Vitamins

 Vitamins are a group of unrelated chemical substances that are

essential in small amounts for the regulation of normal
metabolism, growth, and function of the human body.
 Not all of vitamins can be synthesized in the body &
therefore, some vitamins must be obtained from external
source, such as a proper well balanced diet or dietary
supplements.
 Vitamins become a pharmacological concern when there is an
imbalance in the body’s vitamin supply.
 Deficiency diseases can result from insufficient vitamin
ingestion, irregular absorption, or impaired metabolic use of
these nutrients.
 Ingestion or administration of excessive quantities of vitamins
called hypervitaminosis, may result in toxicity.
 Vitamin Toxicity

 Toxic effects have been observed when large dosages of some

vitamins are ingested.
 Generally water-soluble vitamins are less toxic, since excess
quantities are usually excreted in the urine.
 Excessive amounts of fat soluble vitamins, however, are
stored in the body, which makes toxic levels of these vitamins
easier to obtained
 Physiological Function and Dietary Sources

 Vitamins are usually classified as either fat soluble (vitamins

A,D, E, & K) or water soluble (vitamins B and C).
 Fat-soluble vitamins metabolized slowly & stored in the liver.
 In contrast, water soluble vitamins are rapidly metabolized &
readily excreted in the urine.
 Fat-Soluble Vitamins
1. Vitamin A
 Vitamin A, or retinol, is essential for the proper maintenance of
functional, structural integrity of epithelial cells & plays a
major role in epithelial differentiation
 Bone development & growth in children have also been linked
to adequate vitamin A intake
 When reduced to aldehyde 11-cis-retinal, combines with opsin
to produce visual pigment rhodopsin.
 This pigment present in rods of retina & partly responsible for
process of dark adaptation
 Fat-Soluble Vitamins cont..

 Principal dietary sources of vitamin A are milk fat (cheese &

butter), eggs, liver, carrots, rutabaga, and red cabbage
 An early sign of hypovitaminosis A is night blindness.
 The night blindness may progress to xerophthalmia (dryness
& ulceration of cornea) and blindness.
 Other symptoms of vitamin A deficiency include cessation of
growth and skin changes due to hyperkeratosis.
 Fat-Soluble Vitamins cont..

 Acute hypervitaminosis A results in drowsiness, headache,

vomiting, papilledema, and a bulging fontanel in infants.
 Vitamin A is teratogenic in large amounts, and supplements
should not be given during a normal pregnancy.
 Food & Nutrition Board of Institute of Medicine (IOM) has
reported upper intake level of vitamin A to be 3,000 μg/day
 Fat-Soluble Vitamins cont..

2. Vitamin D
 Vitamin D is the collective term for a group of compounds
formed by the action of ultraviolet irradiation on sterols.
 Cholecalciferol (vitamin D3) and calciferol (vitamin D2) are

formed by irradiation of provitamins 7- dehydrocholesterol

and ergosterol, respectively
 Conversion to vitamin D3 occurs in the skin
 Principal disorder associated with inadequate vitamin D
intake is rickets.
 Fat-Soluble Vitamins cont..

 Requirement for vitamin D is slightly higher in members of

darker-pigmented races, since melanin interferes with the
irradiation that produces vitamin D3 in the skin.
 People with limited exposure to sun may need to supplement
vitamin D intake.
 Hypercalcemia resulting from hypervitaminosis D cause
toxic symptoms: muscle weakness, bone pain, anorexia,
ectopic calcification, hypertension, and cardiac arrhythmias
 Fat-Soluble Vitamins cont..

3. Vitamin E (α-tocopherol): potent antioxidant capable of

protecting polyunsaturated fatty acids from oxidative
breakdown & functions to enhance vitamin A use.
 Sources: plant oils (wheat germ, rice) & lipids of green leaves
 Deficiency is characterized by low serum tocopherol levels
and a positive hydrogen peroxide hemolysis test.
 Prolonged administration of large dosages of vitamin E may
result in muscle weakness, fatigue, headache, and nausea.
─ reversed by discontinuing large-dose supplementation.
 Fat-Soluble Vitamins cont..

4. Vitamin K
 Vitamin K activity is associated with several quinones:

phylloquinone (vitamin K1), menadione (vitamin K3) & a

variety of menaquinones (vitamin K2).

 These quinones promote synthesis of proteins that involved in
coagulation of blood (prothrombin, factor VII (proconvertin),
factor IX (plasma thromboplastin) & factor X (Stuart factor)).
 Vitamin K quinones are obtained from three major sources.
a) Vitamin K is present in various plants (green vegetables).
 Fat-Soluble Vitamins cont..

b) Menaquinones that possess vitamin K2 activity synthesized by

bacteria, particularly gut gram-positive organisms
c) Vitamin K3 is a chemically synthesized quinone that possesses

the same activity as vitamin K1.

 Vitamin K deficiency results in increased bleeding time.
─ two groups at greatest risk are newborn infants & patients
receiving anticoagulant therapy.
 Toxicity of vitamin K: Jaundice may occur in a newborn if
large dosages of vitamin K given to the mother before birth.
 Water-Soluble Vitamins
1. The B Vitamins
 This family of vitamins consists of thiamine (B 1), riboflavin (B2),

niacin (B3), Vitamin Bc/M (B4), Pantothenic acid (B5), pyridoxine

(B6), biotin (B7), inositol or adenylic acid (B8), folic acid (B9), PABA

(B10), pteryl-hepta-glutamic acid (B11) and Cobalamin (B12).

 The B vitamin group is made up of substances that tend to occur

together in foods and are given the collective name vitamin B

complex.
 Water-Soluble Vitamins cont..

 B vitamins are obtained from both meat & vegetable

products, except for vitamin B12, which occurs only in animal

products.
 The richest source of the B vitamin group is seeds, including
the germ of wheat or of rice.
 Severe thiamine (vitamin B1) deficiency results in beriberi
─ symptoms include growth retardation, muscular weakness,
apathy, edema, heart failure & mental deterioration
 Water-Soluble Vitamins cont..

 Riboflavin (vitamin B2) deficiency results in local seborrheic

dermatitis that may be limited to the face and scrotum.
 Niacin or nicotinic acid deficiency produces pellagra.
─ general malaise, photosensitivity, sore, swollen tongue,
gastritis, diarrhea, neurological disturbances & depression
 Pyridoxine (vitamin B6) deficiency symptoms are expressed as

alterations in the skin, blood & central nervous system (PNP)

 Water-Soluble Vitamins cont..

 Severe cyanocobalamin (vitamin B12) deficiency results in

pernicious anemia that is characterized by megaloblastic

anemia and neuropathies.
 Absorption of vitamin B12 from gastrointestinal tract requires

presence of gastric intrinsic factor.

─ this factor binds to vitamin, forming a complex that can be
absorbed in the terminal ileum.
─ lack of this factor results in pernicious anemia
 Water-Soluble Vitamins cont..

 Biotin deficiency is characterized by anorexia, nausea,

vomiting, glossitis, depression, and dry, scaly dermatitis.

 Biotin deficiency occurs when avidin, a biotinbinding

glycoprotein, is present which is found in raw egg whites, binds

the biotin, making it nutritionally unavailable.
 Folic acid deficiency symptoms: megaloblastic anemia,

glossitis, diarrhea, & weight loss, requirement for this vitamin

increases during pregnancy and lactation.
 Water-Soluble Vitamins cont..

2. Vitamin C (ascorbic acid)

 Essential for maintenance of ground substance that binds
cells together & for formation and maintenance of collagen.
 Vitamin C is found in fresh fruit and vegetables
 Deficiency (scurvy): malaise & follicular hyperkeratosis.
 Capillary fragility: hemorrhages, particularly of the gums.
 Abnormal bone & tooth development in growing children
 Requirement for vitamin C ↑during pregnancy & lactation.
 Therapeutic Uses of Vitamins

 All of the vitamins are used as specific treatments for their

respective deficiency diseases.
 The dosages required will vary depending on the severity of
the disease and the vitamin.
 Vitamins have also been used like drugs to “treat” diseases.
 Therapeutic Uses of Vitamins cont..

 Vitamins are considered to be dietary supplements under the

Dietary Supplement Health and Education Act (DSHEA).
 Vitamins and other dietary supplements are not permitted to
be marketed as a treatment or cure for a specific disease or
condition unless approved as a drug for that purpose.
 Therapeutic Uses of Vitamins cont..

1. Cancer
 Vit. A suppress chemically induced tumors in laboratory.
 Epidemiological evidence suggests that foods rich in
carotenes or vit A are associated with a lower risk of cancer.
 The antioxidant properties of vitamins C and E can inhibit the
formation of some carcinogens.
 Antioxidant vitamins studied as cancer chemo preventive
agents for many cancer types: gut & ovarian cancers.
 Therapeutic Uses of Vitamins cont..

2. Coronary Heart Disease

 The role of the antioxidant properties of vitamins C, E, and -
carotene in the prevention of cardiovascular disease has been
the focus of several recent studies.
 Antioxidants reduce oxidation of low-density lipoproteins,
which may play a role in prevention of atherosclerosis.
 Niacin has been used clinically to lower serum cholesterol
levels (↓hyperlipidemia)
 Therapeutic Uses of Vitamins cont..

3. Miscellaneous Uses
 Vitamin A and its retinoid analogues have gained popularity in
the treatment of acne and other dermatological diseases
 Vitamin K supplements are given to neonates until normal
intestinal bacteria that capable of producing vitamin develop
 Folic acid supplements are given to pregnant women to
decrease the risk of neural tube defects such as spina bifida.