Hypovitaminosis is a deficiency in the body of one or a whole group of vitamins. The manifestations of the disease largely depend on the type of hypovitaminosis (on which vitamin is missing), however, all types of vitamin deficiency are characterized by increased fatigue, drowsiness, irritability, decreased appetite. Diagnosis is reduced to the correct assessment of the clinical picture, laboratory determination of the quantitative content of vitamins in blood, hair, nails and urine. Treatment consists in introducing a sufficient amount of missing vitamins into the diet or prescribing them in the form of tablets or injections.
Meaning
Hypovitaminosis or vitamin deficiency is a formidable disease that can lead to serious disorders in the body. In developed countries, hypovitaminosis has been occurring quite easily in recent years, with minimal symptoms. However, without timely treatment, this condition can turn into vitamin deficiency – the complete absence of certain vitamins, which can lead to disability and sometimes death of the patient.
In our country, hypovitaminosis most often affects the elderly and children, with the most common deficiency of vitamins B1, B6, C. When faced with hypovitaminosis, it should be remembered that self-treatment of this condition is unacceptable, since only a specialist can accurately determine which vitamin deficiency has developed and prescribe appropriate treatment. With unauthorized intake of a particular vitamin, hypervitaminosis may occur, which also leads to serious health problems.
Causes of hypovitaminosis
There are many reasons for the lack of vitamins, and for each of the hypovitaminoses, this reason will be different. But there are also factors common to all vitamin deficiency conditions. These include various conditions that lead to a lack or violation of the absorption of vitamins and trace elements, their increased consumption and destruction. Thus, the cause of hypovitaminosis may be a restriction in the diet of certain foods, the use of refined carbohydrates, ground cereals, fine flour, the exclusion of fresh vegetables and fruits, one-sided nutrition. Violation of the ratio of essential nutrients (restriction of animal protein and fat and increased carbohydrate content) will also cause a deterioration in the absorption of vitamins.
Improper storage and heat treatment of food can lead to the destruction of many useful substances in it, and with prolonged boiling, almost all vitamins are destroyed, which is why many products cannot be frozen. It should be remembered that with severe stress, heavy physical labor, and in a cold climate, the need for vitamins increases by 60%.
The cause of hypovitaminosis can be serious diseases (especially of the digestive system – the absorption of vitamins is disrupted), the intake of certain medications (mainly antibiotics). The lack of fat-soluble vitamins develops with a restriction in the diet of fats. Also, do not forget that the metabolism of vitamins and trace elements in the body is closely interrelated, the lack of one vitamin can cause a violation of the metabolism of the rest.
In order to prevent the development of hypovitaminosis, it is necessary to understand the reasons for the insufficiency of each of the vitamins. Thus, hypovitaminosis A develops with a deficiency of protein and carotenes in food, restriction of animal fats, with excessive physical and emotional stress. Also, various infectious diseases, chronic intestinal diseases (chronic enteritis, colitis, NYAK, Crohn’s disease), liver pathology (chronic viral hepatitis, cirrhosis) and thyroid gland, diabetes mellitus can lead to hypovitaminosis A. Hypovitaminosis C appears in the absence of fresh vegetables and fruits in the diet, prolonged heat treatment of food, the predominant use of bakery products, heavy physical and mental labor.
Group B hypovitaminosis can occur for a variety of reasons. Vitamin B1 deficiency develops when coarse flour is excluded from the diet, only ground cereals are used; prolonged consumption of raw fish; excess protein and carbohydrates; alcoholism (especially beer); thyrotoxicosis, diabetes mellitus, chronic enterocolitis; prolonged exposure to heat or cold. Vitamin B2 deficiency occurs when protein and dairy products are excluded from the diet, akrikhin and its derivatives are taken, liver, pancreas and intestinal diseases. Hypovitaminosis B3 (PP, nicotinic acid) can occur with a predominant diet of corn, prolonged exposure to solar radiation, protein deficiency, taking anti-tuberculosis drugs, intestinal diseases.
The main causes of hypovitaminosis B6 are chronic intestinal pathology, taking medications for the treatment of tuberculosis. Hypovitaminosis B9 (folic acid) appears with prolonged heat treatment of food, alcoholism, intestinal resection and chronic enterocolitis, prolonged administration of antibiotics and sulfonamides. Hypovitaminosis B12 is often diagnosed in people with a vegetarian diet, alcoholics, with helminthic invasion, chronic gastrointestinal diseases (atrophic gastritis, enterocolitis), resection of part of the stomach or intestines.
Vitamin D can be produced by the body with sufficient exposure to sunlight. Therefore, hypovitaminosis D (rickets) most often develops in children who live in the northern regions of the country, are not enough in the fresh air. Hypovitaminosis D can also occur with insufficient consumption of animal fats, calcium and phosphorus salts, irrational nutrition. Hypovitaminosis K is detected when using low-fat foods, diseases of the hepatobiliary system and intestines, irrational therapy with antibiotics and anticoagulants.
Symptoms of hypovitaminosis
The clinic of insufficiency of a particular vitamin will be peculiar. Nevertheless, there are signs common to all hypovitaminoses. These include increased fatigue, drowsiness, irritability, nausea, poor appetite. Usually the first signs appear with a significant deficiency of a certain vitamin in the diet. Different groups of vitamins have similar symptoms, which is why only a doctor should diagnose hypovitaminosis, because only he has sufficient knowledge of the symptoms of vitamin deficiency. The clinic of hypovitaminosis with severe deficiency of a particular vitamin is described below.
Hypovitaminosis A is characterized by visual disturbances (night blindness, color perception defects), increased keratinization of the skin, fragility and hair loss. Whitish grooves and elevations form on the nails; the cornea becomes dry, cloudy; there are light clearly defined spots around the mouth. Hypovitaminosis C, or scurvy, is manifested by bleeding gums, tooth loss, hemorrhages in soft tissues.
Hypovitaminosis B1, or beriberi disease, exists in a dry and edematous form. The first form is expressed by dry skin, neuritis. It is characterized by a violation of the sensitivity of the lower extremities to low and elevated temperatures, painful stimuli; cramps in the calf muscles. The edematous form is characterized by shortness of breath, tachycardia, pronounced edema.
Pellagra, or hypovitaminosis B3, is characterized by skin manifestations: the skin becomes dark and flaky, rough; red edematous spots appear on the hands, similar to inflammatory infiltration. The tongue increases, becomes crimson. Also a frequent sign of pellagra is diarrhea, the defeat of the unequal system.
Hypovitaminosis B6 (hyporiboflavinosis) is manifested by conjunctivitis, redness, dryness and peeling of the lips, cracks in the corners of the mouth. The tongue turns crimson, varnished, teeth prints are visible on the sides of it. The skin is thin and dry. As for hypovitaminosis A, it is characterized by a decrease in visual acuity and a violation of color discrimination.
Hypovitaminosis B12 is manifested by B12-folate deficiency anemia: the amount of hemoglobin decreases, in parallel with this, atrophic gastritis with low acidity is diagnosed. The sensitivity of the tongue (burning, tingling), skin and muscles is disturbed, the gait changes. Vessels grow at the junction of the cornea and sclera, a purple rim is formed. Hypovitaminosis K is manifested by increased bleeding, hypocoagulation (insufficient blood clotting).
There are also signs inherent in the combination of insufficiency of several vitamins. So, dry skin with slight peeling (by the type of bran) is characteristic of hypovitaminosis A, C. Glossy skin with scales (small, yellow) in the skin fold (nasolabial, on the bridge of the nose, behind the ears and on the lobes, etc.) is noted with hypovitaminosis B2, B3 (PP), B6. Increased bleeding, hemorrhages under the skin and into soft tissues indicates hypovitaminosis K, P, C. Thickened skin with a mesh of cracks in the joints is observed with hypovitaminosis A, B3 (PP). The so-called “goose bumps” on the buttocks, thighs, forearms are noted with hypovitaminosis A, C, R.
Jaundice of the skin is a sign of hypovitaminosis A, B3. The formation of cracks in the corners of the eyes accompanies the course of hypovitaminosis A and B2. Cyanosis of the lips is a typical sign of hypovitaminosis C, B3, R. Whitish scars at the junction of the red border of the lips into the oral mucosa, an enlarged tongue with furrows and tooth prints are found in hypovitaminosis B1, B3, B6, B12. Gum damage (looseness, bleeding, enlargement of the interdental papillae, hyperemia, atrophic gingivitis with exposure of the roots of the teeth) is characteristic of hypovitaminosis With, P.
Diagnostics
Consultation with a gastroenterologist is mandatory in case of any suspicion of hypovitaminosis. During the initial treatment, the doctor will find out the complaints in detail, analyze the clinical manifestations and make a preliminary diagnosis. In the presence of a modern laboratory, a special examination is possible to determine the level of vitamins of interest in the body. If the patient has a concomitant pathology that could lead to hypovitaminosis, appropriate examinations should be carried out – esophagogastroduodenoscopy, intragastric pH-metry, fecal analysis for helminth eggs (worms).
It is also necessary to find out from the patient whether he has had surgical interventions, after which the absorption of vitamins is disrupted (distal or proximal resection of the stomach, segmental resection of the small intestine, and the like). A repeated consultation with a gastroenterologist (after a full examination and careful collection of anamnesis) will allow you to establish an accurate diagnosis, prescribe the right treatment.
Treatment of hypovitaminosis
Treatment in the gastroenterology department requires only the most severe manifestations of vitamin deficiency – vitamin deficiency. Currently, serious hypovitaminosis is quite rare, most often patients consult a doctor about moderate manifestations of vitamin deficiency. Nevertheless, vitamin deficiency is best treated precisely at the stage of unexpressed hypovitaminosis, but with severe vitamin deficiency, sometimes it is impossible to help the patient.
The main purpose of treatment of hypovitaminosis is the introduction of missing vitamins into the body. The most appropriate method of treating hypovitaminosis will be the intake of these substances with food. Firstly, such forms of vitamins are better absorbed in the intestine. Secondly, other nutrients involved in the metabolism of vitamins and minerals also come with food. A prerequisite for the treatment of hypovitaminosis is a varied diet rich in basic nutrients, fresh vegetables and fruits. Multivitamin preparations are prescribed orally (in the form of drops and tablets), with severe hypovitaminosis, vitamins can be injected.
The use of monopreparations of vitamins is not recommended, since hypovitaminosis usually disrupts the balance of all vitamins and trace elements in the body. Multivitamin preparations can make up for the lack of all vitamins. But polypreparations should be selected with caution, since some vitamins can negatively affect each other when taken at the same time. That is why the most modern drugs for the treatment of hypovitaminosis assume a time-separated intake of different groups of vitamins. In this regard, the ingestion of vitamins with food is the most physiological – after all, nature has already developed an optimal system for the intake of vitamins into the body so that they do not break down and inactivate each other.
To date, there are special vitamin complexes for various categories of the population who may have hypovitaminosis: for workers of hot shops, persons performing heavy physical work, pregnant women, children, as well as for use during recovery after severe infections (salmonellosis, typhoid fever, diphtheria, infectious mononucleosis, etc.) and other diseases.
Prognosis and prevention
The prognosis for moderate hypovitaminosis is favorable, provided that the diet is normalized, timely prevention of hypovitaminosis is carried out. With severe vitamin deficiency, the prognosis is unfavorable, even with proper nutrition and the introduction of all the necessary vitamins, it is not always possible to restore the normal functioning of the body. Occasionally, missed vitamin deficiency can even lead to the death of the patient.
Prevention of hypovitaminosis consists in a balanced and rational diet, the use of a sufficient amount of fresh herbs, vegetables and fruits. In the autumn-winter period, it is necessary to include in the diet fresh and sauerkraut, carrots, fortified drinks (freshly squeezed juices, broth of rosehip and yeast, natural lemonade). During the period of increased vitamin intake, it is necessary to take multivitamin complexes (during pregnancy, severe illness, if work requires physical labor or mental overstrain).