Avitaminosis is a deficiency of one or more vitamins with insufficient amounts of nutrients from food. The reason may be the deterioration of nutrient absorption processes. The clinical picture is determined by the type of beriberi, as well as the severity of the disorders occurring in the body. Diagnosis includes laboratory and instrumental studies. Treatment is carried out by correcting the balance of vitamins with drugs and diet therapy. If possible, the root causes of the development of beriberi are eliminated.
The information on this page should not be used for self-treatment or self-diagnosis purposes. In case of exacerbation of the symptoms of the disease, it is necessary to seek diagnostic tests, diagnosis, and the correct prescription of the treatment method from your doctor.
What is avitaminosis
The human body needs 13 essential vitamins that can be obtained from food. Since each of these vitamins plays an important role in the body, a deficiency can have some health consequences, depending on which substance is lacking: vitamin A, B (thiamin, riboflavin, niacin, pantothenic and folic acid, pyridoxine, biotin, cobalamin), C, D, E or K.
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Vitamin deficiencies remain common throughout the world. If the condition is not running, it often does not have clear symptoms. But even moderate beriberi can have adverse effects. Vitamin deficiency affects people of all ages and is often combined with a lack of minerals (zinc, iron, iodine). The groups most susceptible to vitamin deficiencies are pregnant and lactating women, and young children, due to the relatively high requirement for and susceptibility to these compounds.
Even if we are very health conscious, our highly processed foods and the pace of modern life make it difficult to get all the nutrients, vitamins, and minerals we need from our diet alone. Many people take multivitamins “just in case” because:
. the soil on which our food is grown is not rich in nutrients;
The diet is not as varied as it should be.
The reality is that most people do not need additional vitamins and minerals. But beriberi is more common than we think. It is important to know the signs and symptoms of each of the deficient conditions and understand the simple ways to eliminate these phenomena.
Types and types of beriberi
Avitaminosis is of two types depending on the affected area (wet and dry). Two forms may appear in the same patient, but one form will dominate. Other forms, such as childhood beriberi or Wernicke-Korsakoff syndrome, occur in specific populations.
Table – Types of beriberi following the affected organs and systems
Following the impact of risk factors on the patient, children’s vitamin deficiency is isolated. In this case, the cardiovascular or nervous system suffers.
The disease is usually progressive and has three distinct forms:
· Cardiac or pernicious (1 to 3 months): rapid onset, progressive course, and poor prognosis.
Aphonic (from 4 to 6 months): imperceptible onset and mild course.
· Pseudo-meningitis (from 7 to 9 months): progressive course.
Infants fed by thiamine-deficient mothers are at risk.
The Wernicke-Korsakoff syndrome affects the brain. It can occur acutely (Wernicke’s encephalopathy) and chronically (Korsakov’s psychosis). It develops into chronic alcoholism. Worsening is observed in people whose diet is dominated by carbohydrates, exacerbating subclinical thiamine deficiency.
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Bariatric beriberi causes damage to the nervous system. The condition leads to the development of dry beriberi or Wernicke-Korsakoff syndrome. It is observed after bandaging and gastric bypass.
Pathogenesis
Vitamins are divided into fat-soluble (A, D, E, K) and water-soluble (C, B1, B2, B6, B9, B12, and PP). The deficiency of vitamin-like substances does not cause severe symptoms.
Vitamins are low molecular weight compounds that are cofactors of enzymes. They are necessary to ensure proper metabolic processes. This function is more inherent in water-soluble vitamins (enzyme vitamins). Fat-soluble nutrients (hormonovitamins) have a signaling function aimed at stimulating the endocrine system.
Vitamins cannot be produced in the human body in the right amount. Some nutrients are not synthesized endogenously at all. For proper metabolism, it is necessary to ensure their intake of food. If the amount of nutrients consumed daily does not cover the physiological norm, then there is a violation of biochemical reactions in the body, which is accompanied by the appearance of appropriate symptoms.
Causes of beriberi
The causes of vitamin deficiency can be not only an unbalanced diet and a lack of fresh vegetables and fruits in food. Among the factors contributing to the development of this condition, experts call dysbacteriosis and other pathologies of the gastrointestinal tract that disrupt the digestibility of food. In addition, parasitic infections, helminthic invasions, and hard and hard work in harmful conditions always deplete the body.
An increased amount of vitamins is also required by the body of pregnant women or a person who is in a state of acute stress or physical overstrain. Quickly consumes nutrients and vitamins and a person living in harsh climatic conditions: in frost, the metabolism accelerates to maintain normal body temperature, therefore, consumes more “vitamin fuel” to increase resistance.
Those who eat a varied and healthy diet need not worry about deficiency conditions. People who drink a lot of alcohol or struggle with alcohol addiction are more prone to nutritional deficiencies in the body. Excess alcohol can affect the body’s ability to absorb thiamine.
Other people at higher risk of developing beriberi include:
· Breastfed children whose mothers are nutritionally deficient.
· Those who follow a diet high in carbohydrates, especially refined ones.
· People involved in extremely high physical activity or exercise.
Any person with hyperthyroidism, which can interfere with the absorption of B vitamins
. People with digestive problems that interfere with nutrient absorption, especially as they age.
Any person with a high level of stress.
The risk of beriberi may be increased in those on dialysis or treated with diuretics. Doctors usually take steps to control vitamin levels during these procedures.
Influence of Diet
Often vitamin deficiencies are related to what we eat. Nutrients are complex molecules found in fresh fruits, vegetables, various grains, meats, poultry, and seafood. Each vitamin is found in more than one type of food, and some foods are fortified with multiple nutrients.
For example, milk naturally contains calcium (which is a mineral, not a vitamin) and is fortified with vitamin D. Pasta, rice, and cereal are loaded with several vitamins.
Some diets can lead to vitamin deficiencies. Vitamin B12 is found in meat – a vegan or vegetarian diet may increase the risk of beriberi. People who do not consume dairy products develop vitamin D deficiency.
Dietary risk factors:
A gluten-free diet that is low in grains that are rich or fortified with vitamins. Leads to a deficiency of many vitamins, including folic acid and thiamine.
· A diet high in processed foods and low in fresh fruits and vegetables leads to vitamin E and K deficiencies.
Vitamin deficiency can be avoided even by vegetarians, vegans, or those who do not consume gluten. To do this, you need to replace the excluded foods with other foods that contain the necessary nutrients.
Vitamin D is found in seafood, chicken eggs, and dairy products. The source is also sunlight. Insufficient sun exposure can lead to a deficient condition. In geographic regions with a cold climate, this is a fairly common occurrence during the winter.
Medical Conditions
In addition to dietary factors, medical conditions can affect the absorption of vitamins, even if dietary intake of vitamins is adequate.
Some diseases impede the proper assimilation and metabolism of vitamins:
· alcoholic liver disease;
· liver failure;
kidney disease;
chronic diarrhea;
malabsorption syndrome;
gastric bypass;
Inflammatory bowel disease
· Crohn’s disease;
· irritable bowel syndrome;
pernicious anemia.
Pernicious anemia is a term that confuses most people. This is a type of autoimmune disease that affects the small intestine, reducing the absorption of vitamin B12 and eventually leading to anemia.
Do not self-medicate and self-diagnose! Contact your doctor for an accurate diagnosis of the disease. Only your doctor can correctly diagnose and prescribe the right treatment.
Some common symptoms suggest a metabolic disorder due to a lack of one or more nutrients. Among the characteristic symptoms, we have already called fatigue and fatigue, muscle weakness. Insomnia or vice versa drowsiness, unmotivated irritability, or apathy may appear. The condition of the skin deteriorates sharply – there is a pronounced dryness, a feeling of tightness, peeling, and itching. Hair “dries out” and may fall out, nail plates on the hands and feet exfoliate and crumble, and tooth enamel becomes thinner.
Sometimes appetite decreases and weight loss is observed. In a child or adolescent against the background of beriberi, growth and development may slow down. Also, a common symptom indicating a lack of vitamins is a decrease in the adaptability and resistance of the body: the immune system cannot cope with infections, most often of the respiratory and urinary systems, digestive tract, or skin.
If the above signs are noticed one at a time or several at once, you should consult a doctor for laboratory tests and diagnostics to understand which vitamin the body needs most and prescribe the right treatment.
Avitaminosis A
It is expressed in violations of the condition of the eyes and vision (the so-called “night blindness” – poor vision at dusk and darkness), scaly dry skin. Acute beriberi adversely affects the state of the immune system, and the gastrointestinal tract: a person suffers from frequent colds, food poisoning, and infections.
In addition to the appropriate drugs, carrots, spinach, sea buckthorn along with fatty sour cream, vegetable oils or an additional intake of fish oil should be included in the therapeutic diet.
Avitaminosis D
Vitamin D avitaminosis (which is synthesized in the body under the influence of sunlight) is expressed by:
increased irritability;
sleep disorders;
palpitations;
Unusual sweating.
The lack of this vitamin in children causes rickets, in adults – muscles are affected, and bone deformities can develop. The therapeutic diet usually includes meat and fish products, all types of liver, chicken eggs, and fish oil.
Avitaminosis E
Vitamin E vitamin deficiency is often characterized by disorders of the nervous system. In addition, vitamin E is a natural antioxidant, so its deficiency is immediately expressed in a deterioration in the condition of the skin, muscles, and a decrease in sexual activity.
In men, potency may decrease, in women, the menstrual cycle is disrupted up to the absence of ovulation. During pregnancy, a lack of this vitamin threatens miscarriage. Compensation for the lack of vitamin E is facilitated by the inclusion in the diet of nuts, seeds, milk, as well as meat, and eggs.
Avitaminosis K
Vitamin K vitamin deficiency is not so common and is expressed in blood clotting disorders: the phenomena of internal small hemorrhages or external bleeding. Cuts and small wounds do not heal well, blood often comes from the nose. Doctors recommend including Brussels sprouts, fresh spinach, and beef liver on the menu.
Avitaminosis C
It can manifest itself in anemia and accompanying pallor, and weakness. The gums sometimes begin to bleed, often there is heaviness and swelling of the legs. With severe degrees of lack of this important vitamin in the body, scurvy can develop. There are bleeding, skin ulcers, jaundice, anemia, and damage to the heart muscle. Of the food products, citrus fruits, bell peppers, sorrel, rose hips, and mountain ash, or a decoction of them, help treat.
Avitaminosis of B vitamins
The functioning of the nervous system is disrupted. A person suffers from frequent headaches, insomnia, memory disorders, impaired coordination of movements, and depression develops. There may be convulsive syndrome, tachycardia. Often there are pathological changes on the skin and mucous membranes: red spots with peeling on the face, signs of stomatitis, cracks in the corners of the mouth, dermatitis, and inflammation of the surface of the tongue.
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Sometimes the membranes of the eyes are affected and symptoms of keratitis and conjunctivitis appear, inflammation, increased lacrimation, and sometimes photophobia. Increased dryness of the scalp causes dandruff and worsens the condition of the hair. Against the background of a lack of certain B vitamins, hematopoiesis processes are disturbed, and anemia may develop.
For treatment, the emphasis in the diet is on legumes, cheese, eggs, liver, as well as bananas, and quality bread products.
Rare types of beriberi
With vitamin deficiency of vitamins H, F, P, and other elements, various skin diseases (rashes, eczema, furunculosis), alopecia (baldness), digestive disorders, anorexia (severe malnutrition), and other manifestations can be observed.
Complications
of beriberi are rather severe disorders that, if not taken in time, can lead to death:
in the absence of ascorbic acid and vitamin K, hemorrhages and massive bleeding develop;
B12 deficiency is accompanied by anemia, which is life-threatening;
B1 is accompanied by the development of neuropathies and diseases in the cardiovascular system.
Vitamin deficiency is accompanied not only by specific symptoms but also by mental disorders (depressions or neuroses). The quality of
life gradually worsens, and intellectual and physical performance decreases.
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Diagnosis
Clinical manifestations of beriberi are quite specific. It turns out the nature of the patient’s diet, the presence/absence of chronic diseases of the gastrointestinal tract, and other factors.
Advanced laboratory diagnostic measures to confirm the diagnosis:
Blood tests for vitamin levels. Allows you to get an accurate result, taking into account the daily fluctuations of nutrients in the body.
· Hemogram. It is prescribed to assess the amount of hemoglobin, and the shape and number of red blood cells, which allows you to determine the presence of anemia.
· Coagulogram. Assesses blood clotting parameters.
· Biochemical analysis of blood. Establishes acid-base balance and electrolyte levels.
· Hormonal studies. Determining the parameters of parathyroid hormone, allows you to conduct a study on gonadotropic hormones of the pituitary gland and sex hormones.
Among the instrumental studies of the gastrointestinal tract are MRI or CT of the abdominal cavity, X-ray with passage through the intestines, and fibro gastro duodenoscopy. With a deficiency of vitamin D, an x-ray of bone structures is prescribed.
Methods for the treatment of beriberi
To cure beriberi, first of all, it is necessary to fill the lack of the necessary substance in the body. For this, special dietary nutrition is prescribed, as well as replacement therapy with special vitamin complexes.
The consequences and complications of beriberi require a separate medical examination and treatment. For prevention, it is enough to monitor the balance and diversity of the diet with the obligatory presence of not only fresh vegetables and fruits but also meat, fish, and fats, preventing the development of beriberi and its transition to a chronic form.
Diet and vitamin therapy can be supplemented by treatment of the main cause of beriberi:
Diseases of the gastrointestinal tract – relief of inflammatory processes in the small intestine and stomach, malabsorption, and digestion of vitamins.
Correction of malabsorption – digestive processes are corrected with the help of specific enzyme preparations and synbiotics that normalize the intestinal microflora.
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To normalize the electrolyte balance, saline solutions are introduced, as well as preparations of iron, potassium, and calcium. Restoration of the physiological level of trace elements is necessary for the biochemical absorption of vitamins and the normalization of their transportation processes.
Diet
If the cause of exogenous vitamin deficiency is an unbalanced diet, then treatment is carried out using isolated diet therapy. This allows you to stop the symptoms of hypovitaminosis.
Diet therapy is prescribed only in a satisfactory condition of the patient, as well as in the absence of symptoms of gastrointestinal diseases. The patient must be prepared to follow the doctor’s prescriptions steadily, adhering to the nutrition plan.
Taking vitamin preparations
Most often, diet therapy is supplemented with oral vitamin preparations intended for the correction of mild forms of deficient conditions. With advanced forms of beriberi, parenteral administration (injections) is necessary. Multivitamin complexes or mono preparations may be prescribed. Schemes of administration, dosages, and drugs are selected by the doctor for each patient.
Forecast and prevention
The prognosis directly depends on the cause of the deficient state. With the insufficient intake of vitamins from food, the condition can be easily corrected with the help of a special diet or medication. If we are talking about impaired absorption or transport of nutrients, then the normalization of the vitamin balance with the help of nutrients becomes impossible. In chronic or progressive diseases of the stomach or intestines, consultation with a general practitioner or gastroenterologist is necessary.
The main preventive measure of beriberi is a balanced diet, the presence of a variety of animal and vegetable products in the diet. When choosing products, it is important to pay attention to the seasonality and freshness of products. The level of useful nutrients is also affected by the method and correctness of heat treatment.
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And finally: I am an ardent opponent of the “prophylactic” intake of various dietary supplements and vitamins “for health”, which are promoted by many fitness models. Do not forget to consult a doctor – their appointment should be only wisely. Preventive intake of vitamin-mineral complexes is necessary for those at risk but is not recommended in routine practice.
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