Nutrition Assessment

Vitamin and Mineral Deficiencies: Physical Assessment

January 11, 2017   /

This table might prove useful in detecting nutrient deficiencies during a nutrition-focused physical assessment.

Vitamin or Mineral

Physical Signs of Deficiency

 

Vitamin A

 

  • Hair follicle blockage with a permanent “goose-bump” appearance
  • Dry, rough skin
  • Small, grayish, foamy deposits on the conjunctiva adjacent to the cornea
  • Drying of the eyes and mucous membranes
  • Night blindness

 

Vitamin D

 

  • Rickets (children)

 

Vitamin K

 

  • Small hemorrhages in the skin or mucous membranes

 

Thiamine

 

  • Weight loss
  • Muscular wasting
  • Sometimes edema (wet beriberi)
  • Malaise
  • Mental confusion
  • Tense calf muscles
  • Distended neck veins
  • Jerky movement of eyes
  • Staggering gait and difficulty walking
  • Infants may develop cyanosis
  • Round, swollen (moon) face
  • Foot and wrist drop

 

Riboflavin

 

  • Tearing, burning, and itching of the eyes with fissuring in the corners of the eyes
  • Soreness and burning of the lips, mouth, and tongue with fissuring and/or cracking of the lips and corners of the mouth
  • Purple swollen tongue
  • Seborrhea of the skin in the nasolabial folds, scrotum, or vulva
  • Capillary overgrowth around the corneas

 

Niacin

 

  • Dermatitis or skin eruptions
  • Dementia
  • Diarrhea
  • Tremors
  • Sore tongue
  • Skin that is exposed to sunlight will develop cracks and a scaly form of dermatitis with pigmentation
  • Anorexia
  • Indigestion
  • May also show signs of riboflavin deficiency

 

Vitamin B6

 

  • Tongue inflammation
  • Inflammation of the lining of the mouth
  • Fissures in the corners of the mouth

 

Folate

 

  • Weakness, fatigue, and depression
  • Pallor
  • Dermatologic lesions

 

Vitamin B12

 

  • Lemon-yellow tint to the skin and eyes
  • Smooth, red, thickened tongue

 

Vitamin C

 

  • Impaired wound healing
  • Edema
  • Swollen, bleeding, and/or retracted gums or tooth loss; mottled teeth; enamel erosion
  • Lethargy and fatigue
  • Skin lesions
  • Small red or purplish pinpoint discolorations on the skin or mucous membranes (petechiae)
  • Darkened skin around the hair follicles
  • Corkscrew hair or unemerged, coiled hair

 

Magnesium

 

  • Tremors, muscle spasms, and tetany
  • Personality changes

 

Iron

 

 

 

  • Skin pallor
  • Pale conjuctivia
  • Fatigue
  • Thin, concave nails with raised edges

 

Zinc

 

  • Delayed wound healing
  • Hair loss
  • Skin lesions
  • Eye lesions
  • Nasolabial seborrhea
  • Decubitus ulcers

 

Copper

 

  • Hair and skin depigmentation
  • Pallor

 

Iodine

 

  • Goiter

 

Chromium

 

  • Corneal lesions

 

Reference and recommended reading
Gallagher ML. Intake: the nutrients and their metabolism. In: Mahan LK, Escott-Stump S, Raymond JL. Krause’s Food and the Nutrition Care Process. 13th ed. St Louis, MO: Elsevier Saunders; 2012:32-128.