SESSION 8: THE VITAMINS SX:

✔ loss of sensation in the hands and feet

Essential, non-caloric, organic nutrients needed in
tiny amounts in the diet to perform specific ✔ Muscular weakness
functions that promote growth, reproduction, and
the maintenance of health and life. ✔ Changes to the gait

✔ Coordination problems
2 Characteristics that distinguish vitamins from
energy nutrients: ✔ Advancing paralysis
1. do not yield energy when broken down, but ✔ Abnormal heart action
assist the enzymes that release energy from CHO,
fat and CHON c. Wernicke-Korsakoff Syndrome - a
2. needed in much smaller amounts than the cerebral form of beriberi with the following
prominent symptoms:
energy nutrients (macronutrients).
o double vision
Classification of Vitamins o a drooping upper eyelid
o up-and-down or side-to-side eye movements
a. Water soluble vitamins- dissolve or disperse in
water. o loss of muscle coordination
b. Fat soluble vitamins- dissolve in fatty tissues or o a confused mental status
substances.
2. RIBOFLAVIN (B2)
Water-soluble Vitamins
Main function is a coenzyme in the release of
energy from nutrients in every cell of a body.
1. THIAMINE (B1) - serves as coenzyme and has a
role in nerve functioning related to muscle actions. RDA- 1.3mg/day for men and 1.1mg/day women

Good plant sources are broccoli, asparagus, dark

Coenzymes – a small molecule that works with an
leafy greens, whole grains, enriched bread and
enzyme to promote the enzyme’s activity
cereals.
Recommended Intake: 1.2mg/day for men
Rich animal sources are dairy products, meats, fish,
1.1mg/day for women
poultry and eggs.
Sources: Lean pork, whole or enriched grains and
flours, legumes, seeds and nuts.
Riboflavin Deficiencies
Thiamine Deficiencies Ariboflavinosis- the name for a group of
symptoms associated with Riboflavin deficiency.
a. Wet Beriberi – manifests with edema, affecting
cardiac function by weakening the heart muscle and Seborrheic Dermatitis – is a common skin
vascular system. condition that mainly affects the scalp. It causes
scaly patches, red skin and stubborn dandruff.
This can also affect oily areas of the body, such
b. Dry Beriberi – affects the nervous system
as face, upper chest, and back.
producing paralysis and extreme muscle wasting.
First observed in Asia when the bran was removed
Cheilosis - a deficiency of riboflavin, characterized
to make the rice whiter.
by sores on the lips and cracks at the corners of the
mouth; glossitis (inflammation of the tongue);
dermatitis; and eye strain in the form of itching,
burning, and eye fatigue.

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3. NIACIN (B3) – Participates in the energy - Are involved in the formation of neurotransmitters
metabolism of every body cell Unique because the and are essential for proper nervous system
body can make it from protein Amino acid functioning.
tryptophan can be converted to niacin.
To form 1 mg of Niacin, 60 mg of tryptophan is - Essential for hemoglobin synthesis
needed. - Required for the conversion of tryptophan to niacin
Serves as a coenzyme for fatty acid and
RDA- 16mg NE for men and 14mg NE for women. carbohydrate metabolism.
Niacin in Foods:
▪ Meat, poultry, fish RDA- 1.3 mg/day for men and women
Sources are whole grains and cereals, legumes,
▪ Enriched breads, milk and cereals
chicken, fish, pork and eggs.
▪ Coffee and tea
▪ Veggies like mushroom, asparagus, and
Pyridoxine Deficiency
green, leafy veg – the richest niacin sources.
Heat-resistant = less vulnerable to losses during
Rarely occurs alone, normally accompanies low
food preparation and storage than other water-
intake of other B vitamins.
soluble vitamins.
Symptoms include dermatitis, altered nerve function,
weakness, poor growth, convulsions, and microcytic
Niacin Deficiencies
anemia (small red blood cells deficient in
hemoglobin)
❖ Pellagra – niacin-deficiency dse.
- widespread in US in the 20th century
Pyridoxine Toxicity
among people who subsisted on a
❖ Ataxia (loss of control of body movements)
low-protein diet with staple grain of
❖ Sensory neuropathy- pain, tingling,
corn.
weakness or numbness.
S/Sx of Pellagra:
"the four D's": diarrhea, dermatitis, dementia and death.
5. FOLATE
Diarrhea: damaged to GI tract affects digestion,
absorption and excretion of food, leading to glossitis,
- From the Latin word “folium”, meaning “leaf” The
vomiting and diarrhea.
form found naturally in foods
- Folic acid is a synthetic form used in vitamin
Dementia: confusion, anxiety, insomnia and
supplements and for food fortification. This is more
paranoia.
available for absorption in the body.
- Acts as a coenzyme metabolism
Dermatitis: A symmetric scaly rush occurs only on
- For the synthesis of DNA, RNA and formation of
skin exposed to the sun.
heme portion of hemoglobin.
Dermatologic features of this disorder include:
- Proper formation of fetal neural tubes.
desquamation, erythema, scaling, and keratosis of
sun exposed areas.
Neural Tube Defects
NIACIN Toxicity An opening in the spinal cord or brain that occurs
Vasodilation, liver damage, gout and arthritic very early in human development.
reactions. Malformations of the brain, spinal cord, or both
during embryonic development.
4. PYRIDOXINE (B6) 2 Main Types of NTD
a. Spina Bifida – “split spine”
- Act as coenzyme in the metabolism of amino acids
b. Anencephaly – “no brain”
and proteins.

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RDA- 400mcg/day for men and women - Plays an important role in carbohydrate, fat and
600 mcg/day during pregnancy protein metabolism.
Decrease the risk of heart disease.
Higher intake may reduce the risk of Colorectal Ca RDA – 30mcg/day
among women. Sources are liver, kidney, peanut butter, egg yolks,
and yeast.
Folate Deficiency
❖ Megaloblastic anemia- a form of anemia Biotin Deficiencies
characterized by large RBCs that cannot ❖ Scaly red skin rash, hair loss, loss of
carry oxygen properly. appetite, depression, and glossitis.
❖ Other deficiency symptoms are: glossitis, - Produced by consumption of large
diarrhea, irritability, absentmindedness, amounts of Avidin (a protein in raw egg
depression and anxiety. whites that binds Biotin). Avidin is
denatured by heat.
Folate Toxicity - may mask Pernicious Anemia
[poor RBC production. (red, beefy tongue)] There is no known toxicity of Biotin.

6. COBALAMINE (B12) 8. PANTOTHENIC ACID

- Cobalt containing compounds, also called - From the Greek term pantothen, meaning “from all
Cyanocobalamin. sides”, from its presence in all living things.
- Has a role in folate metabolism by modifying folate - Part of coenzyme A required for the metabolism of
coenzymes to active forms to support metabolic carbohydrates, fats and protein.
functions (DNA and RNA synthesis)
- Metabolism of fatty acids and amino acids AI- 5mg/day
- Maintains myelin sheath that surround and protect Sources are: whole grain, cereals, legumes, meat,
nerve fibers. fish and poultry.
In conjunction with B6 and folate, reduce the levels
of homocysteine which decreases the risk of CAD. No deficiencies occur in humans.

RDA- 2.4mcg daily for young adults Toxicity- 10-20g daily doses may produce diarrhea
Sources are: meat, fish, poultry, eggs and dairy products. and water retention.

Cobalamine (B12) Deficiency 9. CHOLINE

❖ Pernicious anemia (from lack of intrinsic - For the synthesis of acetylcholine and lecithin
factor for B12 absorption) or megaloblastic Can be produced from the amino acid methionine
anemia (from related folate dysfunction), by the body (but not enough to meet needs of the
brain, optic and peripheral nerve damage body)
from loss of myelin sheath. AI – 550mg/day for men, 425mg/day for women
❖ Neuropsychiatric symptoms including Sources are: milk, eggs and peanuts.
delusions and hallucinations.
Deficiency is rare.
7. BIOTIN
Toxicity symptoms include sweating, fishy body
- Acts as a coenzyme that carries carbon dioxide odor, vomiting, liver damage, reduced growth, and
from one compound to another hypotension.
- Synthesized in the lower GI tract by bacterial
microorganism
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10. VITAMIN C Fat-Soluble Vitamins
- Ascorbic Acid (active form, means no scurvy) - Usually occur together in fats and oils of foods.
Functions as an antioxidant and as a coenzyme. - Stored in the liver and fatty tissues.
- As an antioxidant, protects folate, vitamin E and - Not readily excreted.
polyunsaturated substances from destruction by - Excesses from supplements can reach toxic levels
oxygen as they move throughout the body. easily.
- May reduce the risk of cancer development.
Reduces the severity and duration of cold and 1. VITAMIN A
allergy symptoms by reducing blood histamine
concentrations. - A group of compounds that function to maintain
skin and mucous membranes throughout the body.
RDA- 90mg for men, 75mg for women - Specific activities are vision, bone growth,
The metabolic use of smokers is twice that of functioning of the immune system and normal
nonsmokers. reproduction
Sources are: citrus fruits, red and green peppers, - Rhodopsin production (for adjustment to light
strawberries, tomatoes, potatoes, broccoli, and variation)
other green, leafy vegetables. - Without enough Vitamin A, rhodopsin cannot be
Destroyed by air, light and heat. formed, and the retina cannot easily respond to light
changes.
Vitamin C Deficiency
Retinol Activity Equivalent RAE)- 900mcg RAE
❖ Scurvy - disease resulting from a deficiency for men and 700mcg RAE for women.
of vitamin C.
Latent Scurvy – the period in the course of scurvy - Active forms of Vitamin A are retinoids (in animal
when the conditions are present but the symptoms foods) and carotenoids in plant foods)
have not begun to appear. - The carotenoid beta carotene is the primary source
SX: gums around the teeth bleed easily, of Vitamin A from plant foods.
capillaries under the skin break spontaneously,
producing pinpoint hemorrhages. Food sources are: for Retinoids- whole milk, butter,
liver, egg yolks and fatty fish. Carotenoids are found
Overt Scurvy – full-blown scurvy. in deep greens, yellow and orange fruits and
Sx: degeneration of muscles (including the heart vegetables.
muscles); skin becomes rough, brown, scaly, dry, Best sources are broccoli, cantaloupe, sweet
poor wound healing (scar tissue not form without potatoes, carrots, tomatoes and spinach
collagen); soft, malformed, painful long bones, bone Decreased risk of certain cancers and other chronic
fractures; Teeth may become loose in the jawbone diseases.
and fall out; Anemia and infections are common;
Death (from massive bleeding into the joints and Vitamin A Deficiency
body cavities).
❖ Xerophthalmia - the drying of cornea due to
❖ Gingival Redness severe Vit. A deficiency manifested by night
❖ Perifollicular Hemorrhage – hemorrhages blindness.
around hair follicle. ❖ Keratomalacia (keratinization) - the last
and severe stage of Vit. A deficiency; a form
Vitamin C Toxicity of total blindness as a result of dry, hard
Nausea, Abdominal Cramps, Diarrhea, Gout. cornea.

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 ▪ Follicular hyperkeratosis = cells of Vitamin D Deficiency
the skin harden and flatten, making it
dry, rough, scaly, and hard. Symptoms of vit. D deficiency are those of Ca
deficiency.
Vitamin A Toxicity Bones fail to calcify normally and may grow so weak
❖ Hypervitaminosis – a noted among explorers that they become bent when they have to support
who feasted on polar bear liver and other the body’s weight.
large animals. ❖ Rickets (Genu Varum): vit. D def. disease.
- Immediate symptoms include blistered in children.
skin, weakness, anorexia, vomiting, -most obvious sign: bowed legs.
headache, joint pain, irritability, ❖ Osteomalacia: adult rickets; a bone
enlargement of spleen and liver, bone disease. characterized by softening of the
abnormalities and liver damage. bones.
Symptoms: bending of the spine, bowing of legs.
Toxicity does not occur from the carotenoid
precursor in foods. Inadequate vit. D is recognized as a risk factor in
osteoporosis.
Excess carotene in the blood is known as ❖ Osteoporosis: porous bones; reduced bone
carotenemia (bright orange-yellow discoloration). density.
- a.k.a. adult bone loss.
2. VITAMIN D (Calciferol)
Vitamin D Toxicity
- Different from all other nutrients in that the body ❑ Most toxic of all the vitamins
can synthesize it in significant quantities with the ❖ Hypercalcemia (high blood levels of calcium)
help of sunlight. ❖ Hypercalciuria (excess calcium tends to
- Exposure of skin to UV light begins the conversion precipitate in the soft tissues, forming stones,
of Vit. D precursor 7-dehydro-cholestero to including kidney stones).
cholecalciferol (active form of Vit. D). ❖ Arteriosclerosis: calcification and hardening
- Not an essential nutrient. of the blood vessel walls.
- Intestinal absorption of Ca and Ph depends on the
action of Vit. D. 3. VITAMIN E (Tocopherol)
- Regulate blood calcium levels - Acts as an antioxidant, protecting PUFA and
Roles in Bone: Vitamin A in cell membranes from oxidative damage
Promotes bone growth by being oxidized itself (particularly in lung and RBC
bones grow denser and stronger as the minerals cell membranes).
are deposited from the blood. - The name given to a family of compounds which
are found in plants
Alpha-tocopherol, the most widely occurring form
❑ Acts in three ways to maintain blood
and most active.
concentrations of Ca and Ph:
a. Stimulates their absorption from the GIT.
RDA – 15mgalpha-TE for men and women
b. Mobilizes Ca and Ph from bones into the blood.
For Vit. E to function as an antioxidant protecting
c. Stimulates their retention by the kidneys Vitamin D.
against heart disease and possible reduced risk of
AI- 5mcg/day prostate cancer, higher levels – 30 to 70 mg alpha
10mcg/day for 51-70 years old. TE are recommended
15mcg/day for 71 years old and above. Food sources are: vegetable oils, (corn, safflower,
Food sources are: butter, egg yolks, fatty fish and milk. soy, canola and cottonseed) and margarine.

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Whole grains, seeds, nuts, wheat germ, and green
leafy vegetables.
Extensive heating in the process of foods destroys
vitamin E.

Vitamin E Deficiency

Primary deficiency is rare.

Secondary deficiencies occur in premature infants

who are unable to absorb fat normally- cystic
fibrosis, biliary atresia (blocked bile duct), other
disorders of the hepatobiliary system, or liver
transport problems.

Vitamin E Toxicity
Hemorrhage
Excessive vit. E interferes with blood-clotting action
of vit. K and enhances the action of anticoagulant
medications.

4. VITAMIN K (Phytonadione/Phytomenadione)
- Long been known for its role in blood clotting.
- Was called koagulations vitamin.
- Main function is a cofactor in the synthesis of blood
clotting factors, including prothrombin.
- Protein formation in bone, kidney and plasma also
depends on the actions of vitamin K.

RDA- 120 mcg/day for men and 90 mcg for women

Active form is menaquinone.

- Synthesized by microflora (E. coli) in the jejunum

and ileum of the digestive tract.
- From plants, Vit. K is consumed as
phylloquinone.

Primary food sources are: dark green leafy

vegetables (reduce ingestion if ptx is taking
anticoagulants.)
Lesser amounts in dairy products, cereals, meats
and fruits.

Administration of Vitamin K to infants:

0.1 mL to newborns
0.5 mL to preterm/premature
Route: IM (Vastus lateralis; 1cc syringe)

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