Vitamin Deficiency

What is a vitamin deficiency?

A vitamin deficiency is not having enough of a nutrient that your body needs. That shortage can make body systems malfunction. Vitamin deficiencies usually happen because of something you’re not eating. But there are many reasons why you might still have a vitamin deficiency even if you eat a variety of healthy foods. When they happen, vitamin deficiencies can cause serious, permanent or even deadly complications.

Vitamins are a type of micronutrient, a substance your body needs. The micro- in their name means you don’t need a lot of them, but they’re still essential to how your body works.

What are the essential vitamins?

There are 13 essential vitamins. For some, developing a deficiency is easy. For others, it’s rare and difficult to develop one. The essential vitamins are:

• A (retinol and beta-carotene)
• B1 (thiamine)
• B2 (riboflavin)
• B3 (niacin)
• B5 (pantothenic acid)
• B6 (pyridoxine)
• B7 (biotin, also known as vitamin H)
• B9 (folic acid)
• B12 (cyanocobalamin)
• C (ascorbic acid)
• D (calciferol)
• E (tocopherols and tocotrienols)
• K (phylloquinone and menaquinone)

How common are vitamin deficiencies?

It depends on the deficiency. Vitamin A deficiency is the most common worldwide. The World Health Organization estimates it causes blindness in between 250,000 and 500,000 children globally each year. And research shows that far more people of all ages have this deficiency, but it isn’t severe enough to cause symptoms. The other most common vitamin deficiencies worldwide include vitamins D and B12. Other vitamin deficiencies, like vitamin E deficiency, are exceedingly rare.

What are the symptoms of a vitamin deficiency?

The symptoms of a vitamin deficiency mainly depend on which vitamins you’re lacking and how severe the deficiency is. Some of the most common symptoms of vitamin deficiencies include:

• Food cravings or increased hunger: Vitamin deficiencies might make you feel hungry more often or more intensely (experts call that “hidden hunger”). You also might crave certain foods.
• Fatigue: Feeling exhausted often or constantly is possible with vitamin C deficiency (scurvy). It can also happen if you have anemia from a lack of vitamins B6, B9 and B12.
• Skin, hair and nail changes: Rashes and many types of dermatitis can happen with deficiencies of vitamins A, B2, B3 and B6. Lack of vitamin B7 can also cause hair loss (alopecia) and brittle fingernails and toenails.
• Eye issues: Vision loss, night blindness and other eye symptoms are possible with deficiencies of vitamins A, B1, B2, and E.
• Muscle control issues: Muscle weakness or coordination difficulties can happen with deficiencies of vitamins B1, B12 and E.
• Mental ability loss: Deficiencies in vitamins B1, B3, B6 and B12 can affect how your brain works. That can cause memory loss, trouble concentrating, disorientation and confusion.
• Mood changes: You can experience issues like apathy or depression with deficiencies in vitamins B3, B6, B9 and B12.
• Nerve disruptions: Neuropathy can happen with deficiencies in vitamins B1, B6, B12 and E. Neuropathy can feel like numbness, tingling (paresthesia) or nerve pain. It can also cause weakness or uncontrolled muscle movements (convulsions).
• Tongue changes: Your tongue — especially its color or texture — can change with deficiencies of vitamins B2, B3, B6 and B9.
• Swelling: Joint swelling or edema are possible with deficiencies of vitamins B1 and C.
• Bleeding and bruising: Vitamin K deficiency can disrupt clotting (hemostasis). Deficiencies in vitamins C and K can also cause bruising, bleeding gums or spots on your skin called petechiae.
• Bodily function changes: Vitamin B12 deficiency can cause erectile dysfunction. It can also make it hard to control your need to pee (urinary incontinence) or poop (fecal incontinence). Vitamin B3 deficiency (pellagra) can also cause diarrhea.
• Weaker bones: Vitamin D deficiency can cause softer, weaker or easily fractured bones. In children, that can cause bowed or bent bones from rickets. In adults, it can cause osteomalacia.
• Losing balance or falling: This can be a sign of vitamin B12 deficiency. It happens when your nervous system has trouble sending signals related to your body position.

What causes vitamin deficiencies?

Vitamin deficiencies usually happen when you’re not getting enough of the vitamin(s) from what you eat. But vitamin deficiencies aren’t always a result of your choices, especially in places where there’s food insecurity. That’s most common in developing countries, but it can also happen in parts of developed countries with high poverty rates.

Some of the most common other reasons include:

• Alcohol use disorder: Long-term overuse of alcohol can disrupt how your body absorbs most vitamins.
• Genetic diseases: Certain genetic changes (mutations) can cause diseases that disrupt your body’s ability to absorb some nutrients.
• Autoimmune disorders: Some people develop a condition called pernicious anemia. It makes your immune system attack the enzymes you need to absorb vitamin B12.
• Vegetarian or vegan diets: Some nutrients are hard to get if you follow a vegetarian or vegan diet. The best example is vitamin B12. Your healthcare provider can guide you on vitamins to supplement if you follow these diets.
• Lack of sun exposure: Your skin needs sun exposure to create vitamin D. Several factors can limit your sun exposure. Examples include where you live, what you do for work and more.
• Medications: Some medications block how your body processes certain vitamins. Examples include the biguanide drug metformin (Fortamet® or Glumetza®), antibiotics like isoniazid, diuretics like triamterene (Maxzide®), or disease-modifying antirheumatic drugs (DMARDs) like sulfasalazine (Azulfidine®).
• Other conditions or nutrient deficiencies: Having certain medical conditions, like liver disease, can affect how you process vitamins. Being low in some vitamins can also lead to other vitamin deficiencies. And some eating disorders, like anorexia or bulimia, can also cause vitamin deficiencies.
• Weight loss surgery: Some people can’t absorb nutrients because of changes in how they digest food. That’s particularly common after some types of bariatric (weight loss) surgery, like gastric bypass.

What are the complications of this condition?

Essential vitamins get their name because your body can’t work properly without them. That can lead to complications like:

• Brain lesions (damage) and nerve damage
• Paralysis
• Vision loss and blindness
• Weakened immune system
• Death

Not getting enough of certain vitamins can also increase the risk of your baby having birth defects (congenital disorders), especially neural tube defects. The doses of prenatal vitamins you’ll need can vary. Your healthcare provider can tell you more about the daily vitamin doses that you should take.

How are vitamin deficiencies diagnosed?

Blood tests or urinalysis are the main way to diagnose vitamin deficiencies. Healthcare providers, especially primary care providers, may recommend these tests based on symptoms you have. Routine blood work during an annual checkup or physical exam can also catch many deficiencies before you have symptoms.

How are vitamin deficiencies treated?

Treating vitamin deficiencies depends on what caused the deficiency and how severe it is. Some of the most common treatment approaches include:

• Eating more of certain foods: Your healthcare provider might recommend you eat certain things to get more of the vitamins you need.
• Switching to fortified or enriched foods: Fortified foods have added nutrients. Enriched foods have added nutrients to make up for those lost during processing. Fortified foods include milk with vitamins A, B2 or D. Enriched foods include flour, sugar and certain food oils with added A or B vitamins.
• Oral supplements: These are available over the counter in most pharmacies and grocery stores. And if you need higher doses, your provider may prescribe them.
• Injections, infusions and patches: Your provider can prescribe injection or intravenous (IV) infusion vitamins if your levels are very low. And some vitamins come in patches you wear to let the vitamin slowly absorb through your skin.

What can I expect if I have a vitamin deficiency?

What you can expect from a vitamin deficiency depends mainly on the deficiency itself and its severity. Some vitamin deficiencies appear quickly, while others may not show any symptoms for months.

Vitamin deficiencies usually have a positive outlook, especially when they’re less severe. The outlook is also better when they’re reversible and don’t cause permanent damage. But it also depends partly on which deficiency you have. Your healthcare provider is the best person to tell you about the outlook and what you can expect for your specific case.

Are vitamin deficiencies preventable?

Vitamin deficiencies are usually preventable, but sometimes, they happen for reasons you can’t change. That’s especially true with genetic conditions or other factors you can’t control. And you can still develop them even if you eat nutritious foods.

The best way to prevent or reduce your risk of developing them is to eat a wide variety of foods rich in vitamins and other essential nutrients. Examples include vegetables, fruits and lean proteins. Another key step you can take is to see a primary care provider at least once a year. Regular checkups usually involve blood tests that can detect vitamin deficiencies before you ever feel or see a symptom.

How do I take care of myself?

If you have a vitamin deficiency, your healthcare provider can guide you on treating it. They’ll also likely recommend follow-up visits and lab tests to check your vitamin levels and make sure they’re improving.

It’s also important to remember that you should talk to your provider before you take vitamin supplements. That goes for ones available over the counter, too. Your provider can tell you how to use supplements properly. That way, you can avoid unwanted issues like interactions with other medications or taking doses that are too high.

What questions should I ask my doctor?

Some questions you may want to ask include:

• How severe is my vitamin deficiency?
• What could have caused or contributed to it?
• Will it cause any long-term effects?
• What treatments do you recommend?
• Are there any changes I should make in my routine or what I usually eat?
• Are there any symptoms or side effects I should watch for, and what should I do if I have them?

Which vitamin deficiency causes vertical ridges on my nails?

Vertical ridges on your nails can happen with deficiencies of minerals like iron. Vitamins are complex chemical molecules, while minerals are specific elements. They’re similar in that your body needs both vitamins and minerals, but they don’t work quite the same.

Which vitamin deficiency can cause white spots on my nails?

White spots on your nails can happen with a deficiency of the mineral zinc. They aren’t common from vitamin deficiencies.

What vitamin deficiency causes small white spots on my skin?

White spots on your skin can happen with a vitamin B12 deficiency. But they can also happen for many other reasons, ranging from sun exposure to autoimmune disorders like vitiligo.

What vitamin deficiencies can cause hair loss?

Hair loss can happen with deficiencies in vitamin B7, also known as biotin. But this isn’t common because bacteria in your gut also make biotin from many foods.

What vitamin deficiency causes a cracked tongue?

Having cracks on your tongue is normal. Those cracks, called fissures, can happen with some diseases but not with vitamin deficiencies. Vitamin deficiencies like B6 and B9 can cause certain types of glossitis (tongue inflammation). That usually makes your tongue look smooth or swollen.

Which vitamin deficiency causes you to feel cold?

Feeling cold is a common symptom of anemia. Vitamin deficiency anemia can happen when you’re low on vitamins B6, B9 and B12. But that can also happen when you have iron deficiency anemia.