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Vitamins and Minerals Nutritional Deficiencies

The main feature of both rickets and osteomalacia is lack of calcium in the bones
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Vitamin A Deficiency

It plays important roles in the body including vision, maintenance of epithelial tissue, and synthesis of mucous secretion, growth, reproduction and immunity. The organ that is most readily affected is the eye.

Symptoms and Signs

• Night blindness: (Reduced ability to see in dim light)

• Conjunctival xerosis/ drying, Corneal xerosis/drying, Xerophthalmic fundus (retina has white dots).

• Keratomalacia: Perforation of the cornea prolapsed of the iris, loss of ocular contents and perhaps destruction of the eye. All of these may lead to complete blindness

Vitamin B1 Deficiency (Beriberi):

It occurs when people consume highly milled polished rice or maize, and starchy roots such as cassava, which are deprived of thiamine content.

Signs and Symptoms

• Heart palpitation, chest pain.

• Dyspnoea (breathlessness), a rapid, sometimes irregular pulse and distended neck veins with visible pulsations

• The heart is found to be enlarged

• Cyanosis

• Increased oedema

• Severe dyspnea

• Acute circulatory failure and death

• The patient is thin with weak, wasted muscles Anaesthesia and ‘pins-and-needles’ feelings in the feet and arms may increase, eventually causing difficulty in walking

• Foot drop and wrist drop commonly occur

Vitamin B3 (Niacin) Deficiency (Pellagra):

It is generally associated with maize diet.

Early Symptoms of Pellagra: A person appears poorly malnourished, often weak and underweight. A person may also have diminished sensitivity to gentle touch and sometimes some muscular weakness and tremor. Untreated cases of pellagra may die of the disease

The disease is later characterized by the four ‘Ds’

Dermatitis: deepening of the pigmentation, dry skin, scaly and eventual cracked, desquamation, occasionally the skin may blister, the tongue and other parts of the mouth are often sore, red, smooth and raw-looking

Diarrhoea: a patient with pellagra may frequently have bouts of abdominal pain, diarrhoea and other digestive upsets. The upsets include nausea, excessive salivation, and a burning sensation in the epigastrium.

Dementia: this involves the effect of pellagra in nervous system. Symptoms and Signs of Dementia: Irritability, loss of memory, anxiety and insomnia

Death

Vitamin C Deficiency (Scurvy):

Symptoms and Signs: The walls of blood vessels lack solidity and become fragile and bleeding or haemorrhage from various sites results. Other haemorrhages include nosebleeds, blood in the urine or faeces

Moderate deficiency of vitamin C may result in poor healing of wounds. People who do not eat enough vitamin C may not absorb enough iron and may develop iron deficiency anaemia especially in pregnancy

• Tiredness and weakness

• Swollen gums which bleed easily at the base of the teeth

• In the skin - follicular hyperkeratosis, skin bruising, haemorrhages and broken coiled hair

• Swollen painful joints particularly of the knees, hip and elbow also pain in all muscles

• Loss of secretion of lachrymal and salivary glands, loss of hair, dryness of the skin and loss of dental fillings.

• Beading of the ribs

Vitamin D Deficiency (Rickets and Osteomalacia)

The main feature of both rickets and osteomalacia is lack of calcium in the bones. Rickets occurs in children whose bones are still growing. Often children are plump and appear well fed. Osteomalacia occurs in adults who have formed bones. Both conditions are caused mainly by a deficiency of vitamin D, and not by a dietary lack of calcium.

Symptoms and Signs of Rickets: Child tends to be miserable, flabby (toneless state of muscles that causes a pot-belly), impairment of normal development, gastro-intestinal upset and excessive sweating of the head. The main signs of the disease are bone deformation.

Anaemia

• Anaemia is a pathological condition arising as a result of low level of haemoglobin which impairs oxygen transport to the tissues. There are various types of Anaemia such Haemorrhagic, haemolytic and nutritional Anaemia. In this session we will base on Nutritional Anaemia

• Nutritional anaemia is due to deficiency of nutrients that are needed for the synthesis of red blood cells: iron, folic acid and vitamin B12. Thus nutritional anaemia includes: Iron deficiency anaemia, Folic acid deficiency anaemia and Vitamin B12 deficiency anaemia.

Iron Deficiency Anaemia (IDA)

Symptoms and Signs Iron Deficiency Anaemia (IDA)

• Tiredness and fatigue

• Dizziness and/or headaches

• Palpitations

• Difficulty in breathing on exertion

• Inadequate temperature regulations

• Mild degree of splenomegaly

• Brittle finger nail

Folate and Vitamin B12 deficiency anemia (Megaloblastic anaemia)

Symptoms and Signs: Glossitis, sometimes stomatitis, hyper pigmentation of skin and mucosa, peripheral neuropathy (only for B12 Deficiency) and dementia

In children, severe Vitamin B12 deficiency may produce mental regression, convulsions, coma and ultimate death

NB: PERNICIOUS ANEMIA – anemia due to a lack of intrinsic factor, which is essential for vitamin B12 absorption

The symptoms are quite variable, and they can be caused by other conditions. The only sign you can look for is paleness, which is not very reliable. So to know whether a person is anaemic or not, you need to measure the amount of haemoglobin in the blood.

Prevention and treatment of anaemia-related diseases (malaria, worm infestation)

• Iron and folic acid supplementation to the most at risk groups (children, pregnant women, sickle cell disease patients)

• Fortification of foods with relevant nutrients (iron, folic acid)

Iodine Deficiency

Deficiency of iodine in the body leads to conditions termed iodine deficiency disorders (IDD). Iodine is found in the soil and is picked up by different foods (plants, animals, water) obtainable in the area. The major cause of iodine deficiency is its loss from the soil through leaching. Iodine deficiency manifests as goitre as well as a variety of conditions termed hypothyroidism.

Symptoms and Signs of Iodine Deficiency Disorders:  Goitre

A person who is hypothyroid: Feels cold easily, moves slowly and lacks energy, think slowly and appear unconcerned, may be sleepy, has a dry skin and may be constipated

A child who is hypothyroid: Also grows slowly, may be very short and may not do well in school

Women who are hypothyroid during pregnancy may also have; Miscarriage or still birth, Low birth weight babies, Babies with congenital deformities and Babies with cretinism

Control of Iodine Deficiency

• Various medicinal preparations are administered, such as: Injectable iodized oil, Iodinated oil capsules, and Salt iodation

Reference

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