Vitamin Deficiency Guide — Recognizing and Treating Scurvy, Beriberi, Pellagra and More

Timeline: Symptoms appear after 4–6 weeks without fresh food; death possible by 3 months.

Recognize: Bleeding/swollen gums, bruising with no injury, joint pain, wounds that stop healing or reopen, fatigue, corkscrew body hairs.

Treat — any Vitamin C source reverses scurvy within days:

• Fresh citrus (lemon, lime, orange)
• Raw onion or garlic
• Rosehip tea (boil rose hips 10 min — extremely high in C)
• Pine needle tea (boil fresh green pine needles — historical scurvy cure)
• Any raw green vegetable

Note: Cooking destroys Vitamin C — eat raw when possible.

Scurvy symptoms often mimic other conditions. If wounds are not healing and the person has had no fresh food for weeks, assume Vitamin C deficiency and treat immediately.

Timeline: 1–3 months on polished rice or refined grain diet without legumes or meat.

Two forms:

• Wet beriberi: Heart failure — swollen legs, shortness of breath, rapid weak pulse, fluid accumulation. Life-threatening.
• Dry beriberi: Peripheral neuropathy — pins and needles in feet/hands, progressive weakness, difficulty walking.

Recognize: Person eating primarily white rice or refined flour for weeks with no other protein/grain variety.

Treat: Switch from polished to whole grains (brown rice, whole wheat), add legumes (beans, lentils), nuts, pork, or liver. This single dietary change resolves most beriberi.

Timeline: Months of corn-dominant diet without other niacin sources.

The 3 Ds — all three together strongly indicate pellagra:

1. Dermatitis — rough, dark, scaly rash on sun-exposed areas (face, neck, hands)
2. Diarrhea — chronic, watery
3. Dementia — confusion, aggression, disorientation (a 4th D: Death, if untreated)

Why corn? Niacin in corn is bound and not bioavailable unless treated with lime (nixtamalization). Populations eating untreated corn without protein sources are at risk.

Treat: Meat, fish, poultry, peanuts, beans, sunflower seeds, whole grains.

Timeline: Months without animal products or orange/yellow vegetables.

Recognize: Difficulty seeing in dim light (earliest sign), dry eyes, increased frequency of infections. Children: delayed growth.

Progression: Night blindness → dry eyes → corneal ulcers → permanent blindness.

Treat:

• Liver (richest source — one serving per week prevents deficiency)
• Orange/yellow vegetables: carrots, sweet potato, pumpkin
• Dark leafy greens: spinach, kale (beta-carotene converts to Vitamin A)
• Eggs and dairy

Absorption requires fat — eat with any fat source.

Vitamin A deficiency is the leading cause of preventable blindness in children worldwide. Children under 5 are at highest risk.

Timeline: Months to years, especially in children and those with limited sun exposure.

Recognize in children (rickets): Bowed legs, soft skull, delayed teeth, wrist/ankle swelling, delayed walking.

Recognize in adults (osteomalacia): Bone pain, muscle weakness, stress fractures.

Treat:

• Sunlight is most effective: 15 minutes of direct sun on arms/face daily. Darker skin requires longer exposure.
• Fatty fish (salmon, mackerel, sardines)
• Egg yolks and liver

Vitamin D is required for calcium absorption — deficiency causes soft, weak bones even with adequate calcium intake.

Timeline: Months on plant-only diet or with chronic blood loss.

Recognize: Fatigue out of proportion to activity, pale gums and inner eyelids (pull down lower eyelid — should be pink/red), rapid resting heart rate, shortness of breath on exertion, dizziness.

Treat:

• Red meat and liver (highest bioavailability)
• Dark leafy greens combined with Vitamin C (dramatically enhances plant-iron absorption)
• Cook in cast iron pots — acid foods cooked in iron cookware leach bioavailable iron into food
• Avoid tea/coffee with meals (tannins block iron absorption)

Address causes: Hookworm causes iron-deficiency anaemia — treat underlying parasite infection.

Timeline: Months without iodized salt or seafood, especially in inland areas.

Recognize: Goiter (enlarged thyroid — visible swelling at base of neck), fatigue, weight gain, cold intolerance, brain fog.

In pregnancy: Miscarriage, stillbirth, and irreversible cognitive impairment in the child (cretinism) — the most serious consequence of iodine deficiency.

Treat:

• Iodized salt (most accessible source for non-coastal populations)
• Seafood and seaweed (kelp is extremely high in iodine)
• Dairy and eggs

Inland populations on non-iodized salt are at highest risk.

Iodine deficiency during pregnancy causes irreversible cognitive impairment in the child. Pregnant women must prioritize iodized salt even in resource scarcity.