Nutritional Deficiencies

Through our "Health Forensics" program we offer
nutrient depletion and interaction profiles for your drugs.

Some Deficiency Symptoms and Signs

Symptom or Sign	Possible Nutritional Deficiency	Other Possible Causes
General Symptoms and Appearance
Fatigue	Protein-energy, iron, magnesium, potassium, vitamins B1, B12 and other B vitamins and vitamin C	Many physical illnesses including hypothyroidism, cardiac failure, anaemia, chronic fatigue syndrome and depression
Loss of appetite	Zinc	Many chronic illnesses
Pica eating non-nutritive substances	General malnutrition and possibly iron, calcium, zinc, vitamins B1 – thiamine, B3 – niacin, C and D	Normal in infants under 2 years of age, pregnancy especially in young women, mental illness
Loss of taste	Zinc	Common cold, many nasal disorders
Cold intolerance	Iron	Hypothyroidism, anaemia and reduced cardiac output
Pale appearance due to anaemia	Iron, folate and vitamin B12	Excessive bleeding and haematological disorders
Carotenoderma – yellow discolouration of the skin noticeable on the face and trunk	Protein-energy and zinc	Dietary carotenoid excess especially in women, hypothyroidism
Diffuse hyperpigmentation	Protein-energy	Addison’s disease and haemochromatosis
Muscle wasting e.g. clothes appear too big, loss of limb musculature	Protein-energy
Loss of height and excessive curvature of the spine	Calcium and vitamin D	Increasing age and disease- related osteoporosis

Skin
Itchy skin – pruritus	Iron	Many skin diseases, liver disease
Dry skin	Essential Fatty Acids or multiple nutritional deficiencies	Old age, skin conditions e.g. eczema
Red scaly skin in light-exposed areas	Vitamin B3	Excessive sun-exposure in red/fair haired individuals light-exposed areas
Excessive bruising	Vitamin C	Old age, trauma and blood disorders
Haemorrhage or redness around hair follicles	Vitamin C
Bleeding into a joint or other unusual bleeding	Vitamin C	Various blood disorders
Plugging of hair follicles with keratin or coiled hairs	Vitamin C
Fine downy hair on torso – lanugo	Protein-energy. Typical of Persistent anorexia nervosa

Mouth
Sore tongue	Iron, vitamin B12, B2, B3 and possibly other B vitamins	Excessively hot drinks and oral disease
Cracking and peeling of skin on the lips	Vitamin B2 – riboflavin	Excessive exposure to cold or windy weather
Cracking at the corners of the mouth	Iron, vitamin B2 – riboflavin possibly other B vitamins	Poorly fitting dentures, eczema infection with candida albicans
Recurrent mouth ulcers	Iron, vitamin B12, folate and possibly other B vitamins	Coeliac disease, Crohn’s disease recurrent herpes and oral disease
Enlarged veins under the tongue with micro-haemorrhages	Vitamin C	Smoking and old age
Smooth, shinny and sore tongue: atrophic glossitis	Iron, vitamin B12 and folate

Head, Face and Neck
Scalp hair loss	Iron	Any scalp disease, alopecia from other causes
Dandruff	Essential fatty acids and biotin	Fungal infection of scalp
Redness at the sides of the nose	Vitamin B2 –riboflavin, vitamin B6 and zinc	Seborrhoeic dermatitis
Redness or cracking at the outer angle of the eyes	Vitamins B2 or B6
Goitre	Iodine deficiency is likely if goitre is present in > 20% of population – endemic goitre	Adolescence, pregnancy and various forms of thyroid disease
Hands and Nails
Nails - brittle or flaking	Iron and possibly essential fatty acids	Poor circulation and old age
Nails - upturned or spoon-shaped nails	Iron	Psoriasis or other diseases of the nail bed
Carotenoderma – yellow discolouration of the skin noticeable on the palms	Protein-energy and zinc	Dietary carotenoid excess especially in women, hypothyroidism

Musculo-skeletal
Muscle pains and cramps	Magnesium, potassium, sodium, vitamin B1 and vitamin D if there is hypocalcaemia	Muscle or neurological disease, polymyalgia rheumatica and hypocalcaemia
Calf muscle pain after minimal exercise	Vitamin B1 – thiamine	Torn muscle, peripheral vascular disease and myopathy
Excessive calf muscle tenderness	Vitamin B1- thiamine	Torn muscle, thrombosis
Walking with a waddling gait	Vitamin D and resultant myopathy	Osteoarthritis of the hips or disease of the hip-girdle muscles
Difficulty getting up from a low chair or climbing the stairs or weakness of shoulder muscles	Vitamin D and resultant myopathy	Arthritis of the hips or knees, diseases of the nerves or muscles
Bowed legs	Vitamin D - rickets in childhood	Paget’s disease and syphilis
Twitching of facial muscles when tapping on the facial nerve in front of the ear: Chvostek’s sign	Calcium and vitamin D if hypocalcaemia or severe magnesium deficiency	Hypocalcaemia for other reasons e.g. hypoparathyroidism

Eyes
Poor night vision	Zinc, vitamin A and possibly vitamin B2 - riboflavin	Retinal disease
Conjunctival dryness	Vitamin A	Old age and Sjogren’s syndrome

Gastrointestinal
Diarrhoea	Vitamin B3	Irritable bowel syndrome, malabsorption, infective diarrhoea and many other causes
Constipation	Dehydration, fibre, potassium, magnesium and folate	Irritable bowel syndrome, diverticulosis, cancer of the colon

Neurological
Restless legs	Iron or folate	Various neurological disorders, pregnancy, rheumatoid arthritis, and renal failure
Burning feet syndrome	Vitamin B2 –riboflavin	Early peripheral neuropathy
Loss of balance when standing upright with feet together and the eyes closed: Romberg’s test	Vitamin B12 and possibly vitamin B3	Many neurological disorders affecting the cerebellum, spinal chord or peripheral nerves
Loss of vibration sensation in the lower limbs	Vitamin B12 and possibly vitamin B3	Increasing age and peripheral neuropathy
Peripheral neuropathy – numbness, tingling, disordered sensation, pain and or weakness in the hands or feet	Vitamins B1, B12 and possibly B3, B6 and folate and very rarely copper (following gastrointestinal surgery or excess zinc ingestion). Relative lack of essential fatty acids.	Diabetes and many other causes
Unsteady movement or walking (cerebellar ataxia)	Vitamin B1, vitamin E and Coenzyme Q10	Alcohol, hypothyroidism and many neurological and inherited disorders

Mental State
Depression	Vitamins C, B1, B3, B6, B12, folate, biotin and possibly the essential fatty acids	Mental illness, stress and as a consequence of physical illness
Irritability	Folate	Alcoholism, deprcssion and personality disorder
Poor concentration	Iron, vitamins B1, B12, folate and possibly essential fatty acids	Depression, stress, lack of sleep, alcohol, dementia, anaemia, hypothyroidism and many other diseases

Cardio-vascular
Heart failure	Vitamin B1 – thiamin and any deficiency causing anaemia	Coronary, valvular and myocardial disease
Palpitations	Potassium and magnesium and any deficiency causing anaemia	Coronary, valvular and myocardial disease

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