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VITAMIN
Musab Gibreel Elibead
Msc. Food Quality Control
Prof. Ali
Elsaid
 Vitamin is an organic compound and a vital
nutrient that an organism requires in limited
amounts.
 Pro-vitamin is a substance that may be
converted within the body to a vitamin.
 Thirteen vitamins are necessary for health
 Vitamins A, D, E, and K are fat-soluble, and all
others are water-soluble (B and C)
 A deficiency of vitamins may be
 primary (dietary in origin) or
 secondary because of disturbances in intestinal
absorption, transport in the blood, tissue storage,
or metabolic conversion
Fat-soluble
Vitamin
Vitamin A
 Vitamin A is the name given to a group of
related compounds
 retinol (vitamin A alcohol),
 retinal (vitamin A aldehyde),
 retinoic acid (vitamin A acid)
 The generic term retinoids encompasses
vitamin A in its various forms and both
natural and synthetic chemicals that are
structurally related to vitamin A
Sources of Vit A
 Cod liver oil (30000 μg)
 Liver (turkey) (8058 μg 895%)
 Liver (beef, pork, fish) (6500 μg
722%)
 Liver (chicken) (3296 μg 366%)
 Dandelion greens (5588 IU
112%)[
 Sweet potato (961 μg 107%)
 Carrot (835 μg 93%)
 Butter (684 μg 76%)
 Kale (681 μg 76%)
 Cheddar cheese (265 μg 29%)
 Cantaloupe melon (169 μg 19%)
 Egg (140 μg 16%)
 Apricot (96 μg 11%)
 Papaya (55 μg 6%)
 Mango (38 μg 4%)
 pea (38 μg 4%)
 Milk (28 μg 3%)
 Tomatoes
 Seaweed
Note: Data taken from USDA
database, Bracketed values are
retinol activity equivalences
(RAEs) and percentage of the
adult male RDA, per 100 grams
of the foodstuff (average).
Functions of vitamin A
 Maintenance of normal vision
 Cell growth and differentiation
 Metabolic effects of retinoids
 Host resistance to infections
Vitamin A Deficiency
Vitamin A deficiency can occur as either a primary or a
secondary deficiency.
 A primary vitamin A deficiency occurs among children
and adults who do not consume an adequate intake of
provitamin A carotenoids from fruits and vegetables or
preformed vitamin A from animal and dairy products.
Early weaning from breast milk can also increase the
risk of vitamin A deficiency.
 Secondary vitamin A deficiency is associated with
chronic malabsorption of lipids, impaired bile production
and release, and chronic exposure to oxidants, such as
cigarette smoke, and chronic alcoholism.
 The most devastating changes occur in the
eyes and are referred to as xerophthalmia
(dry eye).
 First, xerosis conjunctivae
 Buildup of keratin debris in small opaque
plaques (Bitot spots) and, eventually,
 Erosion of the roughened corneal surface with
softening and destruction of the cornea
(keratomalacia) and total blindness.
Vitamin A Toxicity
 Acute toxicity occurs over a period of hours or a
few days, and is less of a problem than chronic
toxicity.
 Chronic toxicity - ingestion of high amounts of
preformed vitamin A for months or years - results
from daily intakes greater than 25,000 IU for 6
years or longer and more than 100,000 IU for 6
months or longer - are considered toxic.
 Well-established teratogenic effects of
retinoids – contraindicated in pregnancy
 Sources of toxicity
 Diet - liver is high in vitamin A. The liver of certain
animals — including the polar bear, bearded seal,
walrus, moose, and husky — are particularly
toxic.
 Supplements - usually when taken above
recommended dosages - can be toxic. Cod liver
oil is particularly high in vitamin A.
 Medications - at high doses of vitamin A - are
often used on long-term basis in numerous
preventive and therapeutic medical applications,
which may lead to hypervitaminosis A.
Vitamin D
Vitamin D refers to a group of fat-soluble
secosteroids responsible for enhancing
intestinal absorption of calcium, iron,
magnesium, phosphate and zinc. In humans,
the most important compounds in this group
are vitamin D3 (also known as cholecalciferol)
and vitamin D2 (ergocalciferol).
Vitamin D is found in few dietary sources,
Sunlight exposure is the primary source of
vitamin D for majority of people, other than
supplements.
 Major function of the fat-soluble vitamin D
is the maintenance of adequate plasma
levels of calcium and phosphorus
 Metabolic functions,
 Bone mineralization, and
 Neuromuscular transmission
Vitamin D deficiency
 Normal reference range for circulating 25-
(OH)-D is 20 to 100 ng/mL
 concentrations of less than 20 ng/mL constitute
vitamin D deficiency.
 vitamin D deficiency leading to bone softening
diseases as rickets in children and osteomalacia
and osteoporosis in adults.
 Causes
 Diet deficiency
 Limited exposure to sunlight
 Renal disorder
Rickets
Rickets a childhood disease, is
characterized by impeded growth and soft,
weak, deformed long bones that bend and bow
under their weight as children start to walk.
This condition is characterized by bow legs,
which can be caused by calcium or phosphorus
deficiency, as well as a lack of vitamin D.
Osteomalacia
Osteomalacia is a disease in adults that results
from vitamin D deficiency. Characteristics of this
disease are softening of the bones, leading to bending
of the spine, bowing of the legs, proximal muscle
weakness, bone fragility, and increased risk for
fractures, Osteomalacia reduces calcium absorption
and increases calcium loss from bone, which
increases the risk for bone fractures, The effects of
osteomalacia are thought to contribute to chronic
musculoskeletal pain There is no persuasive evidence
of lower vitamin D levels in chronic pain sufferers.
Vitamin D toxicity
Vitamin D toxicity is usually caused by taking
too many supplements Vitamin D toxicity can
lead to too much calcium in the blood.
Symptoms of this include: Weakness, Nausea
and vomiting, Increased urination, Constipation,
Weight loss, Not feeling hungry, Confusion,
Irregular heart beat, Kidney stones
Vitamin D toxicity can be treated by stopping
any supplements of vitamin D and taking in less
calcium.
Vitamin E refers to a group of compounds that include
both tocopherols and tocotrienols, It is dissolves in fat
• α-tocopherol
• β-tocopherol
• γ-tocopherol
• δ-tocopherol
Tocopherols
• α-tocotrienols
• β-tocotrienols
• γ-tocotrienols
• δ-tocotrienols
Tocotrienols
Vitamin E
Sources
Vitamin E Function
As a biological
antioxidant
Prevents lipid
peroxidation of
biological membrane
Prevents
peroxidation of
vitamin A & PUFA
Reproductive
functions & prevents
sterility
Vitamin E
Vitamin E deficiency
 Causes
 Inadequate intake
 Impaired absorption
 Features
 Hemolytic anaemia in the new born
 Muscle weakness (myopathy)
 Spinocerebellar ataxia and impaired vision
Myopathy
Myopathy is a muscular disease in which the muscle
fibers do not function for any one of many reasons,
resulting in muscular weakness. "Myopathy" simply means
muscle disease (myo- Greek μυο "muscle" + pathos -pathy
Greek "suffering"). This meaning implies that the primary
defect is within the muscle, as opposed to the nerves
("neuropathies" or "neurogenic" disorders) or elsewhere
(e.g., the brain etc.). Muscle cramps, stiffness, and spasm
can also be associated with myopathy.
Capture Myopathy, or Shock Disease, is a little-studied
condition observed in wild animals such as hares and birds
that have been captured or handled The condition is
usually lethal and stress has been identified as the single
most determining factor, exacerbated by muscle exertion.
Vitamin E Toxicity
 Vitamin E can act as an anticoagulant,
increasing the risk of bleeding problems. As a
result, many agencies have set a tolerable
upper intake levels (UL) at 1,000 mg (1,500
IU) per day.[
 In combination with certain other drugs such
as aspirin, hypervitaminosis E can be life-
threatening.
 Hypervitaminosis E may also counteract
vitamin K, leading to a vitamin K deficiency
Vitamin K
 Vitamin K refers to a group of structurally
similar, fat-soluble vitamins the human body
needs for complete synthesis of certain
proteins that are required for blood
coagulation, and also certain proteins that the
body uses to control binding of calcium in
bone and other tissues
Vitamin K Types
• Pylloquinone
• Present in plants
Vitamin
K1
• Menaquinone
• Produced by intestinal bacteria
Vitamin
K2
• Menadione
• Synthetic form
Vitamin
K3
Sources
Function
Role in blood
coagulation
• Cofactor for gamma
carboxylation of
glutamic acid in
clotting factors II, VIII,
IX and X
Role in bone
mineralization
• Cofactor for gamma
carboxylation of
glutamic acid in
osteocalcin
Deficiency
Causes In newborn
Impaired absorption
Sterile bacterial flora
Features Bleeding
Prolonged prothrombin time
Vitamin K Deficiency Bleeding
(VKDB)
Haemorrhagic disease of the newborn, also known as
Vitamin K Deficiency Bleeding (VKDB) is a coagulation
disturbance in newborns due to vitamin K deficiency. As a
consequence of vitamin K deficiency there is an impaired
production of coagulation factors II, VII, IX, X, protein C and
protein S by the liver.
Signs and symptoms The disease causes an increased
risk of bleeding. The most common sites of bleeding are the
umbilicus, mucous membranes, gastrointestinal tract,
circumcision and venepunctures.
Causes Newborns are relatively vitamin K deficient for a
variety of reasons. They have low vitamin K stores at birth,
vitamin K passes the placenta poorly, the levels of vitamin K in
breast milk are low and the gut flora has not yet been
developed (vitamin K is normally produced by intestinal
bacteria.
Treatment consists of vitamin K supplementation. This is
Vitamin K Toxicity
 Although allergic reaction from supplementation is
possible, no known toxicity is associated with high
doses of the phylloquinone (vitamin K1) or
menaquinone (vitamin K2) forms of vitamin K, so
no tolerable upper intake level (UL) has been set.
 Blood clotting (coagulation) studies in humans
using 45 mg per day of vitamin K2 (as MK-4) and
even up to 135 mg/day (45 mg three times daily)
of K2 (as MK-4), showed no increase in blood clot
risk. Even doses in rats as high as 250 mg/kg
body weight did not alter the tendency for blood-
clot formation to occur.
Water-soluble
Vitamin
(Vit B and Vit C)
Vitamin C (Ascorbic Acid)
Vitamin C or L-ascorbic acid, or simply ascorbate
(the anion of ascorbic acid), is an essential nutrient for
humans and certain other animal species. Vitamin C
refers to a number of vitamers that have vitamin C
activity in animals, including ascorbic acid and its
salts, and some oxidized forms of the molecule like
dehydroascorbic acid. Ascorbate and ascorbic acid
are both naturally present in the body when either of
these is introduced into cells, since the forms
interconvert according to pH.
Vitamin C is present in milk and some animal
products (liver, fish) and is abundant in a variety of
fruits and vegetables.
Function
 Best-established function of vitamin C is
the activation of prolyl and lysyl
hydroxylases from inactive precursors,
providing for hydroxylation of procollagen.
 Collagen, which normally has the highest
content, of hydroxyproline, particularly in
blood vessels, accounts for the
predisposition to hemorrhages in scurvy.
 Antioxidant properties
 scavenge free radicals directly and
 Act indirectly by regenerating the antioxidant
form of vitamin E
Vitamin C Sources
Vitamin C Deficiency(Scurvy)
Scurvy is an avitaminosis resulting from
lack of vitamin C, since without this vitamin, the
synthesized collagen is too unstable to perform
its function. Scurvy leads to the formation of
brown spots on the skin, spongy gums, and
bleeding from all mucous membranes. The
spots are most abundant on the thighs and legs,
and a person with the ailment looks pale, feels
depressed, and is partially immobilized. In
advanced scurvy there are open, suppurating
wounds and loss of teeth and, eventually, death.
The human body can store only a certain
Vitamin C toxicity
Vitamin C toxicity is usually caused by
taking too many supplements. It is usually
not caused by getting too much vitamin C
from food, It can cause: Diarrhea, Nausea,
Stomach cramps.
Hemochromatosis causes the body to
store too much iron, High doses of vitamin C
could worsen iron overload and cause
damage to body tissues. It is important to
stay within the recommended dosage range
and talk to a healthcare provider before
starting vitamin supplements.
B vitamins
The B vitamins are a group of water-soluble
vitamins that play important roles in cell metabolism.
The B vitamins were once thought to be a single
vitamin, referred to as vitamin B (much as people refer
to vitamin C or vitamin D). Later research showed that
they are chemically distinct vitamins that often coexist
in the same foods. In general, supplements containing
all eight are referred to as a vitamin B complex.
Individual B vitamin supplements are referred to by
the specific name of each vitamin (e.g., B1, B2, B3 etc).
Vitamin B Types
 Vitamin B1 (thiamine)
 Vitamin B2 (riboflavin)
 Vitamin B3 (niacin or niacinamide)
 Vitamin B5 (pantothenic acid)
 Vitamin B6 (pyridoxine, pyridoxal, or
pyridoxamine, or pyridoxine hydrochloride)
 Vitamin B7 (biotin)
 Vitamin B9 (folic acid)
 Vitamin B12 (various cobalamins; commonly
cyanocobalamin in vitamin supplements)
Function
 Support and increase the rate of
metabolism.
 Maintain healthy skin and muscle tone.
 Enhance immune and nervous system
function.
 Promote cell growth and division, including
that of the red blood cells that help prevent
anemia.
 Reduce the risk of pancreatic cancer - one
of the most lethal forms of cancer- when
consumed in food, but not when ingested
Source
 Thiamine: Fortified bread and cereal, fish, lean meat and milk.
 Riboflavin: Cereal, Nuts, Milk, Egg, Green leafy Vegetables.
 Niacin: Diary poultry, fish, Nuts, Egg, Lean Meat.
 Pantothenic acid: Meat, Legumes, whole Grain Cereals.
 Pyridoxine: Bean, Legumes, fish, Nuts, Egg, Meat, bread and
cereal.
 Folic acid: Yeast, Liver, Green Vegetables and whole Grain
Cereals.
 Cobalamin: Meat, Egg, Milk and Milk products, poultry,
shelfish.
 Biotin: Peanuts, Swiss chard and other leafy green vegetables,
raw egg yolk liver, and Saskatoon berries.
Deficiency
Beriberi (vitamin B1
Deficiency)
Beriberi refers to a cluster of symptoms caused
primarily by a nutritional deficit in vitamin B1
(thiamine). Beriberi has conventionally been divided
into three separate entities, relating to the body
system mainly involved (peripheral nervous system
or cardiovascular) or age of person (infantile).
Beriberi is one of several thiamine-deficiency related
conditions which may occur concurrently, including
Wernicke's encephalopathy (mainly affecting the
central nervous system), Korsakoff's syndrome
(amnesia with additional psychiatric manifestations),
and Wernicke-Korsakoff syndrome (with both
neurologic and psychiatric symptoms)
Signs and symptoms
 Symptoms of beriberi include weight loss, emotional
disturbances, impaired sensory perception, weakness and
pain in the limbs, and periods of irregular heart rate.
Edema (swelling of bodily tissues) is common. It may
increase the amount of lactic acid and pyruvic acid within
the blood. In advanced cases, the disease may cause
high-output cardiac failure and death. Symptoms may
occur concurrently with those of Wernicke's
encephalopathy, a primarily neurological thiamine-
deficiency related condition.
 Beriberi is divided into three historical classifications:
 Dry beriberi specially affects the peripheral nervous
system.
 Wet beriberi specially affects the cardiovascular system
and other bodily systems.
 Infantile beriberi affects the children of malnourished
Treatment
Many people with beriberi can be treated with
thiamine alone, Given thiamine intravenously
(and later orally), rapid and dramatic recovery
can occur within hours. In situations where
concentrated thiamine supplements are
unavailable, feeding the person with a thiamine-
rich diet (e.g. whole grain brown bread) will lead
to recovery, though at a much slower rate.
Vitamin B toxicity
Some B vitamins do not have any toxic effects while
others do. For instance, there are no known toxic effects
linked to taking too much thiamine, riboflavin, or biotin.
Large doses of niacin can cause: Increased blood sugar
(glucose) level ,Liver damage, Peptic ulcers ,Skin rashes ,
Even normal doses of niacin can be associated with skin
flushing.
Large doses of vitamin B6 from food sources have not
been reported to cause adverse effects, but taking large
doses regularly can cause: Difficulty coordinating
movement , Numbness ,Sensory changes
Folic acid intake from food is not associated with any
health risk. The risk of toxicity from folic acid intake from
supplements or fortified foods is also low. Be sure to tell
your healthcare providers about any supplements and
medicines you take to make sure that they won’t interfere
with each other.
Vitamin

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Vitamin

  • 1. VITAMIN Musab Gibreel Elibead Msc. Food Quality Control Prof. Ali Elsaid
  • 2.  Vitamin is an organic compound and a vital nutrient that an organism requires in limited amounts.  Pro-vitamin is a substance that may be converted within the body to a vitamin.  Thirteen vitamins are necessary for health  Vitamins A, D, E, and K are fat-soluble, and all others are water-soluble (B and C)  A deficiency of vitamins may be  primary (dietary in origin) or  secondary because of disturbances in intestinal absorption, transport in the blood, tissue storage, or metabolic conversion
  • 4. Vitamin A  Vitamin A is the name given to a group of related compounds  retinol (vitamin A alcohol),  retinal (vitamin A aldehyde),  retinoic acid (vitamin A acid)  The generic term retinoids encompasses vitamin A in its various forms and both natural and synthetic chemicals that are structurally related to vitamin A
  • 5. Sources of Vit A  Cod liver oil (30000 μg)  Liver (turkey) (8058 μg 895%)  Liver (beef, pork, fish) (6500 μg 722%)  Liver (chicken) (3296 μg 366%)  Dandelion greens (5588 IU 112%)[  Sweet potato (961 μg 107%)  Carrot (835 μg 93%)  Butter (684 μg 76%)  Kale (681 μg 76%)  Cheddar cheese (265 μg 29%)  Cantaloupe melon (169 μg 19%)  Egg (140 μg 16%)  Apricot (96 μg 11%)  Papaya (55 μg 6%)  Mango (38 μg 4%)  pea (38 μg 4%)  Milk (28 μg 3%)  Tomatoes  Seaweed Note: Data taken from USDA database, Bracketed values are retinol activity equivalences (RAEs) and percentage of the adult male RDA, per 100 grams of the foodstuff (average).
  • 6.
  • 7. Functions of vitamin A  Maintenance of normal vision  Cell growth and differentiation  Metabolic effects of retinoids  Host resistance to infections
  • 8. Vitamin A Deficiency Vitamin A deficiency can occur as either a primary or a secondary deficiency.  A primary vitamin A deficiency occurs among children and adults who do not consume an adequate intake of provitamin A carotenoids from fruits and vegetables or preformed vitamin A from animal and dairy products. Early weaning from breast milk can also increase the risk of vitamin A deficiency.  Secondary vitamin A deficiency is associated with chronic malabsorption of lipids, impaired bile production and release, and chronic exposure to oxidants, such as cigarette smoke, and chronic alcoholism.
  • 9.  The most devastating changes occur in the eyes and are referred to as xerophthalmia (dry eye).  First, xerosis conjunctivae  Buildup of keratin debris in small opaque plaques (Bitot spots) and, eventually,  Erosion of the roughened corneal surface with softening and destruction of the cornea (keratomalacia) and total blindness.
  • 10.
  • 11. Vitamin A Toxicity  Acute toxicity occurs over a period of hours or a few days, and is less of a problem than chronic toxicity.  Chronic toxicity - ingestion of high amounts of preformed vitamin A for months or years - results from daily intakes greater than 25,000 IU for 6 years or longer and more than 100,000 IU for 6 months or longer - are considered toxic.  Well-established teratogenic effects of retinoids – contraindicated in pregnancy
  • 12.  Sources of toxicity  Diet - liver is high in vitamin A. The liver of certain animals — including the polar bear, bearded seal, walrus, moose, and husky — are particularly toxic.  Supplements - usually when taken above recommended dosages - can be toxic. Cod liver oil is particularly high in vitamin A.  Medications - at high doses of vitamin A - are often used on long-term basis in numerous preventive and therapeutic medical applications, which may lead to hypervitaminosis A.
  • 13. Vitamin D Vitamin D refers to a group of fat-soluble secosteroids responsible for enhancing intestinal absorption of calcium, iron, magnesium, phosphate and zinc. In humans, the most important compounds in this group are vitamin D3 (also known as cholecalciferol) and vitamin D2 (ergocalciferol). Vitamin D is found in few dietary sources, Sunlight exposure is the primary source of vitamin D for majority of people, other than supplements.
  • 14.  Major function of the fat-soluble vitamin D is the maintenance of adequate plasma levels of calcium and phosphorus  Metabolic functions,  Bone mineralization, and  Neuromuscular transmission
  • 15.
  • 16.
  • 17. Vitamin D deficiency  Normal reference range for circulating 25- (OH)-D is 20 to 100 ng/mL  concentrations of less than 20 ng/mL constitute vitamin D deficiency.  vitamin D deficiency leading to bone softening diseases as rickets in children and osteomalacia and osteoporosis in adults.  Causes  Diet deficiency  Limited exposure to sunlight  Renal disorder
  • 18. Rickets Rickets a childhood disease, is characterized by impeded growth and soft, weak, deformed long bones that bend and bow under their weight as children start to walk. This condition is characterized by bow legs, which can be caused by calcium or phosphorus deficiency, as well as a lack of vitamin D.
  • 19.
  • 20. Osteomalacia Osteomalacia is a disease in adults that results from vitamin D deficiency. Characteristics of this disease are softening of the bones, leading to bending of the spine, bowing of the legs, proximal muscle weakness, bone fragility, and increased risk for fractures, Osteomalacia reduces calcium absorption and increases calcium loss from bone, which increases the risk for bone fractures, The effects of osteomalacia are thought to contribute to chronic musculoskeletal pain There is no persuasive evidence of lower vitamin D levels in chronic pain sufferers.
  • 21.
  • 22. Vitamin D toxicity Vitamin D toxicity is usually caused by taking too many supplements Vitamin D toxicity can lead to too much calcium in the blood. Symptoms of this include: Weakness, Nausea and vomiting, Increased urination, Constipation, Weight loss, Not feeling hungry, Confusion, Irregular heart beat, Kidney stones Vitamin D toxicity can be treated by stopping any supplements of vitamin D and taking in less calcium.
  • 23. Vitamin E refers to a group of compounds that include both tocopherols and tocotrienols, It is dissolves in fat • α-tocopherol • β-tocopherol • γ-tocopherol • δ-tocopherol Tocopherols • α-tocotrienols • β-tocotrienols • γ-tocotrienols • δ-tocotrienols Tocotrienols Vitamin E
  • 25. Vitamin E Function As a biological antioxidant Prevents lipid peroxidation of biological membrane Prevents peroxidation of vitamin A & PUFA Reproductive functions & prevents sterility Vitamin E
  • 26. Vitamin E deficiency  Causes  Inadequate intake  Impaired absorption  Features  Hemolytic anaemia in the new born  Muscle weakness (myopathy)  Spinocerebellar ataxia and impaired vision
  • 27. Myopathy Myopathy is a muscular disease in which the muscle fibers do not function for any one of many reasons, resulting in muscular weakness. "Myopathy" simply means muscle disease (myo- Greek μυο "muscle" + pathos -pathy Greek "suffering"). This meaning implies that the primary defect is within the muscle, as opposed to the nerves ("neuropathies" or "neurogenic" disorders) or elsewhere (e.g., the brain etc.). Muscle cramps, stiffness, and spasm can also be associated with myopathy. Capture Myopathy, or Shock Disease, is a little-studied condition observed in wild animals such as hares and birds that have been captured or handled The condition is usually lethal and stress has been identified as the single most determining factor, exacerbated by muscle exertion.
  • 28. Vitamin E Toxicity  Vitamin E can act as an anticoagulant, increasing the risk of bleeding problems. As a result, many agencies have set a tolerable upper intake levels (UL) at 1,000 mg (1,500 IU) per day.[  In combination with certain other drugs such as aspirin, hypervitaminosis E can be life- threatening.  Hypervitaminosis E may also counteract vitamin K, leading to a vitamin K deficiency
  • 29. Vitamin K  Vitamin K refers to a group of structurally similar, fat-soluble vitamins the human body needs for complete synthesis of certain proteins that are required for blood coagulation, and also certain proteins that the body uses to control binding of calcium in bone and other tissues
  • 30. Vitamin K Types • Pylloquinone • Present in plants Vitamin K1 • Menaquinone • Produced by intestinal bacteria Vitamin K2 • Menadione • Synthetic form Vitamin K3
  • 32. Function Role in blood coagulation • Cofactor for gamma carboxylation of glutamic acid in clotting factors II, VIII, IX and X Role in bone mineralization • Cofactor for gamma carboxylation of glutamic acid in osteocalcin
  • 33. Deficiency Causes In newborn Impaired absorption Sterile bacterial flora Features Bleeding Prolonged prothrombin time
  • 34. Vitamin K Deficiency Bleeding (VKDB) Haemorrhagic disease of the newborn, also known as Vitamin K Deficiency Bleeding (VKDB) is a coagulation disturbance in newborns due to vitamin K deficiency. As a consequence of vitamin K deficiency there is an impaired production of coagulation factors II, VII, IX, X, protein C and protein S by the liver. Signs and symptoms The disease causes an increased risk of bleeding. The most common sites of bleeding are the umbilicus, mucous membranes, gastrointestinal tract, circumcision and venepunctures. Causes Newborns are relatively vitamin K deficient for a variety of reasons. They have low vitamin K stores at birth, vitamin K passes the placenta poorly, the levels of vitamin K in breast milk are low and the gut flora has not yet been developed (vitamin K is normally produced by intestinal bacteria. Treatment consists of vitamin K supplementation. This is
  • 35. Vitamin K Toxicity  Although allergic reaction from supplementation is possible, no known toxicity is associated with high doses of the phylloquinone (vitamin K1) or menaquinone (vitamin K2) forms of vitamin K, so no tolerable upper intake level (UL) has been set.  Blood clotting (coagulation) studies in humans using 45 mg per day of vitamin K2 (as MK-4) and even up to 135 mg/day (45 mg three times daily) of K2 (as MK-4), showed no increase in blood clot risk. Even doses in rats as high as 250 mg/kg body weight did not alter the tendency for blood- clot formation to occur.
  • 37. Vitamin C (Ascorbic Acid) Vitamin C or L-ascorbic acid, or simply ascorbate (the anion of ascorbic acid), is an essential nutrient for humans and certain other animal species. Vitamin C refers to a number of vitamers that have vitamin C activity in animals, including ascorbic acid and its salts, and some oxidized forms of the molecule like dehydroascorbic acid. Ascorbate and ascorbic acid are both naturally present in the body when either of these is introduced into cells, since the forms interconvert according to pH. Vitamin C is present in milk and some animal products (liver, fish) and is abundant in a variety of fruits and vegetables.
  • 38. Function  Best-established function of vitamin C is the activation of prolyl and lysyl hydroxylases from inactive precursors, providing for hydroxylation of procollagen.  Collagen, which normally has the highest content, of hydroxyproline, particularly in blood vessels, accounts for the predisposition to hemorrhages in scurvy.  Antioxidant properties  scavenge free radicals directly and  Act indirectly by regenerating the antioxidant form of vitamin E
  • 40. Vitamin C Deficiency(Scurvy) Scurvy is an avitaminosis resulting from lack of vitamin C, since without this vitamin, the synthesized collagen is too unstable to perform its function. Scurvy leads to the formation of brown spots on the skin, spongy gums, and bleeding from all mucous membranes. The spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized. In advanced scurvy there are open, suppurating wounds and loss of teeth and, eventually, death. The human body can store only a certain
  • 41.
  • 42. Vitamin C toxicity Vitamin C toxicity is usually caused by taking too many supplements. It is usually not caused by getting too much vitamin C from food, It can cause: Diarrhea, Nausea, Stomach cramps. Hemochromatosis causes the body to store too much iron, High doses of vitamin C could worsen iron overload and cause damage to body tissues. It is important to stay within the recommended dosage range and talk to a healthcare provider before starting vitamin supplements.
  • 43. B vitamins The B vitamins are a group of water-soluble vitamins that play important roles in cell metabolism. The B vitamins were once thought to be a single vitamin, referred to as vitamin B (much as people refer to vitamin C or vitamin D). Later research showed that they are chemically distinct vitamins that often coexist in the same foods. In general, supplements containing all eight are referred to as a vitamin B complex. Individual B vitamin supplements are referred to by the specific name of each vitamin (e.g., B1, B2, B3 etc).
  • 44. Vitamin B Types  Vitamin B1 (thiamine)  Vitamin B2 (riboflavin)  Vitamin B3 (niacin or niacinamide)  Vitamin B5 (pantothenic acid)  Vitamin B6 (pyridoxine, pyridoxal, or pyridoxamine, or pyridoxine hydrochloride)  Vitamin B7 (biotin)  Vitamin B9 (folic acid)  Vitamin B12 (various cobalamins; commonly cyanocobalamin in vitamin supplements)
  • 45. Function  Support and increase the rate of metabolism.  Maintain healthy skin and muscle tone.  Enhance immune and nervous system function.  Promote cell growth and division, including that of the red blood cells that help prevent anemia.  Reduce the risk of pancreatic cancer - one of the most lethal forms of cancer- when consumed in food, but not when ingested
  • 46. Source  Thiamine: Fortified bread and cereal, fish, lean meat and milk.  Riboflavin: Cereal, Nuts, Milk, Egg, Green leafy Vegetables.  Niacin: Diary poultry, fish, Nuts, Egg, Lean Meat.  Pantothenic acid: Meat, Legumes, whole Grain Cereals.  Pyridoxine: Bean, Legumes, fish, Nuts, Egg, Meat, bread and cereal.  Folic acid: Yeast, Liver, Green Vegetables and whole Grain Cereals.  Cobalamin: Meat, Egg, Milk and Milk products, poultry, shelfish.  Biotin: Peanuts, Swiss chard and other leafy green vegetables, raw egg yolk liver, and Saskatoon berries.
  • 48. Beriberi (vitamin B1 Deficiency) Beriberi refers to a cluster of symptoms caused primarily by a nutritional deficit in vitamin B1 (thiamine). Beriberi has conventionally been divided into three separate entities, relating to the body system mainly involved (peripheral nervous system or cardiovascular) or age of person (infantile). Beriberi is one of several thiamine-deficiency related conditions which may occur concurrently, including Wernicke's encephalopathy (mainly affecting the central nervous system), Korsakoff's syndrome (amnesia with additional psychiatric manifestations), and Wernicke-Korsakoff syndrome (with both neurologic and psychiatric symptoms)
  • 49. Signs and symptoms  Symptoms of beriberi include weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate. Edema (swelling of bodily tissues) is common. It may increase the amount of lactic acid and pyruvic acid within the blood. In advanced cases, the disease may cause high-output cardiac failure and death. Symptoms may occur concurrently with those of Wernicke's encephalopathy, a primarily neurological thiamine- deficiency related condition.  Beriberi is divided into three historical classifications:  Dry beriberi specially affects the peripheral nervous system.  Wet beriberi specially affects the cardiovascular system and other bodily systems.  Infantile beriberi affects the children of malnourished
  • 50. Treatment Many people with beriberi can be treated with thiamine alone, Given thiamine intravenously (and later orally), rapid and dramatic recovery can occur within hours. In situations where concentrated thiamine supplements are unavailable, feeding the person with a thiamine- rich diet (e.g. whole grain brown bread) will lead to recovery, though at a much slower rate.
  • 51.
  • 52. Vitamin B toxicity Some B vitamins do not have any toxic effects while others do. For instance, there are no known toxic effects linked to taking too much thiamine, riboflavin, or biotin. Large doses of niacin can cause: Increased blood sugar (glucose) level ,Liver damage, Peptic ulcers ,Skin rashes , Even normal doses of niacin can be associated with skin flushing. Large doses of vitamin B6 from food sources have not been reported to cause adverse effects, but taking large doses regularly can cause: Difficulty coordinating movement , Numbness ,Sensory changes Folic acid intake from food is not associated with any health risk. The risk of toxicity from folic acid intake from supplements or fortified foods is also low. Be sure to tell your healthcare providers about any supplements and medicines you take to make sure that they won’t interfere with each other.