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25th July 2023
Micronutrient Deficiencies
| Nutrient | Causes | Manifestation | Management |
|---|---|---|---|
| Vitamin K | Liver disease
Excessive anticoagulation with coumarins, i.e., warfarin Malabsorption Drugs i.e., rifampicin, isoniazid |
Bleeding from minor trauma (only evident if hypoprothrombinemia is present) | Life threatening bleeds: fresh frozen plasma (FFP)
Phytomenadione (vitamin K) Green leafy vegetables |
| Vitamin A | A diet lacking in vegetables and animal products | Night blindness
Poor immune system |
Dark green leafy vegetables
Fortification of oil/fats Animal products Supplements |
| Vitamin D | Diet
Lack of sunlight |
Osteomalacia
Osteoporosis |
Supplements
Fish (cod liver oil, salmon, tuna, sardines) |
| Vitamin E | Malabsorption
Pancreatic insufficiency |
Reversible motor and sensory neuropathies | Supplements
Plant oils |
| Vitamin B1 (Thiamine) | Alcohol excess
Diet |
Wernicke’s encephalopathy
Korsakoff’s syndrome Beriberi |
Supplements |
| Vitamin B3 (Niacin) |
Alcohol excess
Diet Carcinoid syndrome |
Pellagra (Ds): Diarrhoea, dermatitis, dementia, depression | Supplements
Animal products – liver |
| Vitamin C | A diet lacking in citrus fruits and vegetables | Scurvy: gingivitis, follicular hyperkeratosis, perifollicular haemorrhage, bruising, poor wound healing | Citrus fruits
Cruciferous vegetables |
| Zinc | A diet lacking in animal products | Acrodermatitis
Alopecia Perioral dermatitis Geophagia Poor immune system |
Improved diet
Supplements |
| Iron | A diet lacking in animal products
Parasitic infections Conditions with increased needs, i.e. infections |
Anaemia
Impaired cognition |
Iron rich/ fortified foods
Low dose Supplements |
| Iodine | A diet lacking in seafood | Goitre
Hypothyroidism |
Supplements
Fortified salts |
Table 1: Micronutrient deficiencies – causes, manifestations, and management
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