1. Water Soluble Vitamins! Mrs. T.L. Divya, M.Sc (N) Assistant Professor, Department of Child Health Nursing, Annammal College Of Nursing, Kuzhithurai B Vitamins

2. Introduction The word vitamin is derived from two words- vital & amine The word vitamine is coined by Casimir Funk in the year 1912. Broadly vitamines are classified as- water soluble and fat soluble.

3. Water Soluble Vitamins: B complex group Elmer V. McCollum has been credited with the discovery of B complex group Elmer V. McCollum has been credited with the discovery of B complex group It constitutes 8 water soluble agents. It constitutes 8 water soluble agents. Vitamin B1 – Thiamine Vitamin B1 – Thiamine Vitamin B2 – Riboflavin Vitamin B2 – Riboflavin Vitamin B3 – Niacin Vitamin B3 – Niacin

4. Contd….. Vitamin B5 – Pantothenic acid Vitamin B5 – Pantothenic acid Vitamin B6 – Pyridoxine Vitamin B6 – Pyridoxine Vitamin B7 – Biotin Vitamin B7 – Biotin Vitamin B9 – Folic acid Vitamin B9 – Folic acid Vitamin B12 – Cobalamine Vitamin B12 – Cobalamine Choline, inositol, PABA (para- aminobenzoic acid) & lipoic acid are synthesized within our body. Choline, inositol, PABA (para- aminobenzoic acid) & lipoic acid are synthesized within our body.

5. Symptoms of insufficiency and risk factors of B Vitamins Neurological issues like memory loss, confusion, irritability etc. Neurological issues like memory loss, confusion, irritability etc. Tiredness and fatigue Tiredness and fatigue Nausea and poor appetite Nausea and poor appetite Skin lesions Skin lesions

6. The casual factors for the deficiency Impaired absorption Impaired absorption Certain genetic conditions Certain genetic conditions A pure vegetarian diet A pure vegetarian diet Age Age Certain medications Certain medications

7. Thiamin (Vitamin B 1 ) Casimir Funk in 1912 obtained vitamin B1 as a crystalline substance from rice polishings. He called it 'vitalamine‘ Casimir Funk in 1912 obtained vitamin B1 as a crystalline substance from rice polishings. He called it 'vitalamine‘ Chief functions in the body Chief functions in the body Part of coenzyme TPP (thiamin pyrophosphate) used in energy metabolism Part of coenzyme TPP (thiamin pyrophosphate) used in energy metabolism Easily destroyed by heat

8. CAUSES OF DEFICIENCY  Poor dietary intake  Reduced absorption  Excessive loss  Diabetic patients

9. Thiamin Sources Pork Pork Whole Grain or Enriched Grains Whole Grain or Enriched Grains

10. Deficiency disorders Deficiency Symptoms Deficiency Symptoms Enlarged heart and possible cardiac failure Enlarged heart and possible cardiac failure Muscular weakness Muscular weakness Apathy, poor short-term memory, confusion, and irritability Apathy, poor short-term memory, confusion, and irritability Anorexia and weight loss Anorexia and weight loss

12. Thiamin Deficiency Wernicke-Korsakoff syndrome is a severe deficiency that develops in those who abuse alcohol. Wernicke-Korsakoff syndrome is a severe deficiency that develops in those who abuse alcohol. Deficiency results in the disease beriberi. Deficiency results in the disease beriberi. No reported toxicities No reported toxicities

13. Thiamin Recommendations (1998 RDA) RDA Men: 1.2 mg/day RDA Women: 1.1 mg/day

14.  Riboflavin D.T.Smith & E.G. Hendrick have been credited with its discovery in the year 1926. Chief functions in the body Part of coenzymes FMN (flavin mononucleotide) and FAD (flavin adenine dinucleotide) used in energy metabolism. Easily destroyed by ultraviolet light and irradiation

15. Causes of deficiency Alcoholism Alcoholism Certain diseases Certain diseases

16. Riboflavin Sources Milk products Milk products Yogurt Yogurt Cheese Cheese Enriched or whole grains Enriched or whole grains Liver Liver

17. Riboflavin Deficiency and Toxicity Deficiency Symptoms Deficiency Symptoms Inflamed eyelids, sensitivity to light, and reddening of the cornea Inflamed eyelids, sensitivity to light, and reddening of the cornea Sore throat, cracks and redness at the corners of the mouth Sore throat, cracks and redness at the corners of the mouth Painful, smooth and purplish red tongue Painful, smooth and purplish red tongue Skin lesions covered with greasy scales Skin lesions covered with greasy scales Deficiency disease is ariboflavinosis Deficiency disease is ariboflavinosis No reported toxicities No reported toxicities

19. Riboflavin Recommendations (1998 RDA) RDA Men: 1.3 mg/day RDA Women: 1.1 mg/day Riboflavin Recommendations (1998 RDA) RDA Men: 1.3 mg/day RDA Women: 1.1 mg/day

20. Niacin- B3 Conrad Elvehjem have been credited with its discovery in the year 1937. Conrad Elvehjem have been credited with its discovery in the year 1937. Chief functions in the body Chief functions in the body Part of coenzymes NAD (nicotinamide adenine dinucleotide) and NADP (its phosphate form) used in energy metabolism Part of coenzymes NAD (nicotinamide adenine dinucleotide) and NADP (its phosphate form) used in energy metabolism

21. Other names Other names Nicotinic acid Nicotinic acid Nicotinamide Nicotinamide Niacinamide Niacinamide Vitamin B 3 Vitamin B 3

22. Causes of deficiency Insufficient dietary intake Insufficient dietary intake Anorexia & obesity Anorexia & obesity Intake of anti tubercular drug s Intake of anti tubercular drug s

23. Niacin Sources All protein foods All protein foods Milk, eggs, meat, fish, poultry Milk, eggs, meat, fish, poultry Whole grain Whole grain Enriched grains Enriched grains Nuts Nuts

24. Deficiency of Niacin: Pellagra 3 Ds 3 Ds Dementia Dementia Diarrhea Diarrhea Dermatitis (worse with sun exposure) Dermatitis (worse with sun exposure) Occurs in 50-60 days Occurs in 50-60 days Poor appetite, weight loss, weakness Poor appetite, weight loss, weakness

26. Niacin Recommendations (1998 RDA) RDA Men: 16 NE/day RDA Men: 16 NE/day RDA Women: 14 NE/day RDA Women: 14 NE/day Upper level of 35 mg/day for adults Upper level of 35 mg/day for adults

27. Pantothenic Acid -B5 Pantothenic acid is involved in energy metabolism as a part of coenzyme A. Pantothenic acid is involved in energy metabolism as a part of coenzyme A.

28. Causes of deficiency Malnutrition Malnutrition

29. Pantothenic Acid Sources Widespread in foods Widespread in foods Organ meats Organ meats Mushrooms Mushrooms Avacado Avacado Broccoli Broccoli Whole grains Whole grains

30. Recommendations (1998 Adequate Intake) In Adults: 5 mg/day In Adults: 5 mg/day

31. Pyridoxine - B 6 Paul Gyorgy have been credited with its discovery in the year 1934. Paul Gyorgy have been credited with its discovery in the year 1934. Other names Other names Pyridoxine Pyridoxine Pyridoxal Pyridoxal Pyridoxamine Pyridoxamine

32. Causes of deficiency Alcoholics Alcoholics Impaired metabolism Impaired metabolism

33. Vitamin B 6 Sources Meat, fish, poultry, liver Meat, fish, poultry, liver Potatoes Potatoes Legumes Legumes Non-citrus fruits Non-citrus fruits Fortified cereal Fortified cereal Soy products Soy products

34. Deficiency symptoms Deficiency symptoms Scaly dermatitis Scaly dermatitis Anemia (small-cell type) Anemia (small-cell type) Depression, confusion, abnormal brain wave pattern, convulsions Depression, confusion, abnormal brain wave pattern, convulsions

35. Recommendations (1998 Adequate Intake) Adults (19-50 years): 1.3 mg/day Adults (19-50 years): 1.3 mg/day Upper level for adults: 100 mg/day Upper level for adults: 100 mg/day

36. Biotin-B7 Chief functions in the body Chief functions in the body Part of a coenzyme used in energy metabolism, fat synthesis, amino acid metabolism, and glycogen synthesis Part of a coenzyme used in energy metabolism, fat synthesis, amino acid metabolism, and glycogen synthesis Naturally B7 can be synthesized only by bacteria, yeast, certain plant species etc.

37. Causes of deficiency Insufficient dietary intake Insufficient dietary intake Hereditary Hereditary Biotinase deficiency Biotinase deficiency Prolonged consumption of raw egg Prolonged consumption of raw egg

38. Biotin Sources Widespread in foods Widespread in foods Organ meats, fish Organ meats, fish Egg yolks Egg yolks Soyabeans Soyabeans Whole grains Whole grains

39. Biotin Deficiency Deficiencies are rare. Deficiencies are rare. Deficiency Symptoms Deficiency Symptoms Depression, lethargy, and hallucinations Depression, lethargy, and hallucinations Numb or tingling sensation in the arms and legs Numb or tingling sensation in the arms and legs Red, scaly rash around the eyes, nose and mouth Red, scaly rash around the eyes, nose and mouth Hair loss Hair loss Biotin can be bound with an raw egg-white protein called avidin. Biotin can be bound with an raw egg-white protein called avidin.

40. Recommendations (1998 Adequate Intake) Adults: 30  g/day Adults: 30  g/day

41. Folate- B9 This vitamin is discovered by Lucy Willis in the year 1933. This vitamin is discovered by Lucy Willis in the year 1933. Other names Other names Folic acid Folic acid Folacin Folacin Pteroylglutamic acid (PGA) Pteroylglutamic acid (PGA)

42. Causes of deficiency Dietary deficiency Dietary deficiency Lifestyle Lifestyle Pre existing conditions Pre existing conditions Genetic defect Genetic defect

43. Folacin Neural Tube Defects – Malformation of the central nervous system that forms very early in the pregnancy (often even before woman realizes she is pregnant Spina bifida- spine develops outside of the body Anencephaly- entire brain and skull above the ears is missing

44. Neural tube defects Spina Bifida Anencephaly

45. Folacin Only known way to prevent these congenital malformations is adequate folacin intake prior to pregnancy Adequate folic acid intake can reduce the risk of NTD by up to 75%

46. Folate Sources Fortified Grains Fortified Grains Leafy Green Vegetables Leafy Green Vegetables Legumes, Seeds Legumes, Seeds Liver Liver

47. Recommendations (1998 Adequate Intake) Adults: 400  g/day Adults: 400  g/day Upper level for adults: 1000  g/day Upper level for adults: 1000  g/day

48. Cobalamine- B12 Vitamin B 12 is involved in the synthesis of new cells, maintains nerve cells, reforms folate coenzymes, and helps break down some fatty acids and amino acids. Vitamin B 12 is involved in the synthesis of new cells, maintains nerve cells, reforms folate coenzymes, and helps break down some fatty acids and amino acids..

49. Causes of deficiency Insufficient dietary intake Insufficient dietary intake Mal absorption Mal absorption Dysfunction of organs Dysfunction of organs Inflammations Inflammations

50. Vitamin B 12 Deficiency and Toxicity Deficiency Symptoms Deficiency Symptoms Anemia – large cell type (same as Folate) Anemia – large cell type (same as Folate) Fatigue and depression Fatigue and depression Degeneration of peripheral nerves progressing to paralysis (irreversible) Degeneration of peripheral nerves progressing to paralysis (irreversible)

51. Contd……. Atrophic gastritis in older adults destroys stomach cells, which diminishes intrinsic factor and hydrochloric acid production. Atrophic gastritis in older adults destroys stomach cells, which diminishes intrinsic factor and hydrochloric acid production. Deficiency disease is called pernicious anemia Deficiency disease is called pernicious anemia

52. Vitamin B 12 Sources Animal products Animal products Meat, poultry fish, shellfish Meat, poultry fish, shellfish Milk, cheese Milk, cheese Eggs Eggs Fortified cereals Fortified cereals

53. Recommendations (1998 Adequate Intake) RDA Adults: 2.4 μg/day RDA Adults: 2.4 μg/day

54. Conclusions 1. 1. Vitamins are derived from a variety of foods. That is why variety is so important. 2. 2. Vitamin deficiencies rarely occur in this country. 3. 3. If they do, it is usually in conjunction with severe illness, stress, or trauma that is superimposed on prolonged inadequate intake. 4. 4. If there is deficiency, usually several vitamins (especially in the case of B vitamins) are involved.

55. Conclusions 1. 1. Toxicity is also rare but a possibility Toxicity is rarely associated with food Toxicity results from supplements 2. 2. Vitamin imposters are used

56. Variety is the Key Vitamins are derived from a variety of foods.