A vitamin is an organic compound and an essential nutrient that an organism requires in limited amounts

1. Dr. Jibin Mathew, Pharm D.,
Clinical Pharmacology
VITAMINS

2.  Nutrients that our body does not make on its own. Thus we must obtain
them from the foods we eat, or via vitamin supplements.
 They are essential for providing good health and are necessary for
many life functions.
 Tasteless, organic compounds
 Required in small amounts
Functions
• Regulate metabolism
• Help convert energy in fat, carbohydrate, and protein into ATP
• Promote growth and reproduction
 Deficiencies can result in potentially serious consequences
Introduction

3.  The discovery of the vitamins was a major scientific achievement
in our understanding of health and disease.
 In 1912, Casimir Funk originally coined the term "vitamine".
 The major period of discovery began in the early nineteenth
century and ended at the mid-twentieth century.
History of Vitamins

4.  The naming of vitamins follows the letters of the alphabet,
starting with A; we are up to the letter K
A, B, C, D, E, and K
B has many subscripts
F, G, and H were dropped
NamingVitamins

5. Classification is based on solubility
1) Nine water-soluble:
B vitamin complex (B1,B2,B3,B5,B6,B7,B9,B12)
vitamin C
2) Four fat-soluble:
Vitamins A
Vitamin D
Vitamin E
Vitamin K
Classification of Vitamins

7.  Fat‐soluble are stored in the liver and fatty tissues. These are
not readily excreted from the body.
 Water‐soluble vitamins travel in the blood and are stored in
limited amounts. These are readily excreted from the body
through urine
What is the difference between fat‐soluble and
water‐soluble vitamins?

8. Fat SolubleVitamins vs. Water SolubleVitamins
Water Soluble Fat Soluble
Absorption Directly to blood Lymph via CM
Storage Circulate freely In cells with fat
Excretion In urine Stored with fat
Toxicity Less likely More Likely
Requirements Every 2-3 days Every week

9.  Recommended Dietary Allowances
 These are suggested levels of essential nutrients considered
adequate to meet nutritional needs of healthy individuals.
What does RDA mean?

10.  For the most part vitamin supplements are safe to take.
 Follow the recommended dosages on the label of the bottle.
 Fat‐soluble vitamins are more likely to be toxic to your health if
taken in excess, because they are stored in the body, where as
water‐soluble are excreted.
Can I take too many vitamins?

11.  It is advised to take your vitamins with a snack or meal to avoid
stomach irritation.
 The presence of carbohydrates and proteins stimulate digestive
enzymes that will allow for better absorption of nutrients for
the supplements. (Iron should be taken on an empty stomach)
Should I take my vitamins with food?

13.  All absorption takes place in the small intestine
 Fat-soluble vitamins
Are absorbed in the duodenum
Storage
• Vitamin A is mainly stored in the liver
• Vitamin D is mainly stored in the fat and muscle tissue
• Vitamins K and E are partially stored in the liver
• Can build up in body to point of toxicity
Vitamin Absorption and Storage

14. Water-soluble vitamins
• Absorbed with water and enter directly into the blood stream
• Most absorbed in the duodenum and jejunum
• Most are not stored in the body
• Excess intake excreted through the urine
• Important to consume adequate amounts daily
• Dietary excesses can be harmful
Vitamin Absorption and Storage

15. Digesting and AbsorbingWater-Soluble
Vitamins
Figure 10.1

16.  Water-soluble vitamins can be destroyed by
• Exposure to air
• Exposure to ultraviolet light
• Water
• Changes in pH
• Heat
• Food preparation techniques
 Fat-soluble vitamins tend to be more stable
Destruction ofVitamins

17. Vitamin toxicity, AKA hypervitaminosis
• Rare
• Results from ingesting excess vitamins and tissue saturation
• Can damage cells
Dietary Reference Intakes include tolerable upper intake limits (UL) for
most vitamins to prevent excess
Toxicity with Overconsumption

18. Beriberi

19. Pellagra

20. Scurvy

21. Rickets

22.  Vitamin D refers to a group of similar lipid-soluble molecules
(major forms are D2 and D3).
 Vitamin D is also important for immune system function.
 Deficiency causes rickets, bone loss.
Vitamin D3 (cholecalciferol) Vitamin D2 (ergocalciferol)
VITAMIN D

24.  Vitamin D production requires UV light (sunlight).
 Sometime after humans migrated north out of Africa about 50,000
years ago, mutations appeared that reduced melanin (pigment)
production in the skin, permitting vitamin D production with less
sunlight.
 Disadvantages of less melanin production are skin that is easily
damaged by the sun, skin cancer risk, and loss of folic acid due to
UV damage.
 The melanin-reducing mutations helped early humans make
vitamin D in northern Europe in winter.

25.  Vitamin E - Collectively refers to 8 related tocopherols.
 It is essential, but roles are unclear. Suggestions include
neural membrane component, antioxidant.
 Obtained in diet, deficiency is rare.

26.  Vitamin K - Refers to phylloquinonone (vitamin K-1), and
several structurally similar molecules.
 Vitamin K is required for proper blood clotting.
 It is used in synthesizing gamma carboxy glutamate, a post-
translationally modified amino acid in prothrombin.
 Sources are vegetables and fruits, deficiency is rare.

27. Bitot’s Spots Xerosis Conjunctiva
Corneal Xerosis Keratomalacia

28. Riboflavin deficiency

29. Vitamin K can be made by intestinal bacteria.
Newborns are given a dose of vitamin K at birth.
Sources of Vitamin K

30. Deficiency Symptoms

31. Thiamin Deficiency

32. Pellagra symptoms: 4 “D’s”
• Diarrhea
• Dermatitis
• Dementia
• Death
Niacin

33. Vitamin B6

34. Function: The body convert food (carbohydrates) into fuel (glucose), which the body uses to
produce energy and also help the body to metabolize fats and protein, nervous system, muscle
function, the flow of electrolytes in and out of nerve and muscle cells, digestion, and
carbohydrate metabolism
Causes: People surviving on white rice or highly refined carbohydrates in developing countries
and among alcoholics
Side effects: Tight feeling in your throat, sweating, feeling warm, mild rash or itching, feeling
restless, tenderness or a hard lump where a thiamine injection was given.
Overdose: Weakness, Headache, Rapid, Irregular Heart Beat, Low Blood Pressure,
Convulsions
Deficiency: Beriberi, polyneuropathy, high-output heart failure, and Wernicke-Korsakoff
syndrome.
Daily Recommended Dietary Allowances (RDA): Male - 1.2mg/day and Female – 1.1mg/day
Vitamin B1 (Thiamine)

35. Function: Riboflavin is necessary for growth and for the production of red blood cells.
Riboflavin also plays an important role in how our bodies get energy from
carbohydrates, fats, and proteins. As a supplement it is used to prevent and treat
riboflavin deficiency and prevent migraines
Causes: Eating disorders, chronic alcoholism, HIV, inflammatory bowel disease,
diabetes, chronic heart disease
Side effects: Itching, Numbness, Burning or prickling sensations, Sensitivity to light
Overdose: allergic reactions, swelling of the face or tongue, hives and difficulty
breathing, yellow-orange discoloration of your urine.
Deficiency: Stomatitis, Red tongue, anemia, during pregnancy riboflavin can result in
birth defects including congenital heart defects and limb deformities
Daily Recommended Dietary Allowances (RDA): Male - 1.8mg/day and Female –
2.5mg/day
Vitamin B2 (Riboflavin)

36. Function: Niacin has used to lower the lipid lowering agents.
Causes: Liver converts tryptophan (amino acid) from high-protein foods
like meats and milk into niacin. When this process breaks, niacin
deficiency occurs.
Side effects: Facial flushing, Hepatotoxicity, Hyperuricemia, Maculopathy
Overdose: blurring of vision, Rapid heartbeat, Gout
Deficiency: Pellagra, decreased tolerance to cold, apathy, amnesia,
delirium
Daily Recommended Dietary Allowances (RDA): Male – 16 mg/day and
Female – 14 mg/day
Vitamin B3 (Niacin)

37. Function: Pantothenic acid is also used orally for osteoarthritis, rheumatoid
arthritis, Parkinson's disease, nerve pain, premenstrual syndrome (PMS),
enlarged prostate, reducing adverse effects of thyroid therapy in congenital
hypothyroidism, reducing signs of aging, skin disorders, salicylate toxicity
Causes: There is impaired energy production, due to low CoA levels (a molecule
in biochemical reactions in protein, carbohydrate and lipid metabolism)
Side effects: Heartburn, Nausea
Overdose: Diarrhea
Deficiency: Apathy, numbness, paresthesia, hypoglycemia, hepatic
encephalopathy
Daily Recommended Dietary Allowances (RDA): Male – 5 mg/day and Female –
5 mg/day
Vitamin B5 (Pantothenic acid)

38. Function: Vitamin B6 is involved in many aspects of macronutrient metabolism,
neurotransmitter synthesis, histamine synthesis, hemoglobin synthesis and function, and
gene expression
Causes: The elderly and alcoholics, type 1 diabetes, liver disease, rheumatoid arthritis, HIV.
Use of oral contraceptives, anticonvulsants, isoniazid, cycloserine and hydrocortisone
negatively impact vitamin B6 status. Hemodialysis reduces vitamin B6 plasma levels.
Side effects: Numbness of the extremities, neuropathy
Overdose: Damage to the dorsal root ganglia, irreversible neurological problems
Deficiency: Seborrhoeic dermatitis-like eruption, atrophic glossitis with ulceration, angular
cheilitis, conjunctivitis, intertrigo, confusion, and neuropathy and sideroblastic anemia
Daily Recommended Dietary Allowances (RDA): Male – 5 mg/day and Female – 5 mg/day
Vitamin B6 (Pyridoxine)

39. Function: Vitamin B7 helps to support adrenal function, helps calm and maintain a healthy
nervous system, and is necessary for key metabolic processes. Biotin is essential for the
metabolism of carbohydrate and fat.
Causes: Daily consumption of raw egg whites for several months, inadequate dietary, genetic
disorders that affect biotin metabolism
Side effects: dry skin, a scaly rash around the eyes or mouth, dry eyes, fatigue, and
depression
Overdose: slower release of insulin, skin rashes, lower vitamin C and B6 levels and high blood
sugar levels.
Deficiency: Brittle and thin fingernails, alopecia, Conjunctivitis, Dermatitis, depression,
lethargy, hallucination, and numbness and tingling of the extremities, nearly half of pregnant
women have abnormal increases of 3-hydroxyisovaleric acid, which reflects reduced status of
biotin
Daily Recommended Dietary Allowances (RDA): Male – 2.5 mg/day and Female – 2 mg/day
Vitamin B7 (Biotin)

40. Function: Birth defects, Heart disease, Age-related hearing loss, Age-related macular
degeneration (AMD), Depression, Cancer (Colon cancer, Breast cancer, cervical cancer,
pancreatic cancer, Stomach cancer)
Causes: Alcoholism, inflammatory bowel disease (IBD), and celiac disease can cause folic
acid deficiency
Side effects: Stomach problems, Sleep problems, Skin reactions, Confusion, Loss of
appetite, Seizures
Overdose: Overdose of folic acid will damage central nervous system. This may manifest
as movement disorders, paralysis, pain or numbness
Deficiency: Poor growth, Tongue inflammation, Gingivitis, Loss of appetite, Shortness of
breath, Forgetfulness, Mental sluggishness
Daily Recommended Dietary Allowances (RDA): Male – 400 mcg/day and Female – 400
mcg/day
Vitamin B9 (Folic acid)

41. Function: Vitamin B12 is used to treat Pernicious anemia, Heart disease, Age-
related macular degeneration (AMD), Fatigue, Breast cancer, Male infertility
Causes: The elderly, diabetes, HIV, eating disorder, People with problems
absorbing nutrients due to Crohn’s disease, pancreatic disease, weight loss
surgery, helicobacter pylori
Side effects: Gout, skin flushing, itching, abdominal pain
Overdose: Reddening of the skin and urine, changes in heart rate and blood
pressure
Deficiency: Gastritis, pernicious anemia, Crohn’s disease, celiac disease, grave
lupus, SLE
Daily Recommended Dietary Allowances (RDA): Male – 2.4 mcg/day and Female –
2.4mcg/day
Vitamin B12

42. THANKYOU