Nutritional Deficiencies (Shelley Pelletier)
Information in standard texts was quite limited. The following was from Lezak:
Korsakoff’s Disease – related to thiamine deficiency (Lezak, 1995, pg. 255, 275)
Folic acid/folate deficiency implicated in a progressive condition of mental deterioration with
concomitant cerebral atrophy (and I believe it is implicated as well in spina bifida).
She briefly discusses difficulties in anorexic young women (who show subtle
neuropsychological deficits), and in the elderly (whose intake of nutrients falls below
recommended standards) who show similar deficits (p. 276).
She notes that changes occur due to aging, and the elderly are often undernourished with regard
to vitamins B12, B6, and folate.
And, the following came from Kaufman:
Neuropathies can develop from malabsorption of vitamins, fats, and other critical substances
through disorders such as starvation, gastrectomy, gastric bypass surgery, and inflammatory
bowel disease.
Alcohol inducted neuropathy = thiamine deficiency
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.
The following web site had significant amounts of information regarding nutrition in general,
and looked pretty reasonable.
http://apps.medsch.ucla.edu/nutrition/nutritdef.htm
The following is drawn from : http://apps.medsch.ucla.edu/nutrition/nutritpath.htm
Fat-soluble vitamin deficiencies and clinical signs
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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. Also, since alcohol
disrupts the
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.
THE FINE PRINT: Caveat emptor! These study materials have helped many people who have successfully completed the ABCN board
certification process, but there is no guarantee that they will work for you. The notes’ authors, web site host, and everyone else involved in the
creation and distribution of these study notes make no promises as to the complete accuracy of the material, and invite you to suggest changes.
The following is drawn from: http://www.bangalorenet.com/health/tips/article.htm
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.
THE FINE PRINT: Caveat emptor! These study materials have helped many people who have successfully completed the ABCN board
certification process, but there is no guarantee that they will work for you. The notes’ authors, web site host, and everyone else involved in the
creation and distribution of these study notes make no promises as to the complete accuracy of the material, and invite you to suggest changes.