vitamin mineral reference guide

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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

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Page 1: Vitamin Mineral Reference Guide

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

Page 2: Vitamin Mineral Reference Guide

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.