Vitamins

Vitamin A
  Retinoic Acid is important in Rod and cone cells for
vision 


  Hair, skin, eyes = impt in night vision and blindness 


  Necessary in PTH function → cofactor 


  Impt. Component of CSF 


  Deficiency: 


o Night Blindness
2+
o ↓ Ca ↑ P = hypothyroidism Vitamin A Excess

o ↑↑ PTH Effect
 Moans, Groans → Pancreatitis Bones →

2+
PTH leaching bone
 Stones → Ca

o Excess production of CSF → pseudotumor cerebri = only cause of

ICP that causes no herniation
Presents with Headache and papilledema CT → Ventricle
enlargement
 LP → ↑↑ pressure
 Treatment:

Serial LP’s to siphon excess CSF

Vitamin B1 (Thiamine) → TTP

  Pyruvate dehydrogenase 


  α - keto glutarate dehydrogenase 


  Branched Chain amino acid dehydrogenase 


  Transketolase 
 Vitamin B1 Deficiecy: 


  Wet Beri Beri = High output cardiac failure 


  Dry beri beri = w/o heart failure 


  Alcoholic = Wernicke’s encephalopathy (temporal lobe) -

ataxia, nystagmus 


o Korsakoff (Mammilary bodies) - confabulation, psychosis

Vitamin B2 (Riboflavin, FADH2)
  Angular cheliosis/stomatitis 


  Best source = Milk, vegetables 


  Sun can breakdown riboflavin → reason why milk is no

longer stored in glass bottles 


  Magenta colored tongue 
 Vitamin B3 = NIACIN


 NAD/NADH Niacin Deficiency 


  Pellagra = 3 D’s = Dementia, Diarrhea, Dermatitis, Death



   Hartnup’s Disease presents very similar 


o A problem with the transport of Tryptophan → which is needed to

make niacin
Trytophan

  needed to make Niacin 


  Source = corn 


  Hartnup’s Disease = defective renal transport, similar to

Pellagra 
 Vitamin B4 = Lipoic acid
 Vitamin B5 = Pantothenic
acid → CoA 
 Vitamin B6 = Pyridoxine 


  Cofactor for all TRANSAMINASES (AST/ALT) 


  INH pulls B6 out of the body 


  Deficiency → neuropathy 
 Vitamin B12 =

Cyanocobalamin 


Use:
 o Methyl malonyl CoA Mutase = needed in prevention of

myelin neuropathy o Homocysteine methyl transferase

  Water soluble although absorbed in proximal ileum 


  Deficiency: 


o Dorsal column/Corticalspinal Tracts will be affect because they are

the longest tracts therefore, need the most
o Megaloblastic Anemia
Folate
  Thymidine synthesis, purine synthesis. 

 st
  1 vitamin to run out in association with rapidly dividing
cells 


  Deficiency: 


o Megaloblastic Anemia without neuropathy
 o Deficiency in

pregnancy can cause neural tube defects in the fetus o
Homocystienemia with risk of DVT and atherosclerosis

MCC
 o Alcoholics and pregnancy - body stores can be depleted in 3

months
Vitamin C

Scurvy - bleeding gums/hair follicles o Needed in:

Proline and lysl hydroxylase - collagen synthesis Dopamine
hydroxylase - catecholamine synthesis Absorption of iron in GI tract
Vitamin D
  Calcium absorption in Gut 

2+
  Reabsorption of Ca from kidneys 

2+
  Osteoblastic activity → ↑ both Ca and P 


  Decreased in Rickets 
 o Children 


o Lateral Bowing of legs