Typical findings in deficiency or excess of various micronutrients
Vitamin and Mineral Deficiencies and Toxicities
| Micronutrient | Deficiency | Toxicity |
|---|---|---|
| Vitamin A | Follicular hyperkeratosis, night blindness, corneal drying, keratomalacia | Dermatitis, xerosis, hair loss, joint pain, hyperostosis, edema, hypercalcemia, hepatomegaly, pseudotumor |
| Vitamin D | Rickets, osteomalacia, hypophosphatemia, muscle weakness | Fatigue, headache, hypercalcemia, bone decalcification |
| Vitamin E | Hemolytic anemia, myopathy, ataxia, ophthalmoplegia, retinopathy, areflexia | Rare: possible interference with vitamin K, arachidonic acid metabolism, headache, myopathy |
| Vitamin K | Bruisability, prolonged prothrombin time | Rapid intravenous infusion: possible flushing, cardiovascular collapse |
| Vitamin C | Scurvy: poor wound healing, perifollicular hemorrhage, gingivitis, dental defects, anemia, joint pain | Diarrhea; possible hyperoxaluria, uricosuria; interference with glucose, occult blood tests; dry mouth, dental erosion |
| Vitamin B 1 (thiamine) | Dry beriberi (polyneuropathy): anorexia, low temperature Wet beriberi (high-output congestive heart failure): lactic acidosis Wernicke-Korsakoff syndrome: ataxia, nystagmus, memory loss, confabulation, ophthalmoplegia | Large-dose intravenous: anorexia, ataxia, ileus, headache, irritability |
| Vitamin B 2 (riboflavin) | Seborrheic dermatitis, stomatitis, cheilosis, geographic tongue, burning eyes, anemia | None |
| Vitamin B 3 (niacin) | Anorexia, lethargy, burning sensations, glossitis, headache, stupor, seizures Pellagra: diarrhea, pigmented dermatitis, dementia | Hyperglycemia, hyperuricemia, GI symptoms, peptic ulcer, flushing, liver dysfunction |
| Vitamin B 6 (pyridoxine) | Peripheral neuritis, seborrhea, glossitis, stomatitis, anemia, CNS/EEG changes, seizures | Metabolic dependency, sensory neuropathy |
| Vitamin B 12 | Glossitis, paresthesias, CNS changes, megaloblastic anemia, depression, diarrhea | None |
| Folic acid | Glossitis, intestinal mucosal dysfunction, megaloblastic anemia | Antagonizes antiepileptic drugs, decreases zinc absorption |
| Biotin | Scaly dermatitis, hair loss, papillae atrophy, myalgia, paresthesias, hypercholesterolemia | None |
| Pantothenic acid | Malaise, GI symptoms, cramps, paresthesias | Diarrhea |
| Calcium | Paresthesias, tetany, seizures, osteopenia, arrhythmia | Hypercalciuria, GI symptoms, lethargy |
| Phosphorus | Hemolysis, muscle weakness, ophthalmoplegia, osteomalacia | Diarrhea |
| Magnesium | Paresthesias, tetany, seizures, arrhythmia | Diarrhea, muscle weakness, arrhythmia |
| Iron | Fatigue, dyspnea, glossitis, anemia, koilonychia | Iron overload (hepatic, cardiac), possible oxidation damage |
| Iodine | Goiter, hypothyroidism | Goiter, hypo/hyperthyroidism |
| Zinc | Lethargy, anorexia, loss of taste/smell, rash, hypogonadism, poor wound healing, immunosuppression | Impaired copper, iron metabolism, reduced HDL, immunosuppression |
| Copper | Anemia, neutropenia, lethargy, depigmentation, connective tissue weakness | GI symptoms, hepatic damage |
| Chromium | Glucose intolerance, neuropathy, hyperlipidemia | None |
| Selenium | Keshan’s cardiomyopathy, muscle weakness | GI symptoms |
| Manganese | Possible weight loss, dermatitis, hair disturbances | Inhalation injury only |
| Molybdenum | Possible headache, vomiting, CNS changes | Interferes with copper metabolism, possible gout |
| Fluorine | Increased dental caries | Teeth mottling, possible bone integrity/fluorosis |
CNS, Central nervous system; EEG, electroencephalography; GI, gastrointestinal; HDL, high-density lipoproteins.
