Vitamins B Complex

Vitamins B Complex & Deficiencies

1. DR SHAHNAWAZ F SHAH
MD, FPM, FIAPM,FCPM (MUHS)
Interventional Spine & Pain Physician
Surat

2. CLASSIFICATION

3. Water Soluble Vitamins
(C & B Complex)
•Release energy. Several B vitamins are key components of
certain coenzymes (molecules that aid enzymes) that help
release energy from food.
•Produce energy. Thiamin, riboflavin, niacin, pantothenic
acid, and biotin engage in energy production.
•Build proteins and cells. Vitamins B6, B12, and folic acid
metabolize amino acids (the building blocks of proteins)
and help cells multiply.
•Make collagen. One of many roles played by vitamin C is to
help make collagen, which knits together wounds, supports
blood vessel walls, and forms a base for teeth and bones.

4. WATER SOLUBLE VITAMINS
•Essential co- enzymes required in energy releasing
mechanisms.
•Act as co- enzymes for metabolism of proteins, carbohydrates
and fats.
•They include-
B1- Thiamine B6 –Pyridoxine
B2 - Riboflavin B7 – Biotin
B3 – Niacin B 9- Folic acid
B5 – pantothenic acid B12 –Cobalamin

Vitamin C (ascorbic acid)

6. VITAMIN B1 (THIAMINE)
•Anti Beri-Beri factor
•Anti Neuritic factor
•Aneurin

7. Characteristics
•Colorless basic organic compound composed
of a sulfated pyramidin ring.
•All living organisms use thiamine, but it is
synthesized only in bacteria, fungi, and plants.
•Contains sulfur and nitrogen group
•Destroyed by alkaline and heat
•Active form- Thiamine pyrophosphate

8. DIETARY SOURCES OF VITAMIN B1
•Foods high in thiamin
–pork,
–fish,
–seeds, nuts,
–beans, green peas,
–tofu,
–brown rice,
–squash,
–asparagus,
–seafood

9. Daily requirement
•Adult Male – 1.3 mg
•Adult Female – 1.0 mg
•Pregnancy and lactation – 2mg
•Children – 1.1mg.

10. M/A OF THIAMINE
•Allows the cell to produce energy






•Synthesis of neurotransmitter
Kreb’s Cycle
Pyruvate
Acetyl CoA
Kreb’s Cycle
α-ketoglutarate
Succinyl-CoA

11. FUNCTIONS OF THIAMINE
•Converting carbohydrate into energy. (ATP
production)
•Maintaining Peripheral Nerve Conduction
•Necessary for healthy mucous membranes.
•Helps in the digestion of food.
•Provides strength to muscles.
•It is very useful for the proper functioning of
heart.

12. VITAMIN B1 DEFICIENCY
Who’s at risk?
Excessive loss
Hemodialysis
Diuretic therapy
Chronic Alcoholism

13. VITAMIN B1 DEFICIENCY
•Beri-Beri
•Wernicke-Korsakoff Syndrome
•Muscle Weakness & Wasting
•Ophthalmoplegia

14. Beri-Beri
•Symptoms include:
–Dry Beri-Beri: No Edema
–Wet Beri-Beri: Pitting Edema on Trunk, Limbs and
Face
–Progressive Wasting of Muscles
–Tachycardia,
–Laboured Breathing
–Numbing and weakening of Extremities
–tingling or burning sensation in the hands and feet

15. Beri-Beri
•Symptoms similar to Congestive Heart Failure
•Slowly Progressive Course
•Rapid Deterioration and Fatal Circulatory
Collapse

16. Beri-Beri

18. Wernicke-Korsakoff Syndrome
•Wernicke’s Encephalopathy (WET BRAIN)
–G- Global Confusion
–O- Ophthamoplegia & Horizontal Nystagmus
–A- Ataxia

•Wernicke’s-Korsakoff Syndrome-
–Above symptoms with: - Confabulatory Psychosis,
Loss of Memory

20. Treatment
•In Acute Thiamine Deficiency (Wet Brain)-
–200mg of Thiamine IV three times a day until
improvement of acute symptoms.
–f/b Oral Thiamine 10mg/d given until complete
recovery.

22. VITAMIN B2 (RIBOFLAVIN)
•also called as beauty vitamin.
•Yellowish green fluorescent compound soluble
in water.
•The word “Riboflavin” is derived from 2
sources-
–Ribose – ribose sugar
–Flavin – yellow.
•widely involved in oxidation- reduction
reaction.

23. DIETARY SOURCES OF VITAMIN B2

24. Daily requirement
•Adult Male – 1.5mg
•Adult female – 1.2 mg
•Pregnancy and lactation – 2 to 2.3 mg
•Children – 1.3mg.

25. FUNCTIONS OF RIBOFLAVIN
•Essential for normal growth.
•Metabolism – It is involved in the metabolism
of carbohydrates, fat & proteins.
•Digestion – it helps in digestion
•Nervous system – it helps in proper
functioning of Nervous system

26. FUNCTIONS OF RIBOFLAVIN
•Very useful for normal tissue respiration.
•Necessary for healthy mucous membranes
•Good for skin, nails and eyes
•helps in protects the body against cancer

27. RIBOFLAVIN DEFICIENCY
•Magenta Tongue.
•Angular Stomatis.
•Dermatitis and Cheilosis.
•Cracks and sores in mouth and lips.

29. VITAMIN B3
•Also known as Niacin

•Essential for metabolism of carbohydrate,
protein & fat.

30. •It is a colorless, water-soluble solid derivative
of pyridine, with a carboxyl group (COOH) at
the 3-position

•It is a pyridine derivative and is a precursor of
the coenzyme NAD (Nicotinamide adenine
dinucleotide)

31. DIETARY SOURCES OF NIACIN
•yeast, meat, poultry, red fish (e.g.,
tuna, salmon), cereals, legumes, and seeds
Milk, green leafy vegetables

32. Daily requirement

•Adult Male – 17mg
•Adult Female – 13 mg
•Pregnancy and lactation – 12 to 15 mg
•Children – 15mg.

33. FUNCTIONS OF NIACIN (VIT B3)
•Releasing energy from carbohydrates, fats and
protiens.
•DNA synthesis.
•production of estrogen progesterone &
testosterone
•Necessary for healthy skin, nerves and digestive
system.
•Helps to detoxify the body.
•Vitamin B3, is very essential for the proper
digestion of the food

34. •may improve arthritis symptoms, including
increasing joint mobility and reducing the
amount of anti-inflammatory medications
needed
•helpful in reducing migraine headaches
•High doses of niacin medications are used to
prevent development of atherosclerosis and
to reduce recurrent complications such as
heart attack and peripheral vascular disease

35. VITAMIN B3 DEFICIENCY
•PELLAGRA -
•Characterised by 4D’s
–Diarrhoea
–Dermatitis
–Dementia
–Death

36. VITAMIN B3 DEFICIENCY
•Casal’s Necklace
–Pigmented and scaling rash forming a ring around
sun exposed area of neck

37. Treatment
•100-200mg of nicotinamide 3 times a day for 5
days

39. VITAMIN B5
•PANTOTHENIC ACID
•water-soluble vitamin.
•It was discovered by Roger J. Williams in 1919.
•This word derived from
–greek word pantos meaning everywhere.
•Part of Coenzyme-A
•Essential for metabolism of CHO, fat, protein

40. DIETARY SOURCES OF VIT B5

41. Daily requirement
•Adult male – 10 mg
•Adult Female – 10 mg
•Children – 5.5mg

42. FUNCTIONS OF VIT B5
•plays an important role in helping release energy
from sugars, starches, and fats.
•They are essential for the cell metabolism.
•They are very helpful in the cholesterol
metabolism.
•Accelerates wound healing.
•It is also used as anti-stress factor.
•Allergies, headaches, arthritis, psoriasis,
insomnia, asthma, and infections have all been
treated with some effectiveness using vitamin B5.

45. VITAMIN B6 (PYRIDOXINE)
•Vitamin B6 is part of the vitamin B complex
group, and its active form, Pyridoxal 5'-
phosphate (PLP) serves as a cofactor in many
enzyme reactions in amino acid, glucose, and
lipid metabolism.

•It is white crystalline substance soluble in
water and alcohol.

46. DIETARY SOURCE OF VIT B6
•Milk, Fish, Vegetables, Beans, Eggs, Peanuts,
sunflower seeds

47. Daily requirement.
•Adults– 2 mg
•Children – 1.7 mg
•Infant – 0.1-0.4 mg

48. FUNCTIONS OF VITAMIN B6
•Make antibodies. Antibodies are needed to fight
many diseases.
•Maintain normal nerve function
•Promotes RBC production & hemoglobin.
•Break down proteins.
•Keep blood sugar (glucose) in normal ranges
•Assists in the balancing of Sodium and Potassium
levels.
•Production of Serotonin, Dopamine,
Noradrenaline and Adrenaline

49. DEFICIENCY OF VITAMIN B6
•Peripheral Neuropathy and Depression
•Microcytic Hypochromic Anemia
•Loss of muscle control, muscle weakness,
cramps and numbness
•Hyperhomocysteinemia and Cardiovascular
Risk
•Treatment of deficiency- 50mg/d until
resolution of symptoms

51. VITAMIN B7 (BIOTIN)
•Also known as
–Biotin
–Vitamin H
–coenzyme R

•Biotin is a coenzyme for carboxylase enzymes,
involved in the synthesis of fatty acids,
isoleucine, and valine, and in gluconeogenesis

53. Daily requirement
•Adults– 100- 200 mcg
•Children – 50-200 mcg.
•Infant – 35 mcg

54. FUNCTIONS OF VITAMIN B7
•convert food into glucose, which is used to
produce energy

•produce fatty acids and amino acids (the
building blocks of protein)

•activate protein/amino acid metabolism in the
hair roots and fingernail cells.

55. FUNCTIONS OF VITAMIN B7
•Maintenance of
–normal skin and mucous membranes

–normal function of the nervous system

–normal hair

–normal psychological functions.

56. VITAMIN-B7 DEFICIENCY
•Nausea, Anorexia, scaling seborrheic
erythematous rash around eyes, nose and
mouth.

•In infants- Alopecia, Rash involving Ears and
hypotonia.

•Treatment of deficiency- 10mg/d of biotin 60

58. VITAMIN B9 (FOLIC ACID)
•also known as folic acid, folacin or folate.

•It is a water soluble vitamin.

•It is a yellow crystalline substance.

59. DIETARY SOURCE

60. FUNCTIONS OF VIT B9
•Formation of RBC – folic acid in combination with vitamin
B12 is essential for formation, maturation of RBCs.
•Nerve – it is necessary for growth & division of all body
cells,
•Hair & Skin – it is essential for the health of skin & hair
•Pregnancy – it is an important nutrient for the pregnant
women & her developing fetus.
•Improves the lactation.
•DNA synthesis, DNA and RNA replication
•Homocysteine metabolism
•Neurotransmitter formation

61. Deficiency Symptoms
•Megaloblastic Anaemia.
•Atrophic Glossitis
•Depression

63. VITAMIN B12 (COBALAMIN)
•Complex organomatrix compound called as
COBALAMIN which is cobalt containing
porphyrin.

•It is freely soluble in water.

64. SOURCES
•Vitamin B12 is mostly found in animal
products such as meat, shellfish, milk, cheese,
and eggs.

65. FUNCTIONS OF VITAMIN B12
•Red Blood Cells – it is essential for production
of RBCs
•Nervous – It improves concentration, memory,
& balance.
•Metabolism of fat, carbohydrate ,proteins,
folic acid.
•Promotes growth and increases apatite.

66. VITAMIN- B12 DEFICIENCY
•Megaloblastic Anemia.
•Pernicious anemia
•Demyelination & irreversible nerve cell death
•Loss of Vibratory and Position Senses
•Abnormal Gait
•Dementia
•Loss of Bladder and Bowel Control

68. Treatment
•To replenish body stores.
–1000μg of Hydroxocobalamin
–at 3 to 7 days interval
–Six IM injections

•For maintainence therapy-
–1000μg of Hydroxocobalamin every 3 months

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