Editing Vitamin deficiency (section)

===Water-soluble vitamins===
{{See also|B vitamins#Deficiencies}}

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! Vitamin !! Symptoms & Diagnosis !! Information
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|[[Thiamine deficiency|Thiamine (Vitamin B<sub>1</sub>) deficiency]] || Weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart beat. Deficiency is assessed by [[red blood cell]] status and [[urine|urinary]] output.<ref>{{cite web|title=Fact Sheet for Health Professionals – Thiamin |url=https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/|access-date=5 February 2019|date=18 August 2018}}</ref><ref name=DRI-Thiamine>{{cite book | title = Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline | chapter = Thiamin | publisher = The National Academies Press | year = 1998 | location = Washington, DC | pages = 58–86 | doi = 10.17226/6015 | pmid = 23193625 | chapter-url = http://www.nap.edu/openbook.php?record_id=6015&page=58 | access-date= 5 February 2019 | isbn = 978-0-309-06554-2 }}</ref> || Especially common in countries that do not require fortification of wheat and maize flour and rice to replace the naturally occurring thiamine content lost to [[Mill (grinding)|milling]], [[Flour#Bleached flour|bleaching]] and other processing.<ref name=Map/> Severe deficiency causes [[beriberi]], which became prevalent in Asia as more people adopted a diet primarily of white rice. [[Wernicke encephalopathy]] and [[Korsakoff syndrome]] are forms of beriberi. Alcoholism can also cause vitamin deficiencies. Long-term deficiencies can be life-threatening.<ref name="AAFP19">{{cite web | title=Vitamins and minerals: How to get what you need | publisher=American Academy of Family Physicians | date=2019 | url=https://familydoctor.org/vitamins-and-minerals-how-to-get-what-you-need/ | access-date=12 February 2019}}</ref>
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|[[Riboflavin deficiency|Riboflavin (Vitamin B<sub>2</sub>) deficiency]]|| Deficiency causes painful red tongue with sore throat, chapped and cracked lips, and inflammation at the corners of the mouth ([[angular cheilitis]]). Eyes can be itchy, watery, bloodshot and sensitive to light. Riboflavin deficiency also causes [[anemia]] with red blood cells that are normal in size and hemoglobin content, but reduced in number. This is distinct from anemia caused by deficiency of folic acid or vitamin B<sub>12</sub>.<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/|title=Fact Sheet for Health Professionals – Riboflavin|publisher=Office of Dietary Supplements, US National Institutes of Health|date=20 August 2018|access-date=6 February 2019}}</ref><ref name=DRI-Riboflavin>{{cite book | title = Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline | chapter = Riboflavin | publisher = The National Academies Press | year = 1998 | location = Washington, DC | pages = 87–122 | doi = 10.17226/6015 | pmid = 23193625 | chapter-url = http://www.nap.edu/openbook.php?record_id=6015&page=87 | access-date = 29 August 2017 | isbn = 978-0-309-06554-2 | url-status = live | archive-url = https://web.archive.org/web/20150717032627/http://www.nap.edu/openbook.php?record_id=6015&page=87 | archive-date = 17 July 2015 }}</ref>   ||Especially common in countries that do not require fortification of wheat and maize flour and rice to replace the naturally occurring riboflavin lost during processing.<ref name=Map/>
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|[[Niacin deficiency|Niacin (Vitamin B<sub>3</sub>) deficiency]] || Deficiency causes [[pellagra]], a reversible nutritional wasting disease characterized by four classic symptoms often referred to as the four Ds: [[diarrhea]], [[dermatitis]], [[dementia]], and death. The dermatitis occurs on areas of skin exposed to sunlight, such as backs of hands and neck. Niacin deficiency is a consequence of a diet low in both niacin and the [[amino acid]] [[tryptophan]], a precursor for the vitamin.  Low plasma tryptophan is a non-specific indicator, meaning it can have other causes. The signs and symptoms of niacin deficiency start to revert within days of oral supplementation with large amounts of the vitamin.<ref>{{cite web |title=Fact Sheet for Health Professionals – Niacin |orig-date=2019 |date=18 November 2022 |url=https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/ |author=<!--Not stated--> |publisher=National Institutes of Health Office of Dietary Supplements |access-date=14 January 2023 |url-status=live |archive-url=https://web.archive.org/web/20221221104511/https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/ |archive-date=21 December 2022}}</ref><ref name=DRI-Niacin>{{cite book | title= Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline |chapter= Niacin |publisher = The National Academies Press |year=1998 |location = Washington, DC | pages=123–149 |doi= 10.17226/6015 |pmid= 23193625 |chapter-url= https://www.nap.edu/read/6015/chapter/8 | access-date = 3 February 2019 |isbn = 978-0-309-06554-2}}</ref>|| Chronic alcoholism is a contributing risk factor.
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|[[Pantothenic acid#Deficiency|Pantothenic acid (Vitamin B<sub>5</sub>) deficiency]] || Irritability, fatigue, and [[apathy]].<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/PantothenicAcid-HealthProfessional/ |title=Fact Sheet for Health Professionals – Pantothenic acid|publisher=Office of Dietary Supplements, US National Institutes of Health|date=20 August 2018|access-date=7 February 2019}}</ref><ref name=DRI-Pantothenic>{{cite book | title = Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline | chapter = Pantothenic Acid | publisher = The National Academies Press | year = 1998 | location = Washington, DC | pages = 357–373 | doi = 10.17226/6015 | pmid = 23193625 | chapter-url = http://www.nap.edu/openbook.php?record_id=6015&page=357 | access-date = 29 August 2017 | isbn = 978-0-309-06554-2}}</ref>||Extremely rare.
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|[[Vitamin B6#Deficiency|Vitamin B<sub>6</sub> deficiency]] || [[Microcytic anemia]], [[electroencephalography|electroencephalographic]] abnormalities, dermatitis, [[seborrhoeic dermatitis]]-like eruption, [[atrophic glossitis]] with [[mouth ulcer|ulceration]], [[angular cheilitis]], [[conjunctivitis]], and [[intertrigo]]. Neurologic symptoms of depression, [[somnolence]], confusion, and [[neuropathy]] (due to impaired [[sphingosine]] synthesis) and [[microcytic anemia]]<ref>{{cite web |title=Fact Sheet for Health Professionals – Vitamin B<sub>6</sub> |orig-date=2018 |date=2 June 2022 |url=https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/ |author=<!--Not stated--> |publisher=National Institutes of Health Office of Dietary Supplements |access-date=14 January 2023 |url-status=live |archive-url=https://web.archive.org/web/20230111134120/https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/ |archive-date=11 January 2023}}</ref><ref name=DRI-B6>{{cite book|chapter-url=https://www.nap.edu/read/6015/chapter/9#150|title=Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline|publisher=The National Academies Press|year=1998|isbn=978-0-309-06554-2|location=Washington, DC|pages=150–195|chapter=Vitamin B<sub>6</sub> |doi=10.17226/6015 |pmid=23193625|lccn=00028380|oclc=475527045|last1=Institute Of Medicine (Us) Standing Committee on the Scientific Evaluation Of Dietary Reference Intakes Its Panel On Folate|first1=Other B Vitamins}}</ref> ||Uncommon, although it may be observed in certain conditions, such as [[end-stage kidney disease]]s or [[malabsorption syndrome]]s, such as [[celiac disease]], [[Crohn disease]] or [[ulcerative colitis]].
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|[[Biotin deficiency|Biotin (Vitamin B<sub>7</sub>) deficiency]] ||Rashes including red, patchy ones near the mouth and fine, brittle hair. [[Hallucination]]s, [[Lethargy]], Mild [[depression (mood)|depression]], which may progress to profound [[fatigue (medical)|fatigue]] and, eventually, to [[somnolence]], Generalized muscular pains ([[myalgia]]) and [[Paresthesias]].  Decreased urinary excretion of biotin and increased urinary excretion of [[3-hydroxyisovaleric acid]] are better indicators of biotin deficiency than concentration in the blood.<ref>{{cite journal |vauthors=Mock NI, Malik MI, Stumbo PJ, Bishop WP, Mock DM |title=Increased urinary excretion of 3-hydroxyisovaleric acid and decreased urinary excretion of biotin are sensitive early indicators of decreased biotin status in experimental biotin deficiency |journal=Am. J. Clin. Nutr. |volume=65 |issue=4 |pages=951–958 |date=1997 |pmid=9094878 |doi=10.1093/ajcn/65.4.951 |doi-access=free }}</ref>  ||Rare, although biotin status can be compromised in alcoholics and during pregnancy and breastfeeding.Deficiency affects hair growth and skin health.<ref>{{Cite web|url=https://ods.od.nih.gov/factsheets/Biotin-HealthProfessional/#h2|title=Fact Sheet for Health Professionals - Biotin|date=8 December 2017|publisher=Office of Dietary Supplements, US [[National Institutes of Health]]|access-date=3 February 2019}}</ref><ref name=DRI-Biotin>{{cite book | title = Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline | chapter = Biotin | publisher = The National Academies Press | year = 1998 | location = Washington, DC | pages = 374–389 | doi = 10.17226/6015 | pmid = 23193625 | chapter-url = http://www.nap.edu/openbook.php?record_id=6015&page=374 |access-date=3 February 2019 | isbn = 978-0-309-06554-2}}</ref>
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|[[Folate deficiency|Folate (Vitamin B<sub>9</sub>) deficiency]] || Symptoms may include [[Fatigue (medical)|feeling tired]], heart [[Heart palpitations|palpitations]], [[shortness of breath]], feeling faint, open sores on the tongue, loss of appetite, changes in the color of the skin or hair, irritability, and [[Emotional and behavioral disorders|behavioral changes]].<ref name="Oldref_20">{{cite journal | vauthors = Haslam N, Probert CS | title = An audit of the investigation and treatment of folic acid deficiency | journal = Journal of the Royal Society of Medicine | volume = 91 | issue = 2 | pages = 72–73 | date = February 1998 | pmid = 9602741 | pmc = 1296488 | doi = 10.1177/014107689809100205 }}</ref> In adults, [[anemia]] (macrocytic, [[megaloblastic anemia]]) can be a sign of advanced folate deficiency. ||Common, and associated with numerous health problems, but primarily with [[neural tube defect]]s (NTDs) in infants when the mother's plasma concentrations were low during the first third of pregnancies. Government-mandated fortification of foods with folic acid has reduced the incidence of NTDs by 25% to 50% in more than 60 countries using such fortification.<ref name=Map /> Deficiency can also result from rare [[gene]]tic factors, such as [[mutation]]s in the [[MTHFR]] gene that lead to compromised folate metabolism.<ref>{{cite web |title=Fact Sheet for Health Professionals – Folate |url=http://ods.od.nih.gov/factsheets/folate.asp |publisher=National Institutes of Health |access-date=11 January 2015}}</ref><ref name=DRI-Folate>{{cite book |title = Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline |chapter = Folate |publisher = The National Academies Press |year=1998 |location = Washington, DC |pages = 196–305 |doi = 10.17226/6015 |pmid = 23193625 |chapter-url = http://www.nap.edu/openbook.php?record_id=6015&page=196 |access-date = 2 February 2019 |isbn=978-0-309-06554-2}}</ref> [[Cerebral folate deficiency]] is a rare condition in which concentrations of folate are low in the brain despite being normal in the blood.<ref>{{cite journal |last1=Gordon |first1=N |title=Cerebral folate deficiency. |journal=Developmental Medicine and Child Neurology |date=2009 |volume=51 |issue=3 |pages=180–182 |doi=10.1111/j.1469-8749.2008.03185.x |pmid=19260931|s2cid=7373721 }}</ref>
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|[[Vitamin B12 deficiency|Vitamin B<sub>12</sub> deficiency]] ||[[Vitamin B12 deficiency anemia|Anemia]], [[Neurology|neurological]] and [[Gastrointestinal disease|digestive]] disorders.<ref name="WD1">{{Cite web|date=2021-07-28|title=Vitamin B12 Deficiency: Causes, Symptoms, and Treatment|url=https://www.webmd.com/diet/vitamin-b12-deficiency-symptoms-causes|archive-url=https://web.archive.org/web/20210728163640/https://www.webmd.com/diet/vitamin-b12-deficiency-symptoms-causes|archive-date=2021-07-28|access-date=2021-09-13}}</ref><ref>{{Cite book|title=Neurologic aspects of systemic disease|vauthors=Reynolds EH|date=2014|isbn=978-0-7020-4087-0|veditors=Biller J, Ferro JM|series=Handbook of Clinical Neurology|volume=120|pages=927–43|chapter=The neurology of folic acid deficiency|doi=10.1016/B978-0-7020-4087-0.00061-9|pmid=24365361}}</ref> This may result in feeling tired, shortness of breath, lightheadedness, headaches, mouth ulcers, [[Pallor|pale]] skin, rapid heartbeat, loss of appetite, hair loss, low blood pressure, decreased ability to think, joint pain, [[Paresthesia|numbness and tingling]] to the fingers and toes, and tinnitus.<ref>{{Cite journal |last1=Hunt |first1=Alesia |last2=Harrington |first2=Dominic |last3=Robinson |first3=Susan |date=2014-09-04 |title=Vitamin B12 deficiency |url=https://www.bmj.com/content/349/bmj.g5226 |journal=BMJ |language=en |volume=349 |pages=g5226 |doi=10.1136/bmj.g5226 |issn=1756-1833 |pmid=25189324}}</ref> Damage to nerves may result in depression, confusion, memory loss, difficulty walking, sense loss, [[mania]], and [[psychosis]].||Lead to [[megaloblastic anemia]], [[subacute combined degeneration of spinal cord]], and [[methylmalonic acidemia]], among other conditions. Supplementation with folate can mask vitamin B<sub>12</sub> deficiency.<ref>{{cite web|url=http://ods.od.nih.gov/factsheets/vitaminb12|title=Fact Sheet for Health Professionals – Vitamin B<sub>12</sub>|publisher=Office of Dietary Supplements, National Institutes of Health |access-date=2 February 2019}}</ref><ref name=DRI-B12>{{cite book |title = Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B<sub>6</sub>, Folate, Vitamin B<sub>12</sub>, Pantothenic Acid, Biotin, and Choline |chapter = Vitamin B<sub>12</sub> |publisher = The National Academies Press |year = 1998 |location = Washington, DC |pages = 306–356 |doi = 10.17226/6015 |pmid = 23193625 |chapter-url = http://www.nap.edu/openbook.php?record_id=6015&page=306 |access-date = 2 February 2019 |isbn = 978-0-309-06554-2}}</ref> Consuming a vegan diet increases the risk, since Vitamin B<sub>12</sub> is mostly found in food and drinks made from animal products, including eggs and dairy products.
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|[[Vitamin C#Deficiency|Vitamin C deficiency]] || Deficiency leads to weakness, weight loss and general aches and pains. Longer-term depletion affects [[connective tissue]]s, severe [[gingivitis|gum disease]], and bleeding from the skin.<ref>{{cite web |url=https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/ |title=Fact Sheet for Health Professionals – Vitamin C |publisher=Office of Dietary Supplements, US National Institutes of Health |date=2016 |access-date=2 February 2019}}</ref><ref name=DRI-C>{{cite book |title=Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids |chapter=Vitamin C |publisher=The National Academies Press |year=2000 |location=Washington, DC |pages=95–185 |doi=10.17226/9810 |pmid=25077263 |chapter-url=https://www.nap.edu/read/9810/chapter/7 |access-date=2 February 2019 |isbn=978-0-309-06935-9|author1=Institute of Medicine (US) Panel on Dietary Antioxidants Related Compounds }}</ref> || Rare, consequently, no countries fortify foods as a means of preventing this deficiency.<ref name=Map /> The historic importance of vitamin C deficiency relates to occurrence on long sea-going voyages, when the ship food supplies had no good source of the vitamin. Deficiency results in [[scurvy]] when plasma concentrations fall below 0.2&nbsp;mg/dL, whereas the normal plasma concentration range is 0.4 to 1.5&nbsp;mg/dL.
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