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Vit -C Sources
• Plant sources
• Citrus fruits
• Gooseberry
• Guava
• Green vegetables
• Tomatoes
• Animal sources
not present
Milk is poor sources
Deficiency
• Scurvy- characterized by
 Spongy and sore gums
 Bleeding of gums
 Loose teeth
 Swollen joints
 Delayed wound healing- due to deficient collagen
formation
 Poor dentine formation in children
• In severe scurvy- loosening and falling of teeth
Folic Acid Deficiency
• Deficiency is most common
• Observed primarily in the pregnant women both developed and
developing countries.
• Folic acid deficiency in pregnant women cause neural defect in
fetus.
• Macrocytic anemia (abnormally large RBC) is a characteristic
feature of folate deficiency.
Vit B 1 Deficiency
• Beri-Beri
• Early symptoms
• Loss of appetite
• Constipation
• Nausea
• Mental retardation
• Peripheral neuropathy
• Irritability
• Impaired metabolism of carbohydrate
• Leads to accumulation of pyruvate in the tissue
which is harmful.
• Increased plasma pyruvate level and also excreted
in urine.
In adults their occur 2 types of beri-
beri
Dry beri-beri (neurological)
• Associated with
neurological manifestations
• Peripheral neuritis
• Muscle weakness
• Walking become difficult,
depends on support to walk
• Death, if not treated
Wet beri-beri
(cardiovascular)
• Edema of legs, face, trunk
and serous cavities
• Swelling of calf muscles
• Increased systolic B.P and
decreased diastolic B.P
• Pulse are fast and bounced
• Heart become week
• Death occur due to heart
failure
Vit B2 Deficiency
Symptoms:
• Cheilosis- painful fissures at corner of mouth
• Painful glossitis- tongue red-purple (magenta
tongue)
• Dermatitis
• Eye- corneal vascularization and inflammation with
cloudiness of cornea, watering and burning of eye.
• Cause pellagra (Pelle-skin Agra-
rough)
Vit B12 Deficiency
• Pernicious anemia (decreased RBC
count leads to decrease in
hemoglobin)
CLINICAL FEATURES
Children
Adults
Children
Rickets
Adults
Osteomalacia
Features Delayed milestones
Delayed closure of anterior fontanelle
Delayed dentition
Deformities of bones
Decreased serum calcium
Frontal bossing
Bowed legs –
Characteristic of
rickets
Beaded ribs –
Characteristic
of rickets
Rachitic rosary
Causes Inadequate exposure to sunlight
Inadequate dietary intake
Features Demineralization occurs mainly in spine, pelvis
and lower extremities
Increased softness & susceptibility to fracture
Bowing of long bones
Causes
Over ingestion
Features
Hyper calcemia
Metastatic calcification
Best sources
 Milk and milk products
Good sources
 Beans
 Leafy vegetables
 Fish
 Cabbage
 Egg yolk
CALCIUM
sources
9-11mg/dl
3
Organs
Intestine
Bone
Kidney
3
Hormones
Calcitriol
PTH
Calcitonin
Hypocalcemia
Hypercalcemia
Inadequate intake
Impaired absorption
Increased excretion
Magnesium deficiency
Acute pancreatitis
Cardiac
arrhythmias
Prolongation
of QT
interval
Cataract
Chronic
hypocalcemia
Contraction of facial muscle in
response to tapping the facial nerve
Chvostek’s
sign
Carpal spasm occurring after occlusion
of the brachial artery with BP cuff for 3
min
Trousseau’s
sign
Severe
symptomatic cases
Intravenous
Calcium
gluconate
Asymptomatic
cases
Calcium
carbonate
Vitamin D
Causes Features
Treatment
Increased intake
Increased absorption
Decreased excretion
Malignancy
Metastatic calcification
Neurological symptoms
Renal symptoms
Gastrointestinal symptoms
Cardiac arrhythmias
Treatment of primary disease
Induction of natriuresis
Calcitonin
Formation of bone and teeth
Production of high energy compounds
DNA and RNA synthesis
Synthesis of coenzymes
Synthesis of phosphoproteins and phospholipids
Activation of enzymes by phosphorylation
Acid base balance

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Roles of Vitamins and Minerals in health