Nutrition and Oral Medicine (Nutrition and Health)

Chapter 6 / Medications, Nutrition, Diet, and Oral Health 95Table 3Clinical Manifestations of Specific Vitamin DeficienciesDeficiencyFat-Soluble VitaminsVitamin AVitamin DVitamin EVitamin KWater-Soluble VitaminsVitamin B 1 (thiamine)Vitamin B 2 (riboflavin)NiacinVitamin B 6 (pyroxidine)Vitamin B 12 (cobalamine)Folic acidVitamin C (ascorbic acid)MineralsCalciumIronZincManifestationsNight blindness, impaired protein utilization, impaired healing, impairedbone and tooth formationBone loss, osteoporosis, low blood calcium, rickets/osteomalacia, muscleweakness, impaired tooth developmentRare: anemia, lethargy, neuromuscular diseaseImpaired blood clotting, bleeding gums, bruising, bleeding after injury orsurgeryImpaired gastric acid production, tingling and numbness in fingers andtoes, stomatitis, beriberi (disorder of the nervous and cardiovascularsystem), and Wernicke-Kosakoff syndromeImpaired metabolism of carbohydrates, fats, and proteins; impaired cellgrowth; seborrheic dermatitis; angular cheilitis; “magenta” tongue; splittongue; burning of oral mucosa; aphthous ulcersPellagralike symptoms of dermatitis, dementia, diarrhea, angular stomatitis,lesions of tongue and oral mucosa, raw erythematous tongueHypochromic anemia, decreased antibody formation, dermatitis of face andscalp, burning feet, peripheral neuropathy, carpal tunnel syndrome,angular stomatitis, cheilitis, glossitisPernicious anemia, hypotension, neuropathy, fatigue, dsypnea, redness andburning of the tongueMegaloblastic anemia, anorexia, glossitis, cheilitis, problems with clottingand bruising, birth defectsCompromised immune system, impaired wound healing, petechiae,bleeding gums and loosening of teeth, damage to nerves, eyes andvascular systemOsteopenia, osteoporosis, muscle cramps, joint aches, heart rhythmirregularities, numbness in arms and legs, ricketsAngular cheilitis, glossitis, dysphagia, mucosal thinning, ulcerations,anemiaHypogeusia, dysgeusia, delayed wound healingmechanical barrier, preventing access to the epithelial surface of the GI tract, increasetransit time, or indirectly inhibit drug absorption because of increased digestion by GIsecretions. Drugs taken with food may remain in the stomach for extended periods andbe broken down before they can be absorbed in the intestines. This is especially significantwith drugs that are meant to be rapidly absorbed or have a short half-life (4). Delayedgastric clearance of such drugs as erythromycin, capoten (Captopril), penicillin, digoxin,and levodopa would cause more of the drug to be metabolized in the stomach and less ofthe active drug available for absorption, causing a suboptimal clinical response (21).Nutrients can bind to drugs and make them unavailable. Iron binds with tetracycline,