vitamins

1. 27. 6. 2023
Common Vitamin deficiencies
Dr. A. Viknesh Prabu MD.,MRCP(London), MRCP(Edinburgh)
Assistant Professor
Department of General Medicine , SBMCH

2. Causative factors
• Low income countries
• Alcohol misuse
• Pregnancy / older age
• Inhabitation
• Congenital conditions
• Intestinal malabsorption
• Drug induced
• Severe carb restriction

3. FAT SOLUBLE VITAMINS

4. Vitamin A

5. VITAMIN A
• Animal origin - Liver , milk , eggs , fish oils
• RNI 600mcg -700 mcg
• Carotenes 11 cis Retinal -Rods for dark adaptation
• Retinoic acid -differentiation of epithelial cells
• Retinoids - normal growth , fertility , haematopoesis , immune function
• Assess serum retinol level

9. Vitamin A excess
• Liver damage
• Hyperostosis
• Teratogenicity
• Nausea / headache / ICT
• Hypercarotenosis

10. Vitamin D

11. • Source - Fish oils, UV exposure,
margarines, egg yolk,
• RNI - 10 mcg
• Calcium homeostasis,
• Bone mineralisation
• Tissue differentiation
• Assess 25 hydroxy vitamin D

16. Vitamin E

17. • Sunflower oil, vegetables , nuts,
seed oils
• NO RNI - 3- 4mg
• Serum tocopherol- cholesterol ratio
• Antioxidant
• Maintain cell membrane structure
• Affects DNA synthesis and cell
signalling
• Anti -inflammatory

19. Vitamin K

20. • Diet - soya oil, intestinal bacteria
• Co-factor in carboxylation reactions
• Gla residues - coagulation factors,
osteocalcin, matrix gla

23. Vitamin B1

24. • Nuts, seeds- legumes, cereals
• RNI - 0.8mg
• Pork , cereal grains, beans

29. Vitamin B2

30. • Source - milk , milk products,
breakfast cereals, bread, sprouts
• 1.1 - 1.3mg
• Involved in ox- red reactions
• RBC Glutathione reductase activity

32. Vitamin B3 / Niacin

33. • NAD / NADP
• Only after 8 weeks of deficiency
• Therapeutic - Lipid lowering agent

37. Vitamin B6/ Pyridoxine

38. • Cofactor in the metabolism of amino
acid
• Drug induced - isoniazid ,
Penicillamine
• Peripheral neuropathy
• Sideroblastic anemia
• Large dose- Anti emetic in
radiotherapy induced nausea,
pregnancy
• Toxicity - sensory peripheral
neuropathy

40. Folic acid

41. • Methyl donor - 5
methyltetrahydrofolate
• DNA / RNA synthesis
• During embryonic development
• Liver , leafy veg

44. Vitamin B12

46. • Animal products
• 1.5 mcg
• Co-factor in coenzyme recycling
• nerve myelination
• DNA synthesis

50. Vitamin C

51. • Citrus fruit , fish fruits,
• 40 mg
• Cofactor in hydroxylation of proline
and lysine for maturation of
collagen
• Intracellular electron transfer

54. Thank you