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What are they?

Vitamins

Nutrition

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Nutrition

Vitamins

Why are we tired without them?

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Nutrition

Vitamins

Eijkman, Indonesia, 1890

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Vitamins

Definition

• Organic

• Essential

• Small Amounts

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Vitamins

International Units

1 International Unit Vitamin A = 0.0003 mg

1 International Unit Vitamin C = 0.000025 mg

1 International Unit Vitamin D = 0.05 mg

* International Units must NEVER be abbreviated to IU

This is mandated by JCAHO, IOM, ISMP

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Vitamins

General Functions

• Coenzymes

• Antioxidants

• Food Additives

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Vitamins

Recommended Daily Allowances (RDA)

Estimated Average Requirement (EAR)

Adequate Intake (AI)

Tolerable Uptake Intake Level (UL)

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Vitamins

Properties

• Solubility

• Storage

• Excretion

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Vitamins

Solubility

Fat Soluble

Water Soluble

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Vitamins: Fat Soluble

Angels Do Everything Kindly

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Vitamin A (Retinol)

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Vitamin A (Retinol)

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Vitamin A (Retinol)

Double Vision

Hair Loss

Liver Damage

Night Blindness

Macular Degeneration

Brittle Hair and Skin

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Vitamin A (Retinol)

GI Disorders (Gall Bladder, Pancreas)

Intestinal Problems (IBS, Crohn’s)

Children with deficient diets

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Vitamin D (Cholecalciferol)

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Vitamin D (Cholecalciferol)

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Vitamin D (Cholecalciferol)

Hypocalcemia

Children - Rickets

Adults - Osteoporosis

Calcification of Soft Tissues and Organs

Hypertension

Hypercalcemia

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Vitamin D (Cholecalciferol)

Taking a closer look at Rickets

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Vitamin D (Cholecalciferol)

GI Disorders (Gall Bladder, Pancreas)

Intestinal Problems (IBS, Crohn’s)

Children

People with limited sunlight exposure

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Vitamin E (Tocopherol)

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Vitamin E (Tocopherol)

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Vitamin E (Tocopherol)

Premature Infants – Hemolytic Anemia

Children and Adults – Weakness

Interferes with Vitamin K and clotting mechanism

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Vitamin E (Tocopherol)

GI Disorders (Gall Bladder, Pancreas)

Intestinal Problems (IBS, Crohn’s)

Premature Infants

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Vitamin K

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Vitamin K

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Vitamin K

May lead to hemorrhage

Interferes with anticoagulant effect of coumadin

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Vitamin K

Malabsorption Syndromes

Persons undergoing intestinal surgery

Newborns

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Vitamins: Water Soluble

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Vitamin C (Ascorbic Acid)

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Vitamin C (Ascorbic Acid)

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Vitamin C (Ascorbic Acid)

GI Disturbances

Diarrhea

Tissue Bleeding

Poor wound healing

Scurvy

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Vitamin C (Ascorbic Acid)

Taking a closer look at Scurvy

Bleeding Gums

Periungual Bleeding

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Vitamin B1 (Thiamine)

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Vitamin B1 (Thiamine)

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Vitamin B1 (Thiamine)

No known toxicities

Wernicke’s Encephalopathy

BeriBeri

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Vitamin B1 (Thiamine)

Taking a closer look at BeriBeri

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Vitamin B1 (Thiamine)

Alcoholics

Diabetics

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Vitamin B2 (Riboflavin)

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Vitamin B3 (Niacin)

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Vitamin B2 (Riboflavin)

No known toxicities

Usually found in conjunction with other B Vitamin deficienciesNo single B2 deficiency

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Vitamin B3 (Niacin)

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Vitamin B3 (Niacin)

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Vitamin B3 (Niacin)

Disorders of the skin and nervous system

Pellegra

Flushing and tingling of the skin

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Vitamin B9 (Folate)

Taking a closer look at Pellegra

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Vitamin B3 (Niacin)

Poor dietary intake

Eating disorders

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Vitamin B6 (Pyridoxine)

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Vitamin B6 (Pyridoxine)

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Vitamin B6 (Pyridoxine)

IrritabilityConvulsions Uncoordinated

MovementsNerve Damage

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Vitamin B9 (Folate)

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Vitamin B9 (Folate)

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Vitamin B9 (Folate)

May mask Vitamin B12 deficiency

Megaloblastic Anemia

Neural Tube Defects

Spina Bifida

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Vitamin B9 (Folate)

Taking a closer look at Spina Bifida

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Vitamin B9 (Folate)

Pregnant Women

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Vitamin B12 (Cobalamin)

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Vitamin B12 (Cobalamin)

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Vitamin B12 (Cobalamin)

No toxicity symptomsPernicious Anemia – lack of the intrinsic factor necessary for B12 absorption

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Vitamin B12 (Cobalamin)

Pernicious Anemia (lack of intrinsic factor)

Vegans (vegetarians who eat no meat)

Elderly (decreased intrinsic factor)

Stomach and/or intestinal surgeries

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The Others

The other water soluble vitamins are fairly plentiful in foods and are associated with no

significant deficiency or toxicity risks.

How to be sure your diet contains enough of the various vitamins?

Eat a balanced and varied diet.