Vitamin Deficiencies – Effects of Malabsorption Syndromes

A malabsorption syndrome is the impaired absorption of nutrients from the intestine which can result in vitamin deficiencies over a period of time. The severity of the signs and symptoms may vary depending on the extent of the deficiency.

Vitamin A, D, E and K are fat soluble vitamins and a deficiency may arise if there is any fat malabsorption syndrome. The deficiencies below are those that may arise from a malabsorption syndrome. Other causes of vitamin deficiencies should also be considered.

Vitamin A Deficiency

  • Absorption : Small intestine
  • Deficiency syndromes :
    • Night blindness (nyctalopia)
    • Xeropthalmia
    • Follicular hyperkeratosis (phyrnoderma)
  • Some signs and symptoms :
    • Poor vision
    • Corneal ulceration
    • Dry hair
    • Dry skin
    • Itchy skin
    • “Weak” fingernails

Vitamin B1 (Thiamine) Deficiency

  • Absorption : Small intestine
  • Deficiency syndromes :
    • Beriberi
    • Wernicke’s encephalopathy
    • Korsakoff syndrome
  • Some signs and symptoms :
    • Muscle cramps, atrophy
    • Hyporeflexia
    • Paresthesia – burning pain present in both legs
    • Poor memory
    • Sleep disturbance
    • Chest pain
    • Increased heart rate (tachycardia)

Vitamin B2 (Riboflavin) Deficiency

  • Absorption : Small intestine
  • Deficiency syndromes :
    • Ariboflavinosis/Hyporiboflavinosis
    • Cheilitis
    • Seborrheic dermatitis
    • Growth retardation (children)
  • Some signs and syndromes :
    • Skin rash – red, scaly and greasy (oily)
    • Mouth sores
    • Swollen tongue
    • Fissuring of the lips, corner of the mouth
    • Itchy eyes
    • Cataracts
    • ‘Sore eyes’
    • Peripheral neuropathy – numbness, tingling, pain of the upper (arm, hands) and lower limbs (legs, feet)

Niacin/Nicotinamide (Vitamin B3) Deficiency

  • Absorption : Small intestine (jejunum)
  • Deficiency syndromes :
    • Pellagra
  • Some signs and symptoms :
    • Dermatitis. Initially red, burning skin rash – sensitive to sun exposure. In later stages, there is darkening (hyperpigmentation) and thickening of the affected skin.
    • Diarrhea – watery, sometimes bloody or with mucus
    • Depression
    • Dementia
    • Dysphagia (difficulty swallowing)
    • Increased salivation (hypersalivation)
    • Abdominal pain
    • Nausea
    • Death if left untreated

Vitamin B6 (Pyridoxine) Deficiency

  • Absorption : Small intestine
  • Deficiency syndromes :
    • Polyneuropathy
  • Some signs and symptoms :
    • Numbness, tingling, pain and/or weakness of the limbs
    • Depression
    • Impaired mental faculties
    • Swollen tongue
    • Seizures
    • Diarrhea
    • Nausea
    • Vomiting
    • Itchy, red skin rash – sensitive to sun exposure, prone to hyperpigmentation (darkening)

Folic Acid/Folate (Vitamin B9) Deficiency

  • Absorption : Small intestine (jejunum)
  • Deficiency syndromes :
    • Macrocytic anemia
    • Pregnancy – spontaneous abortion (miscarriage), birth defects.
    • Associated with an increased risk of heart disease, dementia and cancer.
  • Some signs and symptoms :
    • Pallor (pale skin)
    • Darkening of the skin and mucous membrane, particularly on the fingers, toes, creases of the palms and soles
    • Depression
    • Diarrhea
    • Swollen tongue
    • Fissures of the lips, corner of the mouth
    • Exertional dyspnea – shortness of breath upon exertion

Vitamin B12 Deficiency

  • Absorption : Ileum (terminal part of the small intestine)
  • Deficiency syndromes :
    • Neuropathy
    • Macrocytic anemia
  • Some signs and symptoms :
    • Pallor (pale skin)
    • Swollen red tongue
    • Numbness or tingling in the upper and lower limbs which gradually progresses to the trunk
    • Shortness of breath
    • Chest pain
    • Depression
    • Low energy levels
    • Muscle weakness

Vitamin C Deficiency

  • Absorption : Small intestine (proximal ileum)
  • Deficiency syndromes :
    • Scurvy
  • Some signs and symptoms :
    • Bleeding gums
    • Loose teeth
    • Halitosis (bad breath)
    • Nosebleed (epistaxis)
    • Poor wound healing
    • Purpura, bruising
    • Skin rash – ecchymosis, thickened skin spots
    • Corkscrew hair
    • Anemia
    • Painful joints
    • Numbness and tingling in the hands and feet

Vitamin D Deficiency

  • Absorption : Small intestine (jejunum)
  • Deficiency syndromes :
    • Osteomalacia
    • Rickets
  • Some signs and symptoms :
    • “Weak” bones
    • Bone and cartilage protruberances
    • Bone pain
    • Bowing in the legs (infants/children)
    • Muscle weakness
    • Myalgia – muscle pain
    • Numbness, tingling, burning sensation of the lips, tongue and hands

Vitamin E Deficiency

  • Absorption : Small intestine
  • Deficiency syndromes :
    • Hemolytic anemia
    • Neurological complications
  • Other signs and symptoms :
    • Hyporeflexia or areflexia
    • Muscle weakness
    • Poor coordination
    • Nystagmus
    • Dementia
    • Night blindness
    • Pallor (pale skin) to yellow skin discoloration (jaundice)
    • Dyspnea (shortness of breath)

Vitamin K Deficiency

  • Absorption : Small intestine
  • Deficiency syndromes :
    • Bleeding disorders
    • Birth defects
  • Some signs and symptoms :
    • Purpura, bruising
    • Nosebleeds (epistaxis)
    • Hematuria (blood in the urine)
    • Menorrhagia (heavy/prolonged periods)
    • Gastrointestinal bleeding
    • Delayed clotting of cuts

Related Articles

  1. What is Malabsorption?
  2. Pancreatic Enzyme Deficiency

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