A vitamin that can dissolve in water. Vitamins are nutrients that the body needs in small amounts to stay healthy and work the way it should. Water-soluble vitamins are carried to the body's tissues but are not stored in the body.

1. PREPARED BY; MISS RABIA KHAN BABER

2. TOPICS
Definitions
Introduction to classification
All water soluble vitamins
Biosynthesis
Sources of vitamins
Daily dosage
Biochemical function of vitamins
Deficiencies of vitamin
Sign and symptoms

3. WATER SOLUBLE VITAMINS

4. DEFINITION OF VITAMINS
Vitamins have been defined as organic compounds
occurring in natural foods either as such or as utilisable
precursors, which are required in minute amounts for
normal growth, maintenance and reproduction, i.e. for
normal nutrition and health.

5. They differ from other organic food stuffs in that:
• They do not enter into tissue structures, unlike proteins.
• Do not undergo degradation for providing energy unlike carbohydrates and
lipids.
• Several B complex vitamins play an important role as coenzymes in
several energy transformation reactions in the body.
They differ from hormones: In not being produced
• Within the organism, and most of them have to be provided in the diet.

6. CLASSIFICATION OF VITAMINS
1. FAT-SOLUBLE VITAMINS 2. WATER-SOLUBLE VITAMINS
Vitamin A
Vitamin D
Vitamin E
and
Vitamin K
Vitamin C
(ascorbic
acid)
Vitamin B
complex
group

7. WHAT ARE WATER SOLUBLE
VITAMINS?
A vitamin that can dissolve
in water. Vitamins are nutrients that the body
needs in small amounts to stay healthy and
work the way it should. Water-soluble
vitamins are carried to the body's tissues but are
not stored in the body.

8. VITAMIN B
B vitamins play a vital role in maintaining
good health and well-being. As the
building blocks of a healthy body, B
vitamins have a direct impact on your
energy levels, brain function, and cell
metabolism.

9. Vitamin B complex helps prevent infections and helps support or
promote:
Cell health
Growth of red blood cells
Energy levels
Good eyesight
Healthy brain function
Good digestion
Healthy appetite
Proper nerve function
Hormones and cholesterol production
Cardiovascular health
Muscle tone

10. IMPORTANCE OF VITAMIN B COMPLEX
 IN WOMEN ;
B vitamins are especially important for women who are pregnant and
breastfeeding. These vitamins aid in fetal brain development as well as reduce
the risk of birth defects.
 IN MEN ;
B vitamins are thought to increase testosterone levels in men, which naturally
decrease with age. They also help men build muscle and increase strength

11. B COMPLEX AND THEIR FUNCTIONS
Vitamin B-1 – thiamin
Vitamin B-1 is vital to the healthy growth and function of organs, including
the brain and heart.
Vitamin B-2 – riboflavin
The body needs vitamin B-2 to break down fats and drugs.
Vitamin B-3 – niacin
The body needs niacin to maintain healthy skin, nerves, and digestion.
Doctors sometimes prescribe high doses of niacin to help improve
cholesterol levels.

12. CONT..
Vitamin B-5 – pantothenic acid
Vitamin B-5 is essential for the health of the brain and nervous system.
Vitamin B-6 – pyridoxine
Vitamin B-6 helps the body make new red blood cells, which carry oxygen
throughout the body. It also helps keep the immune system strong.
Vitamin B-7 – biotin
Biotin is essential for healthy hair, nails, and nerve function.

13. CONT..
Vitamin B-9 – folic acid
The body uses folic acid — or folate, its natural form — to make DNA and
genetic material. During pregnancy, folic acid may reduce the risk of
certain birth defects.
Vitamin B-12 – cobalamin
The body’s nerve and blood cells require vitamin B-12. Adequate levels of
B-12 also prevent pernicious anemia, which is a deficiency of this nutrient.

14. SOURCES OF VITAMIN B COPMLEX
Beef
Pork
Fish
Organ meats
Avocados
Leafy greens
Nuts
Legumes
Grains
Milk
Cheese
Yogurt
Enriched and fortified breads and
cereals
Mushrooms

15. SYMPTOMS AND DEFICIENCY OF
VITAMIN B COMPLEX
Skin rashes
Cracks around the mouth
Scaly skin on the lips
Swollen tongue
Fatigue
Weakness
Anemia
Confusion
Irritability or depression
Nausea
Abdominal cramps
Diarrhea
Constipation
Numbness or tingling in the feet
and hands

16. B COMPLEX MALES FEMALES
DURING
PREGNANCY
DURING
BREASTFEEDING
Vitamin B-1 1.2 mg 1.1 mg 1.4 mg 1.4 mg
Vitamin B-2 1.3 mg 1.1 mg 1.4 mg 1.6 mg
Vitamin B-3 or
dietary equivalents
16 mg 14 mg 18 mg 17 mg
Vitamin B-5 5 mg 5 mg 6 mg 7 mg
Vitamin B-6 1.3 mg 1.5 mg 1.9 mg 2.0 mg
Vitamin B-7 30 mcg 30 mcg 30 mcg 35 mcg
Vitamin B-9 or
dietary equivalents
400 mcg 400 mcg 600 mcg 500 mcg
Vitamin B-12 2.4 mcg 2.4 mcg 2.6 mcg 2.8 mcg
RECOMMENDED DIETARYALLOWANCE

17. THIAMINE (B1)
Thiamine is necessary for converting glucose
into fuel for our body and cells in the brain.
Thiamine also plays an important role in
muscle contraction and nerve conduction. Its
deficiency is very rare although chronic
alcohol consumption may lead to thiamine
deficiency.

18. CHEMISTRY OF B1
Free thiamine is a basic substance and contains
(a) A pyrimidine, and
(b) A thiazole ring. It contains sulphur
(sulphur containing vitamin). Generally prepared as a chloride-hydrochloride.
• Solubility: Soluble in water

19. ABSORPTION OF B1
Free thiamine is absorbed readily from the small intestine, but the
pyrophosphate (ester-form) is not. Bulk of the dietary vegetable thiamine is in
the “free” form. In tissues, it is actively phosphorylated to form Thiamine
pyrophosphate (TPP) in Liver, and to a lesser extent in other tissues like
muscle, brain and nucleated RB Cells.

20.  Loss of sensation in hands and feet
 Loss of muscles and paralysis of lower leg
 Speech difficulties
 Mental confusion
 Beriberi
1. Wet beriberi
2. Dry beriberi
SYMPTOMS OF THIAMINE
DEFICIENCY

21. Beriberi is characterised by the following manifestations.
• CV manifestations: These include palpitation, dyspnoea, cardiac hypertrophy
and dilatation, which may progress to congestive cardiac failure.
• Neurological manifestations: These are predominantly those of ascending,
symmetrical, peripheral polyneuritis. These neurological features may be
accompanied occasionally by an acute haemorrhagic polioencephalitis which is
then called as Wernicke’s encephalopathy.
• GI symptoms: Amongst these, anorexia is an early symptom. There may be
gastric atony, with diminished gastric motility and nausea; fever and vomiting
occur in advanced stages.
Dry beriberi: When it is not associated with oedema.
Wet beriberi: Oedema is associated. It is probably in part to congestive cardiac
failure and in part to protein malnutrition (Low plasma albumin).

22. DIETARY SOURCES OF THIAMINE:
Thiamine is found in a variety of food so
its deficiency is rare in people who are
eating a healthy and balanced diet.
Meat
Beef liver
Egg
Flax seeds
Bread
Cereal grains
Asparagus

23. DAILY REQUIREMENTS
• Adult: 0.5 mg for each 1000 calories; 1.0 to 1.5 mg for diets providing 2000 to
3000 C. Minimum requirement is 1.0 mg. Actual requirement is related more
directly to carbohydrates content of diet than to calorie value of diet.
• Children: Ranges from 0.4 mg for infants to 1.3 mg for preadolescents (10 to
12 years of age).
REQUIREMENTS INCREASES IN
• Anoxia-shock and haemorrhage, Serious illness and injury, During prolonged
administration of broadspectrum oral antibiotics, Increased calorie expenditure
like fever, hyperthyroidism, Increased carbohydrate intake, Increased alcohol
intake, and pregnancy and in lactation.

24. RIBOFLAVIN (B2)
Vitamin B2 helps break down proteins, fats, and carbohydrates. It plays a
vital role in maintaining the body’s energy supply.
Riboflavin helps convert carbohydrates into adenosine triphosphate (ATP).
The human body produces ATP from food, and ATP produces energy as the
body requires it. The compound ATP is vital for storing energy in muscles.

25. CHEMISTRY
It is an orange-yellow compound containing,
• A ribose alcohol: D-Ribitol
• A heterocyclic parent ring structure Isoalloxazine (Flavin nucleus). 1-Carbon
of ribityl group is attached at the 9 position of isoalloxazine nucleus. Ribityl is
an alcohol derived from pentose sugar Dribose.
STABILITY:
• It is stable to heat in neutral acid solution but not in alkaline solutions.
Aqueous solutions are unstable to visible and UV light. The reactions are
irreversible.
• Riboflavin undergoes reversible reduction readily in presence of a catalyst to a
colourless substance Leucoriboflavin.

26. ABSORPTION:
• Flavin nucleotides are readily absorbed in small intestine. Free riboflavin
undergoes phosphorylation, a prerequisite for absorption of thiamine.
• Blood/Plasma level: Human blood plasma contains 2.5 to 4.0 μgm%, two-third
as FAD and bulk of remainder as FMN. Concentration in RB cells-15 to 30
μg/100 gm. Leucocytes and platelets-250 μg/100 gm. These values remain
quite constant even in severe riboflavin deficiency, hence determination of
riboflavin in blood is not useful. Riboflavin present in all tissues as nucleotides
bound to proteins (FP), highest concentration in liver and kidney.
• Excretion: Mainly in free form, up to 50 per cent as nucleotides in urine. Daily
urinary excretion 0.1 to 0.4 mg (10 to 20% of intake).
• Milk: Riboflavin is secreted in milk, 40 to 80 per cent in ‘free’ form.
• Faeces: Free and nucleotides tend to remain quite constant, 500 to 750 μg
daily, largely from the unabsorbed bacterial synthesis.

27. SOURCES OF B2
Animal sources
Fish
Crab
Kidney
liver
Eggs
Plant sources
Dairy products
Whole-grain breads
Enriched breads
Wheat bran
Yeast
Beans
Nuts

28. DEFICIENCY MANIFESTATIONS
There is no definite disease entity. Deficiency is usually associated with
deficiencies in other B-vitamins. In human beings lesions of the mouth, tongue,
nose, skin and eyes with weakness, and lassitude reported.

29. SIGN AND SYMPTOMS OF B2
DEFICIENCY
Angular cheilitis
Seborrheic dermatitis
Cracked lips
Dry skin
Inflammation of the tongue
Mouth ulcers
Red lips
Sore throat
Iron-deficiency anemia
Eyes may be sensitive to bright light, and they may be itchy, watery,
or bloodshot

30. Seborrheic dermatitis Angular cheilitis

31. NIACIN (B3)
It is important for the production of chemical responsible for mood and
emotions. Serotonin is a mood regulator chemical produced by our brain and
niacin is essential for converting tryptophan into serotonin. Its deficiency can
directly impact mood and emotions due to impaired production of serotonin.

32. CHEMICAL FORMS OF (B3)
There are two main chemical forms and each has different effects on your
body. Both forms are found in foods as well as supplements.
1. Nicotinic acid : As a supplement, nicotinic acid is a form of niacin used
to reduce cholesterol levels and lower your risk of heart disease
2. Niacinamide : It may help treat psoriasis and reduce your risk of non-
melanoma skin cancer

33. SOURCES OF B3
Liver, chicken, salmon
Whole wheat
Bran
Mushrooms
Peanuts
Legume
 Yeast
Coffee

34. SIGN AND SYMPTOMS OF B3
DEFICIENCY
Memory loss and mental confusion
Fatigue
Depression
Headache
Diarrhea
Skin problems

35. B3 DEFICIENCY CAUSES
 PALLEGRA
Pellagra is the "Disease Of The Three D's"
1. Diarrhea
2. Dermatitis: A scaly rash on skin exposed to light or trauma
3. Dementia: Mental disorientation, delusions and depression
Other features are ulcerations within the mouth (glossitis), nausea. vomiting,
seizures and balance disorder.

36. PENTOTHENIC ACID (B5)
Vitamin B5 is also called pantothenic acid and is one of the most important
vitamins for human life. It’s necessary one for making blood cells, and it
helps you convert the food you eat into energy.

37. BIOLOGICALLY ACTIVE FORM
Active form is coenzyme A

40. FUNCTIONS OF VITAMIN B5
Healthy skin, hair, and eyes
Proper functioning of the nervous system and liver
Healthy digestive tract
Making red blood cells, which carry oxygen throughout the body
Making sex and stress-related hormones in the adrenal glands

41. COSMETIC USES OF B5
Vitamin B5 is often added to hair and skin products, as well as makeup.
Dexpanthenol, a chemical made from B5, is used in creams and lotions
designed to moisturize the skin.

42. SOURCES OF B5
Animal sources
Chicken
Kidney
liver
Eggs
Plant sources
Milk
Legumes
Cereals
Sweet potatoes
Yeast
Beans
Nuts

43. EXCRETION OF B5
Urine :
About 2.5-5 mg are excreted daily in urine
Sweat :
3-4 µg/100 ml
Milk
Secretes 200-300 µg/100 ml

44. SIGN AND SYMPTOMS OF B5
Fatigue
Changed sleep patterns
Confusion
Disturbance
Muscle cramps
Greying of hair
Stomach pain
Insomnia
Vomiting

45. B5 DEFICIENCY
Dermatitis
Alopecia
Gastritis
Enteritis
Ulceration
Heamorrhagic diarrhea

46. Fatigue Greying of hair

47. PYRIDOXINE (B6)
Vitamin B6, also known as pyridoxine, is a water-soluble vitamin that your
body needs for several functions.
It’s significant to protein, fat and carbohydrate metabolism and the
formation of red blood cells and neurotransmitters .
Human body cannot produce vitamin B6, so it must be obtain from food or
supplements.
Most people get enough vitamin B6 through their diet, but certain
populations may be at risk for deficiency.

48. BIOLOGICALLY ACTIVE FORM
Active forms are ;
i. Pyridoxal ii. Pyridoxamine

49. FUNCTIONS AND USES OF VITAMIN B6
Promotes eye health and prevent eye diseases
Prevents clogged arteries and reduce heart disease risk
Helps in treating nausea during pregnancy
Useful in treating symptoms of PMS
Prevents and treat anemia by aiding hemoglobin production
Promotes brain health and reduce Alzheimer's risk
Improve mood and reduces symptoms of depression

50. METABOLIC ROLE OF B6
Acts as coenzyme
Transulfuration
Synthesis of sphingomyelin
Muscle phosphorylase
Immune response
Oxaluria

51. SOURCES OF B6
Animal sources
Egg yolk
Muscle
Fish
Kidney
Liver
Plant sources
Cereals grains
Yeast
Beans
Various seeds

52. ABSORBTION AND EXCRETION OF B6
Intestine :
Dietary vitamin B6 is readily absorbed by small intestine
Urine :
About 0.5-0.7 mg are excreted daily in urine

53. B6 DEFICIENCY
No deficiency disease has been described

54. CLINICALASPECTS OF B6
Convulsions in infant
Pyridoxine responsive anemia
Treatment in tuberculosis
Hormone dependent cancer
Reduce risk of Parkinson`s Disease

55. FOLIC ACID GROUPS (B9)
Folic acid is crucial for proper brain function and plays an important role in
mental and emotional health. It aids in the production of DNA and RNA, the
body's genetic material, and is especially important when cells and tissues are
growing rapidly, such as in infancy, adolescence, and pregnancy.

56. BIOCHEMICAL FUNCTIONS AND
IMPORTANCE OF B9

57. BIRTH DEFECTS
A pregnant women who do not get enough folic acid are more likely to
have children with birth defects. Pregnant women should get 600 mcg of
folic acid per day. Women who plan to become pregnant should make sure
to get the recommended 400 mcg per day since many neural tube defects
can happen shortly after conception and before a woman even knows she is
pregnant. Prenatal vitamins contain the needed amount of folic acid for
pregnant women.
Studies show that women who take folic acid supplements before
conception and during the first trimester may reduce their risk of having
children with neural tube defects by 72 to 100%. Other studies suggest that
in the setting of folic acid fortification of grains, folic acid supplementation
does not appear to offer further benefit for preventing spina bifida.

58. Spina bifida is a birth defect
that occurs when the spine
and spinal cord don't form
properly. It's a type of neural
tube defect. The neural tube
is the structure in a
developing embryo that
eventually becomes the
baby's brain, spinal cord and
the tissues that enclose
them.

59. HEART DISEASE
Folate may help protect the heart through several methods. First, there is
some evidence that getting enough folic acid in your diet can reduce your
risk of heart disease, although this evidence is based on population studies
and not more definitive clinical trials. There is not yet any evidence that
taking folic acid supplements would help.
AGE-RELATED HEARING LOSS
One study suggests that folic acid supplements help slow the progression of
age-related hearing loss in elderly people with high homocysteine levels
and low folate in their diet. It is not known whether healthy seniors would
benefit.

60. AGE-RELATED MACULAR DEGENERATION (AMD)
One large study found that women who took 2,500 mcg of folic acid along
with 500 mg of vitamin B6 and 1,000 mcg of cyanocobalamin (vitamin
B12) daily reduced their risk of developing AMD, an eye disease that can
cause vision loss.
DEPRESSION
The evidence about whether folic acid can help relieve depression is mixed.
Some studies show that 15 to 38% of people with depression have low
folate levels in their bodies, and those with very low levels tend to be the
most depressed. One study found that people who did not get better when
taking antidepressants had low levels of folic acid. A double-blind, placebo-
controlled study found that taking 500 mcg of folic acid daily helped the
antidepressant Prozac work better in women, but possibly not men. Another
study found that taking folic acid and vitamin B12 was no better than
placebo in relieving depression in older people.

61. CANCER
Folic acid in the diet seems to protect against the development of some
forms of cancer, including:
Colon cancer
Breast cancer
Cervical cancer
Pancreatic cancer
Stomach cancer
 Low dietary intake of folate may increase the risk of developing breast
cancer, particularly for women who drink alcohol. Regular use of alcohol,
more than 1½ to 2 glasses per day, is associated with higher risk of breast
cancer. One large study, involving more than 50,000 women followed over
time, suggests that adequate intake of folate may reduce the risk of breast
cancer associated with alcohol.

62. SOURCES OF B9
Animal sources
Whole egg
Beef liver
Salmon
Milk
Plant sources
Whole grains
Wheat
Beans
Yeast
Asparagus
Green leafy vegetables

63. RECOMMENDED DAILY
REQUIREMENT OF B9
PEDIATRIC ADULT
 Infants, 0 to 6 months: 65 mcg
 Infants, 7 to 12 months: 80 mcg
 Children, 1 to 3 years: 150 mcg
 Children, 4 to 8 years: 200 mcg
 Children, 9 to 13 years: 300 mcg
 Teens, 14 to 18 years: 400 mcg
 Men and women, 19 years and older: 400
mcg
 Pregnant women: 600 mcg
 Breastfeeding women: 500 mcg

64. DAILY EXCRETION OF B9
Urine :
About 2-5 μg are excreted daily in urine

65. PRECAUTIONS
At the recommended daily allowance, side effects from folic acid are rare. Very
high doses can cause:
Stomach problems
Sleep problems
Skin reactions
Confusion
Loss of appetite
Nausea
Seizures

66. AVAILABLE FORMS OF B9
Vitamin B9 is found in multivitamins, including children's chewable and
liquid drops, and B complex vitamins. It is also sold separately. It is a good
idea to take folic acid as part of, or along with, a multivitamin because other
B vitamins are needed for it to work. It is available in a variety of forms,
including tablets and soft gels.

67. POSSIBLE DRUG INTERACTIONS
Antibiotics, tetracycline:
Folic acid should not be taken at the same time as the antibiotic tetracycline
because it interferes with the absorption and effectiveness of this medication.
Folic acid, either alone or in combination with other B vitamins, should be
taken at different times from tetracycline. All vitamin B-complex
supplements act in this way and should be taken at different times from
tetracycline.
Phenytoin (Dilantin):
Phenytoin, an anti-seizure medication, may lower levels of folate in the body.
However, folic acid may interfere with the way phenytoin works, raising the
risk of seizures.

68. CONT..
Chemotherapy medications:
Folic acid may raise the amounts of 5-fluorouracil to dangerous levels in the
body. If you are undergoing chemotherapy, ask your oncologist before taking any
supplements or herbs.
Pyrimethamine (Daraprim):
Pyrimethamine is a medication used to prevent and treat malaria and to treat
toxoplasmosis. Folic acid may make this medication less effective.

69. DEFICIENCY OF B9
Poor growth
Tongue inflammation
Gingivitis
Loss of appetite
Shortness of breath
Diarrhea
Irritability
Forgetfulness
Mental sluggishness

70. ANEMIA DUE TO FOLIC ACID (B9)
Having too little folate in blood causes folic acid deficiency anemia.
Folate is necessary for your body to make new red blood cells. Your body
needs red blood cells to carry oxygen to your organs. Not having enough
red blood cells causes a condition called anemia, which can make you feel
weak and tired.

71. TYPES OF ANEMIA CAUSED BY B9
DEFICIENCY

72. Nutritional Macrocytic Anemia;
Cause dietry deficiency of folic acid
Megaloblastic Anemia Of Infancy;
Due to dietry deficiency
Megaloblastic Anemia Of Pregnancy;
Mechanism is not clear, may be relative deficiency
Megaloblastic Anemia In GI Diseases;
B12 deficiency is also associated with neurological manifestations

73. Macrocytic Anemia In Liver Diseases;
Due to inadequate storage/conversion
Macrocytic Anemia After Extensive Intestinal Resection;
Due to inadequate absorption
A Congenital Type;
May be due to reductase deficiency

74. SIGN AND SYMPTOMS OF B9
DEFICIENCY
Fatigue
Dizziness
Feeling cold
Irritability
Headache
Difficulty breathing
Pale skin
Diarrhea
Weight loss
Loss of appetite
Difficulty concentrating

75. WHO IS AT RISK FOR FOLATE-
DEFICIENCY ANEMIA?
Those who don’t eat a healthy diet
Those who drink a lot of alcohol
 Pregnant females
Those who can’t absorb folic acid
Those who are taking certain medicines, such as those used to control
seizures.

76. FIGLU TEST
A urine test for
formiminoglutamic acid, an
intermediate metabolite in L-
histidine catabolism in the
conversion of L-histidine to L-
glutamic acid. It may be an
indicator of vitamin B12 or folic
acid deficiency or liver disease.

77. KEY POINTS ABOUT FOLATE-
DEFICIENCY ANEMIA
Most folate-deficiency anemia is caused by a lack of folic acid in the diet.
Leafy vegetables, citrus fruits, beans, and whole grains are natural sources
of folic acid.
Folate-deficiency anemia in pregnancy may cause a neural tube defect.
Treatment includes a well-balanced diet of foods with folic acid, folic acid
supplements, medicines, and treating underlying diseases.

78. CYANOCOBALAMINE (B12)
Vitamin B12 is an important water-soluble vitamin. It plays an essential role
in the production of your red blood cells and DNA, as well as the proper
functioning of your nervous system.

80. ACTIVE FORMS OF B12
Methylcobalamin and adenosylcobalamin are known as the
“bioactive coenzymes” of vitamin B12. Only in these chemical forms can
the vitamin be directly utilized in the body.
Hydroxocobalamin, on the other hand, does not function as a coenzyme,
but scavenges toxins/free radicals.

81. IMPORTANCE OF B12
 Synthesis of DNA ;
B12 influences cell division and blood formation
 Energy metabolism;
B12 is vital for energy production in the mitochondria
 Lipid metabolism;
Vitamin B12 is important for the building and maintenance of the cell
membrane and myelin sheaths.
 Synthesis of hormones and neurotransmitters
 Detoxification
 Increase RBCs Production

82. MECHANISM OF ABSORPTION OF B12

83. B12 DEFICIENCY AND ITS
EFFECT IN THE BODY

84. Area
Consequences of Vitamin B12
Deficiency
1. DNA synthesis
Anemia, damaged mucous
membranes, risk of cancer
2. Energy metabolism
Chronic fatigue, sluggishness, poor
performance
3. Lipid metabolism
Damage from nerve tingling,
numbness, chronic pain, paralysis,
dementia
4. Hormones & Neurotransmitters Depression, psychoses, schizophrenia
5. Detoxification Chronic diseases, immunodeficiency

85.  B12 Deficiency Anemia ;
Vitamin B12 plays an essential role in the production of the DNA needed to
make red blood cells. Without it, the instructions for building the cells are
incomplete, and cells are unable to divide. This causes a type of anemia
called Megaloblastic Anemia, in which the red blood cells produced in your
bone marrow are large and fragile.
These red blood cells are too large to pass out of your bone marrow and
into your circulation. Therefore, you don’t have as many red blood cells
circulating around your body, and your skin can appear pale in color.
The fragility of these cells also means that many of them break down,
causing an excess of bilirubin.

86.  Pernicious Anemia.
People with pernicious anemia don’t produce enough of an important
protein called intrinsic factor.
Intrinsic factor is essential for preventing a B12 deficiency, as it binds with
vitamin B12 in your gut so that you are able to absorb it.
 Pale or Jaundiced Skin
People with a B12 deficiency often look pale or have a slight yellow tinge
to the skin and whites of the eyes.
 This happens when a lack of B12 causes problems with your body's red
blood cell production.

87.  Weakness and Fatigue
Weakness and fatigue are common symptoms of vitamin B12
deficiency.
They occur because your body doesn’t have enough vitamin B12 to
make red blood cells, which transport oxygen throughout your body.
As a result, you are unable to efficiently transport oxygen to your
body’s cells, making you feel tired and weak.
 Changes to Mobility
If untreated, the damage to your nervous system caused by a B12
deficiency could cause changes to the way you walk and move.
It may even affect your balance and coordination, making you more
prone to falling.

88. NIEWEG’S HYPOTHESIS
 Deficiency of folic acid is not accompanied by neurological lesion but B12
deficiency is associated with neurological lesions, e.g. subacute combined
degeneration of the cord, both produces megaloblastic anaemia, Why? This can
be explained by Nieweg’s hypothesis:
 Nieweg’s hypothesis postulates that folic acid is concerned with DNA
metabolism, would explain how a deficiency of folic acid could produce GI
and bonemarrow abnormalities unaccompanied by neurologic lesions. On the
other hand, a deficiency of B12 could cause neurological lesions as a result of
RNA deficiency as well as changes in the bone marrow and GI tract from DNA
deficiency.

89. ABSORBTION OF B12
A lot of vitamin B12 is released from the protein molecules with the help of
hydrochloric acid and enzymes in the stomach. This free form of the vitamin
is easier to absorb from the walls of the small intestine.

90. SOURCES OF B12
Rich Animal sources
Meat
Egg
Liver
Kidney
Fish
Fair Sources
Milk and other dairy products
Plant sources
It is not really present in vegetable sources

91. RECOMMENDED DAILY
REQUIREMENT OF B12
The average recommended amounts, measured in micrograms (mcg), vary
by age:
Infants up to age 6 months: 0.4 mcg
Babies age 7-12 months: 0.5 mcg
Children age 1-3 years: 0.9 mcg
Kids age 4-8 years: 1.2 mcg
Children age 9-13 years: 1.8 mcg
Teens age 14-18: 2.4 mcg
Adults: 2.4 mcg (2.6 mcg per day if pregnant and 2.8 mcg per day if
breastfeeding)

92. SIGN AND SYMPTOMS OF B12
DEFICIENCY
 Weakness
 Heart palpitations and shortness of breath
 Pale skin
 A smooth tongue
 Constipation, diarrhea, loss of appetite, or gas
 Nerve problems
 Numbness or tingling,
 Muscle weakness
 Problems in walking
 Vision loss
 Mental problems like depression, memory loss, or behavioral changes

93. ASCORBIC ACID (VIT C)
Vitamin C is a water-soluble compound found in living organisms. It is an
essential nutrient for various metabolism in our body and also serves as a
reagent for the preparation of many materials in the pharmaceutical and food
industry.
Vitamin C plays a role in collagen, carnitine, hormone, and amino acid
formation. It is essential for bone and blood vessel health and wound healing
and facilitates recovery from burns. Vitamin C is also an antioxidant, supports
immune function, and facilitates the absorption of iron

94. BIOSYNTHESIS OF VIT C
Vitamin C is a six-carbon lactone which is synthesized from glucose by many
animals. Vitamin C is synthesized in the liver in some mammals and in the
kidney in birds and reptiles. However humans, guinea pigs, bats, etc. are
unable to synthesize vitamin C because they lack enzymes.

95. FUNCTIONS OF VIT C
Vitamin C plays an important role in many physiological processes in
humans. It is needed for the repair of tissues in all parts of the body. The
important functions of vitamin C include the formation of protein used to
make skin, tendons, ligaments, and blood vessels for healing wounds and
forming scar tissue, for repairing and maintaining cartilage, bones, and teeth
and aid in the absorption of iron

96.  Anti oxidant property;
One of the important properties of vitamin C is its antioxidant activity.
Antioxidant activity of vitamin C helps to prevent certain diseases such as
cancer, cardiovascular diseases, common cold, age-related muscular
degeneration and cataract
 Antioxidant mechanism;
Vitamins C can protect the body against the destructive effects of free
radicals. Antioxidants neutralize free radicals by donating one of their own
electrons, ending the electron-stealing reaction.

98.  In cardiovascular diseases;
The antioxidant property of vitamin C helps for the treatment of
cardiovascular diseases. Vitamin C has the capability to prevent plaque
instability in atherosclerosis . The oxidative damage including the oxidative
modification of low-density lipoproteins is a major cause of cardiovascular
disease. The antioxidant property of vitamin C helps to reduce this to a
certain extent

99.  In common cold;
The use of vitamin C might reduce the duration of common cold due to its
anti-histamine effect of high dose of vitamin C.
 Synthesis of protein;
Another important function of vitamin C is its role in the synthesis of protein.
Vitamin C helps in the synthesis of collagen. Collagen protects our skin from
wrinkling and makes our skin firm and strong. Collagen also protects and
supports organs and other soft tissues.

100. FUNCTIONS OF VIT C ON SKIN
 Photo protection;
Vitamin C reduces the damage caused by UV-light exposure. It cannot act
as a sunscreen since it cannot absorb UV light. But the antioxidant activity
of vitamin C helps to protect UV damage caused by free radicals.
 Wound healing;
Vitamin C plays a key role in healing wound by the formation of collagen,
connective tissue. The new tissue is rebuilt with the help of collagen
framework. This function is supported by its co-factor vitamin C. Vitamin
C performs as a strong antioxidant and immune system modulator.

101. METABOLIC ROLE AND FUNCTIONS
Role in cellular oxidation reduction
Role in collagen synthesis
Role in tryptophan metabolism
Role in tyrosine metabolism
Absorbtion of Fe
Action on certain enzymes activation/inhibition
Role in formation of catecholamines
Role in stress

102. ABSORBTION AND EXCRETION OF VIT
C
It is readily absorbed from the small intestine, peritoneum and sub
cutaneous tissues. It is widely distributed throughout the body.
It is exreted through urine.

103. SOURCES OF VIT C
Vitamin C is abundantly available in
many natural sources, including fresh
fruits and vegetables. The richest
sources of ascorbic acid including
citrus fruits such as limes, oranges and
lemons, tomatoes, potatoes, papaya,
green and red peppers, kiwifruit,
strawberries and green leafy vegetables
such as broccoli, fortified cereals and
its juices are also rich sources of
vitamin C

104. 1. Role in Cellular Oxidation-Reduction
The fact that vitamin C is very sensitive to reversible
oxidation, Ascorbic acid → Dehydroascorbic acid,
suggests that it may be involved in cellular oxidationreduction
reactions, perhaps serving as hydrogen
transport agent.
2. Role in Collagen Synthesis
Hydroxyproline and hydroxylysine are important
constituents of mature collagen fibres. Precollagen
molecules contain the amino acids proline and lysine.
They are hydroxylated by corresponding hydroxylases
in presence of vitamin C, Fe++ and molecular O2.

105.  In scurvy, failure of
conversion of procollagen to
collagen due to the failure of
hydroxylation may lead to a
rapid destruction of the
collagen intermediates.

106. 3. Functional Activity of Fibroblasts/Osteoblasts
Ascorbic acid is required for functional activities of fibroblasts, and
osteoblasts, and consequently for formation of MPS of connective tissues,
osteoid tissues, dentine and intercellular cement substance of
capillaries.
4. Role in Tryptophan Metabolism
Vitamin C is required as a cofactor for hydroxylation of tryptophan to form
5–OH derivative, in the pathway of biosynthesis of serotonin (5–HT).

107. 5. Role in Tyrosine Metabolism
Required as a cofactor with the enzyme p-OH phenyl pyruvate hydroxylase,
which is necessary for hydroxylation and conversion of p-OH phenyl pyruvate
to Homogentisic acid.
6.Role in Formation of Catecholamines
Vitamin C is required as a coenzyme with the enzyme dopamine hydroxylase
which catalyses the conversion of dopamine to norepinephrine.
7. Role in Formation of Carnitine
Formation of ‘carnitine’ in liver by hydroxylation of γ-butyrobetaine Is helped
by vitamin C, α- ketoglutarate, Fe++ and a dioxygenase.

108. 8.Role in Electron Transport Systems
Ascorbic acid seems to take part in electron transport system of mammalian
‘microsomes’.The detailed mechanism of role of vitamin C is not definitely
known but it has been suggested that the reaction is coupled with hydroxylation.
9. Action on Certain Enzymes-Activation/Inhibition
Vitamin C is capable of both activating and inhibiting different groups of enzymes.
Arginase and papain are activated, whereas, activity of the enzymes like urease
and β-amylase from plants is inhibited.
10.Effect on Cholesterol Level
Relation of ascorbic acid with hypocholesterolaemia in man and guinea pigs has
been reported.

109. RECOMMENDED DAILY
REQUIREMENT OF VIT C
 The average recommended amounts vary by age and increases in the
presence of any infection.
AGE GROUP DAILY DOSAGE
INFANTS 30 mg/day
ADULTS 75 mg/day
ADOLESCENCE 80 mg/day
PREGNANT WOMEN 100 mg/day
LACTATING WOMEN 150 mg/day

110. SCURVY-VIT C DEFICIENCY
Scurvy is a state of dietary deficiency of vitamin C (ascorbic acid). The human
body lacks the ability to synthesize and make vitamin C and therefore depends on
exogenous dietary sources to meet vitamin C needs.
When vitamin C is deficient, formation of intercellular cement substances in
connective tissues, bones, and dentin is defective, resulting in weakened
capillaries with subsequent hemorrhage and defects in bone and related
structures.

111. In the humans, its deficiency produces a disease called Scurvy.
The main defect is a failure to deposit intercellular cement
substance.
Capillaries are fragile and there is tendency to haemorrhages:
• Petechial, subcutaneous, subperiosteal and even
• internal haemorrhages can occur.
• Wound healing is delayed due to deficient formation of collagen.
• Poor dentine formation in children, leading to poor teeth formation.
• Gums are swollen and becomes spongy and bleeds on slightest pressure–
Hyperaemia, swelling, sponginess and bleeding of gums are seen.
• In severe scurvy, may lead to secondary infection and loosening and falling of
teeth.

112. SCURVY

113. SIGN AND SYMPTOMS OF VITC
DEFICIENCY
 Dry and damaged skin
 Rough, Bumpy Skin
 Late wound healing
 Easy Bruising
 Fatigue
 Weight loss
 Irregular heartbeats
 Dizziness
 Pale or yellowish skin
 Mood swings

114. HYPERVITAMINOSIS (EFFECTS OF
EXCESS ASCORBIC ACID)
• Administration of large amounts of ascorbic acid are not known to produce any
effects in humans. But in rats, dehydroascorbic acid in enormous doses (1.5
gm/kg body wt) produces permanent diabetes, similar to that produced by the
glycoside alloxan; it produces probably destruction of β-cells of islets of
Langerhans. This action is prevented by immediate antecedant IV injection of –
SH compounds like cysteine, Glutathione as in the case of alloxan, which
resembles dehydroascorbic acid in chemical structure.

115. REFERENCES
 Textbook of medical biochemistry, MN Chatterjee
 Kuklinski, B.: Praxisrelevanz des nitrosativen Stresses. 1. Mitteilung:
Diagnostik und Therapie neurologischer Erkran kungen. OM & Ernährung 124
(2008) F2 – F21
 Ariel Miller, Maya Korem, Ronit Almog, Yanina Galboiz, Vitamin B12,
demyelination, remyelination and repair in multiple sclerosis, Journal of the
Neurological Sciences, Volume 233, Issues 1–2, 15 June 2005, Pages 93-97,
ISSN 0022-510X, http://dx.doi.org/10.1016/j.jns.2005.03.009.