Hypovitaminosis
| Classification according to ICD-10 | |
|---|---|
| E56.9 | Vitamin deficiency, unspecified |
| ICD-10 online (WHO version 2019) | |
A hypovitaminosis or a vitamin deficiency exists in diseases and complaints that arise from a deficiency (deficit) in vitamins and are represented by certain clinical symptoms or by biomarkers of the vitamin in question that are outside the range of established limit values. A lack of vitamin intake results in metabolic disorders with typical symptoms . Symptoms that occur as a result of hypovitaminosis usually recede completely.
Acute vitamin deficiency diseases have become a rarity in European nutritional conditions. Only the vitamin B12 deficiency occurs in isolation ; A general insufficient supply of folic acid leads to neural tube defects in a number of births in Germany (in contrast to 60 other countries) . All other vitamin deficiencies are caused by malnutrition , resorption disorders , pregnancy , illness or caused by iatrogenic damage caused by medical interventions .
The almost complete lack of certain vitamins is called avitaminosis .
Causes of the development of hypovitaminoses
Malnutrition
Malnutrition (also malnutrition) is the case when normal food is not supplied in sufficient quantities or is absorbed by the body. In addition to a lack of energy, this usually also leads to hypovitaminosis. Common hypovitaminoses in this case are, for example, pellagra . Pellagra is a deficiency symptom in which too few fresh vegetables and at the same time too much corn are consumed.
Malnutrition
Malnutrition is understood to mean a very one-sided diet, which may also result in high doses of harmful substances being absorbed, but excessive consumption of food that is already low in vitamins can lead to hypovitaminosis. Large amounts of polished rice can trigger Beri-Beri , which often affects people in third world countries and in Asia, whose diet consists mainly of such rice.
Absorption disorders
Resorption describes the ability of organisms to take up ("resorb") a substance. In the event of a corresponding absorption disorder, the body can no longer or only insufficiently absorb the substance. Examples of absorption disorders are bile production disorders, absorption disorders after operations in the gastrointestinal area, in the case of infectious or chronic intestinal inflammation, in the case of congenital defects and impairment of the intestinal flora (e.g. by antibiotics).
pregnancy and breast feeding period
Rickets occurs particularly in infants and young children if there is insufficient or no breastfeeding and / or insufficient exposure to the sun.
stress
Physical stress can also be a trigger, examples of which are infections, trauma, operations and chronic diseases that stress and weaken the body. Drug administration can also affect the function of organs in processing vitamins. But psychological stress can also cause eating disorders and thus cause deficiency symptoms.
Certain diseases
Diseases such as liver dysfunction, kidney dysfunction, exocrine pancreatic insufficiency and diabetes also trigger hypovitaminoses, and vitamin D deficiency can also occur in the various forms of photodermatosis , since people with the corresponding diseases often cannot stay in sunlight long enough for the skin to take the vitamin -D education is stimulated.
Diseases associated with hypovitaminoses and avitaminoses
Anemia , also called anemia , is a decrease in red blood cells and occurs due to a lack of riboflavin (vitamin B2), pyridoxal (vitamin B6), cobalamin (vitamin B12), and folic acid . It has the consequence that the person concerned suffers from fatigue and exhaustion. Due to the lack of blood cells, which are responsible for the transport of oxygen and carbon dioxide in the blood, shortness of breath and paleness of the face and mucous membranes set in. The lack of oxygen in the brain can lead to a drop in performance and headaches and dizziness. In addition, nausea, swallowing difficulties, abdominal and lower back pain can occur.
Ariboflavinosis is caused by a lack of riboflavin (vitamin B2). Symptoms for this disease are skin problems such as cracked corners of the mouth and flakes. In children, vision loss and growth retardation may set in.
Beri-Beri is caused by a deficiency in the vitamin thiamine (vitamin B1). The result is that circulatory disorders occur, but also nerve paralysis and dropsy as well as muscle wasting.
Night blindness is caused by a lack of vitamin A triggered. As a result, there is a significantly reduced visual performance in twilight and darkness. If the deficiency is more pronounced, keratomalacia can occur.
Neural tube defects such as spina bifida and anencephaly are caused by a deficiency in folic acid and the B group vitamin. It is open spina bifida , a malformation on the back, which arises due to incomplete closure of the spine during the development of the baby in the womb. It often results in complete or partial paralysis of the lower half of the body. In anencephaly, on the other hand, the child's brain is incompletely developed or not developed at all, which leads to death within a few hours or days after birth.
Osteomalacia is a deficiency of calciferol (vitamin D) and leads to decalcification of the bones, which in adults leads to bone softening or fragility.
Pellagra is a deficiency of niacin (vitamin B3) and tryptophan , the latter leads to poor protein quality. In addition, skin changes occur as a result of exposure to the sun on uncovered parts of the body as well as digestive and nervous system disorders such as confusion.
Phrynoderm is triggered by a lack of retinol (vitamin A). Dry and flaky skin with prominent follicles forms.
Rickets is caused by a lack of calciferol (vitamin D). The bones soften and bend, joints thicken, and knock knees and spinal curvatures can follow.
Rhagades are triggered by a lack of riboflavin (vitamin B2) and cause the corners of the mouth to crack.
Scurvy is caused by a deficiency in L-ascorbic acid (vitamin C) and causes ulcer disease of the oral mucosa with bleeding gums and bleeding in the skin and muscles.
Xerophthalmia is triggered by a deficiency in retinol or provitamin A and leads to dryness of the outer eye and, in advanced stages, then to blindness.
treatment
Treatment of hypovitaminosis is primarily carried out by changing eating habits in consultation with a doctor or nutritionist. In addition (as a vitamin substitution or vitamin supplementation), vitamins can be administered in preparation form; this should only be done under medical supervision and control in order to prevent incorrect dosages. If hypovitaminosis is not caused by malnutrition or malnutrition, the corresponding disease should be treated.
Hypovitaminoses in the animal kingdom
Hypovitaminoses can also occur in animals, especially in animal husbandry and the errors that arise in the process.
Hypovitaminoses in birds
Four vitamin deficiencies are particularly common in birds, which are caused by poor or one-sided nutrition. The lack of vitamin A means that the plumage is fatigued and symptoms of colds occur. During this time, birds, especially African gray parrots, are prone to aspergillosis . In addition, parakeratoses , especially of the mucous membranes, can occur. The salivary gland also swells and may need to be removed. A vitamin B deficiency can be recognized by a paler feather color or the feathers getting stuck in the feather sheath, accompanied by paralysis of the legs, so that it is no longer possible to hold on to the seat branch normally. The vitamin D deficiency is caused by insufficient exposure to sunlight, especially UV light. The mineral balance of the animal is disturbed, so that rickets occurs in young animals and osteomalacia in adult animals . A vitamin E deficiency in birds causes irreversible neurological damage, which is manifested by staggering, trembling and circular movements.
Guinea pig
Since guinea pigs, like primates (including humans), cannot synthesize vitamin C themselves, they can suffer from scurvy if they are poorly fed.
literature
- Hans Konrad Biesalski, Josef Köhrle, Klaus Schürmann: Vitamins, trace elements and minerals . Thieme, 2002, ISBN 3-13-129371-3 .
- Hahn, Ströhle, Wolters: Nutrition. Wissenschaftliche Verlagsgesellschaft, 2005, ISBN 3-8047-2092-7 .
- A. Jopp: Risk factor vitamin deficiency. Haug Verlag, Stuttgart 2002, ISBN 3-8304-2077-3 .
Individual evidence
- ↑ Silke Klapdor, Eva Richter, Rainer Klapdor: Fat-soluble vitamins in diseases of the pancreas. In: Ernahrung -Umschau , issue 08/12, pages 436–441.
- ↑ Alexandra Jungert and others: Vitamin substitution in the non-child area. Necessity and Risks. In: Deutsches Ärzteblatt. Volume 117, Issue 1–2, January 6, 2020, pp. 14–22.
- ↑ Clinical Diet for Small Animals. Volume 2. 4th edition. Schlütersche Verlagbuchhandlung, Hanover 2002, ISBN 3-87706-893-6 .
- ↑ Erhard F. Kaleta, Maria-Elisabeth Krautwald-Junghanns: Compendium of ornamental bird diseases. 3. Edition. Schlütersche publishing house accounting, Hanover 2007, ISBN 978-3-89993-022-1 .
- ^ Report on vitamin deficiencies in birds at www.birds-online.de ( accessed on August 12, 2011).
