Vitamins topic in Community medicine

1. 1
DR. MELBIN JAMES .S
SENIOR RESIDENT
Department of Community Medicine
SLIMS

2. Essential Micronutrients required in small amounts (mg to gms) to
maintain biological functions , growth and development
TYPES OF VITAMINS – (13)
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5.  Scientific Name of Water soluble vitamins
Functions of Vitamins
 Sources of Group -Vitamins
 Daily Requirements ( RDA)
 Deficiency Related Diseases
 Prevention of Deficiencies
 Summary Table of Vitamins

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7. • Maintain Nerve Cell function and immunity
• Hematopoeitic function – synthesis of RBC
• Regulation of Various hormones and Gene expression
• Aids in DNA replication
• Role in Carbohydrate , Protein and Lipid metabolism
• Facilitates ATP production – energy
• Cofactor for various Enzymatic chemical reactions
General Functions of Vitamins :
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8. Specific Functions of Vitamins :
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Vit B1 ---- Carbohydrate to glucose conversion required and co enzyme for various
decarboxylation reactions
Vit B2 ---- ATP storage and Energy Generation ( Carbohydrate to ATP conversion required)
Vit B3 ---- Prevents CVS diseases ( Increases HDL and lowers LDL)
Vit B5 ---- Biosynthesis of RBC and Corticosteroids ( Anti stress Vitamin)

9. Specific Functions of Vitamins :
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Vit B6 ---- Carbohydrates and AA to energy conversion required and Hb production
Essential for Gluconeogenesis and Neurotransmitter synthesis
Vit B7 ---- For Skin , nail and Hair care
Vit B9 ---- Hematopoeitic and synthesis of nucleic acids
Vit B12 ---- Maintainence of myelination of spinal cord tracts integrity ( synthesis of FA in
myelin sheaths ) . Hematopoeitc as well .Helps in DNA synthesis
Vit C – Antioxidant , inhibits ageing process , tissue growth and repair ( collagen synthesis),
Facilitates iron absorption

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QN “:- WHY WE DON’T HAVE VITAMINS NAMES AS VITAMIN F , G , H , J & P “?
 Vitamin F -----EFA
 Vitamin G -----Vit B2 (Riboflavin)
 Vitamin H ----- Vit B7 ( Biotin)
 Vitamin J & P -----Not beneficial to
human health ( benefits to Rats)

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THE STORY OF VITAMIN C & SCURVY

15. DAILY REQUIREMENTS :
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Vitamins Chemical Name RDA / day
B1 Thiamine 0.5 mg /1000 Kcal of energy intake
( 1-2mg/day)
B2 Riboflavin 0.5 mg /1000 Kcal of energy intake
B3 Niacin 6 mg /1000 Kcal of energy intake
B5 Pantothenic acid 10 mg/day
B6 Pyridoxine/Pyridoxal/
Pyridoxamine
2 mg /day( Adults)
2.5 mg/day ( Pregnancy and lactation)
10mg/day – Patient on INH therapy ( ATT)

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Vitamins Chemical Name RDA / day
B9 Folate / Folic acid Adults – 200 mcg
Pregnancy – 500 mcg
Lactation – 300 mcg
Children – 80 to 120 mcg
B12 Methyl Cobalamine 1 mcg ( Adults)
1.2 mcg ( Pregnancy)
1.5 mcg ( Lactation)
Infants and children – 0.2mcg
C Ascorbic acid 40 mg /day
DAILY REQUIREMENTS :

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 VITAMIN B12

18. Vitamin B1 -THIAMINE
1. BERI BERI -Three types : Wet ( CVS) , Dry ( CNS – Peripheral neurits and paralysis of legs )
, Infantile ( 2-4mths breastfed by deficient mother)
2. Wernickes Korsakoff Psychosis : Ataxia , Opthalmoplegia , peripheral neuritis among
chronic alcoholics
3. Lactic Acidosis : Accumulation of pyruvate and lactic acid in tissues
4. Lost during – Milling , washing , prolonged cooking and storage of fruits and vegetables
Also lost when cereals cooked with baking soda
Prevention : Parboiled rice and diet rich in Thiamine ( Groundnuts and Gingelly seeds)
Stop alcohol intake
VITAMIN DEFICIENCIES :
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20. PARBOILED RICE
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• Method to Preserve Vitamin B1 in rice
• Rice soaked in hot/warm water then boiled in same
water and drained –dry ( partially boiled rice at paddy
stage before milling)
Merits : Thiamine get firm to grains ( pushes from outer to
inner layers of rice grains ) and prevent loss during milling /
polishing
• Long duration storage , Tough rice grains and resistant to
insect/fungi invasion , Easy to digest
Demerits : Reduced flavor and taste
Unpleasant smell and Pale hue to rice ( dark rice)
• Long cooking time

21. Vitamin B2 – RIBOFLAVIN
 ARBOFLAVINOSIS
ANGULAR STOMATITS (CHEILOSIS)
GLOSSITIS
CORNEAL VASCULARISATION
VITAMIN DEFICIENCIES :
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22. TONGUE SIGNS OF VITAMIN DEFICIENCY
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23. Vitamin B3 – NIACIN
PELLAGRA ( Dermatitis , Dementia , Diarrohea , Death ) – 4Ds
Dermatitis – Casals necklace ( Hyperpigmented patch over sun exposed sites)
Common in Maize / Jowar ( sorghum) eaters --- Excess of Leucine blocks the conversion of
Tryptophan to niacin leading to deficiency
60mg tryptophan is converted to 1mg of niacin in body
VITAMIN DEFICIENCIES :
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24. CASAL’S NECKLACE
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25. • VITAMIN B5 ----Burning sole / feet syndrome
• VITAMIN B6 --- Seizures in infants , anemia , peripheral neuropathy
• VITAMIN B7 ---- Dermatitis and Hair fall
• VITAMIN B9 ----Megaloblastic anemia, Neural tube defects and infertility
• VITAMIN B12 ---- Pernicious Anemia , Subacute degeneration of spinal cord
• VITAMIN C ----SCURVY , Swollen Bleeding gums , Delayed wound healing , Teeth bruises
• MULTIPLE DEFICIENCY SYNDROME : Usually VITAMIN B2 + B6 deficiency common
OTHER VITAMINS DEFICIENCIES
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29. 1. White polished rice causes deficiency of ?
A. Tryptophan
B. Thiamine
C. Riboflavin
D. Proteins
2. Cheilosis caused by ?
A. B12 deficiency
B. B2 deficiency
C. Scarlet fever
D. All of the above
MCQs
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30. 3. Pellagra in maize eating population caused due to ?
A. Niacin in bound form
B. Deficiency of tryptophan
C. Excess of Leucine
D. High consumption of milk and milk products
4. A Farmer is having complaints of skin rash which increases on sun exposure . There is also
redness in tongue . Maize is his staple diet . Which vitamin is deficient ?
A. B6
B. B1
C. B3
D. B12
MCQ
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VITAMIN C
VITAMIN A
VITAMIN B Complex
VITAMIN D

32. CONNECTING
THE DOTS –
FIND THE VITAMIN
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