How to check and diagnose nutritional metabolic deficiencies? What are the common detection methods for nutritional metabolic deficiencies?

In a broad sense, nutritional metabolic deficiency should include both insufficient or deficient nutrition and excessive nutrition. Only the former will be discussed here. Malnutrition is often secondary to some medical and surgical causes, such as chronic diarrhea, short bowel syndrome and malabsorption diseases. Non-medical causes of malnutrition are poverty and food shortages. Lack of nutritional knowledge and parents' neglect of scientific feeding methods. In developed countries, malnourished patients can usually be treated by treating the primary disease, providing appropriate diets, educating parents and carefully following up. However, in many third world countries, malnutrition is the main cause of death among children. There are complex interactions between malnutrition, social habits, environment and acute and chronic infections, so treatment is very difficult and cannot be solved simply by providing appropriate food.

Clinical examination of nutritional metabolic deficiencies:

1. Vitamin B1 deficiency (thiamine deficiency) associated with mental symptoms

(1) Mental disorders:

Depressive state; governance disorder; consciousness disorder can manifest as a drowsy state and occasionally a delirious state.

(2) Neurological symptoms:

Neuritis, nystagmus, ataxia, and occasionally retinal hemorrhage.

2. Niacin deficiency is associated with mental disorders

(1) Mental disorders:

①Neurasthenia syndrome:

Often occurs in the early stages of the disease or when the condition is mild

②Depressive state:

Often accompanied by irritability, anxiety, self-blame, suicide attempts, etc., which often occur during the course of the disease

③ Tension syndrome:

There is catatonic excitement or catatonic stupor similar to the catatonic form of schizophrenia

④Disorder of consciousness:

It often occurs in patients with acute onset. In the later stages of the disease, patients may experience confusion, drowsiness, delirium, or confusion. Severe cases may lead to coma, a high mortality rate known as niacin deficiency encephalopathy, which is often accompanied by neurological symptoms and characteristics.

⑤Chronic encephalopathy syndrome:

Patients in the chronic stage may experience slow reaction, impaired memory and calculation, and clumsy and slow movements. In severe cases in the later stages, Korsakov syndrome or dementia may occasionally be seen.

⑥A few cases may present as encephalopathy:

The main clinical symptom is impaired consciousness, with severe neurological symptoms and signs.

(2) Neurological symptoms:

There are nystagmus, pupil changes (dilated pupil, slow light reflex), positive pyramidal tract signs, increased muscle tension, abnormal sensations, peripheral neuritis and epileptic seizures. If accompanied by subacute combined degeneration of the spinal cord, deep sensory movement disorders and ataxia may occur.

(3) Physical symptoms:

Glossitis, which is strawberry tongue; exfoliative dermatitis; gastrointestinal dysfunction. Diarrhea dermatitis is the most obvious, and dementia is often called the three main symptoms of niacin deficiency.

Diagnosis of nutritional deficiencies:

1. There is evidence of nutritional and metabolic deficiency diseases, such as a history of malnutrition due to niacin, vitamin B1 and folic acid deficiency.

2. There are symptoms and signs of nutritional metabolic deficiencies leading to corresponding functional abnormalities.

3. Mental symptoms change with the development of nutritional and metabolic deficiency disease symptoms, that is, mental symptoms appear after physical diseases, and their development and changes are parallel to physical diseases.

4. Related nutritional treatment (niacin, vitamin B1 and folic acid, etc.) has significant therapeutic effect.

5. It should be differentiated from other mental disorders associated with functional impairment and other functional mental illnesses such as schizophrenia, hysteria and depression.