Introduction :-
Water soluble vitamins do not get stored in the body (except vitamin B12) so they can run out of the body in a shorter time. So they need to be continuously supplied to the body
Most of them act as a coenzyme in several metabolic pathways
Vitamin B1 – Thiamine
Work~ It is essential for glucose metabolism,formation of nucleic acid and fatty acids
Deficiency~ beri beri
There are 3 types of beri beri
1)Dry beri beri: peripheral neuritis & paralysis of limbs
2)Wet beriberi: congestive heart failure and peripheral edema
3) Infantile beri beri : cardiomegaly, dyspnea, aphonia, wernicke’s encephalopathy
Diagnosis~ thiamine deficiency is suspected in all cases of malnutrition
24 hr. Urine thiamine excretion test (normal – 40 to 100micrograms)
<15 microgram is confirmatory
Treatment~ 5mg /day resolutes cardiac and neurological symptoms
Higher doses may be required for congestive heart failure
Vitamin B2 – Riboflavin
Work~ part of number of redox reactions
Deficiency~ glossitis, cheilosis, angular stomatitis etc
Diagnosis~ clinical diagnosis mainly
Treatment~ 3 – 10 mg oral riboflavin for several weeks
For infants 1mg daily
Vitamin B3- Niacin
Work~ Niacin is a B vitamin that is made and used by your body to turn food into energy. It helps keep your nervous system healthy and skin glowing
Deficiency~ pellagra, 3 Ds : dermatitis, dementia and diarrhoea
Casal necklace formation :dark pigmented symmetrical cutaneous lesion around neck
Diagnosis~ History of – inadequate diet
Isoniazid treatment
Treatment~ 50-300mg/day
Tryptophan rich food as tryptophan is precursor of niacin
Vitamin B6- Pyridoxine
Work~ Benefits central nervous system and facilitates metabolism of different components of food and RBC formation
Deficiency~ peripheral neuropathy, refractory seizures, microcytic anaemia
Deficiency can occur in malabsorption syndromes or with the use of drugs like isoniazid
Treatment~ 10-50 mg /day to patients on isoniazid to avoid any peripheral neuropathy
In case of refractory seizures 100mg of pyridoxine is injected intramuscularly
VITAMIN B7- Biotin
Work– Biotin helps your body turn the food you eat (protein, carbohydrates, and fat) into energy And thought to supplement hairs, nails and healthy skin
Deficiency~ consuming too much of raw eggs can inhibit biotin uptake from foods
Deficiency symptoms include dry scaly dermatitis, thinning of hairs, brittleness of nails, glossitis etc
Treatment~ 2-5mg daily for 2-3 weeks in mild cases
VITAMIN B5 – Pantothenic acid
Work– It becomes the part of a coenzyme which is essential for metabolism of fatty acids, protein and carbohydrate
Deficiency~ isolate deficiency is rare
Deficiency symptoms include burning feet, insomnia and GIT symptoms
Treatment~ 2-3mg daily for infants
3-5mg daily for Children
VITAMIN B12 – Cobalamin
Work~ Vitamin B12 helps keep your body’s blood and nerve cells healthy and helps make DNA. Vitamin B12 also helps prevent megaloblastic anaemia
Deficiency~ megaloblastic anaemia or pernicious anaemia, progressive demyelination
Vit. B12 binds to intrinsic factor which is secreted by parietal cells of stomach and the complex is absorbed in ileum
Deficiency can occur in impaired intestinal absorption
True deficiency if vitamin B12 occurs in the people who are extremely vegetarian – no use of animal products and fish products
Treatment~ recommended intake in infants is 0.3 micrograms /day
In older children 0.5-1.5 micrograms /day
VITAMIN B9 – Folic acid
Work~ it acts as a coenzyme for normal DNA and RNA synthesis
Deficiency~ deficiency of folate impairs DNA formation hence limits cell division and affects normal growth and repair of tissues.
Erythropoiesis is hindered resting in megaloblastic anaemia
Maternal deficiency of folic acid, during pregnancy results in neural tube defects
Treatment~ 0.5-1mg /day orally for 3 – 4 weeks
VITAMIN C – Ascorbic Acid
Work– maintain connective tissue, helps in formation of collagen, accelerates wound healing
It reduces ferric to ferrous state for better absorption in gut
Also has anti – oxidant properties
Deficiency– gingival swelling (scurvy)
Tenderness of limbs, peripheral edema ,scorbutic rosary
Treatment~ 100-200mg of vitamin c orally or parenterally
Daily intake of 100 mg orange juice produces same effect
Contributor- Medico Shashank Gupta
