Which combination of mechanisms best accounts for multiple nutrient deficiencies in a person with chronic heavy alcohol use?

• A. Poor dietary intake while intoxicated, impaired intestinal absorption due to mucosal injury, increased urinary losses from diuretic effects, and fat malabsorption reducing uptake of fat-soluble vitamins.
• B. Primary loss of nutrients via sweat with no contribution from diet, absorption, or urinary routes, making sweat measurement the only useful diagnostic test for deficiency in these patients.
• C. Exclusive enhanced absorption of all nutrients due to alcohol-induced hyperperfusion of the gut mucosa, which explains why nutrient deficiencies are rare in chronic drinkers.
• D. Genetic mutations caused by alcohol in adulthood that transform vitamins into inactive forms in the bloodstream independent of intake or absorption, thereby explaining deficiencies without any GI or renal contribution.

Answer: (A)