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Diet and Nutrition

Symptoms of vitamin deficiency?

09/24/1998

Question:

how do you know when you have a vitamin def. what are sx. of this problem?

Answer:

Thanks for your question. Vitamin deficiencies are diagnosed by a physician, and you have to exhibit certains signs and symptoms, as well as have lab data to confirm a diagnosis. A vitamin deficiency does not produce overt signs or symptoms until the later stages.

Initially, an MD or RD (registered dietitian) will get a diet history from you. This will tell them if you have a primary vitamin or mineral deficiency due to poor or inadequate intake of a certain nutrient. They will also take a history of your health, to see if certain disease conditions affect your digestion, absorption, transport or regulation of certain vitamins. For example, if you had kidney failure, you may become deficient in calcium. The reason for this, is that the kidney makes the active form of Vitamin D, which is necessary for calcium absorption. If your kidneys are not functioning as well as they should, you may not produce adequate Vitamin D, and therefore may not a absorb calcium as well as you should (even though your diet may be adequate in calcium).

You will also need blood drawn to confirm a diagnosis of a vitamin deficiency. Lab values that are done will be done to show functional properties of the vitamin or mineral, and not the nutrient itself. Few nutrients can be measured in the blood to show levels of that nutrient. For example, iron is part of hemoglobin and hematocrit. If these levels are low, your MD may suspect iron deficiency. Your physician will need to do further lab tests to rule this out (because there are other causes of a low hemoglobin or hematocrit, such as blood loss). For iron, a ferritin level is drawn (this reflects iron storage). So, although your diet may be inadequate in iron, it will take a long time to become anemic. You may be iron deficient, but not yet anemic, since your body stores iron. It is when your iron stores are very low that you become anemic.

When you are truly nutrient deficient, you will show signs or symptoms of that deficiency. But again, just because you missed one day of your RDA for vitamin C, does not mean you will become deficient in Vitamin C. Most people need to be eating a poor quality diet for longer than a month, and sometimes even 6 months to show overt signs of a deficiency. Some populations are higher risk for deficiencies such as alcoholics, people living in poverty, people in third world/underdeveloped countries, or people with chronic diseases which affect the regulation of vitamin/minerals in the body. In addition, certain medications may interact with nutrients and affect their availability in the body (such as methotrexate and folic acid). Methotrexate is a medication used in cancer patients, and patients with arthrititis. An MD will often recommend a folic acid supplementation to offset potential deficiencies.

Some vitamin deficiency signs and symptoms are found by observing a persons skin, hair and eyes. For iron deficiency, your skin may be pale, you may feel weak, fatigued, etc. Protein, zinc and iron deficiency can affect your hair (making it less curly, thin or easily pluckable). But again, just because a person exhibits these symptoms, does not mean they have a vitamin deficiency. Only through diet history, medical history, lab data and physical examination can a person truly be diagnosed with a deficiency.

For more information on eating a healthy diet to prevent deficiencies, see the American Dietetic Association website at www.eatright.org

If you suspect a nutrient deficiency, see a doctor.

I hope this information helped you. Good luck!

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Response by:

Lisa Cicciarello Andrews, MEd, RD, LD Lisa Cicciarello Andrews, MEd, RD, LD
Adjunct Faculty
University of Cincinnati