Parikshya Shrestha
PG Student
Dept. of Oral Pathology and Microbiology
Vitamins
Vitamins may be regarded
as organic compounds
required in the diet in
small amounts to
perform specific
biological functions for
normal maintenance of
optimum growth and
health of the organism.
Vitamins
• Required in small amounts
• Functions
– Regulate metabolism
– Help convert energy in fat, carbohydrate, and protein into
ATP
– Promote growth and reproduction
• Deficiencies can result in potentially serious consequence
Classification of Vitamins
Vitamin Structure and
Function
• All vitamins contain carbon, hydrogen, and oxygen
– Some vitamins contain nitrogen and sulfur
• Fat-soluble vitamins
– Are absorbed in the duodenum
– Storage
• Vitamin A is mainly stored in the liver
• Vitamins K and E are partially stored in the liver
• Vitamin D is mainly stored in the fat and muscle
tissue
– Can build up in body to point of toxicity
Vitamin Absorption and
Storage
• Water-soluble vitamins
– Absorbed with water and enter directly into the blood
stream
– Most absorbed in the duodenum and jejunum
– Most are not stored in the body
– Excess intake excreted through the urine
– Important to consume adequate amounts daily
– Dietary excesses can be harmful
Digesting and Absorbing Water-
Soluble Vitamins
Digesting and Absorbing
Vitamins
Water-Soluble Fat-Soluble
Vitamins Vitamins
Absorbed in
Small Intestine Small Intestine
the
Hydrophobic
or Hydrophilic Hydrophobic
Hydrophilic
Absorbed
Blood Lymph
into the
Stored in the
Not Generally Yes
body
Can build up
and become Not Generally Yes
toxic
Need to
consume Yes No
Bioavailability
• Varies based on
– Amount in food
– Preparation
– Efficiency of digestion and absorption of food
– Individual nutritional status
– Natural or synthetic
• Fat-soluble vitamins are generally less bioavailable than
water-soluble vitamins
• Vitamins from animal foods are generally more
bioavailable than those in plant foods
Destruction of Vitamins
• Water-soluble vitamins can be destroyed by
– Exposure to air
– Exposure to ultraviolet light
– Water
– Changes in pH
– Heat
– Food preparation techniques
• Fat-soluble vitamins tend to be more stable
AVITAMINOSeS
• The avitaminoses are due to the absence of minute amounts of
biologically important materials rather than to the presence of
minute amounts of biologically active materials(infectious
agents).
• They may also occur in more severe forms, but they are seldom
so serious as to be the immediate cause of death.
Provitamins and Preformed
Vitamins
• Provitamins
– Substances found in foods that are not in a form
directly usable by the body
– Converted to the active form once absorbed
• Preformed vitamins
– Vitamins found in foods in their active form
FAT-SOLUBLE VITAMINS
• The fat-soluble vitamins are
– Vitamin A,
– Vitamin D,
– Vitamin E, and
– Vitamin K
• Their availability in diet, absorption and transport are
associated with fat.
• They are soluble in fats and oils and also fat solvents (alcohol,
acetone etc.)
• Stored in liver and adipose tissue.
• Not readily excreted in urine so excess consumption
(particularly A and D) leads to their accumulation and toxic
effects.
VITAMIN A
• Present only in foods of animal origin, however, its provitamin
carotenes are found in plants.
Chemistry
• Term retinoids is often used to include natural and synthetic forms
of vitamin A.
• Retinol, retinal and retinoic acids are regarded as vitamers of
vitamin A
Vitamers : represents chemically similar substances that possess
qualitatively similar vitamin activity.
VITAMIN A
Biochemical Function
• Vision
• Cell growth and differentiation
• Maintenance of healthy epithelial cells
• Growth and mucus secretion by synthesis of certain glycoprotein
and mucopolysaccharides in presence of retinyl phosphate.
• Reproduction ; acts like a hormone and regulates gene expression
• Maintenance of proper immune system
• Cholestrol synthesis
• As antioxidant
Beneficial effect of β -carotene : due to its antioxidant role, increased
consumption of it is associated with decreased incidence of heart
attacks, skin and lung cancer
Functions of vitamin A
1. Vision:
• Vitamin A is a component of the visual pigments of rod and cone
cells. Rhodopsin, the visual pigment of the rod cells in the retina,
protein that detects and absorbs light in the eye.
• When rhodopsin is exposed to light, a series of photochemical
isomerizations occurs, which results in the bleaching of the visual
pigment and release of all-trans retinal and opsin.
• This process triggers a nerve impulse that is transmitted by the
optic nerve to the brain.
• Similar reactions are responsible for color vision in the cone
cells.
Functions of vitamin A (contd..)
2. Growth: Vitamin A deficiency results in a decreased growth rate
in children. Bone development is also slowed.
Growth
• Growth retardation due to impairment in skeletal formation
Reproduction
• Degeneration of germinal epithelium leading to sterility in males
VITAMIN A
Hypervitaminosis A
• Total serum Vitamin A level (normal 20 – 50 μg/dl) is elevated.
• Signs and Symptoms :
– Dermatitis raised intracranial tension
– Enlargement of liver
– Skeletal decalcification
– Tenderness of long bones
– Loss of weight
– Irritability
– Loss of hair
– Joint pains
VITAMIN D
• Also called anti rachitic vitamin.
• Fat soluble vitamin resembling sterols in function and functions
like a hormone.
Chemistry
• Cholecalciferol (Vitamin D3) is found in animals
• Erocalciferol ( Vitamin D2) is found in plants
• These are souces for vitamin D activity and are referred to as
provitamins.
• Vit D2 and D3 are not biologically active. They are metabolized
identically in the body and converted to active forms of Vitamin D.
• Vitamin D is regarded as sunshine vitamin.
Biochemical function
• The major biologic function of vitamin D is to maintain normal
blood levels of calcium and phosphorus.
• Vitamin D aids in the absorption of calcium, helping to form and
maintain strong bones.
• It promotes bone mineralization in concert with a number of other
vitamins, minerals, and hormones.
• It maintains normal cellular growth and function.
• It maintains healthy immune function and preventng excessive
inflammation.
1. Action of calcitriol on intestine.
– Increases the intestinal absorption of calcium and phosphate
– In intestinal cells, calcitriol binds with a cytosolic receptor to
form a calcitriol- receptor complex which approaches nucleus
and interacts with a specific DNA, leading to synthesis of
specific calcium binding protein which increases the calcium
uptake by intestine.
2. Action of calcitriol on bone.
– In osteoblasts of bone, calcitriol stimulates calcium uptake for
deposition as calcium phosphate, thus essential for bone
formation.
3. Action of calcitriol on kidney.
– Calcitriol is also involved in minimizing excretion of
calciumand phosphate through kidney by decreasing their
excretion and enhancing reabsorption.
VITAMIN D
Dietary Sources
• Vit D can be provided to body in 3 ways :
1. Exposure of skin to sunlight for synthesis of Vit D
2. Consumption of natural foods; fatty fish, fish liver oils, egg
yolk etc
3. Irradiating food that contains precursors of vit D and
fortification of foods ( milk, butter etc)
Toxicity
• Least toxic
• No toxic effect even after ingestion of 300 mg/day
VITAMIN E
Deficiency symptoms
• Dietary deficiency of vitamin E in humans is unknown, although
patients with severe fat malabsorption, cystic fibrosis, and some
forms of chronic liver disease suffer deficiency because they are
unable to absorb the vitamin or transport it, exhibiting nerve and
muscle membrane damage.
• Sterility, degenerative changes in muscle, megaloblastic anaemia,
changes in central nervous system.
• Severe symptoms : increased fragility of erythrocytes and minor
neurological symptoms.
VITAMIN K
• Only fat soluble vitamin with specific coenzyme function
• Exists in different forms
– Vitamin K1 (phylloquinone) in plants
– Vitamin K2 (menaquinone) produced by intestinal bacteria and
also found in animals
– Vitamin K3 (menadione) synthetic form
• All three are stable to heat but are lost by oxidizing agents,
irradiation, strong acids and alkalies.
VITAMIN K
Absorption, storage and transport
• Taken in diet or synthesized by intestinal bacteria and absorbed
along with fats and depending on bile salts
• Transported along with LDL and stored mainly in liver.
Biochemical function
• Functions concerned with blood clotting functions : involved in
both the extrinsic and intrinsic systems of coagulation, particularly
with prothrombin (factor II) synthesis and in the regulation of
levels of factors VII, IX, and X (proconvertin, Christmas factor,
and Stuart-Prower factor, respectively).
• Brings about post-translational modification of certain blood
clotting factors
Vegetable oils
VITAMIN K
RDA (Required Daily allowance)
• No RDA since it can be adequately synthesized in the gut.
• Suggested RDA for an adult is 70 – 140 μg/day
Hypervitaminosis K
• Administration of large doses of vitamin K produces hemolytic
anaemia and jaundice, particularly in infants.
• Toxic effect is due to increased breakdown of RBC
VITAMIN K
Deficiency
• Deficiency leads to coagulopathy because of inadequate synthesis
of prothrombin and other clotting factors. Profuse bleeding even
for minor injuries. The blood clotting time is increased.
Deficiency
• Severe vitamin C deficiency result in the disease known as scurvy.
• Characterized by spongy and sore gums, loose teeth, anemia,
swollen joints, decreased immunocompetence, delayed wound
healing, haemorrhage, osteoporosis etc.
Oral effects of Scurvy
• occur chiefly in the gingival and periodontal tissues.
• interdental and marginal gingiva is bright red with a swollen,
smooth, shiny surface.
• In fully developed scurvy the gingiva becomes boggy, ulcerates
and bleeds. The color changes to a violaceous red.
• In infants the enlarged tissue may cover the clinical crowns of the
teeth .
• typical foul breath with fusospirochetal stomatitis.
• In the severe chronic cases, hemorrhages into and swelling of the
periodontal membranes occur, followed by loss of bone and
loosening of the teeth, which eventually exfoliate.
B-COMPLEX VITAMINS
• The B vitamins are widely distributed in foods and their influence
is felt in many parts of the body.
Function
• Thiamin pyrophosphate is required for carbohydrate and branched
chain amino acid metabolism.
• In addition, it acts as coenzyme for transketolase reaction that
mediates the conversion of hexose and pentose phosphates.
• It also plays a role in peripheral nerve conduction but the exact
mechanism is unknown.
Thiamin: Vitamin B1
RDA (Required Daily allowance)
• Adults : 1 – 1.5 mg/day;
• Infants : 0.3 mg/day
• Pregnant and lactating women should increase their daily intake
by 0.4 mg and 0.5 mg respectively
Deficiency
• Thiamin deficiency leads to beriberi, which is generally insidious
in onset, chronic in course and sudden death may occur.
• Beriberi may be of two types: wet and dry.
• In either form, patients may complain of pain and paresthesia.
• Wet beriberi manifests with cardiovascular symptoms due to
impaired myocardial energy metabolism, dysautonomia,
cardiomegaly, highoutput cardiac failure, peripheral edema, and
peripheral neuritis.
• In dry beriberi, same symptoms occur but for the edema.
Deficiency (contd..)
• Alcoholic patients with chronic thiamin deficiency are having
CNS manifestations known as Wernicke’s encephalopathy, which
consists of horizontal nystagmus, ophthalmoplegia, cerebral
ataxia, and mental impairment.
• If there is loss of memory and confabulatory psychosis also
present, it is known as Wernicke-Korsakoff syndrome.
RIBOFLAVIN : Vitamin B2
• Riboflavin, or vitamin B2 through its coenzyme takes part in a
variety of cellular oxidation.
Food Sources
• Animal sources : egg yolk, fish, milk, meat
• Vegetable source : wheat, corn, cabbage, roots and tubers.
Toxicity
• Pyridoxine is the only water-soluble vitamin with significant
toxicity.
• Over consumption is rare, but neurologic symptoms (sensory
neuropathy) occur at intakes above 200 mg/day, an amount more
than 100 times the RDA.
BIOTIN
• formerly known as anti-egg white injury factor, vitamin B7 or
vitamin H
• helps release energy from carbohydrates and aids in the
metabolism of fats, proteins and carbohydrates from food.
Food Sources
• Sources of Biotin include liver, kidney, egg yolk, milk, tomatoes,
grains etc
• Biotin is also made by intestinal bacteria.
• However, the addition of raw egg white (20 eggs/day) to the diet
as a source of protein induces symptoms of biotin deficiency,
namely, dermatitis, glossitis, loss of appetite, and nausea.
macrocytic RBC.
Chemistry
• Complex structure
• Empirical formula (cyanocobalamin) : C63H90N14O14PCo
Vitamin B12 : COBALAMIN
Biochemical Function
• aids in the building of genetic material, production of normal red
blood cells, and maintenance of the nervous system.
• When the vitamin is deficient, unusual fatty acids accumulate and
become incorporated into cell membranes, including those of the
nervous system.
• This may account for some of the neurologic manifestations of
vitamin B12 deficiency.
Food sources
Vitamin B12 : COBALAMIN
.
SUMMARY
REFERENCE
• U. Satyanarayan. Essentials of Biochemistry, 4th edition
• Lippincott’s Illustrated Reviews: Biochemistry; Fifth Edition
• Harper's Illustrated Biochemistry, 28th edition
• Shafer’s Textbook of Oral pathology, 8th edition
• Role of Vitamins in Oral Health & Disease: an Overview.
Indian Journal of Applied Research ; December 2015
• Pavithra R.S., Ramaprabha G , Rajasekar S , Lakshmi sree S
Vitamin Deficiency And Periodontal Disease – A Tie- in
Relationship.; Sch. J. App. Med. Sci., 2017; 5(1A):74-81