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href="#Individual_vitamin_deficiencies"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Individual vitamin deficiencies</span> </div> </a> <button aria-controls="toc-Individual_vitamin_deficiencies-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Individual vitamin deficiencies subsection</span> </button> <ul id="toc-Individual_vitamin_deficiencies-sublist" class="vector-toc-list"> <li id="toc-Water-soluble_vitamins" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Water-soluble_vitamins"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Water-soluble vitamins</span> </div> </a> <ul id="toc-Water-soluble_vitamins-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Fat-soluble_vitamins" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Fat-soluble_vitamins"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Fat-soluble vitamins</span> </div> </a> <ul id="toc-Fat-soluble_vitamins-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Prevention</span> </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Prevention subsection</span> </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Food_fortification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Food_fortification"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Food fortification</span> </div> </a> <ul id="toc-Food_fortification-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genetic_engineering" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genetic_engineering"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Genetic engineering</span> </div> </a> <ul id="toc-Genetic_engineering-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Hypervitaminosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Hypervitaminosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Hypervitaminosis</span> </div> </a> <ul id="toc-Hypervitaminosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Vitamin deficiency</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 44 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-44" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">44 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%86%D9%82%D8%B5_%D8%A7%D9%84%D9%81%D9%8A%D8%AA%D8%A7%D9%85%D9%8A%D9%86" title="نقص الفيتامين – Arabic" lang="ar" hreflang="ar" data-title="نقص الفيتامين" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-hyw mw-list-item"><a href="https://hyw.wikipedia.org/wiki/%D4%BF%D5%A5%D5%B6%D5%BD%D5%A1%D5%B6%D5%AB%D6%82%D5%A9%D5%A5%D6%80%D5%B8%D6%82_%D5%A5%D6%82_%D5%B0%D5%A1%D5%B6%D6%84%D5%A1%D5%B5%D5%AB%D5%B6%D5%B6%D5%A5%D6%80%D5%B8%D6%82_%D5%BA%D5%A1%D5%AF%D5%A1%D5%BD%D5%A8" title="Կենսանիւթերու եւ հանքայիններու պակասը – Western Armenian" lang="hyw" hreflang="hyw" data-title="Կենսանիւթերու եւ հանքայիններու պակասը" data-language-autonym="Արեւմտահայերէն" data-language-local-name="Western Armenian" class="interlanguage-link-target"><span>Արեւմտահայերէն</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%90%D0%B2%D1%96%D1%82%D0%B0%D0%BC%D1%96%D0%BD%D0%BE%D0%B7%D1%8B" title="Авітамінозы – Belarusian" lang="be" hreflang="be" data-title="Авітамінозы" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%92%D1%96%D1%82%D0%B0%D0%BC%D1%96%D0%BD%D0%BD%D0%B0%D1%8F_%D0%BD%D0%B5%D0%B4%D0%B0%D1%81%D1%82%D0%B0%D1%82%D0%BA%D0%BE%D0%B2%D0%B0%D1%81%D1%8C%D1%86%D1%8C" title="Вітамінная недастатковасьць – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Вітамінная недастатковасьць" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%90%D0%B2%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D0%BE%D0%B7%D0%B0" title="Авитаминоза – Bulgarian" lang="bg" hreflang="bg" data-title="Авитаминоза" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Avitaminoza" title="Avitaminoza – Bosnian" lang="bs" hreflang="bs" data-title="Avitaminoza" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Defici%C3%A8ncia_vitam%C3%ADnica" title="Deficiència vitamínica – Catalan" lang="ca" hreflang="ca" data-title="Deficiència vitamínica" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Avitamin%C3%B3za" title="Avitaminóza – Czech" lang="cs" hreflang="cs" data-title="Avitaminóza" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Vitaminmangel" title="Vitaminmangel – Danish" lang="da" hreflang="da" data-title="Vitaminmangel" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Avitaminose" title="Avitaminose – German" lang="de" hreflang="de" data-title="Avitaminose" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Avitaminoos" title="Avitaminoos – Estonian" lang="et" hreflang="et" data-title="Avitaminoos" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Avitaminosis" title="Avitaminosis – Spanish" lang="es" hreflang="es" data-title="Avitaminosis" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Avitaminozo" title="Avitaminozo – Esperanto" lang="eo" hreflang="eo" data-title="Avitaminozo" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Abitaminosi" title="Abitaminosi – Basque" lang="eu" hreflang="eu" data-title="Abitaminosi" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A2%D9%88%DB%8C%D8%AA%D8%A7%D9%85%DB%8C%D9%86%D9%88%D8%B2" title="آویتامینوز – Persian" lang="fa" hreflang="fa" data-title="آویتامینوز" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Avitaminose" title="Avitaminose – French" lang="fr" hreflang="fr" data-title="Avitaminose" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%B9%84%ED%83%80%EB%AF%BC_%EA%B2%B0%ED%95%8D%EC%A6%9D" title="비타민 결핍증 – Korean" lang="ko" hreflang="ko" data-title="비타민 결핍증" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy badge-Q70893996 mw-list-item" title=""><a href="https://hy.wikipedia.org/wiki/%D4%B1%D5%BE%D5%AB%D5%BF%D5%A1%D5%B4%D5%AB%D5%B6%D5%B8%D5%A6" title="Ավիտամինոզ – Armenian" lang="hy" hreflang="hy" data-title="Ավիտամինոզ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/H%C3%B6rgulsj%C3%BAkd%C3%B3mur" title="Hörgulsjúkdómur – Icelandic" lang="is" hreflang="is" data-title="Hörgulsjúkdómur" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Avitaminosi" title="Avitaminosi – Italian" lang="it" hreflang="it" data-title="Avitaminosi" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%90%E1%83%95%E1%83%98%E1%83%A2%E1%83%90%E1%83%9B%E1%83%98%E1%83%9C%E1%83%9D%E1%83%96%E1%83%98" title="ავიტამინოზი – Georgian" lang="ka" hreflang="ka" data-title="ავიტამინოზი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%90%D0%B2%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D0%BE%D0%B7" title="Авитаминоз – Kazakh" lang="kk" hreflang="kk" data-title="Авитаминоз" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%90%D0%B2%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D0%BE%D0%B7" title="Авитаминоз – Kyrgyz" lang="ky" hreflang="ky" data-title="Авитаминоз" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Avitaminoz%C4%97" title="Avitaminozė – Lithuanian" lang="lt" hreflang="lt" data-title="Avitaminozė" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%90%D0%B2%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D0%BE%D0%B7%D0%B0" title="Авитаминоза – Macedonian" lang="mk" hreflang="mk" data-title="Авитаминоза" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Defici%C3%ABntieziekte" title="Deficiëntieziekte – Dutch" lang="nl" hreflang="nl" data-title="Deficiëntieziekte" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%93%E3%82%BF%E3%83%9F%E3%83%B3%E6%AC%A0%E4%B9%8F%E7%97%87" title="ビタミン欠乏症 – Japanese" lang="ja" hreflang="ja" data-title="ビタミン欠乏症" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Avitaminoz" title="Avitaminoz – Uzbek" lang="uz" hreflang="uz" data-title="Avitaminoz" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Awitaminoza" title="Awitaminoza – Polish" lang="pl" hreflang="pl" data-title="Awitaminoza" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Avitaminose" title="Avitaminose – Portuguese" lang="pt" hreflang="pt" data-title="Avitaminose" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Avitaminoz%C4%83" title="Avitaminoză – Romanian" lang="ro" hreflang="ro" data-title="Avitaminoză" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-rue mw-list-item"><a href="https://rue.wikipedia.org/wiki/%D0%90%D0%B2%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D0%BE%D0%B7%D0%B0" title="Авитаминоза – Rusyn" lang="rue" hreflang="rue" data-title="Авитаминоза" data-language-autonym="Русиньскый" data-language-local-name="Rusyn" class="interlanguage-link-target"><span>Русиньскый</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%90%D0%B2%D0%B8%D1%82%D0%B0%D0%BC%D0%B8%D0%BD%D0%BE%D0%B7" title="Авитаминоз – Russian" lang="ru" hreflang="ru" data-title="Авитаминоз" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Avitamin%C3%B3za" title="Avitaminóza – Slovak" lang="sk" hreflang="sk" data-title="Avitaminóza" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Avitaminoza" title="Avitaminoza – Slovenian" lang="sl" hreflang="sl" data-title="Avitaminoza" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Avitaminoza" title="Avitaminoza – Serbian" lang="sr" hreflang="sr" data-title="Avitaminoza" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Avitaminoza" title="Avitaminoza – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Avitaminoza" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Vitaminbrist" title="Vitaminbrist – Swedish" lang="sv" hreflang="sv" data-title="Vitaminbrist" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%89%E0%AE%AF%E0%AE%BF%E0%AE%B0%E0%AF%8D%E0%AE%9A%E0%AF%8D%E0%AE%9A%E0%AE%A4%E0%AF%8D%E0%AE%A4%E0%AF%81%E0%AE%95%E0%AF%8D_%E0%AE%95%E0%AF%81%E0%AE%B1%E0%AF%88%E0%AE%AA%E0%AE%BE%E0%AE%9F%E0%AF%81" title="உயிர்ச்சத்துக் குறைபாடு – Tamil" lang="ta" hreflang="ta" data-title="உயிர்ச்சத்துக் குறைபாடு" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li 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class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Vitamin deficiency</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Avitaminosis, hypovitaminosis</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Endocrinology" title="Endocrinology">Endocrinology</a></td></tr></tbody></table> <p><b>Vitamin deficiency</b> is the condition of a long-term lack of a <a href="/wiki/Vitamin" title="Vitamin">vitamin</a>. When caused by not enough vitamin intake it is classified as a <i>primary deficiency</i>, whereas when due to an underlying disorder such as <a href="/wiki/Malabsorption" title="Malabsorption">malabsorption</a> it is called a <i>secondary deficiency</i>. An underlying disorder can have 2 main causes: </p> <ul><li><a href="/wiki/Metabolic" class="mw-redirect" title="Metabolic">Metabolic</a> causes: <a href="/wiki/Genetic_defect" class="mw-redirect" title="Genetic defect">Genetic defects</a> in enzymes (e.g. <a href="/wiki/Kynureninase" title="Kynureninase">kynureninase</a>) involved in the <a href="/wiki/Kynurenine_pathway" title="Kynurenine pathway">kynurenine pathway</a> of synthesis of <a href="/wiki/Niacin_(nutrient)" class="mw-redirect" title="Niacin (nutrient)">niacin</a> from <a href="/wiki/Tryptophan" title="Tryptophan">tryptophan</a> can lead to <a href="/wiki/Pellagra" title="Pellagra">pellagra</a> (niacin deficiency).<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Lifestyle_disease" title="Lifestyle disease">Lifestyle choices</a>: Lifestyle choices and habits that increase vitamin needs, such as <a href="/wiki/Tobacco_smoking" title="Tobacco smoking">smoking</a> or drinking <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcohol</a>.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Government guidelines on vitamin deficiencies advise certain intakes for healthy people, with specific values for women, men, babies, children, the elderly, and during <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> or <a href="/wiki/Breastfeeding" title="Breastfeeding">breastfeeding</a>.<sup id="cite_ref-DRITable_3-0" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-History_4-0" class="reference"><a href="#cite_note-DRI-History-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-JapanDRI_5-0" class="reference"><a href="#cite_note-JapanDRI-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-EFSA-Recommended_6-0" class="reference"><a href="#cite_note-EFSA-Recommended-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Many countries have mandated vitamin <a href="/wiki/Food_fortification" title="Food fortification">food fortification</a> programs to prevent commonly occurring vitamin deficiencies.<sup id="cite_ref-Copenhagen_7-0" class="reference"><a href="#cite_note-Copenhagen-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WHO-FAO_8-0" class="reference"><a href="#cite_note-WHO-FAO-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WhyFortify_9-0" class="reference"><a href="#cite_note-WhyFortify-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Map_10-0" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li></ul> <p>Conversely, <a href="/wiki/Hypervitaminosis" title="Hypervitaminosis">hypervitaminosis</a> refers to symptoms caused by vitamin intakes in excess of needs, especially for fat-soluble vitamins that can accumulate in body tissues.<sup id="cite_ref-DRITable_3-1" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-JapanDRI_5-1" class="reference"><a href="#cite_note-JapanDRI-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-EFSA_11-0" class="reference"><a href="#cite_note-EFSA-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>The history of the discovery of vitamin deficiencies progressed over centuries from observations that certain conditions – for example, <a href="/wiki/Scurvy" title="Scurvy">scurvy</a> – could be prevented or treated with certain foods having high content of a necessary vitamin, to the identification and description of specific molecules essential for life and health. During the 20th century, several scientists were awarded the <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a> or the <a href="/wiki/Nobel_Prize_in_Chemistry" title="Nobel Prize in Chemistry">Nobel Prize in Chemistry</a> for their roles in the discovery of vitamins.<sup id="cite_ref-Carpenter_12-0" class="reference"><a href="#cite_note-Carpenter-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Karrer_13-0" class="reference"><a href="#cite_note-Karrer-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Kuhn_14-0" class="reference"><a href="#cite_note-Kuhn-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Defining_deficiency">Defining deficiency</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=1" title="Edit section: Defining deficiency"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A number of regions have published guidelines defining vitamin deficiencies and advising specific intakes for healthy people, with different recommendations for women, men, infants, the elderly, and during pregnancy and breast feeding including Japan, the <a href="/wiki/European_Union" title="European Union">European Union</a>, the United States, and Canada.<sup id="cite_ref-EFSA-Recommended_6-1" class="reference"><a href="#cite_note-EFSA-Recommended-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRITable_3-2" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-JapanDRI_5-2" class="reference"><a href="#cite_note-JapanDRI-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> These documents have been updated as research is published. In the US, <a href="/wiki/Recommended_Dietary_Allowances" class="mw-redirect" title="Recommended Dietary Allowances">Recommended Dietary Allowances</a> (RDAs) were first set in 1941 by the Food and Nutrition Board of the <a href="/wiki/National_Academy_of_Sciences" title="National Academy of Sciences">National Academy of Sciences</a>. There were periodic updates, culminating in the <a href="/wiki/Dietary_Reference_Intake" title="Dietary Reference Intake">Dietary Reference Intakes</a>.<sup id="cite_ref-DRI-History_4-1" class="reference"><a href="#cite_note-DRI-History-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Updated in 2016, the US <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> published a set of tables that define <a href="/wiki/Estimated_Average_Requirements" class="mw-redirect" title="Estimated Average Requirements">Estimated Average Requirements</a> (EARs) and (RDAs).<sup id="cite_ref-DRITable_3-3" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-FedReg2016_15-0" class="reference"><a href="#cite_note-FedReg2016-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> RDAs are higher to cover people with higher than average needs. Together, these are part of Dietary Reference Intakes. For a few vitamins, there is not sufficient information to set EARs and RDAs. For these, an Adequate Intake is shown, based on an assumption that what healthy people consume is sufficient.<sup id="cite_ref-DRITable_3-4" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Countries do not always agree on the amounts of vitamins needed to safeguard against deficiency. For example, for vitamin C, the RDAs for women for Japan, the European Union (called Population Reference Intakes) and the US are 100, 95 and 75 mg/day, respectively.<sup id="cite_ref-DRITable_3-5" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-JapanDRI_5-3" class="reference"><a href="#cite_note-JapanDRI-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-EFSAtables_16-0" class="reference"><a href="#cite_note-EFSAtables-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> India sets its recommendation at 40 mg/day.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Individual_vitamin_deficiencies">Individual vitamin deficiencies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=2" title="Edit section: Individual vitamin deficiencies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Reference_ranges_for_blood_tests#Vitamins" title="Reference ranges for blood tests">Reference ranges for blood tests § Vitamins</a></div> <div class="mw-heading mw-heading3"><h3 id="Water-soluble_vitamins">Water-soluble vitamins</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=3" title="Edit section: Water-soluble vitamins"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/B_vitamins#Deficiencies" title="B vitamins">B vitamins § Deficiencies</a></div> <table class="wikitable"> <tbody><tr> <th>Vitamin</th> <th>Symptoms & Diagnosis</th> <th>Information </th></tr> <tr> <td><a href="/wiki/Thiamine_deficiency" title="Thiamine deficiency">Thiamine (Vitamin B<sub>1</sub>) deficiency</a></td> <td>Weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart beat. Deficiency is assessed by <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cell</a> status and <a href="/wiki/Urine" title="Urine">urinary</a> output.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-Thiamine_19-0" class="reference"><a href="#cite_note-DRI-Thiamine-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup></td> <td>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 <a href="/wiki/Mill_(grinding)" title="Mill (grinding)">milling</a>, <a href="/wiki/Flour#Bleached_flour" title="Flour">bleaching</a> and other processing.<sup id="cite_ref-Map_10-1" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Severe deficiency causes <a href="/wiki/Beriberi" class="mw-redirect" title="Beriberi">beriberi</a>, which became prevalent in Asia as more people adopted a diet primarily of white rice. <a href="/wiki/Wernicke_encephalopathy" title="Wernicke encephalopathy">Wernicke encephalopathy</a> and <a href="/wiki/Korsakoff_syndrome" title="Korsakoff syndrome">Korsakoff syndrome</a> are forms of beriberi. Alcoholism can also cause vitamin deficiencies. Long-term deficiencies can be life-threatening.<sup id="cite_ref-AAFP19_20-0" class="reference"><a href="#cite_note-AAFP19-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Riboflavin_deficiency" class="mw-redirect" title="Riboflavin deficiency">Riboflavin (Vitamin B<sub>2</sub>) deficiency</a></td> <td>Deficiency causes painful red tongue with sore throat, chapped and cracked lips, and inflammation at the corners of the mouth (<a href="/wiki/Angular_cheilitis" title="Angular cheilitis">angular cheilitis</a>). Eyes can be itchy, watery, bloodshot and sensitive to light. Riboflavin deficiency also causes <a href="/wiki/Anemia" title="Anemia">anemia</a> 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>.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-Riboflavin_22-0" class="reference"><a href="#cite_note-DRI-Riboflavin-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup></td> <td>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.<sup id="cite_ref-Map_10-2" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Niacin_deficiency" class="mw-redirect" title="Niacin deficiency">Niacin (Vitamin B<sub>3</sub>) deficiency</a></td> <td>Deficiency causes <a href="/wiki/Pellagra" title="Pellagra">pellagra</a>, a reversible nutritional wasting disease characterized by four classic symptoms often referred to as the four Ds: <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, <a href="/wiki/Dermatitis" title="Dermatitis">dermatitis</a>, <a href="/wiki/Dementia" title="Dementia">dementia</a>, 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 <a href="/wiki/Amino_acid" title="Amino acid">amino acid</a> <a href="/wiki/Tryptophan" title="Tryptophan">tryptophan</a>, 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.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-Niacin_24-0" class="reference"><a href="#cite_note-DRI-Niacin-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup></td> <td>Chronic alcoholism is a contributing risk factor. </td></tr> <tr> <td><a href="/wiki/Pantothenic_acid#Deficiency" title="Pantothenic acid">Pantothenic acid (Vitamin B<sub>5</sub>) deficiency</a></td> <td>Irritability, fatigue, and <a href="/wiki/Apathy" title="Apathy">apathy</a>.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-Pantothenic_26-0" class="reference"><a href="#cite_note-DRI-Pantothenic-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup></td> <td>Extremely rare. </td></tr> <tr> <td><a href="/wiki/Vitamin_B6#Deficiency" title="Vitamin B6">Vitamin B<sub>6</sub> deficiency</a></td> <td><a href="/wiki/Microcytic_anemia" title="Microcytic anemia">Microcytic anemia</a>, <a href="/wiki/Electroencephalography" title="Electroencephalography">electroencephalographic</a> abnormalities, dermatitis, <a href="/wiki/Seborrhoeic_dermatitis" title="Seborrhoeic dermatitis">seborrhoeic dermatitis</a>-like eruption, <a href="/wiki/Atrophic_glossitis" class="mw-redirect" title="Atrophic glossitis">atrophic glossitis</a> with <a href="/wiki/Mouth_ulcer" title="Mouth ulcer">ulceration</a>, <a href="/wiki/Angular_cheilitis" title="Angular cheilitis">angular cheilitis</a>, <a href="/wiki/Conjunctivitis" title="Conjunctivitis">conjunctivitis</a>, and <a href="/wiki/Intertrigo" title="Intertrigo">intertrigo</a>. Neurologic symptoms of depression, <a href="/wiki/Somnolence" title="Somnolence">somnolence</a>, confusion, and <a href="/wiki/Neuropathy" class="mw-redirect" title="Neuropathy">neuropathy</a> (due to impaired <a href="/wiki/Sphingosine" title="Sphingosine">sphingosine</a> synthesis) and <a href="/wiki/Microcytic_anemia" title="Microcytic anemia">microcytic anemia</a><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-B6_28-0" class="reference"><a href="#cite_note-DRI-B6-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup></td> <td>Uncommon, although it may be observed in certain conditions, such as <a href="/wiki/End-stage_kidney_disease" class="mw-redirect" title="End-stage kidney disease">end-stage kidney diseases</a> or <a href="/wiki/Malabsorption_syndrome" class="mw-redirect" title="Malabsorption syndrome">malabsorption syndromes</a>, such as <a href="/wiki/Celiac_disease" class="mw-redirect" title="Celiac disease">celiac disease</a>, <a href="/wiki/Crohn_disease" class="mw-redirect" title="Crohn disease">Crohn disease</a> or <a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">ulcerative colitis</a>. </td></tr> <tr> <td><a href="/wiki/Biotin_deficiency" title="Biotin deficiency">Biotin (Vitamin B<sub>7</sub>) deficiency</a></td> <td>Rashes including red, patchy ones near the mouth and fine, brittle hair. <a href="/wiki/Hallucination" title="Hallucination">Hallucinations</a>, <a href="/wiki/Lethargy" title="Lethargy">Lethargy</a>, Mild <a href="/wiki/Depression_(mood)" title="Depression (mood)">depression</a>, which may progress to profound <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a> and, eventually, to <a href="/wiki/Somnolence" title="Somnolence">somnolence</a>, Generalized muscular pains (<a href="/wiki/Myalgia" title="Myalgia">myalgia</a>) and <a href="/wiki/Paresthesias" class="mw-redirect" title="Paresthesias">Paresthesias</a>. Decreased urinary excretion of biotin and increased urinary excretion of <a href="/wiki/3-hydroxyisovaleric_acid" class="mw-redirect" title="3-hydroxyisovaleric acid">3-hydroxyisovaleric acid</a> are better indicators of biotin deficiency than concentration in the blood.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup></td> <td>Rare, although biotin status can be compromised in alcoholics and during pregnancy and breastfeeding.Deficiency affects hair growth and skin health.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-Biotin_31-0" class="reference"><a href="#cite_note-DRI-Biotin-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Folate_deficiency" title="Folate deficiency">Folate (Vitamin B<sub>9</sub>) deficiency</a></td> <td>Symptoms may include <a href="/wiki/Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">feeling tired</a>, heart <a href="/wiki/Heart_palpitations" class="mw-redirect" title="Heart palpitations">palpitations</a>, <a href="/wiki/Shortness_of_breath" title="Shortness of breath">shortness of breath</a>, feeling faint, open sores on the tongue, loss of appetite, changes in the color of the skin or hair, irritability, and <a href="/wiki/Emotional_and_behavioral_disorders" title="Emotional and behavioral disorders">behavioral changes</a>.<sup id="cite_ref-Oldref_20_32-0" class="reference"><a href="#cite_note-Oldref_20-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> In adults, <a href="/wiki/Anemia" title="Anemia">anemia</a> (macrocytic, <a href="/wiki/Megaloblastic_anemia" title="Megaloblastic anemia">megaloblastic anemia</a>) can be a sign of advanced folate deficiency.</td> <td>Common, and associated with numerous health problems, but primarily with <a href="/wiki/Neural_tube_defect" title="Neural tube defect">neural tube defects</a> (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.<sup id="cite_ref-Map_10-3" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Deficiency can also result from rare <a href="/wiki/Gene" title="Gene">genetic</a> factors, such as <a href="/wiki/Mutation" title="Mutation">mutations</a> in the <a href="/wiki/MTHFR" class="mw-redirect" title="MTHFR">MTHFR</a> gene that lead to compromised folate metabolism.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-Folate_34-0" class="reference"><a href="#cite_note-DRI-Folate-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Cerebral_folate_deficiency" title="Cerebral folate deficiency">Cerebral folate deficiency</a> is a rare condition in which concentrations of folate are low in the brain despite being normal in the blood.<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Vitamin_B12_deficiency" title="Vitamin B12 deficiency">Vitamin B<sub>12</sub> deficiency</a></td> <td><a href="/wiki/Vitamin_B12_deficiency_anemia" class="mw-redirect" title="Vitamin B12 deficiency anemia">Anemia</a>, <a href="/wiki/Neurology" title="Neurology">neurological</a> and <a href="/wiki/Gastrointestinal_disease" title="Gastrointestinal disease">digestive</a> disorders.<sup id="cite_ref-WD1_36-0" class="reference"><a href="#cite_note-WD1-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> This may result in feeling tired, shortness of breath, lightheadedness, headaches, mouth ulcers, <a href="/wiki/Pallor" title="Pallor">pale</a> skin, rapid heartbeat, loss of appetite, hair loss, low blood pressure, decreased ability to think, joint pain, <a href="/wiki/Paresthesia" title="Paresthesia">numbness and tingling</a> to the fingers and toes, and tinnitus.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Damage to nerves may result in depression, confusion, memory loss, difficulty walking, sense loss, <a href="/wiki/Mania" title="Mania">mania</a>, and <a href="/wiki/Psychosis" title="Psychosis">psychosis</a>.</td> <td>Lead to <a href="/wiki/Megaloblastic_anemia" title="Megaloblastic anemia">megaloblastic anemia</a>, <a href="/wiki/Subacute_combined_degeneration_of_spinal_cord" title="Subacute combined degeneration of spinal cord">subacute combined degeneration of spinal cord</a>, and <a href="/wiki/Methylmalonic_acidemia" class="mw-redirect" title="Methylmalonic acidemia">methylmalonic acidemia</a>, among other conditions. Supplementation with folate can mask vitamin B<sub>12</sub> deficiency.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-B12_40-0" class="reference"><a href="#cite_note-DRI-B12-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> 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. </td></tr> <tr> <td><a href="/wiki/Vitamin_C#Deficiency" title="Vitamin C">Vitamin C deficiency</a></td> <td>Deficiency leads to weakness, weight loss and general aches and pains. Longer-term depletion affects <a href="/wiki/Connective_tissue" title="Connective tissue">connective tissues</a>, severe <a href="/wiki/Gingivitis" title="Gingivitis">gum disease</a>, and bleeding from the skin.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-C_42-0" class="reference"><a href="#cite_note-DRI-C-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup></td> <td>Rare, consequently, no countries fortify foods as a means of preventing this deficiency.<sup id="cite_ref-Map_10-4" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> 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 <a href="/wiki/Scurvy" title="Scurvy">scurvy</a> when plasma concentrations fall below 0.2 mg/dL, whereas the normal plasma concentration range is 0.4 to 1.5 mg/dL. </td></tr> </tbody></table> <div class="mw-heading mw-heading3"><h3 id="Fat-soluble_vitamins">Fat-soluble vitamins</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=4" title="Edit section: Fat-soluble vitamins"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="wikitable"> <tbody><tr> <th>Vitamin</th> <th>Symptoms & Diagnosis</th> <th>Information </th></tr> <tr> <td><a href="/wiki/Vitamin_A_deficiency" title="Vitamin A deficiency">Vitamin A deficiency</a></td> <td>Can cause <a href="/wiki/Nyctalopia" title="Nyctalopia">nyctalopia</a> (night blindness) and <a href="/wiki/Keratomalacia" title="Keratomalacia">keratomalacia</a>, the latter leading to permanent blindness if not treated. The normal range is 30 to 65 μg/dL, but <a href="/wiki/Blood_plasma" title="Blood plasma">plasma</a> concentrations within the range are not a good indicator of a pending deficiency because the normal range is sustained until liver storage is depleted. After that happens, plasma <a href="/wiki/Retinol" title="Retinol">retinol</a> concentration falls to lower than 20 μg/dL, signifying a state of vitamin A inadequacy.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-ods_44-0" class="reference"><a href="#cite_note-ods-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-A_45-0" class="reference"><a href="#cite_note-DRI-A-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup></td> <td>It is the leading cause of preventable childhood blindness, afflicting 250,000 to 500,000 malnourished children in the developing world each year, about half of whom die within a year of becoming blind, as vitamin A deficiency also weakens the <a href="/wiki/Immune_system" title="Immune system">immune system</a>. </td></tr> <tr> <td><a href="/wiki/Vitamin_D_deficiency" title="Vitamin D deficiency">Vitamin D deficiency</a></td> <td>Usually asymptomatic, causes reduce bone density (<a href="/wiki/Osteomalacia" title="Osteomalacia">osteomalacia</a>), rickets, myopathy, and is associated with the development of <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>. It is typically diagnosed by measuring the concentration of the <a href="/wiki/Calcifediol" title="Calcifediol">25-hydroxyvitamin D</a> (25(OH)D) in plasma, which is the most accurate measure of stores of vitamin D in the body. Deficiency is defined as less than 10 ng/mL, and insufficiency in the range of 10–30 ng/mL. Serum 25(OH)D concentrations above 30 ng/mL are "not consistently associated with increased benefit." Serum concentrations above 50 ng/mL may be cause for concern.</td> <td>Common, most foods do not contain vitamin D, indicating that a deficiency will occur unless people get sunlight exposure or eat manufactured foods purposely fortified with vitamin D. Vitamin D deficiency is a known cause of <a href="/wiki/Rickets" title="Rickets">rickets</a>, and has been linked to numerous other health problems.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-D_47-0" class="reference"><a href="#cite_note-DRI-D-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Vitamin_E_deficiency" title="Vitamin E deficiency">Vitamin E deficiency</a></td> <td>Causes poor conduction of electrical impulses along nerves due to changes in nerve membrane structure and function.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-E_49-0" class="reference"><a href="#cite_note-DRI-E-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> The US Institute of Medicine defines deficiency as a blood concentration of less than 12 μmol/L.</td> <td>Rare, occurring as a consequence of abnormalities in dietary fat absorption or metabolism, such as a defect in the <a href="/wiki/Alpha-tocopherol" class="mw-redirect" title="Alpha-tocopherol">alpha-tocopherol</a> <a href="/wiki/Transport_protein" title="Transport protein">transport protein</a>, rather than from a diet low in vitamin E. </td></tr> <tr> <td><a href="/wiki/Vitamin_K_deficiency" title="Vitamin K deficiency">Vitamin K deficiency</a></td> <td>Signs and symptoms can include sensitivity to bruising, bleeding gums, nosebleeds, and heavy menstrual bleeding in women.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-DRI-K_51-0" class="reference"><a href="#cite_note-DRI-K-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup></td> <td>Rare as consequence of low dietary intake. A deficient state can be a result of fat malabsorption diseases. Newborn infants are a special case. Plasma vitamin K is low at birth, even if the mother is supplemented during pregnancy, because the vitamin is not transported across the placenta. Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for premature and term newborn and young infants. Untreated, consequences can cause brain damage or death. The prevalence of VKDB is reported at 0.25 to 1.7%, with higher risk in Asian populations. The recommended prevention treatment is an <a href="/wiki/Intramuscular_injection" title="Intramuscular injection">intramuscular injection</a> of 1 mg of vitamin K at birth (called the <i>Vitamin K shot.</i>).<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> There are protocols for oral administration, but intramuscular injection is preferred.<sup id="cite_ref-Mihatsch2016_53-0" class="reference"><a href="#cite_note-Mihatsch2016-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> </td></tr> </tbody></table> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=5" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Food_fortification">Food fortification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=6" title="Edit section: Food fortification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Food_fortification" title="Food fortification">Food fortification</a></div> <p>Food fortification is the process of adding <a href="/wiki/Micronutrient" title="Micronutrient">micronutrients</a> (essential trace elements and vitamins) to food as a <a href="/wiki/Public_health" title="Public health">public health</a> policy which aims to reduce the number of people with dietary deficiencies within a population. <a href="/wiki/Staple_food" title="Staple food">Staple foods</a> of a region can lack particular nutrients due to the soil of the region or from inherent inadequacy of a normal diet. Addition of micronutrients to staples and condiments can prevent large-scale <a href="/wiki/Deficiency_disease" class="mw-redirect" title="Deficiency disease">deficiency diseases</a> in these cases.<sup id="cite_ref-Copenhagen_7-1" class="reference"><a href="#cite_note-Copenhagen-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>As defined by the <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> (WHO) and the <a href="/wiki/Food_and_Agriculture_Organization_of_the_United_Nations" class="mw-redirect" title="Food and Agriculture Organization of the United Nations">Food and Agriculture Organization of the United Nations</a> (FAO), fortification refers to "the practice of deliberately increasing the content of an essential micronutrient, i.e., vitamins and minerals in a food irrespective of whether the nutrients were originally in the food before processing or not, so as to improve the nutritional quality of the food supply and to provide a public health benefit with minimal risk to health", whereas enrichment is defined as "synonymous with fortification and refers to the addition of micronutrients to a food which are lost during processing".<sup id="cite_ref-WHO-FAO_8-1" class="reference"><a href="#cite_note-WHO-FAO-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The Food Fortification Initiative lists all countries in the world that conduct fortification programs,<sup id="cite_ref-WhyFortify_9-1" class="reference"><a href="#cite_note-WhyFortify-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> and within each country, what nutrients are added to which foods. Vitamin fortification programs exist in one or more countries for folate, niacin, riboflavin, thiamin, vitamin A, vitamin B<sub>6</sub>, vitamin B<sub>12</sub>, vitamin D and vitamin E. As of 21 December 2018, 81 countries required food fortification with one or more vitamins.<sup id="cite_ref-Map_10-5" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> The most commonly fortified vitamin – as used in 62 countries – is folate; the most commonly fortified food is wheat flour.<sup id="cite_ref-Map_10-6" class="reference"><a href="#cite_note-Map-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Genetic_engineering">Genetic engineering</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=7" title="Edit section: Genetic engineering"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Starting in 2000, rice was experimentally genetically engineered to produce higher than normal <a href="/wiki/Beta-carotene" class="mw-redirect" title="Beta-carotene">beta-carotene</a> content, giving it a yellow/orange color. The product is referred to as <a href="/wiki/Golden_rice" title="Golden rice">golden rice</a> (<i>Oryza sativa</i>).<sup id="cite_ref-grp_54-0" class="reference"><a href="#cite_note-grp-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Federico_55-0" class="reference"><a href="#cite_note-Federico-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Biofortified <a href="/wiki/Sweet_potato" title="Sweet potato">sweet potato</a>, maize, and <a href="/wiki/Cassava" title="Cassava">cassava</a> were other crops introduced to enhance the content of beta-carotene and certain minerals.<sup id="cite_ref-talsma_56-0" class="reference"><a href="#cite_note-talsma-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-mejia_57-0" class="reference"><a href="#cite_note-mejia-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> </p><p>When eaten, beta-carotene is a <a href="/wiki/Provitamin" title="Provitamin">provitamin</a>, converted to retinol (vitamin A). The concept is that in areas of the world where vitamin A deficiency is <a href="/wiki/Endemic" class="mw-redirect" title="Endemic">common</a>, growing and eating this rice would reduce the rates of vitamin A deficiency, particularly its effect on childhood vision problems.<sup id="cite_ref-grp_54-1" class="reference"><a href="#cite_note-grp-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> As of 2018, fortified golden crops were still in the process of government approvals,<sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> and were being assessed for taste and education about their health benefits to improve acceptance and adoption by consumers in impoverished countries.<sup id="cite_ref-talsma_56-1" class="reference"><a href="#cite_note-talsma-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Hypervitaminosis">Hypervitaminosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=8" title="Edit section: Hypervitaminosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some vitamins cause acute or chronic <a href="/wiki/Toxicity" title="Toxicity">toxicity</a>, a condition called <a href="/wiki/Hypervitaminosis" title="Hypervitaminosis">hypervitaminosis</a>, which occurs mainly for <a href="/wiki/Fat-soluble_vitamins" class="mw-redirect" title="Fat-soluble vitamins">fat-soluble vitamins</a> if over-consumed by excessive supplementation. <a href="/wiki/Hypervitaminosis_A" title="Hypervitaminosis A">Hypervitaminosis A</a><sup id="cite_ref-mlpvA_59-0" class="reference"><a href="#cite_note-mlpvA-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Hypervitaminosis_D" class="mw-redirect" title="Hypervitaminosis D">hypervitaminosis D</a><sup id="cite_ref-mlpvD_60-0" class="reference"><a href="#cite_note-mlpvD-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> are the most common examples. Vitamin D toxicity does not result from sun exposure or consuming foods rich in vitamin D, but rather from excessive intake of vitamin D supplements, possibly leading to <a href="/wiki/Hypercalcemia" class="mw-redirect" title="Hypercalcemia">hypercalcemia</a>, nausea, weakness, and <a href="/wiki/Kidney_stone" class="mw-redirect" title="Kidney stone">kidney stones</a>.<sup id="cite_ref-mayo_61-0" class="reference"><a href="#cite_note-mayo-61"><span class="cite-bracket">[</span>61<span class="cite-bracket">]</span></a></sup> </p><p>The United States, European Union and Japan, among other countries, have established <a href="/wiki/Dietary_Reference_Intake#Parameters" title="Dietary Reference Intake">"tolerable upper intake levels"</a> for those vitamins which have documented toxicity.<sup id="cite_ref-DRITable_3-6" class="reference"><a href="#cite_note-DRITable-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-JapanDRI_5-4" class="reference"><a href="#cite_note-JapanDRI-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-EFSA_11-1" class="reference"><a href="#cite_note-EFSA-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=9" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="wikitable sortable" style="float:right; font-size:90%; margin-left:15px"> <caption>The discovery dates of vitamins and their sources </caption> <tbody><tr class="hintergrundfarbe6"> <th>Year of discovery</th> <th>Vitamin </th></tr> <tr> <td>1913</td> <td>Vitamin A (<a href="/wiki/Retinol" title="Retinol">Retinol</a>) </td></tr> <tr> <td>1910</td> <td>Vitamin B<sub>1</sub> (<a href="/wiki/Thiamine" title="Thiamine">Thiamine</a>) </td></tr> <tr> <td>1920</td> <td>Vitamin C (Ascorbic acid) </td></tr> <tr> <td>1920</td> <td>Vitamin D (Calciferol) </td></tr> <tr> <td>1920</td> <td>Vitamin B<sub>2</sub> (<a href="/wiki/Riboflavin" title="Riboflavin">Riboflavin</a>) </td></tr> <tr> <td>1922</td> <td>Vitamin E (<a href="/wiki/Tocopherol" title="Tocopherol">Tocopherol</a>) </td></tr> <tr> <td>1929</td> <td>Vitamin K<sub>1</sub> (<a href="/wiki/Phylloquinone" class="mw-redirect" title="Phylloquinone">Phylloquinone</a>) </td></tr> <tr> <td>1931</td> <td>Vitamin B<sub>5</sub> (<a href="/wiki/Pantothenic_acid" title="Pantothenic acid">Pantothenic acid</a>) </td></tr> <tr> <td>1931</td> <td>Vitamin B<sub>7</sub> (<a href="/wiki/Biotin" title="Biotin">Biotin</a>) </td></tr> <tr> <td>1934</td> <td>Vitamin B<sub>6</sub> (Pyridoxine) </td></tr> <tr> <td>1936</td> <td>Vitamin B<sub>3</sub> (<a href="/wiki/Niacin_(nutrient)" class="mw-redirect" title="Niacin (nutrient)">Niacin</a>) </td></tr> <tr> <td>1941</td> <td>Vitamin B<sub>9</sub> (<a href="/wiki/Folate" title="Folate">Folate</a>) </td></tr> <tr> <td>1948</td> <td><a href="/wiki/Vitamin_B12" title="Vitamin B12">Vitamin B<sub>12</sub></a> (Cobalamins) </td></tr> </tbody></table> <p>In 1747, the Scottish surgeon <a href="/wiki/James_Lind_(physician)" class="mw-redirect" title="James Lind (physician)">James Lind</a> discovered that <a href="/wiki/Citrus" title="Citrus">citrus</a> foods helped prevent <a href="/wiki/Scurvy" title="Scurvy">scurvy</a>, a particularly deadly disease in which <a href="/wiki/Collagen" title="Collagen">collagen</a> is not properly formed, causing poor wound healing, bleeding of the <a href="/wiki/Gingiva" class="mw-redirect" title="Gingiva">gums</a>, severe pain, and death.<sup id="cite_ref-Challem_62-0" class="reference"><a href="#cite_note-Challem-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> In 1753, Lind published his <i>Treatise on the Scurvy</i>, which recommended using lemons and <a href="/wiki/Lime_(fruit)" title="Lime (fruit)">limes</a> to avoid <a href="/wiki/Scurvy" title="Scurvy">scurvy</a>, which was adopted by the British <a href="/wiki/Royal_Navy" title="Royal Navy">Royal Navy</a>. This led to the nickname <i><a href="/wiki/Limey" class="mw-redirect" title="Limey">limey</a></i> for British sailors. Lind's discovery, however, was not widely accepted by individuals in the Royal Navy's <a href="/wiki/Arctic" title="Arctic">Arctic</a> expeditions in the 19th century, where it was widely believed that scurvy could be prevented by practicing good <a href="/wiki/Hygiene" title="Hygiene">hygiene</a>, regular exercise, and maintaining the <a href="/wiki/Morale" title="Morale">morale</a> of the crew while on board, rather than by a diet of fresh food.<sup id="cite_ref-Challem_62-1" class="reference"><a href="#cite_note-Challem-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> </p><p>During the late 18th and early 19th centuries, the use of deprivation studies allowed scientists to isolate and identify a number of vitamins. Lipid from <a href="/wiki/Fish_oil" title="Fish oil">fish oil</a> was used to cure <a href="/wiki/Rickets" title="Rickets">rickets</a> in rats, and the fat-soluble nutrient was called "antirachitic A". Thus, the first "vitamin" bioactivity ever isolated, which cured rickets, was initially called "vitamin A"; however, the bioactivity of this compound is now called <a href="/wiki/Vitamin_D" title="Vitamin D">vitamin D</a>.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">[</span>63<span class="cite-bracket">]</span></a></sup> In 1881, <a href="/wiki/Russian_Empire" title="Russian Empire">Russian</a> medical doctor <a href="/wiki/Nikolai_I._Lunin" class="mw-redirect" title="Nikolai I. Lunin">Nikolai I. Lunin</a> studied the effects of scurvy at the <a href="/wiki/University_of_Tartu" title="University of Tartu">University of Tartu</a>. He fed mice an artificial mixture of all the separate constituents of milk known at that time, namely the <a href="/wiki/Protein" title="Protein">proteins</a>, fats, <a href="/wiki/Carbohydrate" title="Carbohydrate">carbohydrates</a>, and <a href="/wiki/Salt_(chemistry)" title="Salt (chemistry)">salts</a>. The mice that received only the individual constituents died, while the mice fed by milk itself developed normally. He made a conclusion that substances essential for life must be present in milk other than the known principal ingredients. However, his conclusions were rejected by his advisor, <a href="/wiki/Gustav_von_Bunge" title="Gustav von Bunge">Gustav von Bunge</a>.<sup id="cite_ref-Gratzer_64-0" class="reference"><a href="#cite_note-Gratzer-64"><span class="cite-bracket">[</span>64<span class="cite-bracket">]</span></a></sup> </p><p>In East Asia, where polished <a href="/wiki/White_rice" title="White rice">white rice</a> was the common staple food of the middle class, <a href="/wiki/Beriberi" class="mw-redirect" title="Beriberi">beriberi</a> resulting from lack of vitamin B<sub>1</sub> was <a href="/wiki/Endemic_(epidemiology)" title="Endemic (epidemiology)">endemic</a>. In 1884, <a href="/wiki/Takaki_Kanehiro" title="Takaki Kanehiro">Takaki Kanehiro</a>, a British-trained medical doctor of the <a href="/wiki/Imperial_Japanese_Navy" title="Imperial Japanese Navy">Imperial Japanese Navy</a>, observed that beriberi was endemic among low-ranking crew who often ate nothing but rice, but not among officers who consumed a Western-style diet. With the support of the Japanese Navy, he experimented using crews of two <a href="/wiki/Battleship" title="Battleship">battleships</a>; one crew was fed only white rice, while the other was fed a diet of meat, fish, barley, rice, and beans. The group that ate only white rice documented 161 crew members with beriberi and 25 deaths, while the latter group had only 14 cases of beriberi and no deaths. This convinced Takaki and the Japanese Navy that diet was the cause of beriberi, but they mistakenly believed that sufficient amounts of protein prevented it.<sup id="cite_ref-Rosenfeld_65-0" class="reference"><a href="#cite_note-Rosenfeld-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> That diseases could result from some dietary deficiencies was further investigated by <a href="/wiki/Christiaan_Eijkman" title="Christiaan Eijkman">Christiaan Eijkman</a>, who in 1897 discovered that feeding unpolished rice instead of the polished variety to chickens helped to prevent beriberi.<sup id="cite_ref-Wendt_66-0" class="reference"><a href="#cite_note-Wendt-66"><span class="cite-bracket">[</span>66<span class="cite-bracket">]</span></a></sup> The following year, <a href="/wiki/Frederick_Hopkins" class="mw-redirect" title="Frederick Hopkins">Frederick Hopkins</a> postulated that some foods contained "accessory factors" — in addition to proteins, carbohydrates, fats <i>etc.</i> — that are necessary for the functions of the human body.<sup id="cite_ref-Challem_62-2" class="reference"><a href="#cite_note-Challem-62"><span class="cite-bracket">[</span>62<span class="cite-bracket">]</span></a></sup> Hopkins and Eijkman were awarded the <a href="/wiki/Nobel_Prize_for_Physiology_or_Medicine" class="mw-redirect" title="Nobel Prize for Physiology or Medicine">Nobel Prize for Physiology or Medicine</a> in 1929 for their discoveries.<sup id="cite_ref-Carpenter_12-1" class="reference"><a href="#cite_note-Carpenter-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:J._C._Drummond,_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_(Vitamins),_1920.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e3/J._C._Drummond%2C_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_%28Vitamins%29%2C_1920.png/220px-J._C._Drummond%2C_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_%28Vitamins%29%2C_1920.png" decoding="async" width="220" height="258" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e3/J._C._Drummond%2C_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_%28Vitamins%29%2C_1920.png/330px-J._C._Drummond%2C_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_%28Vitamins%29%2C_1920.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e3/J._C._Drummond%2C_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_%28Vitamins%29%2C_1920.png/440px-J._C._Drummond%2C_The_Nomenclature_of_the_So-called_Accessory_Food_Factors_%28Vitamins%29%2C_1920.png 2x" data-file-width="2914" data-file-height="3420" /></a><figcaption><a href="/wiki/Jack_Drummond" title="Jack Drummond">Jack Drummond</a>'s single-paragraph article in 1920 which provided structure and nomenclature used today for vitamins</figcaption></figure> <p>In 1910, the first vitamin complex was isolated by Japanese scientist <a href="/wiki/Umetaro_Suzuki" title="Umetaro Suzuki">Umetaro Suzuki</a>, who succeeded in extracting a water-soluble complex of micronutrients from rice bran and named it <a href="/wiki/Aberic_acid" class="mw-redirect" title="Aberic acid">aberic acid</a> (later <i>Orizanin</i>). He published this discovery in a Japanese scientific journal.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">[</span>67<span class="cite-bracket">]</span></a></sup> When the article was translated into German, the translation failed to state that it was a newly discovered nutrient, a claim made in the original Japanese article, and hence his discovery failed to gain publicity. In 1912 Polish-born biochemist <a href="/wiki/Casimir_Funk" title="Casimir Funk">Casimir Funk</a>, working in London, isolated the same complex of micronutrients and proposed the complex be named "vitamine". It was later to be known as vitamin B<sub>3</sub> (niacin), though he described it as "anti-beri-beri-factor" (which would today be called thiamine or vitamin B<sub>1</sub>). Funk proposed the hypothesis that other diseases, such as rickets, <a href="/wiki/Pellagra" title="Pellagra">pellagra</a>, <a href="/wiki/Coeliac_disease" title="Coeliac disease">coeliac disease</a>, and scurvy could also be cured by vitamins. <a href="/wiki/Maximilian_Nierenstein" title="Maximilian Nierenstein">Max Nierenstein</a>, a friend and reader of Biochemistry at Bristol University, reportedly suggested the "vitamine" name (from "vital amine").<sup id="cite_ref-Nierenstein_68-0" class="reference"><a href="#cite_note-Nierenstein-68"><span class="cite-bracket">[</span>68<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">[</span>69<span class="cite-bracket">]</span></a></sup> The name soon became synonymous with Hopkins' "accessory factors", and by the time it was shown that not all vitamins are <a href="/wiki/Amine" title="Amine">amines</a> the word was already ubiquitous. In 1920, <a href="/wiki/Jack_Cecil_Drummond" class="mw-redirect" title="Jack Cecil Drummond">Jack Cecil Drummond</a> proposed that the final "e" be dropped to deemphasize the "amine" reference, after researchers began to suspect that not all "vitamines" (in particular, <a href="/wiki/Vitamin_A" title="Vitamin A">vitamin A</a>) have an amine component.<sup id="cite_ref-Rosenfeld_65-1" class="reference"><a href="#cite_note-Rosenfeld-65"><span class="cite-bracket">[</span>65<span class="cite-bracket">]</span></a></sup> </p><p>In 1930, <a href="/wiki/Paul_Karrer" title="Paul Karrer">Paul Karrer</a> elucidated the correct structure for <a href="/wiki/Beta-carotene" class="mw-redirect" title="Beta-carotene">beta-carotene</a>, the main precursor of vitamin A, and identified other <a href="/wiki/Carotenoids" class="mw-redirect" title="Carotenoids">carotenoids</a>. Karrer and <a href="/wiki/Norman_Haworth" title="Norman Haworth">Norman Haworth</a> confirmed Albert Szent-Györgyi's discovery of <a href="/wiki/Ascorbic_acid" class="mw-redirect" title="Ascorbic acid">ascorbic acid</a> and made significant contributions to the chemistry of <a href="/wiki/Flavins" class="mw-redirect" title="Flavins">flavins</a>, which led to the identification of <a href="/wiki/Lactoflavin" class="mw-redirect" title="Lactoflavin">lactoflavin</a>. For their investigations on carotenoids, flavins and vitamins A and B<sub>2</sub>, Karrer and Haworth jointly received the <a href="/wiki/Nobel_Prize_in_Chemistry" title="Nobel Prize in Chemistry">Nobel Prize in Chemistry</a> in 1937.<sup id="cite_ref-Karrer_13-1" class="reference"><a href="#cite_note-Karrer-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In 1931, <a href="/wiki/Albert_Szent-Gy%C3%B6rgyi" title="Albert Szent-Györgyi">Albert Szent-Györgyi</a> and a fellow researcher Joseph Svirbely suspected that "hexuronic acid" was actually <a href="/wiki/Vitamin_C" title="Vitamin C">vitamin C</a>, and gave a sample to <a href="/wiki/Charles_Glen_King" title="Charles Glen King">Charles Glen King</a>, who proved its anti-<a href="/wiki/Scurvy" title="Scurvy">scorbutic</a> activity in his long-established <a href="/wiki/Guinea_pig" title="Guinea pig">guinea pig</a> scorbutic assay. In 1937, Szent-Györgyi was awarded the <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a> for this discovery. In 1938, <a href="/wiki/Richard_Kuhn" title="Richard Kuhn">Richard Kuhn</a> was awarded the <a href="/wiki/Nobel_Prize_in_Chemistry" title="Nobel Prize in Chemistry">Nobel Prize in Chemistry</a> for his work on carotenoids and vitamins, specifically B<sub>2</sub> and B<sub>6</sub>.<sup id="cite_ref-Kuhn_14-1" class="reference"><a href="#cite_note-Kuhn-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> In 1943, <a href="/wiki/Edward_Adelbert_Doisy" title="Edward Adelbert Doisy">Edward Adelbert Doisy</a> and <a href="/wiki/Henrik_Dam" title="Henrik Dam">Henrik Dam</a> were awarded the Nobel Prize in Physiology or Medicine for their discovery of <a href="/wiki/Vitamin_K" title="Vitamin K">vitamin K</a> and its chemical structure. In 1967, <a href="/wiki/George_Wald" title="George Wald">George Wald</a> was awarded the Nobel Prize in Physiology or Medicine (jointly with <a href="/wiki/Ragnar_Granit" title="Ragnar Granit">Ragnar Granit</a> and <a href="/wiki/Haldan_Keffer_Hartline" title="Haldan Keffer Hartline">Haldan Keffer Hartline</a>) for the discovery that vitamin A could participate directly in a physiological process.<sup id="cite_ref-Carpenter_12-2" class="reference"><a href="#cite_note-Carpenter-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=10" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Mineral_deficiency" title="Mineral deficiency">Mineral deficiency</a></li> <li><a href="/wiki/Essential_nutrient" class="mw-redirect" title="Essential nutrient">Essential nutrient</a></li> <li><a href="/wiki/Malnutrition" title="Malnutrition">Malnutrition</a></li> <li><a href="/wiki/Vitamin" title="Vitamin">Vitamin</a></li> <li><a href="/wiki/Hypervitaminosis" title="Hypervitaminosis">Hypervitaminosis</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=11" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output 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.citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output 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Retrieved <span class="nowrap">3 February</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Niacin&rft.btitle=Dietary+Reference+Intakes+for+Thiamin%2C+Riboflavin%2C+Niacin%2C+Vitamin+B6%2C+Folate%2C+Vitamin+B12%2C+Pantothenic+Acid%2C+Biotin%2C+and+Choline&rft.place=Washington%2C+DC&rft.pages=123-149&rft.pub=The+National+Academies+Press&rft.date=1998&rft_id=info%3Apmid%2F23193625&rft_id=info%3Adoi%2F10.17226%2F6015&rft.isbn=978-0-309-06554-2&rft_id=https%3A%2F%2Fwww.nap.edu%2Fread%2F6015%2Fchapter%2F8&rfr_id=info%3Asid%2Fen.wikipedia.org%3AVitamin+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-25"><span class="mw-cite-backlink"><b><a href="#cite_ref-25">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://ods.od.nih.gov/factsheets/PantothenicAcid-HealthProfessional/">"Fact Sheet for Health Professionals – Pantothenic acid"</a>. 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Retrieved <span class="nowrap">7 February</span> 2019</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Fact+Sheet+for+Health+Professionals+%E2%80%93+Pantothenic+acid&rft.pub=Office+of+Dietary+Supplements%2C+US+National+Institutes+of+Health&rft.date=2018-08-20&rft_id=https%3A%2F%2Fods.od.nih.gov%2Ffactsheets%2FPantothenicAcid-HealthProfessional%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AVitamin+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-DRI-Pantothenic-26"><span class="mw-cite-backlink"><b><a href="#cite_ref-DRI-Pantothenic_26-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation book cs1"><a rel="nofollow" class="external text" href="http://www.nap.edu/openbook.php?record_id=6015&page=357">"Pantothenic Acid"</a>. <i>Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline</i>. Washington, DC: The National Academies Press. 1998. pp. 357–373. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.17226%2F6015">10.17226/6015</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-309-06554-2" title="Special:BookSources/978-0-309-06554-2"><bdi>978-0-309-06554-2</bdi></a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23193625">23193625</a><span class="reference-accessdate">. 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Washington, DC: The National Academies Press. pp. 150–195. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.17226%2F6015">10.17226/6015</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-309-06554-2" title="Special:BookSources/978-0-309-06554-2"><bdi>978-0-309-06554-2</bdi></a>. <a href="/wiki/LCCN_(identifier)" class="mw-redirect" title="LCCN (identifier)">LCCN</a> <a rel="nofollow" class="external text" href="https://lccn.loc.gov/00028380">00028380</a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/475527045">475527045</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23193625">23193625</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Vitamin+B%3Csub%3E6%3C%2Fsub%3E&rft.btitle=Dietary+Reference+Intakes+for+Thiamin%2C+Riboflavin%2C+Niacin%2C+Vitamin+B6%2C+Folate%2C+Vitamin+B12%2C+Pantothenic+Acid%2C+Biotin%2C+and+Choline&rft.place=Washington%2C+DC&rft.pages=150-195&rft.pub=The+National+Academies+Press&rft.date=1998&rft_id=info%3Adoi%2F10.17226%2F6015&rft_id=info%3Aoclcnum%2F475527045&rft_id=info%3Alccn%2F00028380&rft_id=info%3Apmid%2F23193625&rft.isbn=978-0-309-06554-2&rft.aulast=Institute+Of+Medicine+%28Us%29+Standing+Committee+on+the+Scientific+Evaluation+Of+Dietary+Reference+Intakes+Its+Panel+On+Folate&rft.aufirst=Other+B+Vitamins&rft_id=https%3A%2F%2Fwww.nap.edu%2Fread%2F6015%2Fchapter%2F9%23150&rfr_id=info%3Asid%2Fen.wikipedia.org%3AVitamin+deficiency" class="Z3988"></span></span> </li> <li id="cite_note-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-29">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMockMalikStumboBishop1997" class="citation journal cs1">Mock NI, Malik MI, Stumbo PJ, Bishop WP, Mock DM (1997). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fajcn%2F65.4.951">"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"</a>. <i>Am. 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Washington, DC: The National Academies Press. 1998. pp. 374–389. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.17226%2F6015">10.17226/6015</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-309-06554-2" title="Special:BookSources/978-0-309-06554-2"><bdi>978-0-309-06554-2</bdi></a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23193625">23193625</a><span class="reference-accessdate">. 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Baltimore: Williams and Wilkins Company.</span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Vitamin_deficiency&action=edit&section=12" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 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dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q194435" class="extiw" title="d:Q194435">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: E50-E56</li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=264">264</a>-<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=269">269</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D001361">D001361</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Malnutrition" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Nutritional_pathology" title="Template:Nutritional pathology"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Nutritional_pathology" title="Template talk:Nutritional pathology"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Nutritional_pathology" title="Special:EditPage/Template:Nutritional pathology"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Malnutrition" style="font-size:114%;margin:0 4em"><a href="/wiki/Malnutrition" title="Malnutrition">Malnutrition</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Protein%E2%80%93energy_malnutrition" title="Protein–energy malnutrition">Protein-energy<br />malnutrition</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ascites" title="Ascites">Ascites</a></li> <li><a href="/wiki/Emaciation" title="Emaciation">Emaciation</a></li> <li><a href="/wiki/Kwashiorkor" title="Kwashiorkor">Kwashiorkor</a></li> <li><a href="/wiki/Marasmus" title="Marasmus">Marasmus</a></li> <li><a href="/wiki/Catabolysis" title="Catabolysis">Catabolysis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink selflink">Vitamin deficiency</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/B_vitamins" title="B vitamins">B vitamins</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>B<sub>1</sub> <ul><li><a href="/wiki/Beriberi" class="mw-redirect" title="Beriberi">Beriberi</a></li> <li><a href="/wiki/Wernicke%E2%80%93Korsakoff_syndrome" title="Wernicke–Korsakoff syndrome">Wernicke–Korsakoff syndrome</a></li> <li><a href="/wiki/Wernicke%27s_encephalopathy" class="mw-redirect" title="Wernicke's encephalopathy">Wernicke's encephalopathy</a></li> <li><a href="/wiki/Korsakoff%27s_syndrome" class="mw-redirect" title="Korsakoff's syndrome">Korsakoff's syndrome</a></li></ul></li> <li>B<sub>2</sub> <ul><li><a href="/wiki/Riboflavin#Deficiency" title="Riboflavin">Riboflavin deficiency</a></li></ul></li> <li>B<sub>3</sub> <ul><li><a href="/wiki/Pellagra" title="Pellagra">Pellagra</a></li></ul></li> <li>B<sub>6</sub> <ul><li><a href="/wiki/Pyridoxine_deficiency" class="mw-redirect" title="Pyridoxine deficiency">Pyridoxine deficiency</a></li></ul></li> <li>B<sub>7</sub> <ul><li><a href="/wiki/Biotin_deficiency" title="Biotin deficiency">Biotin deficiency</a></li></ul></li> <li>B<sub>9</sub> <ul><li><a href="/wiki/Folate_deficiency" title="Folate deficiency">Folate deficiency</a></li></ul></li> <li>B<sub>12</sub> <ul><li><a href="/wiki/Vitamin_B12_deficiency" title="Vitamin B12 deficiency">Vitamin B<sub>12</sub> deficiency</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>A: <a href="/wiki/Vitamin_A_deficiency" title="Vitamin A deficiency">Vitamin A deficiency</a> <ul><li><a href="/wiki/Bitot%27s_spots" title="Bitot's spots">Bitot's spots</a></li></ul></li> <li>C: <a href="/wiki/Scurvy" title="Scurvy">Scurvy</a></li> <li>D: <a href="/wiki/Vitamin_D_deficiency" title="Vitamin D deficiency">Vitamin D deficiency</a> <ul><li><a href="/wiki/Rickets" title="Rickets">Rickets</a></li> <li><a href="/wiki/Osteomalacia" title="Osteomalacia">Osteomalacia</a></li> <li><a href="/wiki/Harrison%27s_groove" title="Harrison's groove">Harrison's groove</a></li></ul></li> <li>E: <a href="/wiki/Vitamin_E_deficiency" title="Vitamin E deficiency">Vitamin E deficiency</a></li> <li>K: <a href="/wiki/Vitamin_K_deficiency" title="Vitamin K deficiency">Vitamin K deficiency</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mineral_deficiency" title="Mineral deficiency">Mineral deficiency</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrolyte_imbalance" title="Electrolyte imbalance">Electrolyte imbalance</a> <ul><li><a href="/wiki/Hypocalcemia" title="Hypocalcemia">Calcium</a></li> <li><a href="/wiki/Hypochloremia" title="Hypochloremia">Chloride</a></li> <li><a href="/wiki/Magnesium_deficiency_(medicine)" class="mw-redirect" title="Magnesium deficiency (medicine)">Magnesium</a></li> <li><a href="/wiki/Hypophosphatemia" title="Hypophosphatemia">Phosphate</a></li> <li><a href="/wiki/Hypokalemia" title="Hypokalemia">Potassium</a></li> <li><a href="/wiki/Hyponatremia" title="Hyponatremia">Sodium</a></li></ul></li> <li><a href="/wiki/Iron_deficiency" title="Iron deficiency">Iron</a></li> <li><a href="/wiki/Zinc_deficiency" title="Zinc deficiency">Zinc</a></li> <li><a href="/wiki/Manganese_deficiency_(medicine)" title="Manganese deficiency (medicine)">Manganese</a></li> <li><a href="/wiki/Copper_deficiency" title="Copper deficiency">Copper</a></li> <li><a href="/wiki/Iodine_deficiency" title="Iodine deficiency">Iodine</a></li> <li><a href="/wiki/Chromium_deficiency" title="Chromium deficiency">Chromium</a></li> <li><a href="/wiki/Molybdenum_deficiency" title="Molybdenum deficiency">Molybdenum</a></li> <li><a href="/wiki/Selenium_deficiency" title="Selenium deficiency">Selenium</a> <ul><li><a href="/wiki/Keshan_disease" title="Keshan disease">Keshan disease</a></li></ul></li> <li><a href="/wiki/Fluorine_deficiency" title="Fluorine deficiency">Fluorine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_development_(biology)" class="mw-redirect" title="Human development (biology)">Growth</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Deformity" title="Deformity">Deformity</a></li> <li><a href="/wiki/Delayed_milestone" title="Delayed milestone">Delayed milestone</a></li> <li><a href="/wiki/Failure_to_thrive" title="Failure to thrive">Failure to thrive</a></li> <li><a href="/wiki/Short_stature" title="Short stature">Short stature</a> <ul><li><a href="/wiki/Idiopathic_short_stature" title="Idiopathic short stature">Idiopathic</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">Anorexia</a></li> <li><a href="/wiki/Cachexia" title="Cachexia">Cachexia</a></li> <li><a href="/wiki/Deficiency_(medicine)" title="Deficiency (medicine)">Deficiency (medicine)</a></li> <li><a href="/wiki/Dehydration" title="Dehydration">Dehydration</a></li> <li><a href="/wiki/Epidemiology_of_malnutrition" title="Epidemiology of malnutrition">Epidemiology of malnutrition</a></li> <li><a href="/wiki/Famine" title="Famine">Famine</a></li> <li><a href="/wiki/Food_fortification" title="Food fortification">Food fortification</a></li> <li><a href="/wiki/Hunger" title="Hunger">Hunger</a></li> <li><a href="/wiki/Human_right_to_water_and_sanitation" title="Human right to water and sanitation">Human right to water and sanitation</a></li> <li><a href="/wiki/Micronutrient_deficiency" title="Micronutrient deficiency">Micronutrient deficiency</a></li> <li><a href="/wiki/Right_to_health" title="Right to health">Right to health</a></li> <li><a href="/wiki/Starvation" title="Starvation">Starvation</a></li> <li><a href="/wiki/Starvation_(crime)" title="Starvation (crime)">Starvation (crime)</a></li> <li><a href="/wiki/Terminal_dehydration" title="Terminal dehydration">Terminal dehydration</a></li> <li><a href="/wiki/Undernutrition_in_children" title="Undernutrition in children">Undernutrition in children</a></li> <li><a href="/wiki/Weight_loss" title="Weight loss">Weight loss</a></li> <li><a href="/wiki/World_food_crises_(2022%E2%80%93present)" class="mw-redirect" title="World food crises (2022–present)">World food crises (2022–present)</a></li> <li><a href="/wiki/Underweight" title="Underweight">Underweight</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q194435#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q194435#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata" style="font-size:114%;margin:0 4em"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a> <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q194435#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85010548">United States</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="avitaminóza"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph882792&CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="http://olduli.nli.org.il/F/?func=find-b&local_base=NLX10&find_code=UID&request=987007282448205171">Israel</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="http://esu.com.ua/search_articles.php?id=42367">Encyclopedia of Modern Ukraine</a></span></li></ul></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" 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