Table 2.

Deficiency or surplus of vitamins, major minerals, and trace elements in ALD.

Nutrients	ALD	Signs/Symptoms in Deficiency/Excess	Supplementation	Reference(s)
Vitamin A/Retinol	↓	Night blindness	It may be considered in case of deficiency	[90]
		Immune system disorders		[90,91]
		Severe liver damage		[91]
Vitamin D	↓	Bone diseases (including rickets in children and osteomalacia in adults)	Can be considered	[92]
		Risk of respiratory illness		[93]
		Altered gut barrier/immune function		[94,95,96]
Vitamin E	→-↓	Related to oxidative stress	Can be considered	[97]
Vitamin B1/Thiamine	↓	Wernicke–Korsakoff syndrome	Can be considered	[98]
		Neurologic symptoms		[98]
		Cardiovascular abnormalities		[98]
Folate	↓	Anemia	Can be considered	[99]
		Altered methylation		[100]
		Increased risk of hepatocellular carcinoma		[101,102]
Zinc	↓	Immune abnormalities	It may be considered in case of deficiency	[103]
		Insulin resistance		[104]
		Hepatic encephalopathy		[105,106]
Magnesium	↓	Insulin resistance	Can be considered	[107]
		Hypocalcemia or hypokalemia		[108]
		Muscle cramps		[109]
Iron	↓-↑	Increased risk of hepatocellular carcinoma (surplus)	It may be considered in case of deficiency	[110,111]
		Liver fibrosis (surplus)		[112]
		Insulin resistance (surplus)		[113]
Manganese	↑	Hepatic encephalopathy	No evidence	[114,115]
Copper	↓-↑	Central nervous system dysfunction (deficiency)	No evidence	[68]
Selenium	↓	Ballooning of hepatocytes	Can be considered	[116]

↓ means deficiency, → means normal range, and ↑ means surplus.