Vitamins

Names of the vitamins .

Important points for MCQs.

Name of important disorders for MCQs.

Written By : Faisal Baloch BSN 3rd Year Medicare College Multan.

Fat-Soluble Vitamins:
1. Vitamin A- Retinol, Retinal, Retinoic acid

2. Vitamin D - Cholecalciferol (D3) Ergocalciferol (D2)

3. Vitamin E- Tocopherols, Tocotrienols

4. Vitamin K - Phylloquinone (K1), Menaquinones (K2)

Water-Soluble Vitamins:
1. Vitamin C- Ascorbic acid

2. Vitamin B1 - Thiamine

3. Vitamin B2 - Riboflavin

4. Vitamin B3 - Niacin, Nicotinamide

5. Vitamin B5 - Pantothenic acid

6. Vitamin B6 - Pyridoxine, Pyridoxal, Pyridoxamine

7. Vitamin B7 - Biotin

8. Vitamin B9 - Folic acid, Folates

9. Vitamin B12 (Cobalamin)- Cyanocobalamin, Methylcobalamin, Hydroxocobalamin

(Vitamin A)
Fat soluble vitamin
Retinol
Eye health is most common property.

(i) Vitamin A alcohol or retinol

(ii) Vitamin A aldehyde or retinal (also called retinene)
(iii) Vitamin A acid or retinoic acid.
These forms are sometimes referred to as retinoids.

Vitamin A stored in the liver as retinyl ester,

normally as retinyl palmitate.
Man liver is the only organ where carotenes are converted to vitamin A.
Retinol is transported in the blood with retinol binding protein (RBP). Retinoic acid binding protein (RABP)
specific for retinoic acid.
95% vitamin A is stored as its ester mainly as palmitate in the liver. It is released in the plasma when
required. 10 to 20 mg of vitamin A is present per 100 g of liver
Normal blood level of vitamin A is
18 to 60 μg/dl and that of carotenoids 100 to
300 μg/dl.

Functions

1. Role in Vision ( See detail from book)

2. Growth and metabolism
3. Role in Bone and Teeth Formation
4. Role in Epithelialisation
5. Role in Reproduction

Disorders.
[Link] : Skin becomes dry, scaly and rough. These changes are called as keratinisation

2. Xerophthalmia : Dryness of conjunctivae and cornea

[Link]’s spots : White opaque spots appear in the conjunctiva on either side in each eye

[Link] : Corneal epithelium becomes Keratinised, opaque and may become softened and ulcerated
[Link] formation : Kidney stones

Others : Nyctalopia, Xerosis, loss of cilia, acne, psoriasis, defective dentine

(Vitamin D)
Fat soluble vitamin
Cholecalciferol
Bone health is most common property
D2 Ergocalciferol, D3 cholecalciferol
Biologically Active Form of Vitamin D is Calcitriol.
Vitamin D is considered as a Prohormone
Calcitriol (1,25-di-OH-D3) as a hormone
Sunlight 7-dehydrocholestero
Fish liver oil is the richest source of vitamin D

• Ergosterol: Provitamin D2 found in plants.

• 7-dehydrocholesterol: Provitamin D3 found in the skin.

Functions

1. Mineralisation of bones:
2. Intestinal absorption of calcium and phosphate
3. It lowers the pH in certain parts of the gut such as colon and produces increase in urinary pH
4. It counteracts the inhibitory effect of calcium ions on the hydrolysis of phytate.

Disorders :
Deficiency of Vitamin D produces rickets in growing children and osteomalacia in adults.

1. Rickets :
Incomplete mineralization of bones results in soft pliable bones.
The bone mineral may be reabsorbed away from shaft of long bones making it soft.
The cartilage cells do not degenerate as
they should and ends of the long bones become bulky and soft.
Symptoms : knock knees, bow legs, ankles, knees, wrists and elbows are swollen
due to swelling of epiphyseal cartilage, hot-cross bun, pigeon breast appearance.

Types: There are two types of vitamin D deficiency rickets.

(i) Type I : It is inherited as autosomal recessive trait characterised by defect in conversion of 25-OH-D3
to calcitriol, i.e. 1-α-Hydroxylase deficiency.
(ii) Type II: It is an autosomal recessive disorder in which there is a single amino acid change in one of the
zinc fingers of the DNA binding sites for receptors. This makes the receptors nonfunctional.

2. Osteomalacia :
The deficiency of vitamin D in adults is osteomalacia which is rare. It can occur:
• In pregnancy and lactation: Where there is additional requirement of this vitamin and drainage of it in milk.
• In women who observe purdah or in climates where sunshine is scanty, calcium and
phosphorus absorption is decreased.
This particularly affects pelvic bones.

3. Renal Osteodystrophy
When renal parenchyma is lost or diseased quite significantly, it is unable to form calcitriol and
calcium absorption is impaired. Hypocalcemia leads to increase in PTH which acts on bone to increase
Ca++. Consequently there is excessive bone turnover and structural [Link] condition is known as
renal osteodystrophy.

Others : Peripheral artery disease (PAD), Breast cancer, Diabetes, Heart ailments,.

(Vitamin E)
Fat soluble vitamin
Tocopherols
Most common Antioxidant Property
Its deficiency leads to irreversible degenerative changes leading to permanent sterility. Motility of
sperms is lost and spermatogenesis is impaired.
Tocopheranolactone role in synthesis of coenzyme Q or ubiquinone.
Role in Reproduction in Rats
Removal of free radicals:
Clinical and therapeutic Nocturnal muscle cramp (NMC), Intermittent claudication (IC), Fibrocystic
breast disease (FBD), Atherosclerosis

The tocopherols differ from each other in the

number or position of methyl groups.
• α-tocopherol: 5, 7, 8 trimethyl tocol
• β-tocopherol: 5, 8 dimethyl tocol
• γ-tocopherol: 7, 8 dimethyl tocol
• δ-tocopherol: 8 methyl tocol
The α-tocopherol is the most active in vitamin E activity.

Disorders :
1. Dietary hepatic necrosis
[Link] anemia due to peroxides and dialuric acid
3. Muscular dystrophy

(Vitamin K)
Fat soluble vitamin
Prothrombin : clotting factor
Coagulation
Role in Oxidative Phosphorylation
Calcium Binding Proteins

Types :
Vitamin K1
It is phylloquinone or phytonadione isolated from alfalfa leaves.
Vitamin K2
Also known as farnoquinone, it was isolated from putrid fish meal
Vitamin K3
Known as menadione, is the synthetic analogue of vitamin [Link] is three times more potent than natural
varieties. Itis water-soluble and can be given parenterally.

Disorders :
Hypoprothrombinemia.
Hemorrhagic disease of the newborn

(Vitamin C)
Water soluble
Ascorbic Acid
Normal human blood plasma contains 0.6 to 1.5 mg of ascorbic acid per 100 ml.
Main sources citrous fruit, orange, amla is the riches source.
Destroyed in heat, oxidation and alkalies
Absorption is reduced in achlorhydia (lack of acid)
Coenzyme in hydroxlation reactions of proline and lysine

Functions

1. Role in Cellular Oxidation-Reduction

2. Role in Collagen Synthesis Hydroxy-proline and hydroxy-lysine are important constituents of mature
collagen fibres.
3. Functional Activity of Fibroblasts /Osteoblasts
4. Role in Tryptophan and tyrosine Metabolism
5. Formation Active FH4 (Tetrahydrofolate)
6. Formation of Ferritin
 7. Role in Electron Transport Systems
8. Action on Certain Enzymes-Activation/Inhibition
9. Vitamin C has also been reported to act as coenzymes for cathepsins and liver esterases.
10. Ascorbic acid in both leucocytes and platelets found to be lowered significantly in women taking Oral
contraceptive pills.

Disorder
Scurvy.
The deficiency of vitamin C results in scurvy The main defect is a failure to deposit intercellular
cement substance.
Symptoms :

Capillaries are fragile

Wound healing is delayed
Poor dentine formation
Gums are swollen
Osteoid of bone is poorly laid
Hypochromic microcytic anemia

Bachelor Scurvy: Elderly bachelors and widowers who may prepare their own foods are particularly prone to
development
of vitamin C deficiency.

(Vitamin B9)
Water soluble
Folic acid / Folate
Active “coenzyme” form of the vitamin is the reduced Tetrahydrofolate F.H4
Conversion of Vitamin B9 to THF requires Vitamin C and B12
THF is essential for the synthesis of purines and pyramidines especially thymidine
THF is required for maturation of RBCs
It is the most common vitamin deficiency to pregnant ladies and alcoholic peoples
Used in DNA synthesis and prevention of cancers.

Disorders :

1. Megaloblastic Anemia
2. Neural Tube defects
3. Spina bifida
4. Thrombocytopenia.
5. Granulocytopenia

(Vitamin B12)
Water soluble
 Cyanocobalamine
Central portion of the molecule consists of four reduced and extensively substituted pyrrole
rings, surrounding a single cobalt atom (Co). This central structure is called as Corrin Ring system.
A cyanide group is coordinately bound to the cobalt atom and then is called as cyanocobalamine
Hydroxycobalamine (B12a) (Hydroxocobalamine)
Nitritocobalamine (B12c)
Hydroxycobalamine (B12a) is superior as it is more active in enzyme systems, It is retained longer in
the body when given orally
B12a is more useful for therapeutic administration of B12 by mouth
Intrinsic factor is essential for the absorption of Vitamin B12
A man on normal nonvegetarian diet may store several mg (= 4 mg).
Normal serum level varies
from 0.008 to 0.42 μg/dl. (Average = 0.02 μg/dl) (below).
It is transported in blood with specific proteins named Transcobalamine I and Transcobalamine II and
III Physiologically Transcobalamine II is more important.

Disorders :

1. Adult pernicious anaemia, Juvenile pernicious anaemia:, Congenital pernicious anaemia :

Pernicious anemia is characterized by a deficiency of vitamin B12, caused by destruction of gastric
parietal cells leading to a lack of intrinsic factor,
2. Megaloblastic Anemia
3. Neuro psychiatric disorders
4. Degeneration of spinal cord

Important vitamin disorders to remember

Vitamin A : Night blindness,

Xerophthalmia

Vitamin C : Scurvy

Vitamin D : Rickets and osteomalacia

Vitamin E : Hemolytic anemia, creatinuria

Vitamin K : Bleeding disorders

Vitamin B1 : Beri Beri,

Wernicke Korashkoff

Vitamin B2 : Angular stomatitis, cheilosis

Vitamin B3 : Pellagra
Vitamin B6/H : Dermatitis and glossitis

Vitamin B9 : Megaloblastic anemia

Spina bifida
Neural tube defects

Vitamin B12 : Megaloblastic anemia

Pernicious Anemia
Neuro psychiatric disorders

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