Patients today often are overfed but undernourished. A growing body of literature links dietary choices to brain health and the risk of psychiatric illness. Vitamin deficiencies can affect psychiatric patients in several ways:
* deficiencies may play a causative role in mental illness and exacerbate symptoms
* psychiatric symptoms can result in poor nutrition
* vitamin insufficiency--defined as subclinical deficiency--may compromise patient recovery.
Additionally, genetic differences may compromise vitamin and essential nutrient pathways.
Vitamins are dietary components other than carbohydrates, fats, minerals, and proteins that are necessary for life. B vitamins are required for proper functioning of the methylation cycle, monoamine production, DNA synthesis, and maintenance of phospholipids such as myelin (for a Figure that illustrates the methylation cycle, see this article at CurrentPsychiatry.com). Fat-soluble vitamins A, D, and E play important roles in genetic transcription, antioxidant recycling, and inflammatory regulation in the brain.
To help clinicians recognize and treat vitamin deficiencies among psychiatric patients, this article reviews the role of the 6 essential water-soluble vitamins (B1, B2, B6, B9, B12, and C; Table 1, (1) page 38-39) and 3 fat-soluble vitamins (A, D, and E; Table 2, (1) page 40-41) in brain metabolism and psychiatri.c pathology. Because numerous sources address using supplements to treat vitamin deficiencies, this article emphasizes food sources, which for many patients are adequate to sustain nutrient status.Table 1 Water-soluble vitamins: Deficiency, insufficiency, symptoms, and dietary sources Deficiency Insufficiency Symptoms At-risk patients B1 (thiamine): Glycolysis, tricarboxylic acid cycle Rare; 7% in 5% total, 12% Wernicke - Older adults, heart failure of older Korsakoff malabsorptive patients women syndrome, conditions, memory heavy alcohol impairment, use Those with confusion, diabetes are at lack of risk because of coordination, increased paralysis clearance B2 (riboflavin): FMN, FAD cofactors in glycolysis and oxidative pathways. B6, folate, and glutathione synthesis 10% to 27% of <3%; 95% of Fatigue, Older adults, older adults adolescent cracked lips, low intake of girls sore throat, animal and dairy (measured by bloodshot products, heavy EGRAC) eyes alcohol use B6 (pyridoxal): Methylation cycle 11% to 24% 14% total, 26% Dermatitis, Older adults, (<5ng/ml_); of adults glossitis, women who use 38% of heart convulsions, oral failure migraine, contraceptives, patients chronic pain, alcoholism. 33% depression to 49% of women age > 51 have inadequate intake B9 (folate): Methylation cycle 0.5% total; up 16% of adults, Loss of Depression, to 50% of 19% of appetite, pregnancy and depressed adolescent weight loss, lactation, patients girls weakness, alcoholism, heart dialysis, liver palpitations, disease. behavioral Deficiency disorders during pregnancy is linked to neural tube defects B12 (cobalamin): Methylation cycle (cofactor methionine synthase) 10% to 15% of < 3% to 9% Depression, Vegetarian or older adults irritability, vegan diet anemia, achlorhydria, fatigue, older adults. shortness of Deficiency more breath, high often due to blood poor absorption pressure than low consumption C (ascorbic acid): Antioxidant 7.1% 31% Scurvy, Smokers, infants fatigue, fed boiled or anemia, joint evaporated milk, pain, limited dietary petechia. variation, Symptoms patients with develop after malabsorption, 1 to 3 months chronic of no dietary illnesses intake...
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