vitamin mineral reference guide
TRANSCRIPT
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.