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