Ideally every person from birth through old age would get all the nutrients they need from the food they consume, but deficiencies occur. There are times when the optimal amount of nutrients from food intake are not possible. People who consume energy-dense, nutrient-poor foods can develop a marginal micronutrient intake and low serum concentrations of vitamins. In times of food shortages or limited access to fresh foods, nutrient deficiencies can become even more common, especially vitamin deficiencies.What are vitamins?
Vitamins are organic molecules required in small amounts to prevent deficiency signs and symptoms. The most concern is for water-soluble vitamins—the B vitamins and vitamin C. These are essential nutrients the body cannot make. The body does not store water soluble vitamins in large quantities. You should consume them every day. Water-soluble vitamins are lost during processing because they are fragile. This increases the risk of inadequate intake even in times of plenty. This article will focus on the most common B vitamins and vitamin C.
Water-soluble Vitamins
Water-soluble vitamins bind to proteins in food. Vitamins are generally digested, absorbed and transported similarly. Even when using supplements, water-soluble vitamins are rarely toxic as they are not stored in the body in large quantities. They are absorbed mostly in the small intestine and stomach and are highly bioavailable, depending on nutritional status.
Bioavailability
Bioavailability means the amount of a nutrient that is absorbed across the gut wall into circulation and usable by the body. The more depleted of nutrients a person is, the more absorption occurs. Other nutrients may compete for absorption and some substances in food, such as can decrease bioavailability. Medications, age, illness, and alcohol use can also change bioavailability.
Water-soluble Vitamin Destruction
Water-soluble vitamins are easily destroyed in cooking and storage. They are susceptible to water, as they dissolve in water. Water-soluble vitamins degrade from heat, light, changes in acidity (pH), and oxygen exposure. You can see this happen when cooking vegetables in boiling water. The water takes on the color of the vegetables, as the nutrients move from the vegetables and into the water. Losses of nutrients can be minimized with proper handling, preparation, and storage of foods.
Nutrient Deficiencies That Result in Disease
The most common nutrients that result in deficiency diseases will be reviewed one vitamin at a time with deficiency signs and symptoms and then common sources of the nutrient will be listed. Then information about the use of vitamin supplements will be provided.
Vitamin B1- Thiamin
First on the list is B1, also called Thiamin. The deficiency disease of thiamin is called beriberi. It is common in parts of the world that rely on unfortified, milled rice as a staple food. It causes weak and impaired immune function. There are two types of beriberi. The first is known as dry beriberi, which is characterized by progressive wasting, numbing, and weakness of the extremities, and chronic infections. Wet beriberi is characterized by difficulty breathing, pitting edema, and eventually circulatory collapse. Thiamin is found in beef liver and pork, legumes, nuts, seeds, and eggs. Also, powdered milk, fortified cereals, and grain products are all good sources.
Vitamin B2 – Riboflavin
A deficiency in vitamin B2 or riboflavin causes ariboflavinosis. The first signs of deficiency can be reddening of the lips with cracking at the corners (cheilosis), an inflamed and sore mouth (stomatitis), tongue inflammation (glossitis), eye fatigue, and sensitivity to light.
Vitamin B2 is highly susceptible to photo-oxidation, exposure to light, and begins to degrade within about 20 minutes of exposure to light. Riboflavin is not susceptible to heat degradation. However, it can be lost into the water when cooked. Ariboflavinosis is a common deficiency seen in severe alcoholics. Excess supplementation will cause urine to become bright yellow. Sources of riboflavin are milk and dairy products, including powdered or canned. Beef liver, lamb, mushrooms, and sun-dried tomatoes are also good sources.
Vitamin B3 – Niacin
Vitamin B3 or niacin deficiency results in the disease known as pellagra, which translates to “rough skin”. Diarrhea is one of the first signs. Dermatitis, then dementia, and ultimately death follow. Gastro-intestinal distress will manifest first. This deficiency is seen in chronic alcoholism, poverty, and food shortages. Sources of niacin include turkey, grass-fed beef or wild game, and mushrooms. High doses of niacin supplements can cause transitory flushing or redness of the face and neck, which can be uncomfortable. High doses of niacin, as a supplement, may be harmful to an infant during pregnancy and breastfeeding.
Vitamin B6
A deficiency of Vitamin B6, or pyridoxine deficiency, causes red blood cells to be small and pale, which results in anemia with poor stamina and fatigue due to decreased oxygen availability in tissues. As with B2 or riboflavin deficiency, B6 deficiency also causes cheilosis, glossitis, and stomatitis. Deficiency also causes dizziness and can lead to early stroke. Malnutrition is the main cause of this deficiency disease. Women of childbearing age are higher risk for developing deficiencies of B6. People with inflammatory conditions and smokers are also high risk for developing deficiency of B6. Food sources of B6 include fish, (our favorite) liver, and starchy vegetables. Supplementation can be problematic if taken in large doses, leading to toxicity. B6 toxicity leads to severe neurological problems, such as numbness in the hands and feet.
Vitamin B12
Vitamin B12, or cobalamin, deficiency causes pernicious anemia. Signs and symptoms of B12 deficiency are fatigue, difficulty sleeping, numbness, memory loss, and severe neurological disturbances, such as hallucinations and paranoia. B12 deficiency usually occurs over an extended period of time and may go unnoticed until signs and symptoms become severe. Medications that decrease stomach acid can interfere with B12 metabolism and lead to deficiencies. B12 only comes from animal products, making vegans and vegetarians higher risk for B12 deficiency. Sources of B12 are animal products, including dried eggs, powdered milk, and dehydrated meats.
Folate
Folate deficiency causes large immature red blood cells. This deficiency occurs commonly in alcoholics, people with intestinal diseases, and the elderly. Deficiency during early pregnancy can cause neural tube defects, which can lead to death of the infant during birth. Folate deficiency causes birth defects to occur often before women know they are pregnant. Women of childbearing age should ensure that they have adequate intake of folate before becoming pregnant. Intake of Folate can “mask” B12 deficiency. Misdiagnosis of B12 deficiency is dangerous, especially for babies. It causes severe neurological damage and possibly death. Good sources of folate are dried legumes, peas (including dried), and leafy greens, such as dandelion greens, which are readily available in most wild areas.
Vitamin C
Vitamin C deficiency causes scurvy. Signs and symptoms are bleeding gums, skin irritations, and bruising for seemingly no reason. Poor wound healing is another sign of low vitamin C intake. Vitamin C is available in citrus fruit, which is not always readily available. However, scurvy can be prevented using dried berries, peppers, mango, and brussel sprouts when citrus fruits are not available. Food and drinks containing caffeine can inhibit the bioavailability of vitamin C by increasing urination and depleting vitamin C. Antibiotics and aspirin inhibit the bioavailability of vitamin C. Vitamin C intake should increase if antibiotics are needed. An additional concern for vitamin C status is stress. High levels of physical or mental stress increases the body’s need for vitamin C and can cause deficiency even while consuming the amount of vitamin C that prevents scurvy. Watch for signs and symptoms and increase intake accordingly.
Vitamin Supplements
The use of heavily processed foods where nutrients are lost during processing, stress that depletes nutrients, high energy expenditure, special growth circumstances such as adolescence, pregnancy and lactation, and aging can all lead to inadequate nutrient intake. During time of food shortages or lack of fresh foods, nutrition supplements can be used to augment food intake. Vitamin supplements are not meant to be food substitutes, as there are phytonutrients and trace nutrients in foods that are not available in supplement form. However, supplements can play a role in a preventing the most likely nutrient deficiencies when food supplies are limited for whatever reason.
You may need to adjust the level of supplementation according to individual need. For example, the minimum recommended amount of vitamin C for a male 18 years old or older is 90 milligrams. However, a person under high stress and/or expending more than normal physical energy would need a minimum of 125 milligrams to prevent scurvy.
Use of Vitamin Supplements
For specific nutrients, an alternative to finding fresh foods or using stored foods is the use of vitamin supplements in the form of capsules, tablets, powder, or liquid form can be used to prevent deficiencies. There are some basic guidelines you should understand prior to taking any type of supplement. Do use nutritional supplements in moderation as large doses of some nutrients, as mentioned above, can be harmful. Do use supplements as one way to improve nutrient intake, while finding access to the nutrients you need from fresh foods whenever possible. Drink plenty of water when taking nutritional supplements. Remember that water-soluble vitamins need water to increase bioavailability.
Storing Vitamin Supplements
You should store vitamin supplements separately in sealed containers. Vacuum sealing devices work well for sealing small quantities of vitamin supplements needed for a 2 to 3 weeks’ supply. Supplements will degrade when exposed to air. For long-term storage, use vitamins that are not packaged with minerals, as the minerals can cause oxidation and degradation (loss of potency) of the vitamins. Be sure that oxygen absorbers have been used in the packaging. Store the sealed vitamin supplements in a cool, dry, dark place to avoid degradation from heat and light. They will be preserved longer than you think!
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