Cockatiel Advice and First Aid 101

Parrot Health

All about your parrot's health and wellbeing



If you notice any of these symptoms see your vet immediately.

  • Aspergillosis (Respiratory tract disease) – Lack of appetite, breathing difficulties, weakness, depression and lack of coordination.
  • Psittacine beak and feather disease (PBFD)- Feather loss, beak abnormalities, growths and unusual feather growth and development.
  • Proventricular Dilatation disease (PDD) – Weight loss, vomiting, swollen crop, changes in poop.
  • Candida (Overgrowths of yeasts in birds digestive system) – White lesions around and in mouth and throat, loss of appetite and vomiting.
  • Psittacosis – Lethargic, eye infections, difficulty breathing, diarrhoea.
  • Polyomavirus (unusual development or lack of feathers) – Loss of appetite, enlarged abdomen and diarrhoea.




  • Open-mouthed breathing
  • Change in voice
  • Sneezing
  • Sinus swelling –Rhinorrhea ( Rhinorrhea means runny nose)
  • Nasal granulomas
  • Exercise intolerance
  • Shortness of breath
  • Head-shaking
  • Nasal discharge
  • Inflamed or swollen Cere
  • Stretching the neck
  • Excess yawning
  • Epiphora ( eyes watery )
  • Swelling around the eye
  • Plugged nares


  • Tail-bobbing
  • Loss of voice
  • Change in vocalization
  • Laboured breathing
  • Exercise intolerance
  • Coughing Sounds


Bumblefoot is a very cute name given to very serious condition if left untreated. Bumblefoot can be caused by various reasons such as; unsuitable perches (perches that are cylinder and do not vary in diameters, sandpaper perches) filthy perches, poor diet, poor sanitation, sandpaper cage liners, lack of exercise, obesity and various underling conditions.

Placing unsuitable perches in a parrot’s cage is going to cause pressure point sores to develop, which can lead to infection. It is extremely important that natural wooden perches which are of different diameters are used in cages. Cages should be kept spotless, not only for good foot health, but to prevent bacterial and fungal infections.

The bottom of a bird’s feet should be checked regularly as part of your daily health examination of your bird. If you notice that the bottom of the bird’s feet becoming red and swollen, or if you notice calluses appearing, a vet check will be needed as soon as possible.  

This type of infection can be avoided by giving a balanced diet and sufficient exercise, keeping cages clean, and by providing correct perches. (Regular wellness checks with an avian vet are always recommended for the health of a bird)


It is a misconception that fruit and vegetables can cause birds diarrhoea. Fruit and vegetables can sometimes cause “excess urine” due to the increased water content. Excess urine is called "Polyuria" and is different from diarrhoea.

Poop is made up of three components:

· Faecal matter (the green to brown solid spiral)

· Urine (the clear liquid)

· Urates ( the white to cream colour portion)

NOTE: If your parrot’s faecal matter looks like splattered pea soup with no form; your bird has diarrhoea and needs to be seen by an avian vet as soon as possible!


This article will be very helpful for the novice bird keeper; however, we all need reminding from time to time of the importance of daily health checks. When you are new to bird keeping it is important to become familiar with what is normal, its only through understanding what is normal, that you can better understand what is abnormal. Therefore, by doing a “hands off examination” daily, any change in health or behaviour will be spotted quickly, and the bird can receive treatment before the problem escalates.

Is there anything out of the ordinary? Is your bird’s behaviour normal today, did they greet you in the same way?
Is your bird eating and drinking normally?
Is your bird vocal? Is the bird talking and signing in the same way as normal?
Is your bird active?
Does your bird look bright and alert?
Are your bird’s eyes wide, bright, and alert?
Are your bird’s eyes free from ocular discharge?
Are your bird’s nares clean and clear of nasal discharge? (nostrils).
Is your bird’s vent clean? (bottom)
Are your bird’s feathers in good condition?
Any signs of feather plucking? (Excess feathers at the bottom of the cage)
Any signs of a normal moult?
Any obvious signs of injury?
If the bird sitting upright on the perch in a normal position?

Has food been eaten?
Check seed bowls, empty seed husks can make a seed dish appear full. Many birds have died from starvation due to owners mistaking empty husks as food.
Has water been consumed?
Are there any dangers in the cage such as a broken toy, jagged piece of wood sticking out, or missing toy parts?
Looking at the cage floor, are droppings normal?
A healthy active bird will have droppings scattered across the cage floor. A sick or inactive bird will have droppings in one area, usually under the perch they are sitting on.  
Is there any sign of blood in the cage?
This may seem like a very long list to get through every day, however, once you have made these observations into a routine, and you have become familiar with what is normal for your bird, you will be checking for these things subconsciously.



While home remedies may help in certain non-emergency situations, and can add value to your bird’s health, unless you know exactly what illnesses your bird has, you could be making the situation much worse. Some herbal remedies interfere with blood tests, and other tests, and can actually worsen your parrot’s condition. Grapefruit for example, can interfere with the absorption of antibiotics. So, please don’t waste time, and get your bird the correct medical help it needs.




Dehydration kills quickly. In many cases the cause of death is dehydration, not the illness itself. 


  • Sunken and dull eyes
  • Wrinkles around eyes
  • Mucous membranes in mouth dry or sticky
  • Rescued skin elasticity
  • Lethargy
  • Weakness
  • Not well formed droppings/ dry droppings or no droppings

(Electrolyte recipe for birds)

1 Cup water
2 Teaspoons Sugar
1/8 Teaspoon salt
1/8 Teaspoon Baking Soda



Do you give your birds apple cider vinegar (ACV)? Why do you give your birds ACV? Are your giving it to them because they have a certain problem that you are trying to correct, or is it because you have just heard that it is a good thing to give? Are you using it as a preventative? Many of us jump on the bandwagon without knowing all the pros and cons of a particular medicinal treatment. ACV holds many vitamins and minerals and is used to treat and prevent many medical conditions, however, do you know that giving too much can cause multiple side effects. Below, I will list a few of the side effects it can cause when overdosed and diluted incorrectly.
· Parrots with sensitive digestive systems may find it hard to consume it.
· It can destroy the stomachs good beneficial bacteria.
· It can absorb calcium, leaving the bird deficient.
· It can cause diarrhoea.
· Weight loss.
· Undiluted ACV will burn the mouth, tongue, and digestive tract.  
· If it is not diluted accurately the acidity can cause bloody stools, diarrhoea, lethargy, loss of appetite, rapid weight loss, stomach ulcers, vomiting blood, etc. Often, acidity can cause irreversible damage.
There is a lot of information out there with dosage suggestions, however, because AVC is acidic, and parrots all have different medical needs it is safer to get an accurate dosage from your own avian vet. Do not give your birds ACV daily unless it has been recommended by a vet. 2-3 times a month is plenty for an adult bird when used for health maintenance.


If your bird exhibits these clinical signs, please be sure to make an appointment with your avian veterinarian as soon as possible!


  • Prolonged moult or continual presence of pinfeathers
  • Broken, bent and chewed feathers
  • Abnormality of feathers
  • Stained feathers around the nares, face or vent
  • Redness, swelling, or a loss of feathers around the eyes
  • Flaking skin or beak
  • Baldness
  • Sores on bottom of feet
  • Lameness
  • Shifting of body weight from one leg to the other
  • Overgrown beak or nails
  • Minor changes in vocalisation
  • On set of Biting, which is not caused by a behavioural issue
  • Change in eating and drinking habits
  • Low reproduction in breeding birds
  • Excess regurgitating
  • Passing whole seeds or food in the droppings
  • Lack of powder or dust on the feathers (Cockatoos and African Greys)
  • Foot mutilation
  • Weight loss
  • Increased appetite
  • Increased water consumption
  • Bare patches
  • Lesions on the skin
  • Yellow urates in the droppings
  • Bulky droppings
  • Any change or abnormality, in colour, volume, consistency, and number of droppings
  • Blood in the droppings/ EMERGENCY VISIT TO VET!


When a bird is infested with feather mites there are symptoms you can look out for such as:  

  • Eye inflammation
  • Missing feathers around the eyes
  • Red nostrils
  • Enlarged damaged nostrils
  • Parrot itching
  • Missing feathers or very thin feathering on the face.

Eye inflammation and red nostrils are also signs of infection; if you notice these symptoms or suspect your bird does have feather mites, please consult your avian veterinarian ASAP.

Never buy over-the-counter mite sprays, these should only be prescribed by a vet. Many birds have had life threatening reactions to these types of mite sprays.

Additionally, over-the-counter sprays and medicine don’t work well or quickly; they can mask other underlying symptoms your vet may miss which can lead to misdiagnosis.


If you find a stray parrot or if you are reunited with your own parrot the very first thing you need to do is have a vet appointment, this step should never be missed.

The reasons why a vet appointment is vitally important is listed below:

A captive bird will of course have no idea what it can and cannot eat out in the wild; therefore, the bird may have sampled toxic foods.

The bird has likely been drinking out of contaminated water sources.

The bird has been exposed to the elements and may be suffering from hypothermia or heatstroke.

The bird has been in contact with wild birds which may be carriers of many avian illnesses and parasites.

If the bird has been missing for a period of time it may be suffering from starvation and dehydration.

The bird of course maybe injured or sick; birds hide pain and illness very well. Therefore, a vet would have to do a full physical examination to ensure the bird is healthy. 

The entire outdoor experience for a captive bird would have been severely stressful and the bird is probably in a state of extreme stress and shock when found. This type of stress and cause any underlying illness to manifest themselves. 



Four golden rules to remember when a bird is sick: WARMTH, HYDRATION, FOOD and LIMITED HANDLING!
Warmth - a bird is unable to regulate its body temperature when sick. Therefore, they can die from hypothermia. All their energy needs to be going towards recovery, not trying to keep warm.
Hydration- a bird dies quickly when dehydrated.
Food- a bird’s metabolism is like raging furnace, without fuel it burns out. A bird needs to eat in order for its body to function properly.
Limited handling- when a bird is sick it does NOT want kisses, cuddles or scritches! The reason why the bird is not showing their owners signs to leave them alone is because it's too weak to react. The bird wants to be left alone to recover. They need to remain in their cage to receive the warmth and sleep they desperately need. Do you know a sick or injured bird can go into shock extremely quickly, meaning any sudden movements or mishandling and they can die. A sick or injured bird should ONLY be handled when 100% necessary. Additionally, when you have a sick bird, you have to be able to monitor them closely, this includes watching their droppings for changes, are they vomiting or regurgitating, are they steady on the perch, are the eating and drinking, how often are the eating and drinking etc ?! You can not monitor them this closely outside their cage while perched on your head or sitting on your shoulder. For their own safety its important they stay in the cage because if they weak their flying ability may not be good so they can fall and injure themselves. Some people will take their sick bird out the cage because they are screaming to come out. Well, a bird will always want out the cage if they are used to free flying, however, it’s in their best interest to keep them in their cage to monitor them and for their own safety; the quicker they recover, the faster they can go back to normal activities. 


Heavy metal poisoning is sadly common in captive birds and of course can be fatal if not treated quickly. However, it is avoidable; all that is required is for owners to be mindful of the toys and cages they buy for their birds, furthermore, to ensure their birds are supervised when outside the cage. The most common heavy metals ingested are lead and zinc. The cages bought must be coated with non-toxic paint; many manufactures will quote on their product description if they use non-toxic materials. Do not buy toys which contain metals which are not 100% stainless steel. Birds should not be allowed to chew on furniture, picture frames, walls, jewellery, pennies, paints, batteries, gun pellets, galvanised wire, ceramics, stained glass, etc, which contain zinc or lead. Furniture will often be coated with toxic varnishing’s.
As mentioned above heavy metal poisoning can be fatal if not caught in the early stages; therefore, owners should be aware of the symptoms of heavy metal poisoning which can manifest very slowly over weeks or months or they can show very quickly. Ill list a few symptoms of heavy metal poisoning below.

If you notice any of these symptoms, please see your vet immediately: 
Weakness and lethargy
Difficulty breathing (tail bopping)
Non-hormonal regurgitation
Blood in droppings
Crop stasis
Weight loss
Polyuria/ polydipsia
Feather plucking  



What is it, and what does it mean in practice?

·WHAT-The dictionary definition of quarantine is “a state, period, or place of isolation in which people or animals that have arrived from elsewhere … are placed.” So, it is placing your new parrot in isolation, away from your other parrot/s.

·IN PRACTICE- This means your new parrot/s needs to be in a separate cage, in a separate room, in a completely different part of the house from your current flock. Before attending to the new birds, you need to wash your hands. Always attend to the current flock first, and then the new birds. Be infection/contagion aware. This is regardless of their having been given a clean bill of health by your vet in the first week you have them. The recommended quarantine period is SIX WEEKS, as this gives time for any illnesses to become apparent. Should your new birds show any signs of illness in this time, another vet visit is required, and the quarantine period will need to continue for another six weeks, once the illness has been treated.

· WHY -This protects your current flock from any illness the new birds are carriers of, but also works in reverse. Your current flock will have built resistance to certain illnesses which the new birds could become ill with, particularly if they are fighting another immune suppressing illness. Whilst it can be very inconvenient to quarantine new flock members, particularly once they hear each other in the house, it can save a great deal of stress and heartache in the longer term, as well as veterinary costs.




It is imperative that as parrot owners we practise personal hygiene around our birds. I have heard many times before people say, "I don't wash my hands before handling my birds and they never get sick". Well, these people have been very lucky, as all it takes is for their birds immune system to be slightly compromised and the levels of bacteria which their bodies would usually be able to fight off now can not and the bird becomes sick. For the health of your birds, it's imperative to wash and disinfect your hands before handling them, especially, if you have been handling other pets in the home too. 

Allowing a bird to groom a beard, your hair, pick your teeth or pick under your finger nails are all areas of the body which are teaming with bacteria and can make your birds very sick. When your birds are on you and start picking at your body, give them something else to occupy themselves with such as a toy, a treat or teach them a new word or a new trick. It is one of those situations where we think it will never happen to me, and then you find yourself at the vet with a sick bird and swamped in vet bills. At this current time with the pandemic, you can't walk into a shop without being met with 1000 bottles of hand sanitiser in front of you , grab a bottle and use it each time before handling your birds. 



A first sign of illness is a birds change in behaviour. One behavioural change you may notice is a lack of vocalisation. Sick birds often remain quiet, if you notice the bird has been quiet in over 24 hours, please see your vet ASAP. Another bad sign is change of voice, this is a symptom in many illnesses, if this occurs, see your vet.

AUTHORS NOTE: When you bring home a new bird, it is normal for them not to be vocal for a few days; the stress of moving into new surroundings can cause this, until they feel more secure and settled. Please remember, all new birds need a vet check within the first week you bring them home.


Don't ever use: ointments, Vaseline (petroleum jelly), salves, or any oily creams on your bird without the recommendation of your vet. Using these products will cause the birds feathers to become matted, and prevent the parrot from insulating itself, resulting in hypothermia.



A draft is moving air that can cause parts of the room or cage to be much cooler than other parts; as parrots can’t withstand sudden drops of temperature, it can cause them to become very sick!

The best way to check if your parrots cage is in a draft is by holding a lit match in the area, if the flame flickers then you know that there is a draft. It’s then advisable to relocate the cage to a draft free area.

Please NEVER put your parrot near an open door or open window, or anywhere there can be a draft!



Excess amount of urine in a birds dropping is called polyuria. Polyuria can be caused by; stress, the bird  has taken a bath and drunk too much water while bathing, or it can be caused by a bird eating an excess of fruit and veggies. Chronic polyuria on the other hand, can be a symptom of diabetes, kidney disease, or an infection, (bacterial, viral, fungal or parasitic)

If your bird has had polyuria for more than 24-48 hours this is considered chronic, and you should make an appointment with your vet straight away. It is very important to monitor your bird’s droppings daily for first signs of illness.




It is extremely important to check your parrot’s droppings daily for first signs of illness! Parrots droppings can tell a lot about your bird’s health; any change in colour, or consistency should be brought to your vet’s attention immediately.


Urates should always be white –

  • yellow or green urates may indicate liver disease.
  • Bright lime green or yellow urates may indicate Chlamydiosis (Psittacosis)
  • Brown urates may indicate lead poisoning.
  • Red urates may indicate Internal bleeding (low in the digestive track) or Kidney Disease.

Urine should always be clear

  • Yellow urine may indicate a bacterial infection or yeast infection, kidney disease or liver disease.
  • Red urine may indicate Internal bleeding (low in the digestive track) or Lead Poisoning.

Faecal matter can be green for seed eating birds or brown for birds eating pellets -

  • Black or fresh red blood may indicate bleeding from the digestive tract, intestinal infections, tumours, swallowing of a foreign object, egg binding or parasites.
  • Black or Tar-like droppings may indicate internal bleeding (high in the digestive track)
  • Dark droppings can be mossy green (spread on paper and if dark mossy green may indicate excessive amounts of bile produced by the liver).
  • Pea Green droppings may indicate liver Damage.
  • Reddish brown droppings may indicate heavy metal poisoning.
  • White or Clay colour dropping may indicate pancreas or digestive problems.

Bubbles in parrot droppings, may indicate gas, or an infection.

Undigested seeds in droppings, may indicate symptoms of PDD (Proventricular Dilatation Disease) parasites, poor digestion, intestinal infection, or pancreatic disease.

A decrease in droppings, may indicate that the bird is not eating, or they may have swallowed a foreign object.

An increase in droppings, or bulkiness of droppings, may indicate poor digestion, or egg laying.

Decreased urine, may indicate that the bird is dehydrated.


There is a difference between vomiting and regurgitation, often owners confuse the two. Learn more about their differences in the health section on this website, Read “Vomiting or regurgitation”
As an example a bird may vomit due to: Bacterial infections, viruses, poisoning … etc.
There are many more reasons why a bird may vomit, and these are all listed in my book “How the flock do I care for a parrot”?

NOTE: Vomiting is a medical emergency, so ensure you see a vet immediately. 


Parrots can fluff up their feathers for a few reasons: when they are cold, when they are relaxing /sleeping or when they are sick and trying to keep warm. If your bird is constantly fluffed up, check your room temperature to see if it is not too cold for your bird. If it is not cold, then it means your bird is sick and needs to see a vet. This is one of the first signs of illness that owners notice. 



Birds do not get colds like us humans, they get respiratory infections, which get worse if not treated straight away. 

Here are some symptoms of respiratory infections:

  • Noises whilst breathing.
  • Cough like sounds.
  • Wheezing.
  • Open beak breathing.
  • Repetitive sneezing.
  • Choking fits and even holding onto bars in stationary position to try to open up airway.

Visible symptoms can include:

  • Changes to the Cere.
  • Raised rings around the nostrils, or nares.
  • Colour changes, texture changes, swelling could be signs of an infection starting. Nares should have a similar coloured flap inside, but not be plugged, running, full of puss, or yellowy gunk.

NOTE: Ignoring these symptoms could result in the infection spreading down into the air sacs, and the nares become permanently enlarged. The Cere can be completely destroyed, leaving the bird with permanent breathing problems and in pain.


A sick bird should be kept in a room temperature that's 80 to 90°F (27 to 32°C).The room should be kept quiet with low lighting until it is taken to your avian veterinarian.



  • The bird has bright alert eyes.
    Has no trouble perching.
    Moves with coordination.
    Bears weight evenly. All four toes are present on each foot and in the proper position.
    Breathes easily, with no sign of labouring or tail-bobbing.
    The eyes, ears and nostrils are free of discharge.
    Has a healthy plumage; there is no evidence of damage from feather-picking or other trauma. There is no bald patches. 
  • Consistently produces droppings that are normal in appearance. No pasting of the vent.
  • The beak is in good condition without signs of damage or discolouration.
  • The skin is a healthy colour and free from dryness and irritation.



It is extremely harmful to smoke around birds; it can cause pneumonia , conjunctivitis , secondary infections, not to mention all the other toxic chemicals being ingested by your bird, and it can cause death.

Vaping on the other hand, people may ASSUME its ok because its vapour not smoke ... thinks again! Vaping actually has a far more concentrated mixture of nicotine than cigarettes! Vaping is just as dangerous as smoking is around birds, and can actually cause death in birds.

AUTHORS NOTE: One would not smoke around a toddler for known reasons; a birds respiratory system is actually more sensitive than a child’s, so one can do the math as to why it’s so extremely dangerous for these creatures!


If your bird starts walking around and around in circles OR starts star gazing (which if where they tilt head backwards and stare upwards) these are medical emergencies. Walking in circles can be caused by a number of nasty illnesses and neurological issues. One common reason is toxicity or a severe reaction to a toxin!

NOTE: If you notice your birds doing this see your vet IMMEDIATELY!


  • Bird sitting on the bottom of the cage floor
  • Rocking back and forth
  • Sitting on her tail feathers with her legs spread apart
  • Tail wagging or bobbing
  • Abdominal distention
  • Straining as if trying to lay an egg
  • Laboured breathing
  • Lack of droppings
  • Ruffled feathers
  • Bluish white limbs
  • The hen may make crying sounds

An X-ray or ultrasound may be needed for a diagnosis of egg binding because the egg is not externally visible.


  • Redness
  • Swelling
  • Discharge  
  • Lethargy
  • Lack of appetite

Please seek vet attention ASAP is you think your parrot is showing any signs of infection. If left too long, your parrot can develop 'systematic infection' meaning; an infection that affects the whole body if it goes into the bloodstream.



Inside the nares of most parrots is the operculum, this is small and brownish in colour. Many inexperienced owners mistake this as an obstruction, dirt, or foreign body, such as a seed and try to get it out. Doing so can cause serious injury, and can cause heavy bleeding. If you see any obstruction in there, or notice nasal discharge, see your vet ASAP. Please don’t attempt to remove anything yourself, or you could end up seriously hurting your bird!


The breathing process of birds is very different to that of mammals. Their lungs are relatively half the size of mammals, and whilst their respiratory systems are slower than mammals, their breathing is much more efficient. We will try to explain as clearly as possible.

Birds’ lungs do not expand and contract during breathing, and they do not have a diaphragm. Instead, the chest muscles force the sternum out and a vacuum effect occurs in the air sacs, pulling air into the lungs. More muscles are then used to put greater pressure on the air sacs to force the air out of the lungs. However, this happens in 2 stages, or 2 breaths in and out.

With only two lungs this would be impossible – to be breathing air out whilst breathing in – but the exhaled breath is pulled into a set of air sacs, so the new breath can be pulled in via different air sacs.

It means the bird can manage altitudes, with higher oxygen levels and constantly inflated lungs. By doing this, the lungs are never deflated, and each breath remains longer in the body.

Depending on the species, the bird can have 7 or 9 air sacs. When fully inflated, these air sacs expand into cavities in the bones. If a bird is flighted, this happens to a much greater degree. The air sacs extend into the humorous, the skull, the femur and the vertebrae. When the bird takes flight, more of the air sacs are inflated into the bone cavities, helped by the wing muscles being engaged. The greater the inflation of the air sacs, the lighter the bird becomes to remain airborne. As the air passes over the blood capillaries on the walls of the lungs, carbon dioxide is removed, and oxygen replaces it. The area of blood capillaries doing this job in avian lungs is much greater than in mammals, making avian breathing much more efficient with higher concentrations of oxygen absorbed with each breath.

Singing is accomplished by forcing air through the vocal organs or Syrinx. The bird can do this whilst breathing in and breathing out and therefore, whilst in flight

JUST AN INTERESTING READ: In the home environment, anything toxic remains in the bird’s respiratory system much longer and in much higher concentrations than it would for mammals. Therefore, toxins that do not affect cats, dogs and humans can be fatal to birds.

The sternum MUST be able to move when a bird is held or restrained and its body not be constricted (pressurising air sacs), or it will be oxygen deprived and could suffocate.

Because the air sacs are within the bones, respiratory infections must be quickly acted upon as they can enter the bones.




Please don’t add vitamins to your parrot’s water, unless instructed to by your avian vet. The over-the- counter vitamins you can buy to add to water, lose their potency fast, and increase the growth of bacteria in the water. This can make your bird sick. Parrots will often not drink their water if they can taste anything foreign in it, often leaving the parrot very dehydrated.


Many people confuse vomiting and regurgitation, so here is the difference between the two:


When a bird vomits it will shake and flick its head quiet violently. DIGESTED food from its stomach will be flicked everywhere, often including on your birds own head and the contents will be mattered around its mouth.


When a bird regurgitates it will use a pumping movement in its neck and bring up UN-DIGESTED food from its crop. The food will then be brought up in one neat pile on either a favourite toy, person, or fed to chicks.



Cockatiels are one of the few species of parrots that will eat their own poop; one of the main reasons is because they are lacking in B vitamins, choline, and vitamin C. Other causes of eating their own poop maybe: stress, stress of being weaned, change of diet, and environmental changes.

If you find that your bird is eating its own droppings, it is recommended to have your bird examined by an avian vet. The vet will be able to do an examination of your bird, and prescribe a good vitamin supplement, if vitamin depletion is the cause of course.


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