What problems occur with malnutrition?
As your reserves of fat and muscle decline, you may experience general weakness, fatigue, difficulty working or doing simple jobs about the house. You may notice the cold more as your insulating layers of fat disappear. Sleep patterns may be disturbed.
Cuts or wounds and fractured bones may not heal properly or as quickly. You may be at increased risk of infections such as pneumonia.
In children or adolescents, growth or puberty may be affected. Milestones may be delayed.
Women of menstruating age may experience menstrual disturbances or cessation of periods altogether. Infertility often occurs as a protective mechanism when women become malnourished. This can be reversed with good nutrition.
Older people often become dependent on others for basic care such as getting up out of a chair, going to the toilet or getting up stairs but these problems are far more common when old people have become undernourished. Falls and fractured hips and wrists are more common as muscles no longer support weight and bones become more brittle (osteoporosis). Bed sores may also develop due to immobility and undernutrition, particularly if confined to bed or a chair.
If you have undergone surgery or have been the subject of trauma, your recovery is likely to be prolonged unless measures are taken to remedy your lack of adequate nutrition before and after the event. Surgical wounds and “join ups” of the bowel inside you may not heal at all unless nutritional support has been given before the operation.
Symptoms of specific deficiencies may also become apparent (see table).
Your response to certain drugs/medications may be affected for example Warfarin which may become more powerful causing poor anticoagulant control and bleeding. You may also notice that alcohol has a more potent affect on you than before.
Liver dysfunction may occur and enlargement of the liver due to fat within it is sometimes found.
Swelling of the ankles (oedema) is common in malnutrition. Abdominal swelling is found in severe cases of malnutrition due to accumulation of fluid within the abdominal cavity (ascites).
Lack of adequate nutrition can also lead to deficiencies of specific nutrients such as vitamins or other essential substances. Sometimes, the first evidence of malnutrition is a specific deficiency disorder such as one of those shown in Table 1.
Deficiency |
Disease name |
Appearances /symptoms |
Vitamin A |
Xerophthalmia |
Night blindness |
Vitamin B1 (thiamine) |
Beri-beri
Wernicke-Korsakov syndrome |
Shortness of breath due to heart failure; numbness and tingling of hands and feet. Impaired consciousness and brain function |
Vitamin B2 (riboflavin) |
|
Cracked lips/ sore tongue |
Vitamin B3 (niacin) |
Pellagra |
Rash on sun exposed skin; diarrhoea |
Vitamin B6 (pyridoxine) |
|
Depression; Premenstrual tension |
Vitamin B12(cyanocobalamin) |
Pernicious anaemia/ sub-acute combined degeneration of the cord/Peripheral neuropathy |
Numbness and tingling of hands and feet; fatigue and shortness of breath due to anaemia; visual disturbances. |
Vitamin C |
Scurvy |
Bleeding gums, swollen painful joints; bleeding; mental disturbances; impaired wound healing |
Vitamin D |
Rickets/osteomalacia |
Painful bones, fractures, impaired growth |
Vitamin E |
|
Anaemia in infants; heart and muscle disorders; numbness and tingling in hands and feet |
Vitamin K |
Hypoprothrombinaemia |
Bruising/easy bleeding |
Folic acid |
Anaemia |
Tiredness, shortness of breath |
Essential fatty acids |
|
Skin rash |
Calcium |
Hypocalcaemic tetany |
Painful muscle spasms; impaired consciousness |
Magnesium |
Hypomagnesaemic tetany |
Painful muscle spasms; impaired consciousness |
Potassium |
Hypokalaemia |
Muscle weakness; palpitations; bowel dysfunction |
Sodium |
Hyponatraemia |
Muscle cramps; dizziness; collapse; confusion |
Zinc |
|
Thrush like rashes, peeling skin rashes, diarrhoea, impaired immunity |
Iron |
|
Anaemia, fatigue, sore tongue, blue sclera, difficulty swallowing (rare). Dry skin and poor hair quality. |
Selenium |
|
Heart failure; muscle weakness |
Copper |
|
Anaemia |
Various deficiencies associated with malnutrition