Vitamins A & D Deficiencies - Sight & Strength Woes
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Vitamin A (Retinol): "Sight"
- Xerophthalmia. Earliest: Nyctalopia.
- Signs: Conj. xerosis (X1A), Bitot’s spots (X1B).
Corneal xerosis (X2), Keratomalacia (X3). - Serum Retinol: < 20 µg/dL.
- Prophylaxis (<5 yrs): 100,000 IU (6-12mo), 200,000 IU (>12mo) q6mo.
⭐ WHO Xerophthalmia: XN (Night blind), X1A (Conj. xerosis), X1B (Bitot's), X2 (Corneal xerosis), X3A/B (Keratomalacia), XS, XF.
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Vitamin D (Calciferol): "Strength"
- Deficiency: Rickets (children), Osteomalacia (adults).
- Rickets: Craniotabes, Rachitic rosary, Harrison's sulcus, Bowed legs/Knock knees.
- Biochemistry: ↓ Serum Ca, ↓ P; ↑ ALP, ↑ PTH.
- Serum $25(OH)D$: Deficiency < 20 ng/mL (or < 50 nmol/L).
- Rx: High dose Vit D (600,000 IU Stoss).
B-Complex & C Deficiencies - Energy & Repair Crew
| Vit | CoE Form | Deficiency | Key Features |
|---|---|---|---|
| B1 (Thiamine) | TPP | Beriberi, Wernicke-Korsakoff | Polished rice; Wernicke's triad (ataxia, confusion, ophthalmoplegia); heart failure |
| B2 (Riboflavin) | FAD, FMN | Ariboflavinosis | Angular stomatitis, cheilosis, glossitis  |
| B3 (Niacin) | NAD, NADP | Pellagra | 📌 3Ds: Dermatitis (Casal's necklace), Diarrhea, Dementia  |
| B5 (Pantothenic Acid) | CoA | Burning feet syndrome | Paresthesia (toes), burning feet |
| B6 (Pyridoxine) | PLP | Neuropathy, Anemia (Sideroblastic) | Isoniazid; convulsions (infants); peripheral neuropathy |
| B7 (Biotin) | Biocytin | (Rare) Avidin toxicity | Raw egg white ingestion; alopecia, dermatitis |
| B9 (Folate) | THF | Megaloblastic anemia, NTDs | ↑Homocysteine; glossitis; NO neurological sx |
| B12 (Cobalamin) | Methylcobalamin | Megaloblastic anemia, Neuropathy | Pernicious anemia; SACD (neurological sx); vegan diet; ↑MMA & Homocysteine |
Iron & Iodine Deficiencies - Vitality & Growth Guards
⭐ Iron deficiency is the most common nutritional deficiency worldwide.
| Feature | Iron Deficiency (ID) / Anemia (IDA) | Iodine Deficiency Disorders (IDD) |
|---|---|---|
| Problem | Impaired Hemoglobin (Hb) synthesis, ↓O₂ transport. | ↓Thyroid hormone synthesis, impacting growth & development. |
| Key Indicator | S. Ferritin < 15 ng/mL. Hb cutoffs: Pregnant <11, Non-preg women <12, Men <13 g/dL. | Urinary Iodine Excretion (UIE) < 100 µg/L (population). Neonatal TSH > 5 mIU/L. |
| Clinical | Fatigue, pallor, glossitis, koilonychia.  | Goitre, hypothyroidism, cretinism (neurological/myxedematous).  |
| Prevention | Prophylaxis: IFA tablet (Iron 100mg + Folic Acid 0.5mg). Dietary diversification. | Universal Salt Iodization (USI) with $KIO_3$ (≥ 15 ppm at consumer level). |
Other Deficiencies & Programs - Trace Element Tales
- Zinc: Deficiency: Acrodermatitis enteropathica, impaired immunity.
- Diarrhea dose: 10-20 mg for 14 days.
- Diarrhea dose: 10-20 mg for 14 days.
- Fluoride: Optimal water level: 0.5-0.8 ppm. Excess: Dental/Skeletal Fluorosis.
- NPPCF: National Programme for Prevention & Control of Fluorosis.
- Selenium: Deficiency: Keshan disease (cardiomyopathy).
- Copper: Deficiency: Menkes disease (kinky hair).
⭐ Zinc supplementation (10-20 mg for 14 days) significantly reduces duration and severity of acute diarrhea in children.
High‑Yield Points - ⚡ Biggest Takeaways
- Vitamin A deficiency causes night blindness and Bitot's spots.
- Iron deficiency is the most common, leading to microcytic hypochromic anemia.
- Iodine deficiency results in goiter and cretinism.
- Vitamin D deficiency manifests as rickets in children and osteomalacia in adults.
- Vitamin B12 deficiency causes megaloblastic anemia and neurological deficits.
- Folic acid deficiency leads to megaloblastic anemia and neural tube defects.
- Zinc deficiency is linked to growth retardation and impaired immunity.
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