HealthMap

Nutrient Deficiencies in Severe Anorexia

Severe anorexia nervosa leads to a state of profound starvation and malnutrition, resulting in multiple widespread nutritional deficiencies. Based on biochemical and nutritional evaluations, the most common and critical deficiencies include:

Primary Mineral Deficiencies

• Zinc: Extremely common, often leading to altered taste (dysgeusia), loss of appetite, compromised immune function, and delayed healing.
• Magnesium: Essential for neuromuscular and cardiovascular function; deficiency can cause muscle spasms, weakness, and cardiac arrhythmias.
• Calcium: Depleted due to inadequate dietary intake and hormonal imbalances, severely increasing the risk of osteopenia and osteoporosis.
• Potassium: Often dangerously low due to inadequate intake, purging, or the use of diuretics and laxatives, risking fatal heart arrhythmias.
• Iron: Leads to microcytic or normocytic anemia, causing severe fatigue, weakness, and pallor.

Primary Vitamin Deficiencies

• Vitamin D: Frequently deficient due to poor dietary intake and lack of sufficient sunlight exposure, impairing calcium absorption and bone health.
• B-Complex Vitamins (especially B1 / Thiamine, B12, and Folate): Thiamine deficiency is critical to monitor, especially during refeeding, to prevent Wernicke-Korsakoff syndrome. B12 and folate deficiencies contribute to megaloblastic anemia and neurological complications.
• Fat-Soluble Vitamins (A, E, and K): Deficiencies occur due to the extreme restriction of dietary fats, impacting vision, antioxidant protection, and blood clotting mechanisms.

Macronutrient and Functional Deficiencies

• Essential Fatty Acids: Lack of necessary fats impairs cellular membrane integrity, brain function, and hormone production.
• Protein and Amino Acids: Severe muscle wasting occurs as the body breaks down lean tissue for energy, leading to low serum albumin and edema.

Note: In severe anorexia, correcting these deficiencies requires careful, medically supervised refeeding to avoid dangerous shifts in electrolytes and fluids known as refeeding syndrome.