Vitamins

vitamins

2. CONTENTS
•Introduction
•Classification
•Vitamins
-Absorption & Excretion
-Daily Requirements
-Sources
-Physiology & Pathology Of Deficiency
-Clinical Features
-Management
•Conclusion
•Reference

3. INTRODUCTION
Group of organic compounds that are essential for normal
growth & nutrition & are required in small quantities in
diet as they cannot be synthesized by the body.
•The term vitamin is derived from the words VITAL & AMINE,
because vitamins are required for life & were originally thought to be
amines

4. Water – solubleWater – soluble
Vitamin B complexVitamin B complex
Vitamin BVitamin B
11(thiamine)(thiamine)
Vitamin BVitamin B
22 (riboflavin) (riboflavin)
Vitamin BVitamin B
33 (niacin) (niacin)
Vitamin BVitamin B
55 ( pantothenic acid ) ( pantothenic acid )
Vitamin BVitamin B
66 (pyridoxine) (pyridoxine)
Vitamin BVitamin B
88 (biotin) (biotin)
Vitamin BVitamin B
99 (folic acid) (folic acid)
Vitamin BVitamin B
12 12 (cyanocobalamin)(cyanocobalamin)
Vitamin C (Ascorbic acid)Vitamin C (Ascorbic acid)
Fat-SolubleFat-Soluble
Vitamin AVitamin A
Vitamin DVitamin D
Vitamin EVitamin E
Vitamin KVitamin K

5. WATER-SOLUBLE VITAMINS
- Soluble in water
- Absorption is simple except for vitamin B12
- Deficiency manifests rapidly as there is no storageno storage
- Toxicity is unlikely, since excess is excreted
- Major vitamins are B & C
FAT-SOLUBLE VITAMINS
- They are soluble in fat
- Absorption requires bile salts
- Deficiency manifests when stores are depleted
- Hypervitaminosis may result
- Major vitamins are A, D, E & K

6. •Also known as Also known as aneurin. aneurin. for the detrimental neurological effects if
not present in the diet
•Discovered by Eijkman in 1897. Discovered by Eijkman in 1897.
•It is a colorless basic organic compound composed of a sulfated It is a colorless basic organic compound composed of a sulfated
pyrimidine ring.pyrimidine ring.
ABSORPTION & EXCRETION:ABSORPTION & EXCRETION:
AbsorbedAbsorbed
•It is phosphorylated by the liver & kidneys. It is phosphorylated by the liver & kidneys.
•In tissues, it is found as thiamine pyrophosphate which is a coenzyme In tissues, it is found as thiamine pyrophosphate which is a coenzyme
for decarboxylation of pyruvate to acetyl coenzyme A. for decarboxylation of pyruvate to acetyl coenzyme A.
ExcessExcess -excreted in the urine -excreted in the urine
THIAMINTHIAMIN
EE

8. RDA FOR THIAMIN
•1.1 mg/day for women
•1.2 mg/day for men
•Most exceed RDA in diet
•Surplus is rapidly lost in urine; non toxic
WHO IS AT RISK FOR DEFICIENCY?
•Poor
•Alcoholics
•Elderly
•Diet consisting of highly processed
foods

9. DEFICIENCY OF VITAMIN B 1
BERIBERI
•WET BERIBERI
•DRY BERIBERI
•INFANTILE BERIBERI
•WERNICKE'S ENCEPHALOPATHYWERNICKE'S ENCEPHALOPATHY

10. It is marked by cardiac
dilation with 4
chamber enlargement,
pallor & flabbiness of
myocardium.


CARDIOVASCULAR
MANIFESTATIONS
-COMMON

11. Loss of reflexes in knees
& feet
Numbnesss of feet
DRY BERIBERI
emaciation
aphonia
Wrist drop
Great
weakness
Dyspnea
orthropnea
foot drop

12. WET BERIBERIWET BERIBERI
•Complete rest.Complete rest.
•Thiamine 50 mg IM for 3 daysThiamine 50 mg IM for 3 days
then 10 mg TID daily by P.Othen 10 mg TID daily by P.O
INFANTILE BERIBERI INFANTILE BERIBERI is treated via mother's milk. is treated via mother's milk.
The mothers should receive 10,000 mcg BD daily. The mothers should receive 10,000 mcg BD daily.
In addition, infants should be given thiamine in doses of 10,000-20,000 In addition, infants should be given thiamine in doses of 10,000-20,000
mcg IM OD in a day for 3daysmcg IM OD in a day for 3days
WERNICKE'S ENCEPHALOPATHYWERNICKE'S ENCEPHALOPATHY
•Injection of thiamine should be given. Injection of thiamine should be given.
50 mg by slow IV infusion followed by 50 mg daily P.O for a week.50 mg by slow IV infusion followed by 50 mg daily P.O for a week.
MANAGEMENT

13. •Also called as the Beauty vitamin (ANTIOXIDANT)Also called as the Beauty vitamin (ANTIOXIDANT)
•Derived from two sources ribose-referring to ribose(sugar found in Derived from two sources ribose-referring to ribose(sugar found in
several vitamins & enzymes) & flavin meaning yellow. several vitamins & enzymes) & flavin meaning yellow.
ABSORPTION & EXCRETIONABSORPTION & EXCRETION
•AbsorptionAbsorption
•Stored Stored
•ExcretedExcreted primarily in the urine,bile & sweat primarily in the urine,bile & sweat

15. DAILY REQUIREMENTDAILY REQUIREMENT
•For infants- 60 mcg/kg of body weight daily.For infants- 60 mcg/kg of body weight daily.
•Men- 1.5 mg daily . Men- 1.5 mg daily .
•Women- 1.2 mg daily Women- 1.2 mg daily
•Children- 1.3 mg daily Children- 1.3 mg daily
•Pregnancy & lactation – additional 0.2-0.4mg daily Pregnancy & lactation – additional 0.2-0.4mg daily

16. Deficiency symptomsDeficiency symptoms:-:-
•It affects the nasolabial fold & ala of the nose which exhibits a It affects the nasolabial fold & ala of the nose which exhibits a scaly scaly
gray dermatitis.gray dermatitis.
•Ocular changesOcular changes:- :- corneal vasodilatation,photophobia, superficial & corneal vasodilatation,photophobia, superficial &
interstitial keratitis, Itching & burning of the eyes.interstitial keratitis, Itching & burning of the eyes.
•Skin & nailsSkin & nails: : dull or oily hairdull or oily hair, , an oily skin, premature wrinkles on the an oily skin, premature wrinkles on the
face & arms, & split nails.face & arms, & split nails.
•Others:Others:- - malfunctioning of adrenal glands, anemia, vaginal itching & malfunctioning of adrenal glands, anemia, vaginal itching &
cataract.cataract.

17. ORAL MANIFESTATIONSORAL MANIFESTATIONS
Tongue :Tongue :
•Glossitis begins with soreness of lip & lateral margins of the tongue.Glossitis begins with soreness of lip & lateral margins of the tongue.
•Tongue has a reddened coarsely granular appearance.Tongue has a reddened coarsely granular appearance.
•In severe cases, the tongue becomes glazed & smooth due to complete In severe cases, the tongue becomes glazed & smooth due to complete
atrophy of the papillae & exhibits a magenta color.atrophy of the papillae & exhibits a magenta color.
Lip :-Lip :-
•Lips become red & shiny because of desquamation of epithelium.Lips become red & shiny because of desquamation of epithelium.
•There is maceration at angle of mouth withThere is maceration at angle of mouth with
pain on the opening mouth, it again results inpain on the opening mouth, it again results in
fissuring & cracking with ulceration.fissuring & cracking with ulceration.
•As the disease progresses, angular cheilitis As the disease progresses, angular cheilitis
spread to the cheek, the tissues bleed easily spread to the cheek, the tissues bleed easily
& are painful if secondary infected.& are painful if secondary infected.

18. MANAGEMENT
•Riboflavin 25,000-50,000 mcg daily in divided doses.

19. •Its also known as nicotinic acid.
• Deficiency of niacin leads to a disease called as pellagra - rough skin.
•Absorbed
•Excreted in the urine mostly as salts & to a smaller extent as free
niacin.

21. DAILY REQUIREMENTSDAILY REQUIREMENTS
•Infants- 650 mcg per kg body weight daily.Infants- 650 mcg per kg body weight daily.
•Men-17 mg daily.Men-17 mg daily.
•Women- 13 mg daily.Women- 13 mg daily.
•Children- I3 mg daily.Children- I3 mg daily.
•Pregnancy & lactation- 12 to 15 mg daily Pregnancy & lactation- 12 to 15 mg daily

22. Clinical features:-Clinical features:-
Prodromal symptoms: developed in 3 weeks with loss of appetite, vague Prodromal symptoms: developed in 3 weeks with loss of appetite, vague
G.I disturbances & numbness or burning in various locations.G.I disturbances & numbness or burning in various locations.
•It is called as disease ofIt is called as disease of
33
DEMENTIA
DIARRHEA
DERMATITIS

23. ORAL MANIFESTATIONS SEEN IN PELLAGRA:ORAL MANIFESTATIONS SEEN IN PELLAGRA:
Oral mucosaOral mucosa: becomes fiery red & painful & profuse salivation.: becomes fiery red & painful & profuse salivation.
TongueTongue::
•The epithelium is desquamated.The epithelium is desquamated.
•The filiform papillae are most sensitive & disappear 1The filiform papillae are most sensitive & disappear 1
STST
; the fungiform ; the fungiform
papillae may become enlarged.papillae may become enlarged.
•In early stagesIn early stages, only the tip & margins of the tongue are swollen & , only the tip & margins of the tongue are swollen &
beefybeefy

24. •In advanced cases, the tongue loses all the papillae & the reddening
becomes intense.The tongue becomes so swollen that indentation from
the teeth are found along the borders of the tongue.
•The mouth is sore & shows angular cheilitis.
•Tenderness, pain & ulceration begin at the interdental papillae &
spreads rapidly

25. MANAGEMENT
•Niacin 10 mg or 10,000 mcg per day.
•Alcohol should be stopped.
THERAPEUTIC USES OF NIACIN
•Nicotinic acid when given parentrally ,produce
vasodilatation & histamine release.
•Serum cholesterol levels are lowered

26. pantothen meaning "from everywhere“-small quantities of pantothenic acid
are found in nearly every food
ABSORPTION & EXCRETIONABSORPTION & EXCRETION
•AbsorbedAbsorbed ExcretedExcreted in urine in urine
SOURCES SOURCES

27. DAILY REQUIREMENT
Men – 10 mg
Women – 10 mg
Children – 5.5 mg
DEFICIENCY
Gopalan’s
burning foot syndrome
Manifested as paresthesia
In lower extremities
MANAGEMENT
1000 mg daily
for 6 weeks.

28. •It’s a white crystalline substance soluble in water & alcohol.
Absorption & excretion :-
•Absorbed by passive diffusion.
•Excreted in the feces & in sweat.

30. DEFICIENCY SYMPTOMS:DEFICIENCY SYMPTOMS:
•Nervous Nervous :- peripheral neuropathy, mental retardation, irritability, :- peripheral neuropathy, mental retardation, irritability,
mental confusion & nervousness.mental confusion & nervousness.
•BloodBlood: Anemia, albuminuria & leukopenia.: Anemia, albuminuria & leukopenia.
•SSkinkin : dermatitis & eczema. : dermatitis & eczema.
•Others Others :- kidney stones, inflammation of the colon, damage to the :- kidney stones, inflammation of the colon, damage to the
pancreas, loss of muscular control, migraine headache & premature pancreas, loss of muscular control, migraine headache & premature
senility.senility.
ManagementManagement
•10-50 mg daily in divided doses.10-50 mg daily in divided doses.

31. EFFECT OF DRUGS ON ACTIVITY OF B6 CO-ENZYME
•Isoniazid inhibit pyridoxal kinase,which reduces formation of PLP &
cause deficiency of vitamin B6
•Penicillamine also act on B6 antagonist.
•Mild deficiency in women taking oral contraceptives & steroids
•Ethanol inactivates PLP,So deficiency common in alcoholics

32. •Known as anti egg white injury factor(avidin,protein present in egg
white has great affinity to biotin)
DAILY REQUIREMENTS
•Men & women – 100-200 mg
•Children – 50-200 mg
•Infants – 35 mg.

34. DEFICIENCY SYMPTOMS: DEFICIENCY SYMPTOMS:
MANAGEMENT:MANAGEMENT:
•20 mcg of biotin taken daily for 10 days IM can heal skin lesions.20 mcg of biotin taken daily for 10 days IM can heal skin lesions.
•Oral biotin to be taken in amount of 400 mcg daily for 8-12 weeks.Oral biotin to be taken in amount of 400 mcg daily for 8-12 weeks.
•Shampoo coating with 1% biotin can be useful in controlling excessive Shampoo coating with 1% biotin can be useful in controlling excessive
hair loss.hair loss.
Oral:Oral: fleshy part of tongue fleshy part of tongue
may waste awaymay waste away

35. •Also known as folacin or folate.
•It is yellow crystalline substance sparingly soluble
in water & soluble in acid solution.
ABSORPTION & EXERTION
•Absorbed
•stored
•Excreted in the feaces & urine

37. DAILY REQUIREMENTSDAILY REQUIREMENTS
•Men & women- 100 mcg.Men & women- 100 mcg.
•Children- 80 mcg. Children- 80 mcg.
•Infants- 25 mcg.Infants- 25 mcg.
•Pregnant women- 400 mcg.Pregnant women- 400 mcg.
•Lactating women- 150 mcg.Lactating women- 150 mcg.

38. CAUES FOR FOLATE DEFICIENCY
•Pregnancy
•Defective absorption
•Drugs(anticonvusants will inhibit the intestinal enzyme,so folate
absorption is reduced)
•Hemolytic anemia
•Dietary deficiency

39. MANAGEMENTMANAGEMENT
A daily dose of 5,000 -10,000 mcg of folic acid is sufficient & maintenance A daily dose of 5,000 -10,000 mcg of folic acid is sufficient & maintenance
dose of 5000 mcg in week is given in cases of megaloblastic anemia. dose of 5000 mcg in week is given in cases of megaloblastic anemia.

40. •It is freely soluble in water.It is freely soluble in water.
ABSORPTION & EXCRETIONABSORPTION & EXCRETION
•gastric juice , Calcium & protein rich foods is essential to facilitate its gastric juice , Calcium & protein rich foods is essential to facilitate its
absorption in the intestine.absorption in the intestine.
•storedstored
•ExcretedExcreted in normal urine, stools & breast milk . in normal urine, stools & breast milk .

42. Daily requirementsDaily requirements
•Men & women-l mcg.Men & women-l mcg.
•Children-0.2-1 mcg.Children-0.2-1 mcg.
•Infants-0.2 mcgInfants-0.2 mcg

43. ManagementManagement
•Oral :6-150 mcg. Oral :6-150 mcg.
Helps in the treatment of lack of concentration, fatigue depression, Helps in the treatment of lack of concentration, fatigue depression,
insomnia, anorexia, poor memory & loss of weight. insomnia, anorexia, poor memory & loss of weight.
•Parenteral - 1000 mcg of vitamin given twice weekly in cases of anemia.Parenteral - 1000 mcg of vitamin given twice weekly in cases of anemia.

44. •It is also called as ascorbic acid & antibiotic vitamin.It is also called as ascorbic acid & antibiotic vitamin.
Daily requirementsDaily requirements : :
•Men & women – 40 mg.Men & women – 40 mg.
•Infants – 25 mgInfants – 25 mg
•Children – 40 mg Children – 40 mg
•Pregnant & lactating women – 80 mg.Pregnant & lactating women – 80 mg.

46. Deficiency:Deficiency:
•Mild deficiency may appear in the form of lassitude fatigue, anorexia, Mild deficiency may appear in the form of lassitude fatigue, anorexia,
muscular pain & greater susceptibility to infection.muscular pain & greater susceptibility to infection.
•A prolonged deficiency may cause A prolonged deficiency may cause scurvy.scurvy.
PathogenesisPathogenesis
•There is defective formation of collagen in connective tissues because There is defective formation of collagen in connective tissues because
of failure of hydroxylation of proline to hydroxyproline which is a of failure of hydroxylation of proline to hydroxyproline which is a
characteristic amino acid of collagen.characteristic amino acid of collagen.
•There is also increase permeability of capillary (hemorrhage), anemia There is also increase permeability of capillary (hemorrhage), anemia
due to erythropoiesis & defective collagen formation.due to erythropoiesis & defective collagen formation.

47. CLINICAL FEATURES CLINICAL FEATURES
•Infantile scurvy Infantile scurvy – lassitude, anorexia, painful limbs & enlargement – lassitude, anorexia, painful limbs & enlargement
of costochondral junction.of costochondral junction.
•FolliculosisFolliculosis – hair follicle rises above skin & there are perifollicular – hair follicle rises above skin & there are perifollicular
hemorrhage. hemorrhage.
•HemorrhageHemorrhage may occur in the joint, into nerve sheath under the may occur in the joint, into nerve sheath under the
nails or conjunctiva.nails or conjunctiva.
•Petechial hemorrhage Petechial hemorrhage occurs in abdomen, legs, arms, ankle & occurs in abdomen, legs, arms, ankle &
nailbeds.nailbeds.

48. •Scorbutic child usually assumes a frog like position & this may reflect as
subperiosteal hemorrhage.
•Epistaxis, anemia & delayed wound healing.
•Edema of the limbs & face in severe ascorbic acid deficiency.
•It may lead to premature aging, thyroid insufficiency
& lower resistance to all infections.

49. ORAL MANIFESTATIONSORAL MANIFESTATIONS
•SiteSite – it occurs chiefly in gingival & periodontal region. – it occurs chiefly in gingival & periodontal region.
•AppearanceAppearance – interdental & marginal gingiva is bright red, swollen, – interdental & marginal gingiva is bright red, swollen,
smooth, shiny surface producing an appearance known as smooth, shiny surface producing an appearance known as scurvy scurvy
budbud. In fully developed scurvy, the gingiva becomes boggy, ulcerated & . In fully developed scurvy, the gingiva becomes boggy, ulcerated &
bleeds easily.bleeds easily.
•Color Color – color changes to violaceous red.– color changes to violaceous red.
•BreathBreath – typical – typical fetid breath fetid breath of the patient with of the patient with
fusospirochetal stomatitis.fusospirochetal stomatitis.
•Severe casesSevere cases-hemorrhage & swelling of PDL membrane occurs -hemorrhage & swelling of PDL membrane occurs
followed by loss of bone & loosening of teeth which are exfoliated.followed by loss of bone & loosening of teeth which are exfoliated.
MANAGEMENTMANAGEMENT
•VitaminC 250 mg 3 times daily can be given VitaminC 250 mg 3 times daily can be given

50. THERAPEUTIC USE OF VITAMIN C
•Used as an adjuvant in bacterial infections
•Beneficial in treating tuberculosis
•Heal wounds
TOXICITY
Can cause diarrhoea & eventual iron overload

51. •Vitamin A or retinol is found in foods of animal origin, while carotene Vitamin A or retinol is found in foods of animal origin, while carotene
in foods of plant.in foods of plant.
AbsorptionAbsorption StorageStorage
•Absorption of vitamin A increases if it is taken with fats.Absorption of vitamin A increases if it is taken with fats.
•Absorption more rapid in men than in women.Absorption more rapid in men than in women.
• Absorption in diarrhea, Jaundice & abdominal disorders.Absorption in diarrhea, Jaundice & abdominal disorders.
ExcretionExcretion
•Vitamin A which is not absorbed is excreted within one or two days in Vitamin A which is not absorbed is excreted within one or two days in
feaces.feaces.

53. REQUIREMENTSREQUIREMENTS
•Men & women-600 mcgMen & women-600 mcg
•Pregnancy & lactation-950 mcgPregnancy & lactation-950 mcg
•Children-600 mcgChildren-600 mcg
•Infants-350 mcg Infants-350 mcg

54. Oral manifestationsOral manifestations
•Epithelial invasion Epithelial invasion of pulpal tissue. Distortion of shapes of the of pulpal tissue. Distortion of shapes of the
incisors & the molars .incisors & the molars .
•Hypoplasia of teethHypoplasia of teeth-since the enamel forming cells are disturbed, -since the enamel forming cells are disturbed,
enamel matrix is poorly defined so that calcification is disturbed & enamel matrix is poorly defined so that calcification is disturbed &
enamel hypoplasia results.enamel hypoplasia results.
•DentinDentin-it is atypical in structure. lacking the normal tubular -it is atypical in structure. lacking the normal tubular
arrangement & containing vascular & cellular inclusions.arrangement & containing vascular & cellular inclusions.
•CariesCaries-increased caries susceptibility.-increased caries susceptibility.

55. •EruptionEruption-eruption is delayed. In prolonged deficiency, eruption -eruption is delayed. In prolonged deficiency, eruption
ceases completely.ceases completely.
•AAlveolarlveolar bonebone-alveolar bone is retarded in its rate of formation.-alveolar bone is retarded in its rate of formation.
•Gingiva-Gingiva-gingival epithelium becomes hyperplastic .gingival epithelium becomes hyperplastic .
In prolonged deficiency it shows keratinization.In prolonged deficiency it shows keratinization.
•PeriodontalPeriodontal diseasedisease-tissue is easily invaded by bacteria that may -tissue is easily invaded by bacteria that may
cause periodontal disease & microabscess formation.cause periodontal disease & microabscess formation.
•Salivary gland-Salivary gland-major major & minor salivary glands undergo typical & minor salivary glands undergo typical
keratinizing metaplasia.keratinizing metaplasia.

56. FormsForms
•DD
33-it is present in fish liver oils & animal fats.-it is present in fish liver oils & animal fats.
It is called as cholecalciferol.It is called as cholecalciferol.
•DD
22-it is obtained artificially by irradiation of ergosterol -it is obtained artificially by irradiation of ergosterol
& called as & called as ergocalciferolergocalciferol..
AbsorptionAbsorption
•Bile is essential for the absorption of vitamin D, fat helps in its Bile is essential for the absorption of vitamin D, fat helps in its
absorption too.absorption too.
•AbsorbedAbsorbed from the jejunum of the small intestine from the jejunum of the small intestine
•ExcretionExcretion -primarily in the feces with the aid of bile salts. -primarily in the feces with the aid of bile salts.
RequirementRequirement
•Infants & children- 0.01 mg.Infants & children- 0.01 mg.
•Men & women- 5-10 mg.Men & women- 5-10 mg.
•Pregnancy & lactating women- 10mg.Pregnancy & lactating women- 10mg.
SUNSHINE
VITAMIN

58. RICKETSRICKETS
Any disorder in vitamin-calcium phosphorous metabolism that results in Any disorder in vitamin-calcium phosphorous metabolism that results in
hypomineralised bone matrix &leads failure of endochondral hypomineralised bone matrix &leads failure of endochondral
calcification. calcification.
•It develops in an area where sunlight is deficient.It develops in an area where sunlight is deficient.
•Develops secondary to malabsorption of vitamin DDevelops secondary to malabsorption of vitamin D
•Secondary to abnormality of Vit D activationSecondary to abnormality of Vit D activation
•Secondary to abnormalities in renal absorptionSecondary to abnormalities in renal absorption

59. CLINICAL FEATURES CLINICAL FEATURES

60. ORAL MANIFESTATIONS
•Caries- there is higher caries index in rickets as compared to normal.
•Enamel- there may be hypoplasia of enamel
•Pulp- there are large pulp chamber, high pulp horns & delayed closure
of root apices.
•Malocclusion- the osteoid is so soft that teeth get displaced leading to
malocclusion of the teeth

61. OSTEOMALACIAOSTEOMALACIA
Known as Known as adult rickets .adult rickets .
Only flat bones & diaphysis of it are affected Only flat bones & diaphysis of it are affected
Clinical featuresClinical features
•Seen in adults & pelvic deformities are commonly seen in females.Seen in adults & pelvic deformities are commonly seen in females.
•BoneBone- remodeling of bone occur in the absence of adequate calcium - remodeling of bone occur in the absence of adequate calcium
resulting in softening & distortion of the skeleton.resulting in softening & distortion of the skeleton.
•SymptomsSymptoms- the majority of patients have bone pain & muscle - the majority of patients have bone pain & muscle
weaknessweakness
•Others-Others- there is increased tendency towards fracture, peculiar there is increased tendency towards fracture, peculiar
waddling or penguin gait, tetany & green stick bone fractures waddling or penguin gait, tetany & green stick bone fractures
Oral manifestationsOral manifestations
•Incidence of severe periodontitis in some cases of osteomalacia Incidence of severe periodontitis in some cases of osteomalacia

62. •It is also called as It is also called as anti-aging anti-aging factor. factor.
Absorption & excretionAbsorption & excretion
•Vitamin E in the diet is Vitamin E in the diet is absorbedabsorbed from the GIT from the GIT
•About 1/3rd of the vitamin is About 1/3rd of the vitamin is excretedexcreted in through the bile & the in through the bile & the
balance is excreted in the urine.balance is excreted in the urine.
Daily requirementsDaily requirements
•Men - 8-10 mgMen - 8-10 mg
•Women - 5-8 mgWomen - 5-8 mg
•Children - 8.3 mgChildren - 8.3 mg
•Infants - 4-5 mgInfants - 4-5 mg

64. DEFICIENCY SYMPTOMSDEFICIENCY SYMPTOMS
•MusclesMuscles--itit causes degenerative changes in muscles. There is muscle causes degenerative changes in muscles. There is muscle
fiber atrophy which is replaced by connective tissue.fiber atrophy which is replaced by connective tissue.
•Heart-Heart-there is necrosis & fibrosis of heart muscles.there is necrosis & fibrosis of heart muscles.
•Blood capillaries- Blood capillaries- degenerative changes in the blood capillaries degenerative changes in the blood capillaries
which in turn lead to heart & lung diseases, pulmonary embolism & which in turn lead to heart & lung diseases, pulmonary embolism &
brain stroke.brain stroke.
HYPERVITAMINOSISHYPERVITAMINOSIS
Doses above 1000IU per day causes hemorrhageDoses above 1000IU per day causes hemorrhage

65. •It is essential for the production of a type of protein called It is essential for the production of a type of protein called
prothrombin & other factors involve in the blood clotting mechanism. prothrombin & other factors involve in the blood clotting mechanism.
Hence it is known as Hence it is known as ANTI-ANTI-HEMORRHAGIC HEMORRHAGIC VITAMINVITAMIN..
FormsForms
•K1- K1- itit is the form which occurs in plants.is the form which occurs in plants.
•KK
2 2 - - itit is produced by most bacteria present in human intestine if not is produced by most bacteria present in human intestine if not
supplied in the diet .supplied in the diet .
RequirementsRequirements
•Men & women- Men & women- 50-100mg/day50-100mg/day

67. Functions
•Synthesis- hepatic synthesis of coagulation factors II, V, VII, IX & X.
•Clotting- it prevents hemorrhage only in cases when there is defective
production of prothrombin.
•Oxidative phosphorylation- It acts as a cofactor, in oxidative
phosphorylation associated with lipid.
Effects of deficiency
•Prolongation of prothrombin time &
•Delayed clotting time
•There may be nasal bleeding
Oral manifestations
•Gingival bleeding can also occur in cases of vitamin K deficiency.
Hypervitamnosis
•Large quantities of menadione may cause.

68. IMPORTANCE OF VITAMINS
VITAMINS FUNCTION
B1, B2, B3, B5, B 6, B7, B9, B12, C,
K
COENZYME
B1, B2, B3, B5, B6, B7 METABOLISM OF ENERGY
YIELDING NUTRIENTS
B 6, B 9, B12 RED BLOOD CELL SYNTHESIS
B6, B9, B12 AMINO ACID METABOLISM
B 7, B 5, B 3 FATTY ACID SYNTHESIS
C , E ANTIOXIDENT PROTECTION
B1, B6, B12 NERVE TRANSMISSION
A, D GENE EXPRESSION

70. CONCLUSION
Do not mislead: Vitamins may be required to supplement an
inadequate diet but never to complement it.
 Vitamins provide a profitable market for the pharmaceutical
industry ,and a rent in the consumer’s wallet.

71. •THANK YOU