Mild form of vitamin deficiency may remain asymptomatic or have non-specific symptoms like malaise, lethargy, loss of appetite, poor weight gain and tachypnea. Many of them may present with increased history of infections like diarrhea. Specific symptoms of deficiency depend on the type of vitamin.

• Vitmain A – nyctalopia, bitot spots, dry skin, dry hair, brittle finger nails, corneal perforation and xerophthalmia
• Vitamin B1 – neurologic symptoms like poor memory, Korsakoff syndrome, muscle cramps, muscle atrophy, paresthesia, and cardiovascular symptoms like tachycardia, chest pain, hypotension, and shock. 
• Vitamin B 12 – neuropathy and myelopathy resulting in impaired vibration sense, ataxia and paresthesia, depression, paranoid psychosis, optic atrophy, nystagmus, and chiasmatic lesion.
• Vitamin C – Irritability, pain and tenderness in legs, pseudoparalysis, hemorrhage, jaundice, shortness of breath, bone pain and scurvy. 
• Vitamin D – bowing of legs in children, periosteal bone pain and osteomalacia in adults.
• Vitamin E – hyporeflexia, limb ataxia, muscle weakness, dissociated nystagmus, areflexia, dysphagia, and dysarthria. 
• Vitamin K – ecchymosis, petechiae, hematomas, and bleeding at the site of puncture or surgery. 

• Anemia

  BACKGROUND: Anemia is associated with increased morbidity and mortality in many chronic diseases. Little is known about anemia in cystic fibrosis (CF). [ncbi.nlm.nih.gov]

  Symptoms of anemia due to vitamin B12 deficiency or folate deficiency develop slowly and are similar to symptoms caused by other types of anemia, such as fatigue, weakness, and paleness. [msdmanuals.com]

  Causes of vitamin deficiency anemias, also known as megaloblastic anemias, include: Folate deficiency anemia. Folate, also known as vitamin B-9, is a nutrient found mainly in fruits and leafy green vegetables. [mayoclinic.org]

  When this happens, low levels of intrinsic factor produce symptoms of juvenile pernicious anemia in patients younger than age 10. [drugs.com]

• Fatigue

  Fatigue isn’t something that you should ignore. [steptohealth.com]

  For more information on how to reduce fatigue, consider reading about the 11 best vitamins and supplements to boost energy. Summary Excessive fatigue and tiredness may be a sign of vitamin D deficiency. [healthline.com]

  Thyroid disease resulting from low levels of iodine — which can lead to hypothyroidism — can cause fatigue, weight gain and brittle nails as well as puffy eyes. [news.com.au]

  Fatigue - Early on, someone with a vitamin C deficiency will tend to get tired easily and experience reduced energy. Because chronic fatigue is a symptom of so many illnesses, it can be hard to catch a specific condition based on this symptom. [fitday.com]

  A 2006 study discovered a connection between iodine intake and thyroid disease — a condition that can lead to fatigue, exhaustion, and puffy eyes, among many others. [medicaldaily.com]

• Malnutrition

  CONCLUSIONS: This is the first prospective cohort to investigate malnutrition after RYGB in nonseverely obese patients. [ncbi.nlm.nih.gov]

  Deficiency of vitamin a due to malnutrition, malabsorption, or dietary lack. It is manifested with reduced night vision, night blindness, and xerophthalmia. [icd9data.com]

• Asymptomatic

  Mild forms may remain asymptomatic for long time. Most common symptoms of vitamin deficiency are non-specific like tiredness, poor appetite, and lethargy. [symptoma.com]

  Carotenemia is usually asymptomatic but may lead to carotenosis, in which the skin becomes yellow. [merckmanuals.com]

  Asymptomatic Scurvy: Its Relation to Wound He-ling and Its Incidence in Patients with Peptic Ulcer. New England J. Med., 217:443, 1937. Google Scholar 53. [link.springer.com]

  Asymptomatic type B right atrial thrombus in a case with protein S deficiency. Ann Card Anaesth. 2014;17(3):237-239. (PubMed) 16. van der Meer JH, van der Poll T, van 't Veer C. [lpi.oregonstate.edu]

  Risk factors for advanced colonic neoplasia and hyperplastic polyps in asymptomatic individuals. JAMA 2003;290:2959-67. [ PubMed abstract ] Wactawski-Wende J, Kotchen JM, Anderson GL, Assaf AR, Brunner RL, O'Sullivan MJ, et al. [ods.od.nih.gov]

• Malaise

  A condition due to a dietary deficiency of ascorbic acid (vitamin c), characterized by malaise, lethargy, and weakness. As the disease progresses, joints, muscles, and subcutaneous tissues may become the sites of hemorrhage. [icd9data.com]

  Scurvy is characterized by general malaise and lethargy, progressing on to spotty skin, losing teeth, and bleeding and swollen gums. Slow wound healing and general weakness is also a regular symptom. If left untreated scurvy can be fatal. [noorvitamins.com]

  Mild form of vitamin deficiency may remain asymptomatic or have non-specific symptoms like malaise, lethargy, loss of appetite, poor weight gain and tachypnea. Many of them may present with increased history of infections like diarrhea. [symptoma.com]

  The subjects exhibited various degrees of signs and symptoms, including irritability and restlessness; fatigue; apathy; malaise; sleep disturbances; gastrointestinal complaints such as nausea, vomiting, and abdominal cramps; neurobiological symptoms such [nap.edu]

  Initial symptoms can include fatigue (probably the result of impaired carnitine biosynthesis), malaise, and inflammation of the gums [ 4, 11 ]. [ods.od.nih.gov]

• Aspiration

  This Course is beneficial for Pre-Medical (NEET and AIIMS) aspirants. [unacademy.com]

• Diarrhea

  Many of them may present with increased history of infections like diarrhea. Specific symptoms of deficiency depend on the type of vitamin. [symptoma.com]

  Taking high doses of phosphorus supplements for a short time can cause diarrhea or stomach pain. [huel.com]

  Plus Illness A child's weakened immune system is more susceptible to infectious diseases like measles and diarrhea. [vitaminangels.org]

  This increases the chance of death from malaria, measles and diarrhea. Who is at risk for vitamin A deficiency? Vitamin A deficiency is a big problem in developing nations in Africa and Southeast Asia. [aao.org]

  and it is used in laxatives Loss of appetite, nausea, vomiting, diarrhea, confusion, tremors, loss of coordination, and occasionally fatal convulsions Sometimes associated with calcium and potassium deficiencies at the same time Marginal deficiency [iceberglabs.net]

• Failure to Thrive

  Complications can include: Excessively high calcium level Failure to thrive (in infants) Kidney damage due to high calcium Liver damage Taking too much vitamin A during pregnancy may cause abnormal development in the growing baby. [medlineplus.gov]

  In children, toxicity can cause pruritus, anorexia, and failure to thrive. Hepatomegaly and splenomegaly may occur. In carotenosis, the skin (but not the sclera) becomes deep yellow, especially on the palms and soles. [merckmanuals.com]

  During infancy, signs of a vitamin B12 deficiency include failure to thrive, movement disorders, developmental delays, and megaloblastic anemia [ 33 ]. [ods.od.nih.gov]

• Dyspepsia

  Furthermore, the nicotinic acid group had a significantly greater risk of diabetes, gastrointestinal dyspepsia, diarrhea, ulceration, bleeding events in the gut and brain, and skin rashes and ulcerations. [ods.od.nih.gov]

  Prevalences of endoscopic and histological findings in subjects with and without dyspepsia. Br Med J 302:749–752. Johnson PR Jr, Roloff JS. 1982. Vitamin B 12 deficiency in an infant strictly breastfed by a mother with latent pernicious anemia. [nap.edu]

• Chronic Diarrhea

  diarrhea, fat malabsorptive conditions Beef liver, dairy products. [mdedge.com]

  Chronic diarrhea also leads to excessive loss of vitamin A in young children, and vitamin A deficiency increases the risk of diarrhea [ 5, 15 ]. The most common symptom of vitamin A deficiency in young children and pregnant women is xerophthalmia. [ods.od.nih.gov]

  Persons who are positive for human immunodeficiency virus with chronic diarrhea may also require either increased oral or parenteral B 12. [nap.edu]

• Intestinal Disease

  This may be due to surgery to your stomach or small intestine (such as gastric bypass surgery), abnormal bacterial growth in your small intestine, or an intestinal disease, such as Crohn's disease or celiac disease, that interferes with absorption of [mayoclinic.org]

  Groen, Juda: The Absorption of Glucose from the Small Intestine in Deficiency Diseases. New England J. Med., 218:247–253, Feb. 10, 1938. CrossRef Google Scholar 39. Cowgill, G. R.: Human Requirements for Vitamin B 1. J. A. M. [link.springer.com]

• Cracked Lips

  lips, sore tongue and mouth, burning eyes; skin rashes; anemia Niacin Pellagra (diarrhea; inflamed skin and mucous membranes; mental confusion and/or dementia) Vitamin B6 Anemia; convulsions similar to epileptic seizures; skin rashes; upset stomach; [dummies.com]

  Many of us suffer from bad breath, cracked lips and agonising headaches. But they could all be a sign of something much more sinister. [dailymail.co.uk]

  The symptoms are cracked lips, swelling of the throat, bloodshot eyes, bright pink tongue and low red blood cell count. [stylecraze.com]

  B6, folate, and glutathione synthesis 10% to 27% of older adults Fatigue, cracked lips, sore throat, bloodshot eyes Older adults, low intake of animal and dairy products, heavy alcohol use Dairy, meat and fish, eggs, mushrooms, almonds, leafy greens, [mdedge.com]

  It causes distinctive bright pink tongues, although other symptoms are cracked lips, throat swelling, bloodshot eyes, and low red blood cell count. Ultimately it can cause comas and death. [listverse.com]

• Night Blindness

  It is manifested with reduced night vision, night blindness, and xerophthalmia. [icd9data.com]

  Vitamin A deficiency stops the production of these pigments, leading to night blindness. Your eye also needs vitamin A to nourish other parts of your eye, including the cornea. [aao.org]

  Well, the answer is you will suffer from night blindness, which is abnormally poor vision in dim light. [study.com]

  Treatment of Vitamin A Deficiency The night blindness associated with vitamin A deficiency can be reversed with treatment. Total blindness, however, cannot be treated. [adoptionnutrition.org]

  Night Blindness: This disease causes the patient to either lose complete sight or a blurry vision at night. Deficiency of vitamin A causes night blindness. Including carrots in your diet can help to get rid of this disease. [stylecraze.com]

• Myopathy

  Muscle Weakness: Vitamin E deficiency can cause myopathy, where the muscular fibers do not function and go weak. 7. Leg Cramps: Leg cramps can be explained as the sudden, painful and involuntary contraction of the muscles. [stylecraze.com]

  SPF 15 reduces production by 99% Fatty fish and fish liver oils, sun-dried mushrooms E (tocopherols and tocotrienols): Antioxidant, PUFA protectant, gene regulation Rare 93% Anemia, neuropathy, myopathy, abnormal eye movements, weakness, retinal damage [mdedge.com]

• Muscular Atrophy

  Essential for proper spermatogenesis, pregnancy, lactation and muscular function. Sterility (impotency) and muscular atrophy. [studyadda.com]

  Clinical signs of beriberi primarily involve the nervous system, e.g., muscular atrophy and peripheral paralysis. Takaki correctly attributed the disease to a food deficiency, but mistakenly believed that sufficient amounts of protein prevented it. [clinchem.aaccjnls.org]

• Dry Skin

  Dry Skin: Vitamin E is widely known and is important ingredients in all our lotions and moisturizers. Vitamin E deficiency can cause dry skin. 5. [stylecraze.com]

  Vitmain A – nyctalopia, bitot spots, dry skin, dry hair, brittle finger nails, corneal perforation and xerophthalmia Vitamin B1 – neurologic symptoms like poor memory, Korsakoff syndrome, muscle cramps, muscle atrophy, paresthesia, and cardiovascular [symptoma.com]

  Other symptoms include: Dry eyes Eye inflammation Dry skin Dry hair Broken fingernails Decreased resistance to infections Diagnosis of Vitamin A Deficiency The diagnosis is based on clinical symptoms and a low level of vitamin A in the blood. [adoptionnutrition.org]

  Other signs of an iodine deficiency include dry skin, weight gain, and brittle nails. Healing Foods: Cranberries, yogurt, kelp, potatoes, strawberries, and navy beans. [medicaldaily.com]

• Petechiae

  It may lead to bleeding, manifested with ecchymoses, petechiae, and hematomas. In infants it may cause hemorrhagic disease of newborn with intracranial and retroperitoneal bleeding. [icd9data.com]

  Petechiae. Petechiae are small 1-2 mm red or purple spots on the skin that result from minor hemorrhage due to broken capillary blood vessels. Petechiae can result from both niacin (vitamin B3) and vitamin C deficiency. Follicular hyperkeratosis. [podiatrytoday.com]

  Deficiency more often due to poor absorption than low consumption Meat, seafood, eggs, and dairy C (ascorbic acid): Antioxidant 7.1% 31% Scurvy, fatigue, anemia, joint pain, petechia. [mdedge.com]

  Vitamin K – ecchymosis, petechiae, hematomas, and bleeding at the site of puncture or surgery. The initial test for the diagnosis of suspected vitamin deficiency is serum levels of specific vitamin. [symptoma.com]

  As vitamin C deficiency progresses, collagen synthesis becomes impaired and connective tissues become weakened, causing petechiae, ecchymoses, purpura, joint pain, poor wound healing, hyperkeratosis, and corkscrew hairs [ 1, 2, 4, 6-8 ]. [ods.od.nih.gov]

• Skin Disease

  Vitamin A deficiency can lead to blindness, skin disease and growth retardation in children. What causes vitamin A deficiency? Primary vitamin A deficiency is caused by prolonged dietary deprivation. [dermnetnz.org]

  Niacin (vitamin B3) prevents the skin disease known as pellagra. Riboflavin (vitamin B2) helps with metabolism of fats, carbohydrates, and proteins. Thiamin (vitamin B1) prevents the nervous system disease called beriberi. [ffinetwork.org]

  Disease is pellagra, rare in U.S. [iceberglabs.net]

  […] of skin cancer [ 1 ]. [ods.od.nih.gov]

• Skin Rash

  hair loss; emotional depression; skin rashes (in infants younger than 6 months) [dummies.com]

  Biotin and Health Hair, nail, and skin health Signs of biotin deficiency include skin rashes, hair loss, and brittle nails [ 10, 13 ]. Therefore, biotin supplements are often promoted for hair, skin, and nail health [ 17, 24, 25 ]. [ods.od.nih.gov]

  Most adults with the deficiency demonstrated a red, scaly, skin rash, frequently around the eyes, nose, and mouth. Most of the adults had neurological symptoms, including depression, lethargy, hallucinations, and paresthesia of the extremities. [nap.edu]

• Skin Lesion

  lesions. 12 Skin lesions in pellagra tend to be symmetric and occur in sun-exposed areas and on pressure points. [podiatrytoday.com]

  Skin lesions, loss of appetite, weakness, hairfall, paralysis. Folic acid group Green vegetables, soyabean, yeast, kidneys, liver, synthesised by intestinal bacteria. Essential for synthesis of DNA and maturation of blood corpuscles. [studyadda.com]

  Expressed in normal human skin and vascular tissues, GRP has been colocalized with abnormal mineral deposits in the extracellular matrix in calcified arteries and calcified skin lesions (22). [lpi.oregonstate.edu]

  […] changes). q Abnormal = severe skin lesions. r Abnormal total erythrocyte riboflavin = < 400 nmol/L (15 µg/100 mL); authors’ conclusion. s Normal total erythrocyte riboflavin = ≥ 530 nmol/L (20 µg/100 mL); authors’ conclusion. t Abnormal = severe symptoms [nap.edu]

• Intracranial Hemorrhage

  […] bruising excessive bleeding after surgery Rare symptoms bleeding in the brain (intracranial hemorrhage) skeletal abnormalities and mild hearing loss (in severe cases) Diagnosis VKCFD is diagnosed by a variety of blood tests that should be performed by [wfh.org]

  In infants, vitamin K deficiency may result in life-threatening bleeding within the skull (intracranial hemorrhage ) (8). [lpi.oregonstate.edu]

• Agitated Delirium

  In the late 1880s, Korsakoff described a spectrum of cognitive disorders, including a confabulatory amnestic state following an agitated delirium, occurring in conjunction with peripheral polyneuropathy. [ncbi.nlm.nih.gov]

The initial test for the diagnosis of suspected vitamin deficiency is serum levels of specific vitamin. Imaging studies are used for evaluating the growth of the bones or for checking excessive deposition of periosteal bone. Urinary excretion of some vitamins, for example thiamine, may be useful. Deficiency may be assessed using radioassay and non-radioisotopic assay as well. Other procedures like dark adaptation test may be adopted for a particular vitamin.

• Macrocytosis

  […] and protein-energy malnutrition. 5 In elderly patients with ineffective erythropoiesis (formation of erythrocytes), it is important for pharmacists to note that microcytosis (low mean corpuscle volume: [MCV]) should suggest sideroblastic anemia, while macrocytosis [uspharmacist.com]

  The expected findings of very low serum cobalamin levels, anemia, and macrocytosis are often lacking. Arch Intern Med 148:1712–1714. Carmel R. 1992. [nap.edu]

  Circulating unbetabolied folic acid and 5-methyltetrahydrofolate in relation to anemia, macrocytosis, and cognitive test performance in American seniors. [ods.od.nih.gov]

Treatment modality depends on the severity of vitamin deficiency. Replenishment of the deficient vitamin is the first step in treatment. In most of the cases restoration of body stores helps to resolve the symptoms. The daily maintenance dose varies with the type of vitamin, age and severity of the condition. Parenteral administration of the vitamin is recommended in severe cases of deficiency. Duration of therapy depends on the symptoms and is usually continued till the symptoms improve. Comorbid conditions, if any, should be identified and treated appropriately. During recovery care should be taken to provide a balanced and liberal diet. Long term supplementation may be needed in some cases. If the deficiency affects gait, balance or functions of any of the organs, physical and occupational therapy may be helpful. Follow-up is very important to confirm that the levels are well within the acceptable range. Most of the cases can be treated on an outpatient basis, unless there is a serious associated condition. Support for cardiac function may be necessary in some cases, particularly wet beriberi. Some patients may need neuropsychological intervention to improve cognition and social functioning.

Timely diagnosis and treatment can help in early recovery. Most of the deficiencies are easily treatable, provided that it is subclinical and has not progressed much. Most of the manifestations resolve considerably when treated appropriately. In vitamin A deficiency, morbidity may increase with infection or when blindness has progressed. Corneal perforation, keratomalacia and punctate keratopathy are irreversible even with standard treatment modalities. Korsakoff syndrome is a poor prognostic factor in thiamine deficiency. Neurologic deficit in vitamin B12 deficiency improves considerably with vitamin B12 therapy. Outcome is generally better in younger patients.

Poverty and food faddism are some of the common causes of vitamin deficiency in developed countries. In developing countries, dietary deficiency and malabsorption are the main causes of vitamin deficiency. Malabsorption is the main cause for the deficiency of fat soluble vitamins [3]. Diseases and conditions may also result in specific vitamin deficiency.
Some of the major etiological factors of vitamin deficiency include:

• Vitamin A – Fat malabsorption, Cystic fibrosis, pancreatic insufficiency, and inflammatory bowel disease may result in vitamin A deficiency. The risk of deficiency of this vitamin is more in vegans, refugees, immigrant population, alcohol dependency, and in children from economically underprivileged population. 
• Vitamin B – Lack of adequate intake and malabsorption are the most common causes of deficiency of vitamin B complex. Celiac disease, enteritis, exudative enteropathy, intestinal resection, atrophic gastritis, pancreatic deficiency, certain medications like proton pump inhibitors and colchicine result in vitamin B12 deficiency. Conditions like hyperthyroidism, severe infection, increased physical exercise, and diets high in carbohydrate or saturated fat, lead to thiamine deficiency [4]. Diarrhea, diuretic therapy, peritoneal dialysis, and hemodialysis increase the rate of thiamine depletion in the body leading to deficiency [5]. 
• Vitamin C – Prolonged deficiency of the vitamin in the diet is the major cause of vitamin C deficiency. Alcoholism, smoking, anorexia nervosa, type I diabetes, Crohn’s disease and overload disorders increase the risk of this vitamin deficiency. 
• Vitamin D – Inadequate exposure to sunlight, malabsorption, and use of certain medications are the major cause of vitamin D deficiency. 
• Vitamin E – Malabsorption, cystic fibrosis, abetalipoproteinemia, cholestatic hepatobiliary disease, and short bowel syndrome may all lead to vitamin E deficiency. 
• Vitamin K – Vitamin K deficiency is caused by chronic illness, malnutrition, alcoholism, multiple surgeries in the abdomen, cholestatic disease, cystic fibrosis, inflammatory bowel disease, chronic kidney disease and parenchymal liver disease [6]. 

About 250 million children worldwide are at risk of developing vitamin deficiency. The majority of them are malnourished and develop complications like measles and diarrhea that often lead to death. Vitamin A deficiency is the most common and every year about 500,000 children become blind due to the same. Accurate statistics on the prevalence and incidence of other vitamin deficiencies are not available. Difficulty in estimation may arise due to differences in etiologies and assays. Approximately 3 million people are affected by vitamin B12 deficiency in United States. Prevalence of vitamin C was found to be more among men, particularly those older than 60 years. Prevalence of vitamin C was reported as 8.2% in men and 6% in women [7]. Vitamin D deficiency is more prevalent among elderly and hospitalized patients. About 60% of the patients in nursing homes are reported to have deficiency of vitamin D [8]. Healthy adults also may have vitamin D deficiency. About 10.3% of the general population have this and the prevalence is greater among dark-skinned people. As the production of vitamin D declines with age, elderly population is at a higher risk of this deficiency. Although it may occur at any age, vitamin K deficiency is more common among infants. The prevalence varies according to geographic region in US [9].

Deficiency of vitamins are caused by decreased intake, malabsorption, and increased requirements or due to altered metabolism. In most of the cases, the body stores vitamins to last for some time even when the diet has inadequate amounts when compared to daily requirements. This lasts for few weeks but once this reserve is over the serum levels of the vitamin drops. The concentration of the vitamin in the serum may also be affected by other factors like infection, nutritional status, and presence of other nutrients. When thiamine stores are depleted, it results in weakness, tachycardia and deep tendon reflexes. Vitamin C deficiency affects collagen synthesis leading to poor wound healing. Impaired collagen synthesis results in gum hemorrhage, defective dentine formation, and also loss of teeth. When the circulating level of vitamin D is lower, parathyroid hormone levels increase, resulting in decreased mineralization of bones. Vitamin E plays an important role as antioxidant, and also has an immunomodulator and antiplatelet effect [10]. Deficiency of this vitamin results in ataxia, hyporeflexia, and muscle weakness.

Having a well-balanced diet is the most important preventive measure for vitamin deficiency. Having a variety of foods, like cereals, breads, crackers, vegetables, fruits and fortified foods help to provide the recommended doses of these nutrients. Those who have associated conditions like gastrectomy, pancreatectomy, or atrophic gastritis should undergo periodic testing to check for deficiencies. Vegetarians should supplement the amount of vitamin B12 in their diet as they are at an increased risk of developing deficiency.

Micronutrient deficiencies, including vitamins and mineral deficiencies, are one of the major contributors to the global disease burden [1]. About 2 million people all over the world are considered to be deficient in vitamins and other minerals. The most important nutrients among them are vitamin A, iodine, iron and zinc. Vitamin deficiencies increase the risk of infections and also cause premature death, poor health, blindness, stunted growth, mental retardation, learning disability and low work capacity. It also increases the mortality rate due to associated conditions like measles, malaria, pneumonia and diarrhea. These conditions are some of the leading causes of death in the world [2]. Vitamin deficiencies may also result in overt clinical syndromes like osteomalacia, peripheral neuropathy, night blindness and beriberi.

Vitamin and mineral deficiencies, called as micronutrient deficiencies, are one of the most important cause of diseases and death. Vitamin A, iron, zinc and iodine are the major deficiencies noted worldwide. These deficiencies cause diseases and also increase the risk of blindness, poor health, stunted growth and learning disability. Poverty, malnourishment, and fad diets are the most common causes of vitamin deficiency. It may also be caused by difficulty in absorbing the nutrients due to diseases or conditions. Inadequate exposure to sunlight is the major cause of deficiency of vitamin D. About 250 million children worldwide are at risk of developing different kinds of vitamin deficiency. Many of them develop measles and diarrhea which may lead to death.
In all these cases, the body uses up the vitamin stores when there is inadequate amounts of vitamins in the diet. When the body reserves are over, serum levels drop and start affecting metabolism. It results in signs and symptoms specific of different vitamins. Mild forms may remain asymptomatic for long time. Most common symptoms of vitamin deficiency are non-specific like tiredness, poor appetite, and lethargy. Each vitamin is associated with a specific set of symptoms like

• Vitamin A – night blindness, dry skin and hair, and dry eyes
• Vitamin B – beriberi, anemia, depression and poor memory
• Vitamin C – scurvy
• Vitamin D – bowing of legs in children, osteomalacia in adults
• Vitamin E – muscle weakness, neuromuscular problems, anemia
• Vitamin K – Bleeding at the site of surgery or puncture

Testing the levels of vitamin in the blood is the first way to assess deficiency of vitamin. Imaging techniques may be used to assess damage caused to the internal organs. Treatment suggested depends on the severity of the symptoms. Replenishing the deficient vitamins is the first step in the treatment. The dose and route of administration varies with the type of vitamin and severity of deficiency. Treatment is usually continued till the symptoms resolve. Having a well-balanced diet with lots of vegetables, fruits, whole grains and fortified foods go a long way in preventing and controlling the symptoms of vitamin deficiency. Those who have diseases that increase the risk of vitamin deficiency should monitor the levels to prevent complications. Timely diagnosis and treatment is the most important step in recovery. Most of the deficiencies are easily treatable.

1. Ezzati M., Lopez A. D., Rodgers A., Hoorn S. Vander, Murray C. J. Comparative Risk Assessment Collaborating Group. Selected Major Risk Factors and Global and Regional Burden of Disease. Lancet. 2002;360(9343):1342–1343.
2. World Health Organization. The World Health Report 2001: Reducing risks, promoting healthy life. Geneva, World Health Organization, 2001.
3. Kuwabara, A., Tanaka, K., Tsugawa, N., Nakase, H., Tsuji, H., Shide, K. et al. (2009) High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease. Osteoporos Int 20: 935–942.
4. Sriram K, Manzanares W, Joseph K. Thiamine in nutrition therapy. Nutr Clin Pract. 2012;27(1):41-50.
5. Al-Attas OS, Al-Daghri NM, Alfadda A, Abd Al-Rahman SH, Sabico S. Blood Thiamine and Derivatives as measured by High-Performance Liquid Chromatography: Levels and Associations in DM Patients with Varying Degrees of Microalbuminuria. J Endocrinol Invest. 2011; 35(11):951-956.
6. Ansell JE, Kumar R, Deykin D. The spectrum of vitamin K deficiency. JAMA. Jul 4 1977;238(1):40-42.
7. Hampl JS, Taylor CA, Johnston CS. Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994. Am J Public Health. May 2004;94(5):870-875.
8. Thomas MK, Lloyd-Jones DM, Thadhani RI, et al. Hypovitaminosis D in medical inpatients. N Engl J Med. Mar 19 1998;338(12):777-783.
9. Shearer MJ. Vitamin K deficiency bleeding (VKDB) in early infancy. Blood Rev. 18 2008; 23(2):49-59.
10. Traber MG, Stevens JF. Vitamins C and E: beneficial effects from a mechanistic perspective. Free Radic Biol Med. 2011;51(5):1000-1013.