Treating Deficiencies

By: Maged Taman

One of the most rewarding treatments in medicine is finding a deficit or deficiency and replace it. In most patients well being and energy are better when these deficiencies are replaced. The cause as well need to be found and treated. Here are some of the deficits in clinical practice:

Blood loss: tested by low hemoglobin and replaced with blood if severe or iron if less severe.

Volume depletion: tested by low blood pressure and presence of cause of fluid loss like diarrhea and corrected with enteral or parenteral replacement.

Low sodium: in cases of depletion of sodium treatment is salt tablets. More commonly water excess is the cause and fluid restriction or laxis diuretic is needed to get rid of the excess water.

Low potassium: loss is commonly from diarrhea or vomiting or renal second to diuretics. Treatment is to give potassium orally or in severe cases intravenous.

Low Magnesium: commonly second to same causes of low potassium and may be associated. treatment is oral replacement with magnesium salts in severes cases intravenously.

Low iron: even without anemia iron replacement can make patient feel more energetic and healthy but need to monitor iron in the blood every few month.

Low B12: it is common as we age and treatment oral or intramuscular correct the deficit.

Low folate: more so in malnutried and in alcoholic and need to be replaced orally less so parenteral.

Thyroid deficiency: the screening is by TSH hormone which is high in these cases. Giving thyroid hormone orally to bring TSH to normal value improve the wide range of symptoms patient has.

low Cortisol: either due to primary failure to produce the hormone or second to long use of cortisone by patients for other medical problems cause variety of symptoms. Significant fatigue in this case dramatically improves with cortisone therapy.

Low 25 vitamin D: replacement improves energy and back/bone pains.

Low calcium: beside replacement treat cause.

Low bicarbonate: commonly second to renal failure or failure of the kidney to acidify urine is corrected by given oral bicarbonate and intravenous in severe cases.

Low Male or female hormones: improve sexual aspects and possibly fertility.

Low Growth hormones: height (if epiphysis is still open) and energy improve with replacement.

Low oxygen: a common cause is sleep apnea which cause low O2 particularly at night and fatigue/sleepiness in the day time. CPAP machine used for breathing at night improve much this condition.

Low Albumin: which if no sickness denotes low protein intake particularly in elderly and improve with protein supplements like ensure.

Low immunoglobulins: in people with reccurent infections will cause better life for them.