Special Operations Forces Medical Handbook

5-137

Vitamin NameB1Thiamine B2RiboflavinB3Niacin B6PyridoxineB12CyanocobalaminCAscorbic acid FolateFolic acid

Vitamin and Mineral Facts

MAJ Victor Yu, SP, USA & LCDR (sel) Edward T. Moldenhauer, MSC, USN

Dietary SourcesWhole and enriched grains, dried beans, peas, sunflower seeds, porkMilk, mushrooms, spinach, enriched grains, liverBran, enriched grains, peanuts, mushrooms, tuna, salmon, chicken, beefAnimal protein foods, sunflower seeds, spinach, broccoli, bananasAnimal foods, especially organ meats, oysters, clams. Note: Not found in plants!Citrus fruits such as oranges and strawberries; broccoli, greensGreen leafy vegetables, fortified cereals, organ meats, sunflower seeds, oranges

DeciencyDry beriberi-peripheral neuropathy in legsCerebral beriberi-dementia, Wernicke-Korsakoff syndromeWet beriberi-heart failureInflammation of mouth and tongue, cracks at corners of the mouthPellagra-thickened skin, swollen tongue, bloody diarrhea, psychosisHeadache, anemia, convulsions, nausea, vomiting, flaky skin, sore tongueMacrocytic anemia, poor nerve functionScurvy-bleeding and bruising around hair follicles on the lower legs, splinter hemorrhages, bleeding gums, loose teethDiarrhea, poor growth, depression

TreatmentThe usual treatment daily dose for adults is 50 to 100 mg IV or IM x 7 -14 days. Subsequently, a dose of 10 mg per day po until the patient is fully recovered. Adjust dosage for children. Improvement should be apparent within 6- 24 hours by reduced restlessness; the disappearance of cyanosis, reduction in heart rate, respiratory rate, and cardiac size, and clearing of pulmonary congestion.RDA is 1.1 to 1.3 mgAdministration of niacin will reverse the neurologic symptoms and signs. 10-20 mg per day in the presence of adequate amounts of dietary protein is sufficient.RDA is 1.3 - 1.7 mgRDA is 2-3 mcgInfantile scurvy - 50 mg of ascorbic acid qid x 1 week then 50 mg tid x 1 month, supplemented fruits and vegetables such as orange, strawberry, Brussels sprouts, and broccoli.Adult scurvy - 250 mg qid until asymptomatic. Ascorbic acid of 300-500 mg per day in divided doses po for several months in chronic scurvy.RDA is 400 mcg

Chapter 16: Human Nutrional Deficiencies

Table 5-8