Question

What are some of the treatments/prognosis in somebody with a deficiency or an overdose of vitamins/minerals?

Answer 1

Mineral deficiency and toxicity treatment

Minerals are specific kinds of nutrients that your body needs in order to function properly. A mineral deficiency occurs when your body doesn’t obtain or absorb the required amount of a mineral. There are five main categories of mineral deficiency: calcium, iron, magnesium, potassium, and zinc.

Treatment:

• The treatment for a mineral deficiency depends upon the type and the severity of the deficiency. Underlying conditions are also a factor.
• Your doctor may order further tests to identify the amount of damage before deciding on a treatment plan. This can include treatment for other diseases or a change in medication.
• Dietary changes: A change in eating habits may help if you have a minor mineral deficiency. People with anemia due to a lack of iron in the diet, may be asked to eat more meat, poultry, eggs, and iron-fortified cereals.
• Referring to a registered dietitian if deficiency is more severe. They’ll help you modify your eating habits. This will include guidelines on how to eat a well-balanced diet rich in fruits, vegetables, and whole grains. The dietitian may also ask you to keep a food diary to track what foods you’re eating and your progress.
• Supplements : Certain mineral deficiencies cannot be treated with diet alone. You may be required to take a multivitamin or mineral supplement. These may be taken alone or with other supplements that help the body absorb or use the mineral. Vitamin D, for example, is usually taken along with calcium. Your healthcare provider will decide how much and how often you should take supplements. It’s important to follow your provider’s instructions because excessive intake of certain supplements can be harmful.
• Emergency treatment : Hospitalization may be required in very severe cases of mineral deficiency. Minerals and other nutrients can be administered intravenously. Treatment may be required one or more times a day for several days. This type of treatment can have side effects including fever or chills, swelling of the hands or feet, or changes in heartbeat. Your healthcare provider will administer additional blood tests to determine whether treatment was successful.

Mineral toxicity:

The term mineral toxicity refers to a condition in which the concentration in the body of any one of the minerals necessary for life is abnormally high, and which has an adverse effect on health.

Treatment :

• Iron toxicity is treated by efforts to remove the remaining iron from the stomach by administering a solution of 5 percent sodium bicarbonate. Where plasma iron levels have risen above 0.35 mg/dL, the patient is treated with deferoxamine. Treatment of manganese toxicity involves removal of the patient from the high manganese environment as well as giving him or her lifelong doses of the drug L-dopa. The treatment is only partially successful. Treatment of nitrite or nitrate toxicity involves inhalation of 100 percent oxygen for several hours. If oxygen treatment is not effective, then a solution of 1.0 percent methylene blue may be injected in a dose of 1.0 mg methylene blue/kg body weight.
• With regard to disorders of copper metabolism, Wilson's disease can be successfully controlled by lifelong treatment with d-penicillamine, trientine, and zinc acetate. Treatment also involves avoiding foods that are high in copper, such as liver, nuts, chocolate, and mollusks. After an initial period of treatment with penicillamine, Wilson's disease may be treated with zinc (150 mg oral Zn/day). The zinc inhibits the absorption of dietary copper. Patients with this disease must, however, comply with treatment for the rest of their lives, as untreated Wilson's disease is invariably fatal. Patients who develop liver failure as a result of the disease may be candidates for a liver transplant.
• Children with Menkes disease are sometimes helped temporarily by intravenous injections of copper supplements. There is, however, no cure for the disease as of the early 2000s, and most children with the disorder live only a few years.
• Nutritional concerns: Families consuming a well-balanced diet without overuse of dietary supplements are unlikely to have problems with mineral toxicity. Children or adolescents diagnosed with Wilson's disease must observe the dietary limitations described earlier.

Prognosis

• The prognosis for mineral toxicity due to sodium, potassium, calcium, and phosphate is usually excellent. Toxicity due to the deposit of calcium phosphate crystals is not usually reversible. The prognosis for treating iodine toxicity is excellent. For any mineral overdose that causes coma or seizures, the prognosis for recovery is often poor, and death results in a small fraction of patients. For any mineral toxicity that causes nerve damage, the prognosis is often fair to poor. Wilson's disease is fatal, usually before age 30, unless the patient complies with continual lifelong treatment to prevent brain or liver disease. Children diagnosed with Menkes disease rarely live past their third birthday.

Vitamin Deficiency and Toxicity Treatment

Vitamins in your diet play a vital role in maintaining good health. In the present lifestyle of processed foods and fatty diet, people are prone to have one or many vitamin deficiency. This can also happen due to an improper digestive system. Vitamins with enzymes help to release energy in the body and maintain chemical activities.

There are 13 types of vitamins:

1. Thiamine
2. Riboflavin
3. Niacin
4. B6 (pyridoxine)
5. Folacin
6. B12 (cyanocobalamin)
7. Pantothenic acid
8. Biotin
9. Vitamin C
10. Vitamin A
11. Vitamin D
12. Vitamin E and
13. Vitamin K

• Vitamin A deficiency (VAD) or hypovitaminosis A is a lack of vitamin A in blood and tissues. Vitamin A deficiency can be treated with vitamin A supplements. The amount of supplements depends upon the age of the child. Vitamin A supplements can reverse night blindness and help the eyes become properly lubricated again. However, vision loss caused by scarring from corneal ulcers cannot be reversed.
• International organizations are working to address vitamin A deficiency in at-risk populations, and seek to promote prevention through adequate diet and vitamin supplements.

Treatment for vitamin B12 deficiency

• Treatment given for vitamin B12 deficiency will depend on what doctors find is causing it. If a lack of B12 in the diet is found to be the likely cause, advice on eating more vitamin B12 rich food will be given. Good sources of vitamin B12 include meat, salmon, milk, eggs, some fortified breakfast cereals and some soy products.
• Vitamin B12 supplement tablets may also be prescribed.
• Regular vitamin B12 injections of hydroxycobalamin may also be recommended.
• Further blood tests will be needed to check for improvements in vitamin B12 levels so supplements or injection doses can be regulated.

Vitamin C deficiency treatment

• Scurvy is the name for a vitamin C deficiency. It can lead to anemia, debility, exhaustion, spontaneous bleeding, pain in the limbs, and especially the legs, swelling in some parts of the body, and sometimes ulceration of the gums and loss of teeth.
• Treatment involves administering vitamin C supplements by mouth or by injection.
• The recommended dosage is: 1 to 2 grams (g) per day for 2 to 3 days, 500 milligrams (mg) for the next 7 days, 100 mg for 1 to 3 months.
• Within 24 hours, patients can expect to see an improvement in fatigue, lethargy, pain, anorexia, and confusion. Bruising, bleeding, and weakness start to resolve within 1 to 2 weeks.
• Increase dietary intake by Consumimg all fruits and vegetables that contain Vitamin C. Best dietary sources include green peppers, strawberries, green, leafy vegetables, white potatoes, tomatoes, citrus fruits, broccoli, cantaloupe, and sweet potatoes.

Vitamin D deficiency treatment

• Vitamin D3 has been shown to be the best choice for supplements. Vitamin D2 supplements do not raise your levels the same amount as D3 and, in some cases, they have been shown to decrease levels over long-term use.
• The amount of vitamin D that is needed to correct a deficiency will depend on the severity of the deficiency and your individual health risks. The time of year will also matter. For example, if you are on the low end of adequate blood levels and heading in to the winter months you would need a bit more than if you were heading in to the summer months. The goal for everyone is to get your stores to a safe level and prevent them from dropping with a maintenance plan.
• What you take is as important as how you take it. Vitamin D supplements should be taken with a meal that contains fat. Studies have shown that when taken on an empty stomach versus with a meal containing fat, there was an average of 32% more vitamin D absorption in the fat-containing meal. This ranged from 11%-52%. Even an 11% reduction is significant and can impact your vitamin level. A recent study instructed people to take their supplement with their largest meal (typically the one with the most fat), and in three months, their blood levels went up an average of 56.7%.
• There are supplements that can be taken on a daily, weekly, or monthly basis. It's a matter of preference and, most importantly, which one you will be more likely to take. You may start out at a higher dose and decrease after a month or two. Most experts feel that the goal is to get your level above 30-40 ng/mL, depending on your risk factors, and then take a maintenance amount. When you are deficient, it is recommended to have your blood tested after two to three months of taking the supplement to be sure that your levels are going up. Work with your doctors to find the optimal plan for you.

Vitamin E deficiency treatment

• Vitamin E is a fat-soluble vitamin with antioxidant qualities that helps keep your immune system strong.
• You should only attempt to correct a suspected vitamin E deficiency after consulting your doctor. Supplements may cause complications, so it’s best to eat a healthy diet that includes many foods rich in vitamin E.
• Diet: You can find vitamin E in a wide range of foods. These include: nuts and seeds, such as almonds, sunflower seeds, peanuts, and peanut butter, whole grains, vegetable-based oils, especially olive and sunflower, leafy vegetables, eggs, fortified cereals, kiwi, mango.
• Supplementation : Although taking supplements is a popular way to add vitamins and minerals to your diet, you should be cautious about taking vitamin E in supplement form.

Treatment for Vitamin K deficiency

• There are two main kinds of vitamin K. Vitamin K1 (phylloquinone) comes from plants, especially leafy green vegetables like spinach and kale. Vitamin K2 (menaquinone) is naturally created in the intestinal tract and works similarly to K1.
• The treatment for vitamin K is the drug phytonadione, which is vitamin K1. Most of the time doctors prescribe it as an oral medication. A doctor or nurse might also inject it under the skin (as opposed to into a vein or muscle). The dosage for adults ranges from 1 to 25 milligrams (mg).
• Doctors will prescribe a smaller phytonadione dose for someone who is taking an anticoagulant. Typically this dosage is about 1 to 10 mg. This is to avoid a complication due to anticoagulants interfering with the body’s vitamin K production.
• In infants, the American Academy of Pediatrics recommends that newborns get a single shot of 0.5 to 1 mg vitamin K1 at birth. A higher dose may be necessary if the mother has been taking anticoagulants or anti-seizure drugs.

Vitamin overdose treatment

Treatment for Vitamin A toxicity

Symptoms of vitamin A toxicity usually resolve after stopping vitamin A and instituting supportive therapy. The pigmentation of carotenemia usually disappears with the omission of carrots from the diet.
Patients with increased intracranial pressure may need therapeutic lumbar punctures or further treatment with medications such as diuretics and mannitol.

Patients with symptomatic hypercalcemia require the following:

Close monitoring
Treatment with intravenous fluids and diuretics
Additional therapy, including pamidronate, calcitonin, corticosteroids, or mithramycin
Discontinuation of vitamin A.

Vitamin D
Place patients with vitamin D toxicity on a low-calcium diet. Consider oral calcium disodium edetate to increase fecal excretion of calcium.

In cases of severe hypercalcemia, patients may require hydration, diuretics, steroids (hydrocortisone 100 mg IV q6h), calcitonin (4-8 IU/kg q6-12h), and/or mithramycin (25 mcg/kg qDay IV over 4-6 h for 1-4 days). Peritoneal or hemodialysis may be necessary if large amounts of fluids cannot be given.

Other Vitamins
Vitamins K, B-1, B-2, B-6, B-12, and C, and folate

These usually require only supportive measures.

Vitamin B-3

Provide supportive treatment as needed. Aspirin taken 30 minutes before niacin decreases the flush response.

Vitamin E

Management of vitamin E toxicity consists of discontinuing vitamin E supplements and monitoring the PT if bleeding complications develop.

Vitamin K replacement through the oral or subcutaneous route should reduce the elevated PT and decrease the risk of bleeding in patients who are taking anticoagulants or who have vitamin K deficiency.