EES Healthcare Solutions DSL 11-0583

Vitamin and Mineral Reference Guide

Vitamin/Mineral Symptoms Diagnosis Treating the Deficiency

Iron

Anemia

Dysphagia

Koiloncychia

Enteropathy

Fatigue

Rapid heart rate/palpitations

Decreased work performance

Impaired learning ability

CBC; low Hgb/Hct, low MCV

Decreased serum iron

Decreased percentage of saturation

Increased TIBC

Increased transferrin

Decreased serum ferritin

Iron replacement therapy, up to 300 mg/d elemental iron, usually as 3 or 4 tablets given during the course of the day

Iron preparations should be taken on an empty stomach because food can inhibit iron absorption

When oral treatment has failed or with severe anemia, IV iron infusion should be considered

Thiamin/B1

Anorexia

Gait ataxia

Paresthesia

Muscle cramps

Irritability

Decreased urinary thiamin excretion

Decreased RBC transketolase

Decreased serum thiamin

Increased lactic acid

Increased pyruvate

With hyperemesis, parenteral doses of 100 mg/d for the first 7 days, followed by daily oral doses of 50 mg/d until complete recovery

Simultaneous therapeutic doses of other waste soluble vitamins

Magnesium deficiency must be treated simultaneously

Administration with food reduces rates of absorption

B-12

Pernicious anemia

Pale with slightly icteric skin and eyes

Fatigue, light-headedness, or vertigo

Shortness of breath

Tinnitus

Palpitations, rapid pulse, angina and symptoms of congestive failure

Numbness and paresthesia in extremities

Ataxia

Anorexia

Diarrhea

CBC; elevated MCV, high RDW, Howell-Jolly bodies, reticulocytopenia

Low serum B12

Increased MMA and increased homocysteine

Decreased transcobalamin II-B12

Neurologic disease can occur with normal hematocrit

1000 ug/wk IM for 8 weeks, then 1000 ug/mo IM for life or 350-500 ug/d oral crystalline B12

Neurologic defects might not reverse with supplementation

EES Healthcare Solutions DSL 11-0583

Vitamin D

Osteomalacia

Disorders of calcium deficiency; rachitic tetany

Decreased 25-hydroxycholecalciferol

Decreased serum phosphorus

Increased serum alkaline phosphatase

Increased parathyroid hormone

Decreased urinary calcium

Decreased or normal serum calcium

50,000 IU/wk ergocalciferol (D2) orally or intramuscularly, for 8 weeks

Information taken from ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient, Surgery for Obesity and Related Diseases 2008. 4; S73-S108. *Please note that this is not an all inclusive list.