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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
o ↓ Ca2+ ↑ P = hypothyroidism
• Vitamin A Excess
o ↑↑ PTH Effect
 Moans, Groans → Pancreatitis
 Bones → PTH leaching bone
 Stones → Ca2+
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 → neuopathy

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.
• 1st vitamin to run out in association with rapidly dividing cells
• Deficiency:
o Megaloblastic Anemia without neuropathy
o Defieciency in pregnancy can cause neural tube defects in the fetus
o Homocystienemia with risk of DVT and arthersclerosis
• 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
• Reabsorption of Ca2+ from kidneys
• Osteoblastic activity → ↑ both Ca2+ and P
• Decreased in Rickets
o Children
o Lateral Bowing of legs
• Decreased in Osteomalacia = Soft bones
• Vitamin D resistance Rickets
o X-linked dominant ( Father → daughter)
o Kidney is leaking phosphorus, so calcium goes with it

Vitamin E
• anti-oxidant ( absorbs free radicals)
• Skin, eyes, hair
• Decreased in Retinopathhy
• Decreased in Alzheimers

Vitamin K
• Clotting Factors 2,7,9,10, (1972) proteins C (shortest half life) & S
• γ-carboxylation of these factors

Biotin
• Cofactor for all CARBOXYLASES
• Pyruvate carboxylase ( Gluconeogenesis/FA Syn)

Minerals:

Fe2+
• Hemoglobin → O2 Transport
• Supports electron transport chain → Complex III/IV
• When decreased = Possible mental retardation in children

Ca2+
• Necessary for muscle contraction
o All muscles need INTRACELLULAR Ca2+
o Cardiac & Smooth Muscle need EXTRACELLULAR Ca2+
 Needed for atrial contraction
• IP3/DAG Second messenger system

Mg2+
• Co-factor for ALL KINASES and PTH

Cu2+
• Need for the hydroxylation of lysine
• Deficiency
o Minky’s kinky hair
 Orange hair
 Feels like copper wiring
• Excess = Wilson’s Disease = hepatolenticular degeneration
o Lenticular → Basal ganglia
o Hepato → liver
o Keisher-fleisher rings in iris Trace Elements:
Chromium - neede in Insulin action
o Ceruloplasmin deficiency
Selenium - necessary for heart
Zn
Manganese - xanthine oxidase
• Hair, taste buds, dysgusia, sperm