Vitamin Deficiencies Flashcards
Water Soluble Vitamins vs Fat Soluble Vitamins
Water Soluble Vitamins
- Do not reach toxic levels
- Are excreted by kidneys so are needed more frequently
Fat Soluble Vitamins
- Accumulate and are stored in adipose tissue
- Can reach toxic levels
Dietary Factors - Inadequate Intake
Poor dietary habits
Food Insecurity
Restricted Diets - Vegans
Elderly
Dietary Factors - Unbalanced Diets
High Intake of refined carbohydrates and processed foods
- Deficient: B vitamins, Iron, Zinc
Low Consumption of fruits and veggies
- Deficient: Vitamin C, Folate, Potassium
Malabsorption - Celiac Disease
Iron
Calcium
Vitamin B
VItamin D
Malabsorption - IBD
Fat Soluble Vitamins (A, D, E, K)
+
Iron, Zinc
Malabsorption - Chronic Diarrhea
Loss of water soluble vitamins and electrolytes
Malabsorption - Post-Bariatric surgery
Reduces absorption of:
- Iron
- Calcium
- Vitamin B12
- Fat Soluble Vitamins
Malabsorption - Chronic Pancreatitis
Reduced digestive enzyme production
- Less Fat Absorption (A, D, E, K)
Increased Nutrient Requirements - Pregnancy and Lactation
Needs more:
- Calcium
- Vitamin D
- Iron
- Folic Acid
Increased Nutrient Requirements - Infancy and Adolescent
Needs more:
- Calcium
- Vitamin D
- Iron
- Zinc
Increased Nutrient Requirements - Elderly
Reduced efficiency in nutrient absorption, needs higher intake of
- Calcium
- Vitamin D
- Vitamin B12
Medications that affect absorption of vitamins
PPI
Metformin
Diuretics
Anticonvulsants
Corticosteroids
Medication Use - PPIs
Reduces stomach acid, lowering absorption of
- Vitamin B12
- Calcium
- Magnesium
Medication Use - Metformin
Long term use can cause Vitamin B12 deficiency
Medication Use - Diuretics
Potassium, Magnesium, Calcium depletion
Medication Use - Anticonvulsants
Reduces Vitamin D levels, increasing chances of osteoporosis
Medication Use - Corticosteroids
Depletes calcium and potassium
- Can cause sodium retention
Chronic Medical Conditions - Liver Disease
Impairs vitamin storage and metabolism:
- Vitamin A, D, E, K
Chronic Medical Conditions - Kidney Disease
Loss of water soluble vitamins due to dialysis
- Disturbances in calcium, phosphorus homeostasis
Chronic Medical Conditions - Heart Failure
Increased nutrient need due to medication use and fluid balance issues
Alcohol Use
Reduces absorption and utilization of B vitamins
- Especially thiamine
- Also folate, magnesium, zinc
Can damage liver which impairs fat soluble vitamin storage
Substance Use Disorder
Poor dietary intake and nutrient depletion
Potential for micronutrient deficiencies
Smoking
Increases oxidative stress
- Higher Vitamin C requirements
- Deficiency in folate and Vitamin E
Limited Sunlight
Needs more vitamin D
Hemochromatosis
Build up of iron leading to damage to organs
- Restrict proteins
Phenylketonuria
Body can not break down pheynlalanine, can build up to toxic levels
- Restrict proteins
24 Hour Dietary Recall
Snapshot of what patient eats in a day
Food Frequency Questionnaire
Checklist to see frequency of consumption of key groups (week/month)
- How often do you eat leafy veggies
Typical Day Diet Assessment
Meal patterns, portion sizes, common food sizes
- Simialr to 24 hour dietary recall with just a bit of structure and more detaield info
Food Group Inquiry
Specifc questions on patient’s intake of specific groups that can impact their health
Subjective Global Assessment
Focuses on risk factors of malnutrition
- Weight changes
- Dietary changes
- GI symptoms
- Functional capacity
- Disease states
Symptoms Suggestive of Deficiency
Fatigue
Hair Loss
Brittle Nails
Poor wound healing
Twitching
Impaired cognition
Recommendations for Vitamin Deficiency
Nutrional Counseling (Dietary sources)
Supplement Recommendation (If indicated)
Referral to other health care providers (dietician)
