Vitamin Mineral Deficiencies and Toxicities

Typical findings in deficiency or excess of various micronutrients

Vitamin and Mineral Deficiencies and Toxicities

MicronutrientDeficiencyToxicity
Vitamin AFollicular hyperkeratosis, night blindness, corneal drying, keratomalaciaDermatitis, xerosis, hair loss, joint pain, hyperostosis, edema, hypercalcemia, hepatomegaly, pseudotumor
Vitamin DRickets, osteomalacia, hypophosphatemia, muscle weaknessFatigue, headache, hypercalcemia, bone decalcification
Vitamin EHemolytic anemia, myopathy, ataxia, ophthalmoplegia, retinopathy, areflexiaRare: possible interference with vitamin K, arachidonic acid metabolism, headache, myopathy
Vitamin KBruisability, prolonged prothrombin timeRapid intravenous infusion: possible flushing, cardiovascular collapse
Vitamin CScurvy: poor wound healing, perifollicular hemorrhage, gingivitis, dental defects, anemia, joint painDiarrhea; possible hyperoxaluria, uricosuria; interference with glucose, occult blood tests; dry mouth, dental erosion
Vitamin B (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 (riboflavin)Seborrheic dermatitis, stomatitis, cheilosis, geographic tongue, burning eyes, anemiaNone
Vitamin B (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 (pyridoxine)Peripheral neuritis, seborrhea, glossitis, stomatitis, anemia, CNS/EEG changes, seizuresMetabolic dependency, sensory neuropathy
Vitamin B 12Glossitis, paresthesias, CNS changes, megaloblastic anemia, depression, diarrheaNone
Folic acidGlossitis, intestinal mucosal dysfunction, megaloblastic anemiaAntagonizes antiepileptic drugs, decreases zinc absorption
BiotinScaly dermatitis, hair loss, papillae atrophy, myalgia, paresthesias, hypercholesterolemiaNone
Pantothenic acidMalaise, GI symptoms, cramps, paresthesiasDiarrhea
CalciumParesthesias, tetany, seizures, osteopenia, arrhythmiaHypercalciuria, GI symptoms, lethargy
PhosphorusHemolysis, muscle weakness, ophthalmoplegia, osteomalaciaDiarrhea
MagnesiumParesthesias, tetany, seizures, arrhythmiaDiarrhea, muscle weakness, arrhythmia
IronFatigue, dyspnea, glossitis, anemia, koilonychiaIron overload (hepatic, cardiac), possible oxidation damage
IodineGoiter, hypothyroidismGoiter, hypo/hyperthyroidism
ZincLethargy, anorexia, loss of taste/smell, rash, hypogonadism, poor wound healing, immunosuppressionImpaired copper, iron metabolism, reduced HDL, immunosuppression
CopperAnemia, neutropenia, lethargy, depigmentation, connective tissue weaknessGI symptoms, hepatic damage
ChromiumGlucose intolerance, neuropathy, hyperlipidemiaNone
SeleniumKeshan’s cardiomyopathy, muscle weaknessGI symptoms
ManganesePossible weight loss, dermatitis, hair disturbancesInhalation injury only
MolybdenumPossible headache, vomiting, CNS changesInterferes with copper metabolism, possible gout
FluorineIncreased dental cariesTeeth mottling, possible bone integrity/fluorosis

CNS, Central nervous system; EEG, electroencephalography; GI, gastrointestinal; HDL, high-density lipoproteins.

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