What are disorders of vitamin absorption?

There are many types of disorders of vitamin absorption. The causes, symptoms, diagnosis and treatment of each vary.

Biotin deficiency can lead to skin rashes, weight loss, hair loss and numbness. Foods high in biotin are liver, egg yolk, soybeans, milk and meat.

Vitamin B12 deficiency can lead to pernicious anemia and neurological deterioration. Children with short bowel syndrome who have lost their ileocecal valve are at risk for vitamin B12 deficiency. Vitamin B12 can only be found in animal foods.

Folate deficiency leads to megaloblastic anemia, neural tube defects in the fetus of pregnant woman, and an impaired immune system. Folate is found in green and leafy vegetables.

Niacin deficiency can lead to dermatitis, diarrhea and dementia (also called pellagra). Foods high in niacin include milk, eggs, whole grains, and enriched cereals and grains.

Vitamin A deficiency can present with night blindness, dry eyes and skin, as well as poor bone growth and poor immune syndrome. It is often seen in children with liver disease because these patients cannot absorb fat-soluble vitamins.

Vitamin D deficiency is common in the United States and can lead to bone diseases like rickets. Foods rich in vitamin D include fortified milk, fish, liver, and egg yolk. Recent studies suggest that patients with chronic inflammatory conditions, like inflammatory bowel disease, can benefit from correction of vitamin D deficiency. Vitamin D deficiency is also common in liver disease.

Vitamin E deficiency can present with hemolytic anemia in preterm infants and fat malabsorption causes deficiency and hyporeflexia. Foods high in vitamin E include sardines, green and leafy vegetables, vegetable oils, butter, liver and egg yolk.

Vitamin K deficiency is a rare primary deficiency but can occur in the setting of liver disease. Other signs of this deficiency include bleeding and possibly poor bone mineral density. Foods high in vitamin K include cow’s milk, green leafy vegetables, pork and liver.

Diagnosis and treatment

At The Children's Hospital of Philadelphia, children with disorders of vitamin absorption are evaluated and treated by doctors in the Division of Gastroenterology (GI), Hepatology and Nutrition.