Vitamin fat soluble bph class

1. FAT SOLUBLE VITAMINFAT SOLUBLE VITAMIN
MAN BAHADUR RANA
BPH
ACAS,NEPAL

2. Fat soluble Vitamins
A, D, E, and K  fat soluble
Their availability in the diet, absorption and transport  fat.
 stored in liver and adipose tissue.
readily excreted in urine.
Excess consumption (particularly A and D)  accumulation toxic effects.

3. Vitamin A(Retinol)
Major Dietary Sources: Animal sources contain (preformed) vitamin
The best sources are liver, kidney, egg yolk ,milk, cheese, butter. Fish (cod or
shark) liver oils are very rich in vitamin A.
Vegetable sources contain the provitamin A-carotenes that give rise to vitamin A
in the body. Yellow and dark green vegetables and fruits are good sources of
carotenes e.g.carrots,spinach, pumpkins, mango, papaya etc.
RDA: 3000-5000 I U per day,
It is higher in growing children, pregnant women, lactating mothers, and individuals
with hepatic disease.
1Retinal equivalent=1mcg of retinol=3.33 IU of vit. A

4. Function of Vitamin A(Retinol)
1. Visual cycle
Vitamin A  rhodopsin of rod and cone cells. Rhodopsin photochemical
isomerizations visual cycle.
2. Cholesterol synthesis
3.Carotenoids antioxidants  reduce the risk of cancers
β-Carotene beneficial to prevent heart attacks.
4 essential normal reproduction spermatogenesis in the male and preventing
fetal resorption in the female.
5. Retinol and retinoic acid in the synthesis of transferrin, the iron transport
protein.

5. Deficiency of Vitamin A(Retinol)
3rd most common nutritional deficiency in the world and common in malnourished
children in Asia, Africa, and South America
Night blindness (nyctalopia
xerophthalmia.
dryness in conjunctiva and cornea ,and keratinization of
epithelial cells.,
white triangular plaques  Bitot's spots

6. Deficiency of Vitamin A(Retinol)
Persistance of xerophthalmia for a long time,
keratomalacia,
causing total blindness.
Phrynoderma is a skin lesion and is characterized by
follicular hyperkeratosis.

7. Hypervitaminosis A
 >7.5 mg/day
Skin dry and pruritic, hepatic dysfunction
In Pregnant women  congenital malformations in the developing fetus.

8. Vitamin D
Major dietary Source
Plants (vitamin D2): ergocalciferol
Animal tissues (fatty fish, liver, egg-yolk, fortified milk – vitamin D3):
cholecalciferol
1 USP unit=1 IU=0.025 µg of vitamin D3
Adult RDA=100 I U or 2.5 µg
Pregnant and lactating mother as well as infants and children about 220 I U / day

9. Functions
 Functions
 Bone development
 Calcium and phosphorous absorption (small intestine)
 Calcium resorption (bone and kidney)
 Maintain blood calcium levels

10. Functions
 Bone development
Calcium and phosphorous absorption (small intestine)
Calcitriol  specific calcium-binding protein enhanced calcium uptake.
Calcium reabsorption (bone and kidney)
In the Osteoblasts of bone, calcitriol  calcium uptake
Maintain blood calcium levels
Calcitriol  mobilization of calcium and phosphate from bone increase in
plasma calcium and phosphate

11. Vitamin D Deficiency Children
Rickets
• Failure of bone mineralization in infants and
children

12. 12
Vitamin D Deficiency - Rickets

13. 13
Osteomalacia
Normal pelvis

14. Deficiency of Vitamin D
Osteomalacia
In case of osteomalacia (adult
rickets)
Idiopathic steatorrhea or celiac
disease- deformities or
dwarfism.

15. 15
Vitamin D Toxicity
• Calcification of soft tissue
– Lungs, heart, blood vessels
– Hardening of arteries (calcification)
• Hypercalcemia stone formation in kidneys

16. Vitamin E (Tocopherols)
•Major dietary sources:
• Many vegetable oils are rich sources of vitamin E. Wheat germ oil, cotton
seed oil, peanut oil, corn oil and sunflower oil are the good sources.
•lt is also present in meat, milk, butter and eggs.
The RDA for vitamin E
 Women 8 mg (12 I U)/d
 Men 10 mg(15 IU)/d

17. 17
Vitamin E is essential for the membrane structure and integrity of the cell,
hence it is regarded as a membrane antioxidant
Function of Vitamin E (Tocopherols)

18. Function of Vitamin E (Tocopherols)
•Antioxidant Free radical scavenger
•Protects cell membranes
•Protects LDL from oxidation
•Protects lungs from pollutants
•Protects heart and liver
•Supplementation may increase antibody production

19. 19
Vitamin E Deficiency
• Uncommon
• However, Severe malnutrition / cirrhosis
Increased fragility of erythrocytes and minor
Neurological symptoms

20. Vitamin K
Major dietary sources:
•Plants like spinach, alfalfa, cabbage, cauliflower, tomatoes are rich source etc.
•Fruits and cereals are poor sources.
•lt is also present in egg yolk, meat,liver, cheese and dairy products.
•There is no RDA for vitamin K, but 70 to 140 μg/day is recommended as an
adequate level.

21. Functions of Vitamin K
•A major role in coagulation pathways process.
•lt brings about the posttranslational modification of certain blood clotting factors
•responsible for : Clotting factors – prothrombin, factors VII, IX, X

22. Signs and Symptoms of Vitamin K Deficiency
Vitamin K deficiency is rare in
adult
• Mucosal bleeding
• Easy bruisability
• Melena
• Hematuria
• Hemorrhagic Disease of the
Newborn

23. Vitamin K Deficiency in Human
Hemorrhagic disease in first few days of life; death caused by
subdural hemorrhage