Vitamin B and C.pptx

1. Water Soluble Vitamins BY ABDULLAH BIN MOHD SUBRI

2. Cobalamine Vitamin B12 Pyridoxine Vitamine B6 Riboflavin Vitamin B2 Vitamin C Niacin Vitamin B3 Thiamine Vitamin B1 Water Soluble Vitamins

3. Thiamine (Vitamin B1) • RDA is 0.4mg/1000 kcal • Biologic action • Thiamine pyrophosphate is a cofactor for oxidative decarboxylation of pyruvate to form acetyl-CoA • Major source for 5 carbon compounds for nucleic acid synthesis and NADPH for fatty acid synthesis • Dietary sources • Unrefined or fortified cereal grains • Organ meats • Legumes Thiamine content in human milk is (16μg/ml) while in cow milk is (40-50μg/ml)

4. • Deficiency • Prolonged periods of low thiamine intake below 1mg/day. • Beriberi mainly presenting with cardiomegaly, cyanosis, dyspnea and aphonia. • Diagnosis • Suspect Thiamine deficiency in all cases of malnutrition • Reading of 24hr urinary thiamine excretion of less than 15μg/day. • Increase in transketolase activity of more than 15% after addition of thiamine in vitro • Treatment • Mild beriberi : thiamine 5mg/day • Severe cases : thiamine 10mg IV twice daily

5. Riboflavin (Vitamin B2) • RDA is 0.4mg/1000 kcal for infants and 0.8-1.2 mg/ 1000 kcal for children. • Biologic action • Involved in oxidation- reduction reactions that affects fatty acid synthesis • Part of two coenzymes • Flavin adenine dinucleotide • Flavin mononucleotide • Dietary Sourced • Meat • Poultry • Fish • Dairy products • Plants Human milk contains 40-70μg/ 100 kcal and cow milk contains 250 μg/ 100 kcal

6. • Deficiency • Due to inadequate intake or malabsorption causing ariboflavinosis • Features • Photophobia • Glossitis • Angular stomatitis • Seborrheic dermatitis • Corneal vascularization • cataracts • Diagnosis • Loss of the vitamin by urinary excretion of less than 10% intake over 24 hours • Increase of 20% glutathione reductase in RBC • Treatment • Children • 1mg riboflavin 3x daily • Infants • 0.5mg riboflavin 2x daily

7. Niacin (Vitamin B3) • Requirements (expressed in niacin equivalents, NE): • 1 NE= 1mg niacin or 60 mg of tryptophan • RDA: 6.4-8 NE/ 1000Cal • Dietary sources • Milk • Cereals • Leafy vegetables • Fish • Coffee • Tea Human milk has 30mg/ 100 kcal niacin while cow milk has 0.12mg/ 100 kcal • Deficiency • Pellagra • Dermatitis • Diarrhea • Dementia • Apathy • Headache • Memory loss • Diagnosis • Urinary excretion of N1- methylnicotinamide below 3mg in 24 hours indicate deficiency. • Treatment • Daily oral dosage is 10x the RDA • Parenteral therapy if GI absorption is inadequate.

8. Pyridoxine (Vitamin B6) • Sources • Colonic bacteria • Yeast • Sunflower seeds • Soya beans • Walnuts • Biologic action • Food assimilation • Essential fatty acid metabolism • Decrease homocysteine formation to protect CVS • Helps in absorption of Vitamin B12 • Production of monoamine neurotransmitter. • Deficiency • Anemia • Neuropathy • Seizures • Mouth sores • Treatment • 10-50 mg/day to patients on INH to prevent neurologic effects

9. Cobalamin (Vitamin B12) • Requirement • 0.3 μg/day for infants • 0.5-1.5 μg/day for older children • 2.0 μg/day for adolescents • Dietary sources • Liver, kidney, heart and muscle meat • Clams • Oysters • Biologic action • Coenzyme 5-deoxyadenosyl cobalamin helps in formation of succinyl CoA , a step in the Kreb Cycle • Deficiency • Methylmalonic aciduria • Megaloblastic anemia • Neutrophil hypersegmentation • Thrombocytopenia • Progressive demyelination • Diagnosis • Megaloblastic anemia • Treatment • Parenteral administration of 1mg Cobalamin

10. Vitamin C • Requirement • 30-40 mg/day for infants • 40-70 mg/day for children • Biologic actions • Strong reducing agent in biological systems • Normal functioning of leukocytes, fibroblast, osteoblast and microsomes • Metabolism of carnitine, serotonin and folate. • Dietary sources • Vegetables such as cauliflower and broccoli • Citrus fruits • Canned and frozen food Vitamin C is about 5-15 mg/100 kcal in human milk and 0.2-2.0 mg/ 100 kcal in cows milk

11. • Deficiency • Scurvy • Anorexia • Diarrhea • Pallor • Increased susceptibility to infection • Bleeding gums • Diagnosis • Physical finding and history of inadequate intake of Vitamin C • Ground glass appearance of long bones on X-ray • White line of Frenkel • Treatment • 100-200 mg of Vitamin C orally • 100ml or orange juice with pulp

12. VITAMIN NAME DIETARY SOURCES DEFICIENCY VITAMIN B1 THIAMINE ORGAN MEAT LEGUMES BERIBERI VITAMIN B2 RIBOFLAVIN MEAT FISH DAIRY PRODUCTS ARIBOFLAVINOSIS VITAMIN B3 NIACIN LEAFY VEGETABLES FIS PELLAGRA VITAMIN B6 PYRIDOXINE SOYA BEAN WALNUT ANEMIA NEUROPATHY VITAMIN B12 COBALAMIN ORGAN MEAT CLAMS OYSTERS MEGALOBLASTIC ANEMIA VITAMIN C ASCORBIC ACID CITRUS FRUITS SCURVY

13. References… • Ghai Essential Pediatrics, 9th edition, vinod k paul,arvind bagga, CBS Publisher and Distributors Pvt Ltd,

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