Signs and Symptoms of Common Nutritional Deficiencies

At a recent conference Associate Professor Kouris advised that anecdotal evidence is showing the lack of minerals in our diet is more prevalent than vitamins.

Associate Professor Kouris shared a slide containing a list: Iron, Zinc, Magnesium, Iodine, Calcium, Vitamin D and Vitamin B12.

According to A/Prof Kouris, nutritional disorders are among the most common problems encountered in general practice and more than 70% of the patients seen by GPs are at high risk of either having or developing a nutritional deficiency.

Some groups are more at risk of nutrient deficiencies, including those with stomach or bowel problems and patients with chronic illness, including NIDDM where excess urine loss may render them vulnerable to magnesium, zinc or chromium deficiency.

Medications may also further complicate nutritional status, for example patients on PPIs or H2 receptor blockers are likely to become deficient in mineral, and vitamins B, C and D.  Those prescribed loop and thiazide diuretics may be at risk of mineral deficiencies, vitamin B deficiency and may become CoQ10 deficient.  Many other medicines also have a tendency to deplete, including antacids, steroids, bile acid sequestrants, oestrogens, laxatives and anticonvulsants to name a few.

In addition to recommending a blood test to check for deficiencies and a referral to a dietition, A/Prof Kouris discussed how the appearance of finger-nails and tongues can also provide clues to deficiencies.  For example, brittle concave finger-nails may be a sign of iron deficiency, white spots on finger-nails a sign of zinc deficiency and splitting/flaking nails a sign of calcium or protein deficiency. A bright red tongue, in combination with yellow skin, may be a sign of B12 deficiency and a smooth pale tongue a sign of iron deficiency.

When talking about zinc deficiency, A/Prof Kouris noted that 60% of the population are consuming less than the recommended daily intake of this important mineral.  Zinc is vital for the proper functioning of over 100 enzyme reactions in the body, including those involved in the metabolism of proteins, carbohydrates and fats and the synthesis of omega-3, cholesterol, vitamin B6 and DNA.

Blood can be tested for plasma zinc levels however only 1% of the zinc in the body is found in the blood and A/Prof Kouris recommends aiming for >12umol/l. 

Key clinical signs of zinc deficiency include stretch marks, dry skin, appetite loss, hair loss, sleep problems, reduced sperm count, mental fatigue and growth problems in children.  Hearing loss in the elderly may also be a symptom of low zinc levels.

For zinc supplementation A/Prof Kouris recommended 30mg per day. Zinc picolinate, zinc citrate or zinc amino acid chelate are all suitable formulations.  Zinc supplements should be taken separately from iron supplements, fibre and other medications.

“If they are low in zinc they are probably going to have low stomach acid and the lining of their gut may not be as good as it should be which will affect the absorption of other nutrients.

Learn more about vitamins, minerals and zinc testing in the education modules below.

Source:, Friday 1 August 2014