Vitamins B Complex & Deficiencies

1. DR SHAHNAWAZ F SHAH
MD, FPM, FIAPM,FCPM (MUHS)
Interventional Spine & Pain Physician
Surat

2. CLASSIFICATION

3. Water Soluble Vitamins
(C & B Complex)
• Release energy. Several B vitamins are key components of
certain coenzymes (molecules that aid enzymes) that help
release energy from food.
• Produce energy. Thiamin, riboflavin, niacin, pantothenic
acid, and biotin engage in energy production.
• Build proteins and cells. Vitamins B6, B12, and folic acid
metabolize amino acids (the building blocks of proteins)
and help cells multiply.
• Make collagen. One of many roles played by vitamin C is to
help make collagen, which knits together wounds, supports
blood vessel walls, and forms a base for teeth and bones.

4. WATER SOLUBLE VITAMINS
• Essential co- enzymes required in energy releasing
mechanisms.
• Act as co- enzymes for metabolism of proteins, carbohydrates
and fats.
• They include-
B1- Thiamine B6 –Pyridoxine
B2 - Riboflavin B7 – Biotin
B3 – Niacin B 9- Folic acid
B5 – pantothenic acid B12 –Cobalamin
Vitamin C (ascorbic acid)

6. VITAMIN B1 (THIAMINE)
• Anti Beri-Beri factor
• Anti Neuritic factor
• Aneurin

7. Characteristics
• Colorless basic organic compound composed
of a sulfated pyramidin ring.
• All living organisms use thiamine, but it is
synthesized only in bacteria, fungi, and plants.
• Contains sulfur and nitrogen group
• Destroyed by alkaline and heat
• Active form- Thiamine pyrophosphate

8. DIETARY SOURCES OF VITAMIN B1
• Foods high in thiamin
– pork,
– fish,
– seeds, nuts,
– beans, green peas,
– tofu,
– brown rice,
– squash,
– asparagus,
– seafood

9. Daily requirement
• Adult Male – 1.3 mg
• Adult Female – 1.0 mg
• Pregnancy and lactation – 2mg
• Children – 1.1mg.

10. M/A OF THIAMINE
• Allows the cell to produce energy
• Synthesis of neurotransmitter
Kreb’s Cycle
Pyruvate
Acetyl CoA
Kreb’s Cycle
α-ketoglutarate
Succinyl-CoA

11. FUNCTIONS OF THIAMINE
• Converting carbohydrate into energy. (ATP
production)
• Maintaining Peripheral Nerve Conduction
• Necessary for healthy mucous membranes.
• Helps in the digestion of food.
• Provides strength to muscles.
• It is very useful for the proper functioning of
heart.

12. VITAMIN B1 DEFICIENCY
Who’s at risk?
 Excessive loss
Hemodialysis
Diuretic therapy
 Chronic Alcoholism

13. VITAMIN B1 DEFICIENCY
• Beri-Beri
• Wernicke-Korsakoff Syndrome
• Muscle Weakness & Wasting
• Ophthalmoplegia

14. Beri-Beri
• Symptoms include:
– Dry Beri-Beri: No Edema
– Wet Beri-Beri: Pitting Edema on Trunk, Limbs and
Face
– Progressive Wasting of Muscles
– Tachycardia,
– Laboured Breathing
– Numbing and weakening of Extremities
– tingling or burning sensation in the hands and feet

15. Beri-Beri
• Symptoms similar to Congestive Heart Failure
• Slowly Progressive Course
• Rapid Deterioration and Fatal Circulatory
Collapse

16. Beri-Beri

18. Wernicke-Korsakoff Syndrome
• Wernicke’s Encephalopathy (WET BRAIN)
– G- Global Confusion
– O- Ophthamoplegia & Horizontal Nystagmus
– A- Ataxia
• Wernicke’s-Korsakoff Syndrome-
– Above symptoms with: - Confabulatory Psychosis,
Loss of Memory

20. Treatment
• In Acute Thiamine Deficiency (Wet Brain)-
– 200mg of Thiamine IV three times a day until
improvement of acute symptoms.
– f/b Oral Thiamine 10mg/d given until complete
recovery.

22. VITAMIN B2 (RIBOFLAVIN)
• also called as beauty vitamin.
• Yellowish green fluorescent compound soluble
in water.
• The word “Riboflavin” is derived from 2
sources-
– Ribose – ribose sugar
– Flavin – yellow.
• widely involved in oxidation- reduction
reaction.

23. DIETARY SOURCES OF VITAMIN B2

24. Daily requirement
• Adult Male – 1.5mg
• Adult female – 1.2 mg
• Pregnancy and lactation – 2 to 2.3 mg
• Children – 1.3mg.

25. FUNCTIONS OF RIBOFLAVIN
• Essential for normal growth.
• Metabolism – It is involved in the metabolism
of carbohydrates, fat & proteins.
• Digestion – it helps in digestion
• Nervous system – it helps in proper
functioning of Nervous system

26. FUNCTIONS OF RIBOFLAVIN
• Very useful for normal tissue respiration.
• Necessary for healthy mucous membranes
• Good for skin, nails and eyes
• helps in protects the body against cancer

27. RIBOFLAVIN DEFICIENCY
• Magenta Tongue.
• Angular Stomatis.
• Dermatitis and Cheilosis.
• Cracks and sores in mouth and lips.

29. VITAMIN B3
• Also known as Niacin
• Essential for metabolism of carbohydrate,
protein & fat.

30. • It is a colorless, water-soluble solid derivative
of pyridine, with a carboxyl group (COOH) at
the 3-position
• It is a pyridine derivative and is a precursor of
the coenzyme NAD (Nicotinamide adenine
dinucleotide)

31. DIETARY SOURCES OF NIACIN
• yeast, meat, poultry, red fish (e.g.,
tuna, salmon), cereals, legumes, and seeds
Milk, green leafy vegetables

32. Daily requirement
• Adult Male – 17mg
• Adult Female – 13 mg
• Pregnancy and lactation – 12 to 15 mg
• Children – 15mg.

33. FUNCTIONS OF NIACIN (VIT B3)
• Releasing energy from carbohydrates, fats and
protiens.
• DNA synthesis.
• production of estrogen progesterone &
testosterone
• Necessary for healthy skin, nerves and digestive
system.
• Helps to detoxify the body.
• Vitamin B3, is very essential for the proper
digestion of the food

34. • may improve arthritis symptoms, including
increasing joint mobility and reducing the
amount of anti-inflammatory medications
needed
• helpful in reducing migraine headaches
• High doses of niacin medications are used to
prevent development of atherosclerosis and
to reduce recurrent complications such as
heart attack and peripheral vascular disease

35. VITAMIN B3 DEFICIENCY
• PELLAGRA -
• Characterised by 4D’s
– Diarrhoea
– Dermatitis
– Dementia
– Death

36. VITAMIN B3 DEFICIENCY
• Casal’s Necklace
– Pigmented and scaling rash forming a ring around
sun exposed area of neck

37. Treatment
• 100-200mg of nicotinamide 3 times a day for 5
days

39. VITAMIN B5
• PANTOTHENIC ACID
• water-soluble vitamin.
• It was discovered by Roger J. Williams in 1919.
• This word derived from
– greek word pantos meaning everywhere.
• Part of Coenzyme-A
• Essential for metabolism of CHO, fat, protein

40. DIETARY SOURCES OF VIT B5

41. Daily requirement
• Adult male – 10 mg
• Adult Female – 10 mg
• Children – 5.5mg

42. FUNCTIONS OF VIT B5
• plays an important role in helping release energy
from sugars, starches, and fats.
• They are essential for the cell metabolism.
• They are very helpful in the cholesterol
metabolism.
• Accelerates wound healing.
• It is also used as anti-stress factor.
• Allergies, headaches, arthritis, psoriasis,
insomnia, asthma, and infections have all been
treated with some effectiveness using vitamin B5.

45. VITAMIN B6 (PYRIDOXINE)
• Vitamin B6 is part of the vitamin B complex
group, and its active form, Pyridoxal 5'-
phosphate (PLP) serves as a cofactor in many
enzyme reactions in amino acid, glucose, and
lipid metabolism.
• It is white crystalline substance soluble in
water and alcohol.

46. DIETARY SOURCE OF VIT B6
• Milk, Fish, Vegetables, Beans, Eggs, Peanuts,
sunflower seeds

47. Daily requirement.
• Adults– 2 mg
• Children – 1.7 mg
• Infant – 0.1-0.4 mg

48. FUNCTIONS OF VITAMIN B6
• Make antibodies. Antibodies are needed to fight
many diseases.
• Maintain normal nerve function
• Promotes RBC production & hemoglobin.
• Break down proteins.
• Keep blood sugar (glucose) in normal ranges
• Assists in the balancing of Sodium and Potassium
levels.
• Production of Serotonin, Dopamine,
Noradrenaline and Adrenaline

49. DEFICIENCY OF VITAMIN B6
• Peripheral Neuropathy and Depression
• Microcytic Hypochromic Anemia
• Loss of muscle control, muscle weakness,
cramps and numbness
• Hyperhomocysteinemia and Cardiovascular
Risk
• Treatment of deficiency- 50mg/d until
resolution of symptoms

51. VITAMIN B7 (BIOTIN)
• Also known as
– Biotin
– Vitamin H
– coenzyme R
• Biotin is a coenzyme for carboxylase enzymes,
involved in the synthesis of fatty acids,
isoleucine, and valine, and in gluconeogenesis

53. Daily requirement
• Adults– 100- 200 mcg
• Children – 50-200 mcg.
• Infant – 35 mcg

54. FUNCTIONS OF VITAMIN B7
• convert food into glucose, which is used to
produce energy
• produce fatty acids and amino acids (the
building blocks of protein)
• activate protein/amino acid metabolism in the
hair roots and fingernail cells.

55. FUNCTIONS OF VITAMIN B7
• Maintenance of
– normal skin and mucous membranes
– normal function of the nervous system
– normal hair
– normal psychological functions.

56. VITAMIN-B7 DEFICIENCY
• Nausea, Anorexia, scaling seborrheic
erythematous rash around eyes, nose and
mouth.
• In infants- Alopecia, Rash involving Ears and
hypotonia.
• Treatment of deficiency- 10mg/d of biotin 60

58. VITAMIN B9 (FOLIC ACID)
• also known as folic acid, folacin or folate.
• It is a water soluble vitamin.
• It is a yellow crystalline substance.

59. DIETARY SOURCE

60. FUNCTIONS OF VIT B9
• Formation of RBC – folic acid in combination with vitamin
B12 is essential for formation, maturation of RBCs.
• Nerve – it is necessary for growth & division of all body
cells,
• Hair & Skin – it is essential for the health of skin & hair
• Pregnancy – it is an important nutrient for the pregnant
women & her developing fetus.
• Improves the lactation.
• DNA synthesis, DNA and RNA replication
• Homocysteine metabolism
• Neurotransmitter formation

61. Deficiency Symptoms
• Megaloblastic Anaemia.
• Atrophic Glossitis
• Depression

63. VITAMIN B12 (COBALAMIN)
• Complex organomatrix compound called as
COBALAMIN which is cobalt containing
porphyrin.
• It is freely soluble in water.

64. SOURCES
• Vitamin B12 is mostly found in animal
products such as meat, shellfish, milk, cheese,
and eggs.

65. FUNCTIONS OF VITAMIN B12
• Red Blood Cells – it is essential for production
of RBCs
• Nervous – It improves concentration, memory,
& balance.
• Metabolism of fat, carbohydrate ,proteins,
folic acid.
• Promotes growth and increases apatite.

66. VITAMIN- B12 DEFICIENCY
• Megaloblastic Anemia.
• Pernicious anemia
• Demyelination & irreversible nerve cell death
• Loss of Vibratory and Position Senses
• Abnormal Gait
• Dementia
• Loss of Bladder and Bowel Control

68. Treatment
• To replenish body stores.
– 1000μg of Hydroxocobalamin
– at 3 to 7 days interval
– Six IM injections
• For maintainence therapy-
– 1000μg of Hydroxocobalamin every 3 months

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