vitamins disorder

1. DISORDER OF VITAMIN
INTRODUCTION:
These disorders are often submerged, or accompanied by those related
to general under nutrition, especially in the third world countries. In
developed countries, specific vitamin deficiency may be seen in young
children, adolescents, pregnant and lactating women and those in the
low socioeconomic status. Similarly many clinical disorders (e.g. fat
malabsorption) may lead to various specific vitamin deficiencies.
Vitamins are classified according to their solubility into two categories.
A) Fat-soluble vitamins - vitamin A
- Vitamin D
- Vitamin E
- Vitamin K
B) Water-soluble vitamins - vitamin C
- Vitamin B – complex e.g.
Thiamin, niacin, pyridoxine, folic acid, vit. B12 (cobalamin), biotin,
pantothenic acid E.t.c

2. 1- DISORDER OF VITAMIN A
Daily requirement of vitamin A
300-600 µg. Of retinol for children, 750 µg in adults and 1150 µg during
lactation.
Function of vitamin A
A) Maintaining of normal vision in reduced light (rhodopsin pigment
In retina)
B) Potentiating the differentiation of specialized epithelial cells,
mainly mucus secreting cells.
C) It also has possible anticancer function.
Deficiency of vitamin A leads to the following disorders
A) Xerophthalmia (conjuctival keratinization)
B) Keratomalacia-(corneal softening and ulcerations)
C) Night blindless
D) Corneal scaring and blindless
E) Impaired immune response with increased mortality from
infections(in children)
F) Possibly, increased incidence of cancer of oral cavity, larynx,
esophagus, stomach, pancreas, gastrointestinal tract, urinary
bladder, prostate etc.
G) Other possible consequences: infertility, impaired growth.

3. 2- DISORDER OF VITAMIN D
Daily requirements of vitamin D
Adults : 2.5 µg (100 IU)
Infants & children : 5 µg (200 IU)
Pregnancy : 10 µg (400 IU)
Function of vitamin D
A) maintenance of normal plasma levels of calcium and
phosphorus by its action on
- intestine (increasing calcium absorption)
- bones (mobilization of calcium from bones)
- Kidneys (stimulation of parathyroid hormone dependent
reabsorption of calcium in the distal renal tubules).
B) Maintenance of calcium metabolism by two opposing action
i) Reabsorption of calcium from bone in collaboration
with parathyroid hormone in hypocalcaemia.
ii) Normal mineralization of epiphysis cartilage and
osteoid matrix.
Deficiency of vitamin D leads to the following disorders
A) Rickets in children (impaired development and
calcification of bones)
B) Osteomalacia in adults (impaired calcification of
bones)
C) Hypocalcemic tetany
D) Possible consequences include
-Disturbed immunoregulation

4. -impaired control of cell proliferation and
differentiation.
3- DISORDERS OF VITAMIN E
Functions of vitamin E
A) It acts as an excellent antioxidant (only lipid – soluble anti –
oxidant which serves to scavenge free radicals formed in redox
reactions throughout the body).
B) It has some undetermined protective role for neurons and RBCs.
Deficiency of vitamin E leads to the following disorders
A) Degenerations of neurons in posterior column of spinal cord.
B) Neuronal pigmentation and loss in sensory nuclei of trigeminal,
auditory and vagus nerves.
C) Primary or denervation muscle disease.
D) Retinal pigmentary degeneration.
E) RBC, s life span decreases due to loss of protection against
oxidative agents.
F) Possibly, infertility.

5. 4- DISORDERS OF VITAMIN K
Functions of vitamin k
A) It is an important cofactor for hepatic microsomal
carboxylation reaction.
B) Carboxylation reaction is important in synthesis of four
coagulation factors, factor ii (prothrombin), factor vii, factor IX
and factor X.
C) It is also required in the synthesis of thrombin, protein C, S and
Z, which are related to blood coagulation.
D) Protein osteocalcin required for calcification of bones require
protein K for its synthesis.
Deficiency of vitamin K leads to following
disorders
A)Hypoprothrombinemiaandhence increased
hoaemorrhagic tendency.
B) In adultsit may lead to gingival bleeding,hematuria,
ecchymosis, malena

6. 5- DISORDERS OF THIAMINE (VITAMIN B1)
Thiamine (vitamine B1) is a water soluble vitamin relatively stable to
heat but rapidly destroyed in neutral and alkaline solution.
Daily requirements of thiamine
0.5 mg / 1000 k calories
Function of thiamine
An oxidative decarboxylation of alpha keto acids leading to the
synthesis of ATP.
B As a co-factor transketolase in the pentose phosphate pathway.
C maintenance of neural membrane and normal nerve condition,
especially of peripheral nerves.
D essential for utilization of carbohydrates in the body.
E maintenance of appetite and normal digestion.
Deficiency of thiamine leads to the following disorders
A) Dry beriberi (involvement of peripheral nerves)
B) Wet beriberi (involvement of heart)
C) Wernicke-korsakoff syndrome (central nervous system
involvement).

7. 6-DISORDERS OF RIBOFLAVIN (VITAMIN B2)
Riboflavin is a yellow crystalline substance. It is sometimes
referred to as vitamin B2 but this is not correct since vitamin B2 is
a complex of several vitamins.
Daily requirements of riboflavin
0.6 mg / 1000 K cal.
Functions of riboflavin
A) Maintenance of normal cell metabolism: the coenzymes of
riboflavin- i.e. flavin mononucleotide (FMN) and flavin adenine
dinucleotide (FAD) participate in wide ranges of redox
reactions in the cells.
B) It also plays a role in protein, carbohydrate and fat
metabolism.
Deficiency of riboflavin leads to the following disorders
Is called as Ariboflavinosis consisting of angular stomatitis, cheilosis,
and soreness of tongue, redness and burning sensation of eyes,
vascularization of cornea, nosolabial seborrhea and scrotal or vulval
dermatitis. Erythroid hypoplasia may be seen. Similar findings may also
be seen in pyridoxine deficiency.

8. 7-DISORDERS OF NIACIN
Niacin is the generic designation for nicotinic acid and its functionally
active derivatives e.g. nicotinamide with its two co-enzymes –
Nicotinamide adenine dinucleotide (NAD) and Nicotinamide adenine
dinucleotide phosphate (NADP)
Daily requirements of niacin
6.6 mg / 1000 Kcal.
Functions of niacin
A) NAD and NADPH have central roles in cellular intermediary
metabolism.
B) NAD functions as coenzymes for a variety of dehydrogenase
involved in the metabolism of fat, amino acids and carbohydrates.
C) NADP functions in a variety of dehydrogenation reactions in
hexose monophosphate shunt of glucose metabolism.
D) It is also essential for normal functioning of the skin, intestinal
tract and the nervous system.
Deficiency of niacin leads to the followind disorders
Deficiency of niacin is called as pellagra, characterized by three
D,s : dermatitis, diarrhea and dementia.
Other features include glossitis, stomatitis.

9. 8-DISORDERS OF PANTOTHENIC ACID (VITAMIN B5)
Pantothenic acid is widely distributed in animal and vegetables
foods. Daily requirements are about 10 mg. No deficiency states
have been reported in man.
9-DISORDERS OF PYRIDOXINE (VITAMIN B6)
Three naturally occurring substances pyridoxine, pyridoxals and
pyridoxamine and their phosphates possess vitamin B6 activity
are generally referred to as pyridoxine. All are equally active
metabolically, and all are converted in the tissues to the
coenzyme form pyridoxal - 5 – phosphate.
Daily requirement of pyridoxine
The amount of pyridoxine which is require daily is: 1:5 mg.
Functions of pyridoxine
A) Transmethylation of methionine in the metabolism of
typtophan.
B) Synthesis of delta amino levulinic acid (the heme precursor)
C) Stabilization of muscle phosphorylase.
D) Transmission of neural impulses.
E) Metabolism of lipid and amino acid.
F) Immune response regulation.

10. Deficiency of pyridoxine leads to the following disorders
A) Neurologic manifestations – dizziness, convulsions.
B) Seborrheic dermatitis, cheilosis, glossitis, angular stomatitis.
C) Peripheral neuropathy.
D) Impaired T – cell function and antibody synthesis.
E) Hypochromic – pyridoxine responsive anemia.
F) Mental retardation in children born to pyridoxine – deficient
mothers.
10-DISORDERS OF FOLIC ACID (FOLATES)
Folic acid is a generally used term for pteroylmonoglutamic
acid, the precursor of a large number of folate compounds.
They occur in two forms, the free folates and the bound
folates.
Daily requirements of folates
Free folates required per day are follows
Healthy adults : 100 µg (mcg)
Pregnancy : 300 µg (mcg)
Lactation : 150 µg (mcg)
Children : 100 µg (mcg)
Requirements are in increased in physiological conditions of
increased demands (as mentioned above) as well as in
hemolytic anemias, infections and neoplastic diseases.
Functions of folates

11. A) It serves as an acceptor – donor of one – carbon
fragments such as methyl and formyl group.
B) These functions are essential for the synthesis of DNA.
Deficiency of folates leads to the following disorders
A) Megaloblastic anemia
B) Glossitis, gastrointestinal disturbances
C) Infertility, sterility or even fetal abnormalities
11-DISORDERS OF VITAMIN B12 (COBALAMIN OR
CYANOCOBALAMI N)
Cobalamin is a complex organ metallic compound of a
corrin ring to which is attached a cobalt atom. The
synthetic therapeutic form of vitamin B12 is a stable,
red, crystalline substance called as cyanocobalamin.
Daily requirements of vitamin B12
Approximately 1 mcg (µg).
Functions of vitamin B12
A) Synthesis of DNA
B) Involved in unknown reactions in carbohydrates, fat
and protein metabolism.
Deficiency of vitamin B12 can leads to the following
disorders
A) Megaloblastic anemia.

12. B) Pernicious anemia (intrinsic factor deficiency)
C) Demyelienating neurological lesions.
D) Infertility.
12-DISORDERS OF ASCORBIC ACID (VITAMIN C)
Ascorbic acid is a white crystalline substance highly
soluble in water but rapidly destroyed by oxidation and
high temperatures. Man, monkey and guinea pigs are
the only species known to require vitamin C in their
diets.
Daily requirements of ascorbic acid
Infants : 20 mg / day
Childrens and infants : 40 – 60 mg / day
Lactating women : 80 – 100 mg / day
functions of ascorbic acid
A) It accelerates the hydroxylation reactions. E.g. in
production of collagen, it acts as a cofactor prolyl
hydroxylase.
B) Help in and enhances absorption of iron by
intestinal mucosa.
C) Hydroxylation reaction: conversion of dopamine to
form norepinephrine; synthesis of carnitine from
lysine.

13. D) Due to its reducing nature, it prevents oxidation of
tetrahydrofolates and thus maintains the pool of
folic acid.
Deficiency of vitamin c (Ascorbic acid) is called as
scurvy.
It shows following clinical features:
A) Haemorrhages : purpura, ecchymoses in skin,
gingival bleeding, subperiosteal hematomas and
hemarthrosis (bleeding in joints)
B) Abnormal development of bones and cartilages in
children. E.g. scorbutic rosary in cases of scurvy,
involving rib cage.
C) Gingival enlargement and infections.
D) Skin rash
E) Anemia
F) Impaired wound healing and inflammatory
response.

14. REFERENCES
Dr. prakash ghadi, “Pathophysiology for S.Y B.
Pharm. Students of all universities in Maharashtra
and Rajeep Gandhi Health University, Karnataka, 2nd
edition-Reprint FEB. 2004, carrier publication, Nashik
Maharashtra, page no. 272-287.