FA vitamins
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- night blindness, dry skin
- Vit A deficiency
- arthralgias, fatigue, headaches, sore throat, alopecia, skin changes, hyperCa
- Vit A excess
- Vit B1 is a cofactor for which enzymes?
- pyruvate DH a-ketoglutarate DH transketolase branched-chain AA DH
- Vit B1 deficiency
- Wernicke-Korsakoff syndrome Dry beriberi - polyneuritis, symmetrical muscle wasting Wet beriberi - high-output cardiac failure, edema
- Vit B2 deficiency
- Cheilosis/angular stomatitis Corneal vascularization Smooth purple tongue
- Made from tryptophan in a process that requires pyridoxine (PLP)
- Vit B3 niacin
- dementia, diarrhea, dermatitis
- Vit B3 deficiency
- causes of Vit B3 deficiency
- Hartnup disease - dec tryptophan absorption malignant carcinoid syndrome - increased tryptophan metabolism INH - decreased Vit B6
- essential component of CoA and fatty acid synthase
- Vit B5
- dermatitis, enteritis, alopecia, adrenal insufficiency
- Vit B5 deficiency
- rxns involving B6
- transamination decarboxylation glycogen phosphorylase heme synthesis cystathione synthase
- B6 deficiency
- convulsions, hyperirritability, peripheral neuropathy inducible by INH and OCs
- cofactor for homocysteine methyltransferase and methylmalonyl-CoA mutase
- Vit B12
- Vit B12 deficiency
- megaloblastic anemia neuro sx (paresthesias, subacute combined degeneration) usually caused by malabs (sprue, enteritis, Diphyllobothrium latum), lack of IF (pernicious anemia, gastric bypass surgery), or absence of terminal ileum (Crohn's) found in animal problems and made only by microorgs.
- converted to THF, a coenzyme for 1-carbon transfer/methylationreactions; important for synthesis of nitrogenous bases in DNA and RNA
- folic acid
- most common vitamin deficiency in the US
- folic acid seen in alcoholism and pregnancy can be caused by phenytoin, sulfonamides, MTX
- caused by antibiotic use or excessive ingestion of raw eggs
- biotin deficiency
- Biotin is a cofactor for...
- pyruvate carboxylase (pyruvate to OAA) acetyl-CoA carboxylase (acetyl CoA to malonyl CoA) propionyl-CoA carboxylase (propionyl CoA to methylmalonyl CoA)
- Vit C actions
- -keep Fe in reduced state - more easily absorbable -cofactor in collagen synthesis -necessary for dopamine-b-hydroxylase, which converts dopamine to NE
- swollen gums, bruising, anemia, poor wound healing
- scurvy
- only vitamins missing from breast milk
- Vit D and K
- made by intestinal flora
- Vit K
- hypercalcemia, hypercalciuria, loss of appetite, stupor
- Vit D excess also seen in sarcoidosis - inc activation of vit D by epithelioid macrophages
- protects erythrocytes and membranes from free radical damage
- Vit E "E for erythrocytes"
- deficiency results in neurodysfct (myelopathy), hemolytic anemia, muscle weakness
- Vit E
- gamma-carboxylation of glutamic acid residues
- Vit K
- ethanol hypoglycemia
- pyruvate reduced to lactate OAA reduced to malate inhibit gluconeogenesis and stimulate fatty acid synthesis
- delayed wound healing, hypogonadism, dec adult hair; may predispose to alcoholic cirrhosis
- zinc deficiency