plast Reconstr Surg. 2006;117(7 Suppl):42S-58S.
  5. Cashman KD. Calcium and vitamin D. Novartis Found Symp. 2007;282:123-38; discussion 138-42, 212-8.
  6. Centers for Disease Control and Prevention. . Accessed May 19, 2009.
  7. Denic S, Agarwal MM. Nutritional iron deficiency: an evolutionary perspective. Nutrition. 2007;23(7-8):603-14. Epub 2007 Jun 20.
  8. Natural Standard: The Authority on Integrative Medicine. . Copyright © 2009. Accessed May 19, 2009.
  9. Tucker ON, Szomstein S, Rosenthal RJ. Nutritional consequences of weight-loss surgery. Med Clin North Am. 2007;91(3):499-514, xii. Review.
  10. Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007;370(9586):511-20.

Causes and risk factors
  • Risk factors for developing nutritional deficiencies include unhealthy dieting to lose weight, smoking, and alcohol dependence. Also at risk are patients on special diets recovering from gastric surgery, especially those who have undergone bariatric surgery like gastric bypass. Gastric bypass surgery removes some of the stomach, leaving only a walnut-sized portion. This decrease in the size of the stomach and a decrease in the amount of food eaten may lead to nutritional deficiencies; there are not enough nutrients absorbed for the body to use (called malabsorption). Malabsorption can cause nutrient deficiencies. Other causes include achlorhydria and hypochlorhydria, states where gastric acid levels are either absent or low in the stomach, respectively, causing malabsorption of certain vitamins and minerals. Stomach acidity is necessary in order to change some vitamins and minerals, such as vitamin B12 and iron, into forms that the body can absorb.
  • Cachexia is the physical wasting with loss of weight and muscle mass caused by disease. Cachexia can be a sign of various underlying disorders, such as cancer, certain infectious diseases (such as tuberculosis and acquired immunodeficiency syndrome), and autoimmune disorders (such as rheumatoid arthritis). The individual does not consume and absorb enough nutrients. Loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite occurs over time. Cachexia can occur in people who are eating enough, but who cannot absorb the nutrients.
  • Many prescription medications may cause various nutrients to be depleted from the body. This nutrient depletion may occur immediately (acute) or over time when taking certain prescribed medications. Medications commonly causing nutrient depletion include: antibiotic, anticonvulsant, antidiabetic, anti-inflammatory, cardiovascular, cholesterol-lowering, female hormones, antigout, psychotherapeutic, anti-ulcer, and laxative medications. Nutrient depletion caused by medications can occur due to a decrease in absorption of the nutrient caused by the medication or by biochemical changes.
  • Malnutrition occurs when the individual does not get enough calories or nutrients to keep themselves healthy. Nutrients are protein, fat, carbohydrates, vitamins, and minerals. Malnutrition may make the body weak, and it may cause health problems such as trouble fighting infections and healing.

Selected nutritional deficiency symptoms and complications
  • Note: See the Integrative Therapies section for a more detailed explanation of each nutrient and its function in the body.
  • Biotin: Symptoms of biotin deficiency include dermatitis, eye inflammation, hair loss, loss of muscle control, insomnia, and muscle weakness.
  • Calcium: Symptoms of calcium deficiency include brittle nails, cramps, delusions, depression, insomnia, irritability, osteoporosis, palpitations, periodontal disease, rickets, and tooth decay.
  • Copper: Symptoms of copper deficiency include anemia, arterial damage, depression, diarrhea, fatigue, fragile bones, hair loss, hyperthyroidism, and weakness.
  • Essential fatty acids: Symptoms of essential fatty acid deficiency include diarrhea, dry skin and hair, hair loss, immune impairment, infertility, poor wound healing, premenstrual syndrome, acne, eczema, gall stones, and liver degeneration.
  • Folic acid: Symptoms of folic acid deficiency include anemia, apathy, diarrhea, fatigue, headaches, insomnia, loss of appetite, neural tube defects in fetus, paranoia, shortness of breath, and weakness.
  • Iodine: Symptoms of iodine deficiency include cretinism, fatigue, hypothyroidism, and weight gain.
  • Iron: Symptoms of iron deficiency include anemia, brittle nails, confusion, constipation, depression, dizziness, fatigue, headaches, inflamed tongue, and mouth lesions.
  • Niacin: Symptoms of niacin deficiency include bad breath, canker sores, confusion, depression, dermatitis, diarrhea, emotional instability, fatigue, irritability, loss of appetite, memory impairment, muscle weakness, nausea, skin eruptions, and inflammation.
  • Pantothenic acid: Symptoms of pantothenic acid (vitamin B5) deficiency include abdominal pains, burning feet, depression, eczema, fatigue, hair loss, immune impairment, insomnia, irritability, low blood pressure, muscle spasms, nausea, and poor coordination.
  • Pyridoxine (vitamin B6): Symptoms of pyridoxine (vitamin B6) deficiency include acne, anemia, arthritis, eye inflammation, depression, dizziness, facial oiliness, fatigue, impaired wound healing, irritability, loss of appetite, loss of hair, mouth lesions, and nausea.
  • Riboflavin: Symptoms of riboflavin (vitamin B2) deficiency include blurred vision, cataracts, depression, dermatitis, dizziness, hair loss, inflamed eyes, mouth lesions, nervousness, neurological symptoms (numbness, loss of sensation, "electric shock" sensations), seizures, sensitivity to light, sleepiness, and weakness.
  • Thiamin: Symptoms of thiamin (vitamin B1) deficiency include confusion, constipation, digestive problems, irritability, loss of appetite, memory loss, nervousness, numbness of hands and feet, pain sensitivity, poor coordination, and weakness.
  • Vitamin A: Symptoms of vitamin A deficiency include acne, dry hair, fatigue, growth impairment, insomnia, hyperkeratosis (thickening and roughness of skin), immune impairment, night blindness, and weight loss.
  • Vitamin B12: Symptoms of vitamin B12 deficiency include anemia, constipation, depression, dizziness, fatigue, intestinal disturbances, headaches, irritability, loss of vibration sensation, low stomach acid, mental disturbances, moodiness, mouth lesions, numbness, and spinal cord degeneration.
  • Vitamin C: Symptoms of vitamin C deficiency include bleeding gums, depression, easy bruising, impaired wound healing, irritability, joint pains, loose teeth, malaise, and tiredness.
  • Vitamin D: Symptoms of vitamin D deficiency include burning sensations in the mouth, diarrhea, insomnia, blurred vision, nervousness, osteomalacia, osteoporosis, rickets, and scalp sweating.
  • Vitamin E: Symptoms of vitamin E deficiency include neurological problems (such as gait disturbances and poor reflexes) and shortened red blood cell life.
  • Vitamin K: Symptoms of vitamin K deficiency include heavy menstrual bleeding, gastrointestinal bleeding, hematuria (blood in the urine), nosebleeds, bleeding gums, and easy bruising.

Diagnosis and treatment
  • If a doctor believes that an individual is suffering from a lack of nutrition, the healthcare provider will weigh the individual and make a dietary assessment, which includes a diet history or food frequency analysis.
  • Blood tests to look for anemia, thyroid disorders, and to measure levels of specific nutrients (such as vitamins and minerals) are usually used.
  • Diagnosis using contrast X-rays of the gastrointestinal tract may be carried out to test for underlying digestive disorders. If the deficiency is severe, the individual will be admitted to a hospital where nutrients will be administered using a tube passed through the nose into the stomach (G-tube) or intravenously (IV) directly into the bloodstream.
  • Changing the diet will resolve the problem if poor eating habits are the cause. Each individual will have specific nutrient (vitamin and mineral) deficiencies, so it is important for a doctor to determine which nutrient deficiency is present. A sample of blood will generally be taken in a clinic or hospital and analyzed for vitamin and mineral status. In some cases, such as Crohn's disease (a chronic, episodic, inflammatory condition of the gastrointestinal tract characterized by affecting the entire wall of the involved bowel or intestines) or gastric bypass, long-term vitamin and mineral supplementation will be required. These conditions cause changes in the absorption of nutrients and can cause long-term vitamin and mineral deficiencies.
  • If medications are causing nutrient depletion, supplementation with multivitamin therapy or the depleted nutrient, such as coenzyme Q10 (with certain cholesterol-lowering medications called HMG-CoA reductase inhibitors), is recommended by healthcare providers. It is recommended to discuss any interactions with medications or dietary supplements with a healthcare provider.
  • Nutritionist: A nutritionist is a health professional dedicated to food and nutritional science, preventive nutrition, diseases related to nutrient deficiencies, and the use of nutrient manipulation to enhance the clinical response to human diseases. Nutritionists evaluate the diets of individuals suffering from medical disorders and suggest ways of fighting various health problems by modifying the individual's intake of certain food items.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.