A 40 year old, formerly obese woman presents to her physician. She was very proud of having lost 36Kg. during the previous 2 years, but now noticed that her "hair is falling out." On questioning, she repos having followed a strict fat-free diet. Her alopecia is probably related to a deficiency of which of the following vitamins?
While it is hard to develop a deficiency in oil-soluble vitamins (A, D, E, K) because the liver stores these substances, deficiency states can be seen in chronic malnutrition (specifically chronic fat deprivation) and chronic malabsorption. Vitamin A is necessary for formation of retinal pigments (deficiency can cause night blindness) and for appropriate differentiation of epithelial tissues (including hair follicles, mucous membranes, skin, bone, and adrenal coex). Vitamin C, which is water soluble rather than oil soluble, is necessary for collagen synthesis. Vitamin D is impoant in calcium absorption and metabolism. Vitamin E is a lipid antioxidant that is impoant in the stabilization of cell membranes. Ref: Bender D.A. (2011). Chapter 44. Micronutrients: Vitamins & Minerals. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds),Harper's Illustrated Biochemistry, 29e.
Vitamin A
Vitamin C
Vitamin D
Vitamin E