Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid) It is a peptide composed of...

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Vitamin B5 Vitamin B5 ( Pantothenic Acid) ( Pantothenic Acid)

Transcript of Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid) It is a peptide composed of...

Page 1: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Vitamin B5Vitamin B5( Pantothenic Acid)( Pantothenic Acid)

Page 2: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Vitamin B5 ( Pantothenic Acid)Vitamin B5 ( Pantothenic Acid)It is a It is a peptidepeptide composed of composed of D-Pantoic acid D-Pantoic acid and and β-β-AlanineAlanine and is found as calcium salt or as alcohol and is found as calcium salt or as alcohol (Pantothenol). The biologically active form of Vitamin B5 (Pantothenol). The biologically active form of Vitamin B5 is is coenzyme Acoenzyme A (CoA). (CoA).

RDARDA:: 7-10 mg (4 Years and over) 7-10 mg (4 Years and over) 3-5 mg (less than 4 Years)3-5 mg (less than 4 Years)

PantothenolPantothenol

Pantothenic acidPantothenic acid

Principal Sources in FoodPrincipal Sources in FoodPrincipal dietary sources of vitamin B5 include: Principal dietary sources of vitamin B5 include: FoodFood Serving size mg Serving size mgCalf liver Calf liver 100 g100 g 7.97.9Pea nutsPea nuts 100 g100 g 2.62.6PeasPeas 100 g100 g 2.12.1SoybeansSoybeans 100 g100 g 1.91.9Brown riceBrown rice 100 g100 g 1.71.7lobsterlobster 100 g100 g 1.71.7Water melonWater melon 100 g 100 g 1.61.6EggEgg 1, Avg size1, Avg size 0.90.9Brewer’s YeastBrewer’s Yeast 10 g10 g 0.70.7

Page 3: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Functions of vitamin B5Functions of vitamin B5Pantothenic acid is a part of CoA that acts as an Pantothenic acid is a part of CoA that acts as an intracellular intracellular carrier for few carbons-groups carrier for few carbons-groups and assists more than 100 and assists more than 100 pathways of intermediate metabolism including those of:pathways of intermediate metabolism including those of:

1. Synthesis of Sterols 1. Synthesis of Sterols (Cholesterol and 7-(Cholesterol and 7-Dehydrocholesterol), Fatty acids, and Keto-Dehydrocholesterol), Fatty acids, and Keto-acids such as Pyruvic acid.acids such as Pyruvic acid.

2. Energy production2. Energy production

3. Synthesis of vitamins A and D.3. Synthesis of vitamins A and D.

4. Biosynthesis of protein 4. Biosynthesis of protein and amino acid by assisting and amino acid by assisting the formation of leucine, arginine and methionine.the formation of leucine, arginine and methionine.

5. 5. It is essential for the formation of It is essential for the formation of hemoglobin hemoglobin and electron-carrying cytochrome proteins and electron-carrying cytochrome proteins of of the mitochondrial respiratory chain.the mitochondrial respiratory chain.

6.6.Biosynthesis of the neurotransmitter Biosynthesis of the neurotransmitter acetylcholineacetylcholine..

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Symptoms of Vitamin B5 DeficiencySymptoms of Vitamin B5 Deficiency

1.1.ParesthesiasParesthesias (It is a sensation of tingling, (It is a sensation of tingling, pricking, pricking, or numbness of a person's skin) or numbness of a person's skin) and burning and burning sensation in lower legs and sensation in lower legs and feets.feets.2. 2. Joint and muscle aches Joint and muscle aches 3. 3. Fading of hair color Fading of hair color 4. 4. AnemiaAnemia5. 5. Reduced immunity: impaired antibody responseReduced immunity: impaired antibody response6. 6. Headache, depression, insomnia, and fatigueHeadache, depression, insomnia, and fatigue

ParesthesiasParesthesias Muscle aches Muscle aches AnemiaAnemia InsomniaInsomnia fatiguefatigue

Page 5: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

People at high risk of Vitamin B5 Deficiency People at high risk of Vitamin B5 Deficiency

Pantothenic acid is widely prevalent in foods, Pantothenic acid is widely prevalent in foods, subclinical deficiency only may occur, usually in subclinical deficiency only may occur, usually in conjunction with other B-vitamin deficiencies in conjunction with other B-vitamin deficiencies in case of:case of:

Chronic illness Chronic illness Heavy alcohol consumptionHeavy alcohol consumptionDuring hypo-caloric dieting for During hypo-caloric dieting for weight-loss.weight-loss.

Page 6: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Uses of Pantothenic acid in Prevention and TherapyUses of Pantothenic acid in Prevention and Therapy1.1.Microcytic anemiaMicrocytic anemia ( (through its role in through its role in hemoglobin synthesis in conjunction with iron hemoglobin synthesis in conjunction with iron supplementation).supplementation).

2.2.Lupus erythematosus: Lupus erythematosus: Calcium Calcium pantothenate, alone or in conjunction with pantothenate, alone or in conjunction with vitamin E can help in treatment of Lupus vitamin E can help in treatment of Lupus erythematosus and other erythematosus and other autoimmune autoimmune disorders.disorders.

3.3.Tiredness and fatigue Tiredness and fatigue as those associated as those associated with subclinical pantothenic acid.with subclinical pantothenic acid.

4.4.Arthritis:Arthritis: Pantothenic acid deficiencies are Pantothenic acid deficiencies are often found in patients with osteoarthritis and often found in patients with osteoarthritis and rheumatoid arthritis. In this case calcium rheumatoid arthritis. In this case calcium pantothenate can be effective.pantothenate can be effective.

Lupus erythematosusLupus erythematosus

FatigueFatigue

ArthritisArthritis

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5. Wound healing 5. Wound healing after trauma or after trauma or operations.operations.

6. 6. Management of dyslipidemia Management of dyslipidemia (abnormal amount of lipids e.g. (abnormal amount of lipids e.g. cholesterol and/or fat, in the blood).cholesterol and/or fat, in the blood).

7. 7. Diabetic neuropathy Diabetic neuropathy ((nerve nerve disease disease or damage that can occur in people or damage that can occur in people with diabetes).with diabetes).

9. 9. Dexapantothenol (vitamin B5 Dexapantothenol (vitamin B5 Formulation) Formulation) is used topically in is used topically in treatment of burns and itching .treatment of burns and itching .

Wound healing Wound healing

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Vitamin B6 Vitamin B6 (Pyridoxine)(Pyridoxine)

Page 9: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Vitamin B6 (Pyridoxine)Vitamin B6 (Pyridoxine) In 1934, a Hungarian physician, Paul Gyorgy In 1934, a Hungarian physician, Paul Gyorgy discovered a substance that was able to cure adiscovered a substance that was able to cure a skin disease in rats (skin disease in rats (Dermititis acrodyniaDermititis acrodynia), this ), this

substance he named vitamin Bsubstance he named vitamin B6.6.

Vitamin B6 converted in the body to its major active Vitamin B6 converted in the body to its major active form: form: pyridoxal-5-phosphatepyridoxal-5-phosphate (PLP)(PLP). The . The activation requires adequate activation requires adequate zinc zinc andand riboflavin riboflavin. .

Total body stores of vitamin B6 are low (only about Total body stores of vitamin B6 are low (only about 150 mg) hence a steady supply of vitamin B6 is 150 mg) hence a steady supply of vitamin B6 is essential to avoid its deficiency.essential to avoid its deficiency.

Chemically it is a Chemically it is a pyridine derivative.pyridine derivative.RDARDA

1.2 – 1.4 mg (Adult)1.2 – 1.4 mg (Adult)0.6 mg (Infants less than 1 year)0.6 mg (Infants less than 1 year)2.2mg (During pregnancy and lactation)2.2mg (During pregnancy and lactation)

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DIFFERENT FORMS OF PYRIDOXINEDIFFERENT FORMS OF PYRIDOXINE

N

CH2OH

CH2OHHO

H3C

Pyridoxol

N

CHO

CH2OHHO

H3C

Pyridoxal

N

CH2NH2

CH2OHHO

H3C

Pyridoxine

N

COOH

CH2OHHO

H3C

Pyridoxic Acid

1

3 5

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Calf liver Calf liver

PotatoesPotatoesBanana Banana

LentilsLentilsTroutTrout SpinachSpinach

Sources of Vitamin B6Sources of Vitamin B6

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Functions of Vitamin B6Functions of Vitamin B6PLP is a coenzyme involved in more than 100 metabolic PLP is a coenzyme involved in more than 100 metabolic reactions in the body including:reactions in the body including:

Protein synthesis Protein synthesis through interconversion of amino through interconversion of amino acids. acids.

Conversion of tryptophan to niacin.Conversion of tryptophan to niacin.

It helps in maintaing blood glucose It helps in maintaing blood glucose within a normal within a normal range. When caloric intake is low, vitamin B6 help to range. When caloric intake is low, vitamin B6 help to convert stored carbohydrate to glucose to maintain convert stored carbohydrate to glucose to maintain normal blood sugar levels.normal blood sugar levels.

Lipid metabolismLipid metabolism: It is important in : It is important in synthesis of lipids of synthesis of lipids of myelin sheath surrounding nervesmyelin sheath surrounding nerves and also in and also in

production of polyunsaturated fatty acids of cell production of polyunsaturated fatty acids of cell membranes.membranes. It helps in hemoglobin synthesis It helps in hemoglobin synthesis and oxygen transport and oxygen transport by red blood cells.by red blood cells.

Page 13: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Symptoms of Vitamin B6 DeficiencySymptoms of Vitamin B6 Deficiency

Skin disorders: Skin disorders: DermatitisDermatitis (skin inflammation), (skin inflammation), Stomatitis Stomatitis (inflammation of the mucous lining of any of the (inflammation of the mucous lining of any of the structures in the mouth), structures in the mouth), GlossitisGlossitis (is inflammation or (is inflammation or infection of the tongue ), and infection of the tongue ), and Painful fissures and cracksPainful fissures and cracks at the angles of the mouth and on the lips.at the angles of the mouth and on the lips.

Abnormal brain-wave patterns, convulsions, and muscle Abnormal brain-wave patterns, convulsions, and muscle twitching.twitching.

Depression,Depression, irritability, anxiety, confusion, headache, irritability, anxiety, confusion, headache, and insomnia.and insomnia.

DermatitisDermatitis Stomatitis Stomatitis GlossitisGlossitis Abnormal brain-Abnormal brain-wave patternswave patterns

convulsionconvulsion

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Anemia and decreased antibody Anemia and decreased antibody production production

Possible increased risk of atherosclerosis Possible increased risk of atherosclerosis due to increased total cholesterol and LDL-due to increased total cholesterol and LDL-cholesterol in the blood, and reduced levels of cholesterol in the blood, and reduced levels of HDL-cholesterol.HDL-cholesterol.

Possible increased Possible increased risk of calcium-oxalate risk of calcium-oxalate kidney stones.kidney stones.

AtherosclerosisAtherosclerosisAnemiaAnemia Kidney stones.Kidney stones.

Page 15: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

People at high risk of vitamin B6 DeficiencyPeople at high risk of vitamin B6 Deficiency During rapid growth rate During rapid growth rate in childhood, in childhood, adolesence, and during lactation and adolesence, and during lactation and pregnancy; sharply increase in vitamin B6 pregnancy; sharply increase in vitamin B6 requirements.requirements.

High protein intakes High protein intakes increase vitamin increase vitamin B6 requirements.B6 requirements.

Older people Older people (little diets intake and less (little diets intake and less efficient absorption).efficient absorption).

Many common drugs (including Many common drugs (including oral oral contraceptive pills contraceptive pills and and theophyllinetheophylline) can ) can reduce vitamin B6 stores.reduce vitamin B6 stores.

Page 16: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

People with chronic People with chronic digestive problems digestive problems e.g. liver problems, diarrhea or e.g. liver problems, diarrhea or irritable irritable

bowel syndrome (poor bowel syndrome (poor vitamin B6 vitamin B6 absorption).absorption).

People with other chronic diseasesPeople with other chronic diseases, , including asthma, coronary heart including asthma, coronary heart disease, disease, diabetes, kidney failure, diabetes, kidney failure, rheumatoid rheumatoid arthritis, and cancer of arthritis, and cancer of the breast, bladder, the breast, bladder, and lymph and lymph nodes.nodes.

Individuals with a poor quality Individuals with a poor quality diet or an diet or an inadequate B6 intake.inadequate B6 intake.

Alcohol consumption Alcohol consumption also promotes also promotes the destruction and loss of vitamin B6 the destruction and loss of vitamin B6 from the body.from the body.

LiverLiver

Page 17: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Uses of Vitamin B6 in Prevention and TherapyUses of Vitamin B6 in Prevention and Therapy

1.Treatment and prevention of deficiency and for 1.Treatment and prevention of deficiency and for people at high risk of deficiency of Vitamin B6.people at high risk of deficiency of Vitamin B6.

2.2.Skin disordersSkin disorders (eruptions, acne etc.).(eruptions, acne etc.).

3. Reduction of the severity and frequency of 3. Reduction of the severity and frequency of bronchial bronchial asthma.asthma.

4.4.Atherosclerosis and cardio-vascular disease Atherosclerosis and cardio-vascular disease (It (It reduces tendency for platelets to clump together, reduces tendency for platelets to clump together, lowers LDL-cholesterol and raises HDL lowers LDL-cholesterol and raises HDL cholesterol.cholesterol.

5. In certain 5. In certain anemiaanemia, alone or with iron and vitamin A., alone or with iron and vitamin A.

6. 6. In Pregnancy-associated nausea and vomiting.In Pregnancy-associated nausea and vomiting.

Page 18: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

77. . Premenstrual syndrome Premenstrual syndrome (It helps prevention (It helps prevention of mood swings, edema, acne, and breast of mood swings, edema, acne, and breast tenderness characteristic of PMS)tenderness characteristic of PMS)

8. 8. ArthritisArthritis (it helps in reduction of swelling and (it helps in reduction of swelling and inflammation in the joints of the fingers).inflammation in the joints of the fingers).

9. 9. Nerve disorders Nerve disorders e.g. carpal tunnel syndrome e.g. carpal tunnel syndrome ((occurs when the median nerve, which runs occurs when the median nerve, which runs from the forearm into the palm of the hand, from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist)becomes pressed or squeezed at the wrist) and other forms of nerve inflammation and and other forms of nerve inflammation and neuropathy.neuropathy.

Page 19: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Toxicity and side effects of vitamin B6Toxicity and side effects of vitamin B6

Very high doses (1000 mg/day) for long time Very high doses (1000 mg/day) for long time peripheral nerve conditions: numbness in peripheral nerve conditions: numbness in

hands and feet. hands and feet.

Doses of vitamin B6 not exceeding 500mg/day, Doses of vitamin B6 not exceeding 500mg/day, or higher doses for short periods (days to weeks), or higher doses for short periods (days to weeks), are nontoxic in healthy persons. are nontoxic in healthy persons.

Very high doses of vitamin B6 during lactation Very high doses of vitamin B6 during lactation may may reduce milk production.reduce milk production.

Page 20: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Vitamin B6 –Drug InteractionVitamin B6 –Drug InteractionDrug class Examples Mechanism of

interaction

Hydrazines Iproniazid,Isoniazid, hydralazine

React with pyridoxal and PLP to form a hydrazone

Antibiotic Cycloserine Reacts with PLP to form an oxime

L-DOPA l-3,4-dihydroxyphenylalanine Reacts with PLP to formtetrahydroquinolineDerivatives

Chelator Penicillamine Reacts with PLP to formthiazolidine

Alcohol Ethanol Increased catabolism of PLP, low plasma levels

Page 21: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

VITAMIN B7VITAMIN B7

Page 22: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Vitamin B7 (BIOTIN)Vitamin B7 (BIOTIN)

It is It is 2-Imidazolidinone tetrahydro- 2-Imidazolidinone tetrahydro- thiophene-4-valeric acid.thiophene-4-valeric acid.

Biotin is a Biotin is a cofactorcofactor required for required for enzymes that are involved in enzymes that are involved in carboxylation reactions carboxylation reactions e.g. e.g. acetyl-acetyl-CoA carboxylase CoA carboxylase and and pyruvate pyruvate carboxylase carboxylase used in the metabolism used in the metabolism of carbohydrates, lipids and amino of carbohydrates, lipids and amino acidsacids

RDA: 100- 200 RDA: 100- 200 μμg/day.g/day.

Page 23: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Principal Sources of Vitamin B7 Principal Sources of Vitamin B7

Calf liver Calf liver SoybeansSoybeans Whole wheatWhole wheat

Oat mealOat meal MushroomsMushrooms AvocadoAvocado

Milk & Egg Milk & Egg

Page 24: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Functions of Vitamin B7Functions of Vitamin B7These functions are dependent on a biotin-These functions are dependent on a biotin-containing enzymes:containing enzymes:

1.1.Glucose synthesis Glucose synthesis (The key initial step in (The key initial step in gluconeogenesis).gluconeogenesis).2.2.Fat metabolism Fat metabolism (synthesis and breakdown of (synthesis and breakdown of fatty acids as well as the essential fatty acid fatty acids as well as the essential fatty acid metabolism such as conversion of linoleic acid to metabolism such as conversion of linoleic acid to various eicosanoids).various eicosanoids).3.3.Amino acid metabolism Amino acid metabolism (breakdown of amino (breakdown of amino acids, such as threonine, isoleucine, and acids, such as threonine, isoleucine, and methionine, for use as energy).methionine, for use as energy).4.4.Cell division and growthCell division and growth (Biotin plays an (Biotin plays an important role in DNA synthesis).important role in DNA synthesis).

Page 25: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Biotin DeficiencyBiotin Deficiency

Biotin is found in numerous foods and also is Biotin is found in numerous foods and also is synthesized by intestinal bacteria and synthesized by intestinal bacteria and deficiency of deficiency of this vitamin is rare.this vitamin is rare.

Deficiencies are generally Deficiencies are generally seen only after: seen only after: -long antibiotic therapies which deplete the long antibiotic therapies which deplete the intestinal flora intestinal flora -anticonvulsant therapy (affect biotin metabolism).anticonvulsant therapy (affect biotin metabolism).-excessive consumption of excessive consumption of raw eggs (a biotinraw eggs (a biotin antagonist). antagonist). The egg white protein, The egg white protein, avidinavidin, , prevents intestinal absorption of the biotin.prevents intestinal absorption of the biotin.

Page 26: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

BIOTIN DEFICIENCY SYMPTOMSBIOTIN DEFICIENCY SYMPTOMS

ExtremeExtreme exhaustionexhaustion DrowsinessDrowsiness Muscle painMuscle pain

Loss of appetiteLoss of appetiteDepressionDepressionGrayish skin colorGrayish skin color Hair lossHair loss

Page 27: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Uses of Vitamin B7 in Prevention and TherapyUses of Vitamin B7 in Prevention and Therapy

Inherited syndromes Inherited syndromes of impaired biotin metabolism in of impaired biotin metabolism in children.children.

Anticonvulsant therapy Anticonvulsant therapy (Biotin supplements during chronic (Biotin supplements during chronic anticonvulsant therapy reduce the risk of biotin deficiency).anticonvulsant therapy reduce the risk of biotin deficiency).

Diabetes Diabetes (Biotin supplements help control blood glucose).(Biotin supplements help control blood glucose).

Dermatologic disorders e.g. Seborrheic dermatosis, acne, Dermatologic disorders e.g. Seborrheic dermatosis, acne, and and other forms of scaly other forms of scaly skin rash can respond to biotin, skin rash can respond to biotin, particularly when taken as part of a complete vitamin B particularly when taken as part of a complete vitamin B complex in conjunction with essential fatty acids (omega-6 complex in conjunction with essential fatty acids (omega-6 and omega-3 fatty acids). and omega-3 fatty acids).

Hair and nail disordersHair and nail disorders: People with dry, brittle hair and : People with dry, brittle hair and fingernails may benefit from biotin.fingernails may benefit from biotin.

Page 28: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

VITAMIN B9 VITAMIN B9 (FOLIC ACID)(FOLIC ACID)

Page 29: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

It is a water soluble conjugate of It is a water soluble conjugate of pteridine base, pteridine base, p-p-aminobenzoicaminobenzoic acid and glutamic acid or acid and glutamic acid or pteroylmonoglutamic acid.pteroylmonoglutamic acid.Most of folate absorbed Most of folate absorbed from the diet is converted from the diet is converted to the to the active form, active form, tetrahydrofolatetetrahydrofolate ( (THF)THF) coenzyme.coenzyme.

N5-methyl-THFN5-methyl-THF is the is the major storage form in the major storage form in the body body (~50% in liver(~50% in liver): ): needs vitamin B12 to be needs vitamin B12 to be active.active.

RDA:RDA: 200 200 μμg/dayg/dayTherapy: Therapy: 400 – 800 400 – 800 μμg/dayg/day

Principal Sources in FoodPrincipal Sources in FoodPrincipal dietary sources of biotin Principal dietary sources of biotin include: include: FoodFood Serving size Serving size μμggCalf liver Calf liver 100 g100 g 108108SoybeansSoybeans 100 g 100 g 9595Brewer’s YeastBrewer’s Yeast10 g10 g 9292Wheat germWheat germ 100 g100 g 270270Egg Egg 1, Avg size1, Avg size 100100SpinachSpinach 100 g100 g 134134BroccoliBroccoli 100 g100 g 105105

Page 30: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

CHEMICAL STRUCTURE OF FOLIC ACIDCHEMICAL STRUCTURE OF FOLIC ACID

Page 31: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

FUNCTIONS OF VITAMIN B9FUNCTIONS OF VITAMIN B9

THF derivatives act as coenzymes for C1-transfer THF derivatives act as coenzymes for C1-transfer (methyl, methylene, formyl or formimino group) (methyl, methylene, formyl or formimino group) during biosynthetic reactions which helps the during biosynthetic reactions which helps the following functions:following functions:

1.1.Production of RBCs Production of RBCs through its role in creating through its role in creating hemeheme (the iron containing substance in (the iron containing substance in haemoglobin).haemoglobin).

2.2.Production of WBCsProduction of WBCs..

3.3.Protein metabolismProtein metabolism. It plays a central role in the . It plays a central role in the interconversion of amino acids such as glycine, interconversion of amino acids such as glycine, serine and serine and methioninemethionine and the synthesis of and the synthesis of structural and functional proteins.structural and functional proteins.

Page 32: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

4.4. Production of nucleotides (Production of nucleotides (ATP, GTP, and ATP, GTP, and dTMP) dTMP) and thusand thus nucleic acidsnucleic acids: DNA and : DNA and RNA which are essential for growing and RNA which are essential for growing and dividing cells. Therefore, cells that rapidly dividing cells. Therefore, cells that rapidly turn over and are replaced, such as turn over and are replaced, such as blood blood cells and cells lining the digestive tractcells and cells lining the digestive tract, are , are particularly dependent on THF.particularly dependent on THF.

5.5. Proper formation of the brain, spinal Proper formation of the brain, spinal cord, and nerve cells cord, and nerve cells (CNS) in the embryo. (CNS) in the embryo. Closure of the neural tube in the fetus (Closure of the neural tube in the fetus (in in the 28th day of pregnancythe 28th day of pregnancy) cannot be ) cannot be completed without Vitamin B9.completed without Vitamin B9.

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1.1. The most pronounced The most pronounced effect of folate deficiency on effect of folate deficiency on cellular processes is upon cellular processes is upon DNA synthesis DNA synthesis (due to (due to an impairment in dTMP synthesis) an impairment in dTMP synthesis) arrest of cell arrest of cell cycle of rapidly proliferating cells, particularly, the cycle of rapidly proliferating cells, particularly, the RBCs RBCs megaloblastic anemia megaloblastic anemia as for vitamin B12 as for vitamin B12 deficiency (characterized by deficiency (characterized by abnormally large abnormally large immature and dysfunctional erythrocytesimmature and dysfunctional erythrocytes) ) easy easy fatigue, weakness, shortness of breath, decreased fatigue, weakness, shortness of breath, decreased ability to concentrate.ability to concentrate.

2.2. Impairments in white blood Impairments in white blood cell development cell development and leukopenia and leukopenia reduce immune responses reduce immune responses to infection and/or cancer.to infection and/or cancer.

Major Symptoms of Vitamin B9 DeficiencyMajor Symptoms of Vitamin B9 Deficiency

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3.3. Impaired cell growth in the Impaired cell growth in the digestive tract, digestive tract, inflammation of tissues in the mouth, stomachinflammation of tissues in the mouth, stomach, , and intestine reduced absorption of nutrients.and intestine reduced absorption of nutrients.

4.4. Impaired fetal growth and development, birth Impaired fetal growth and development, birth defects such as Neural Tube Defects defects such as Neural Tube Defects (NTDs) (NTDs) e.g. Spina bifida.e.g. Spina bifida.

Megaloblastic anemiaMegaloblastic anemia LeucopeniaLeucopenia Neural Tube Defects e.g. Spina Neural Tube Defects e.g. Spina Bifida (SB) SB occurs when two Bifida (SB) SB occurs when two sides of the spine fail to close and sides of the spine fail to close and protect spinal cordprotect spinal cord

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People at High Risk of Vitamin B9 Deficiency People at High Risk of Vitamin B9 Deficiency

1.1. People who depend on People who depend on processed food and neglect processed food and neglect whole grains and vegetables.whole grains and vegetables.

2.2. Smoking.Smoking.3.3. Many chronic diseases Many chronic diseases and health status such as and health status such as

psoriasis, anemia, infections, cancer, fever, trauma, psoriasis, anemia, infections, cancer, fever, trauma, surgery, or burns sharply increase folate requirements.surgery, or burns sharply increase folate requirements.

4.4. Liver disease interferes Liver disease interferes with folate metabolism and with folate metabolism and increases excretion.increases excretion.

5.5. Rapid growth childhoodRapid growth childhood, and adolescence., and adolescence.6.6. PregnancyPregnancy..7.7. Heavy alcohol consumption Heavy alcohol consumption interferes with absorption, interferes with absorption,

impairs conversion to THF, and increases excretion.impairs conversion to THF, and increases excretion.8.8. Deficiency of ascorbic acidDeficiency of ascorbic acid..9.9. Deficiency of vitamin B12 Deficiency of vitamin B12 impairs folate metabolism impairs folate metabolism

and produces signs of folate deficiency.and produces signs of folate deficiency.

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Uses of Folic Acid in Prevention and TherapyUses of Folic Acid in Prevention and Therapy

1.1. Prophylaxis from birth defects: Prophylaxis from birth defects: Supplemental folate (400μg/day) days before Supplemental folate (400μg/day) days before conception and during early pregnancy reduces conception and during early pregnancy reduces the risk of birth defects, particularly neural tube the risk of birth defects, particularly neural tube defects, defects, cleft lip and palate.cleft lip and palate.

2.2. Atherosclerosis: Atherosclerosis: Folate help preventing atherosclerosis (heart Folate help preventing atherosclerosis (heart attack, attack, and peripheral vascular disease) in and peripheral vascular disease) in people with people with elevated homocysteine (THF with elevated homocysteine (THF with Vitamin B12 Vitamin B12 detoxify homocysteine to detoxify homocysteine to methionine).methionine).

3.3. Enhance immunity in case of infections.Enhance immunity in case of infections.

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4.4. Cancer: Cancer: Folate supplements may also reduce the risk of Folate supplements may also reduce the risk of colon cancer in people with inflammatory bowel colon cancer in people with inflammatory bowel diseases. diseases. Folate + vitamin A can reduce the risk Folate + vitamin A can reduce the risk of of cervical dysplasia (cervical dysplasia (abnormal changes in abnormal changes in the cells on the surface of the cervixthe cells on the surface of the cervix)) progressing progressing to cervical cancerto cervical cancer. . Folate + vitamin B12 Folate + vitamin B12 can can reduce dysplasia in the lungs of smokers and reduce dysplasia in the lungs of smokers and reduce the risk of lung cancer.reduce the risk of lung cancer.

4.4. Psychiatric/nervous disorders: Psychiatric/nervous disorders: Symptoms of dementia in elderly people may Symptoms of dementia in elderly people may be improved by folic acid supplementation. be improved by folic acid supplementation. Folate can be adjunctive therapy with lithium Folate can be adjunctive therapy with lithium in the treatment of manic- depressive illness.in the treatment of manic- depressive illness.

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Folic Acid – Drug InteractionsFolic Acid – Drug Interactions

Drugs reduce folate level Drugs reduce folate level e.ge.g..

AspirinAspirinoral contraceptive pillsoral contraceptive pillsAntacidsAntacidsAnticonvulsantAnticonvulsantantibiotics.antibiotics.

Folic acid antagonistsFolic acid antagonists e.g.e.g.

MethotrexateMethotrexate

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VITAMIN B12 VITAMIN B12 (Cobalamin, Antipernicious anemia factor)(Cobalamin, Antipernicious anemia factor)

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Vitamin B12Vitamin B12

1.1. Vitamin B12 is a Vitamin B12 is a family of related compounds family of related compounds containing a cobalt atom containing a cobalt atom (cobalamins). (cobalamins).

2.2. The two dietary forms of vitamin B12 are The two dietary forms of vitamin B12 are available and they are known as available and they are known as methylcobalamin methylcobalamin (methyl-B12)(methyl-B12) and 5- and 5- deoxyadenosylcobalamin deoxyadenosylcobalamin (coenzyme-B12). (coenzyme-B12).

3.3. Synthetic forms Synthetic forms of vitamin B12 are known as of vitamin B12 are known as hydroxy-cobalaminhydroxy-cobalamin and and cyanocobalamin cyanocobalamin (not (not occur naturally in foods). occur naturally in foods).

4.4. Structure of B12 is very complicated and based Structure of B12 is very complicated and based on a corrin ring, similar to porphyrin ring found on a corrin ring, similar to porphyrin ring found in heme, chlorophyll, and cytochrome. in heme, chlorophyll, and cytochrome.

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A B

CD

Vitamin B12

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5.5. The central metal ion is The central metal ion is cobalt (Co) cobalt (Co) which which coordinates with nitrogens of corrin ring and that coordinates with nitrogens of corrin ring and that of dimethylbenzimidazole group. of dimethylbenzimidazole group.

6.6. The sixth coordination can be The sixth coordination can be : CN- (in : CN- (in Cyanocobolamin),Cyanocobolamin),HO-(in Hydroxycobalamin),CHHO-(in Hydroxycobalamin),CH33

(in Methylcobalamin, Me-B12), (in Methylcobalamin, Me-B12), deoxyadenosyl deoxyadenosyl group (Adenosylcobalamin, Ado-B12 = group (Adenosylcobalamin, Ado-B12 = coenzyme-B12). coenzyme-B12).

7.7. Very small amounts of vitamin B12 are stored in Very small amounts of vitamin B12 are stored in our bodies, about 90% of which (2–5 mg) is our bodies, about 90% of which (2–5 mg) is stored in the liver and is sufficient for 2 years.stored in the liver and is sufficient for 2 years.

Page 43: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

Sources of vitamin B12Sources of vitamin B12

The intestinal flora produces the vitamin required for man The intestinal flora produces the vitamin required for man and animals. and animals. Vitamin B12 can be obtained from animal Vitamin B12 can be obtained from animal diet only.diet only.

Principal Sources in FoodPrincipal Sources in FoodPrincipal dietary sources of vitamin Principal dietary sources of vitamin B12 include: B12 include: FoodFood Serving size Serving size μμggCalf liver Calf liver 100 g100 g 60 60Egg Egg 1, Avg size1, Avg size 1 1BeefBeef 100 g100 g 2 2MilkMilk 1, large glass1, large glass 0.4 0.4Hard CheeseHard Cheese 30 g30 g 0.6 0.6MusselsMussels 100 g100 g 8 8

Required Daily Required Daily Amount (RDA)Amount (RDA)

AgeAge μμg/dayg/day1 - 31 - 3 0.90.94 - 84 - 8 1.21.29 – 139 – 13 1.81.814 – 1814 – 18 2.42.4>18>18 2.42.4

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Vitamin B12 Vitamin B12 in food is bound to proteinin food is bound to protein..

HCl of the stomach releases the free vitamin HCl of the stomach releases the free vitamin B12.B12.

Once released, vitamin B12 combines with Once released, vitamin B12 combines with glycoprotein intrinsic factor (IF) secreted by the glycoprotein intrinsic factor (IF) secreted by the parietal cells of stomach parietal cells of stomach to form a complex which to form a complex which can be absorbed from ileum.can be absorbed from ileum.

Absorption of vitamin B12Absorption of vitamin B12

Page 45: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

1.1. Essential with folic acid Essential with folic acid in RBCs maturation (it in RBCs maturation (it protects against Pernicious anemia).protects against Pernicious anemia).

2.2. Folate metabolismFolate metabolism. Vitamin B12 is vital in . Vitamin B12 is vital in activation of folate to the active THF. In vitamin activation of folate to the active THF. In vitamin B12 deficiency, tissue stores of folate are B12 deficiency, tissue stores of folate are “trapped” as inactive methylated forms, and a “trapped” as inactive methylated forms, and a functional folate deficiency results. functional folate deficiency results.

3.3. Protein metabolismProtein metabolism: Act as coenzyme with : Act as coenzyme with THF in the synthesis of THF in the synthesis of methionine from methionine from homocysteine.homocysteine.

Functions of Vitamin B12Functions of Vitamin B12

Page 46: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

4.4. It is vital in fat metabolism.It is vital in fat metabolism.

5.5. Helps maintain the antioxidant Helps maintain the antioxidant status by status by maintaining glutathione in the reduced form.maintaining glutathione in the reduced form.

6.6. Nervous system Nervous system (It is vital in (It is vital in synthesis of synthesis of myelin sheath of neurons).myelin sheath of neurons).

7.7. Cell replicationCell replication. It is essential with THF in . It is essential with THF in synthesis of nucleic acids.synthesis of nucleic acids.

Page 47: Vitamin B5 ( Pantothenic Acid). Vitamin B5 ( Pantothenic Acid)  It is a peptide composed of D-Pantoic acid and β- Alanine and is found as calcium salt.

People at High Risk of Vitamin B12 DeficiencyPeople at High Risk of Vitamin B12 Deficiency

1.1. Eldery people: Eldery people: Gastric secretion and intrinsic factor is Gastric secretion and intrinsic factor is diminished. Both are required for optimum vitamin B12 diminished. Both are required for optimum vitamin B12 absorption.absorption.

2.2. People suffering from chronic gastritis People suffering from chronic gastritis with atrophy with atrophy of the parietal cells that produce intrinsic factor.of the parietal cells that produce intrinsic factor.

3.3. Intestinal diseases Intestinal diseases e.ge.g. chronic enteritis with diarrhea . chronic enteritis with diarrhea reduce absorption of vitamin B12.reduce absorption of vitamin B12.

4.4. Liver disease impair vitamin B12 Liver disease impair vitamin B12 status (as the liver status (as the liver is the site of vitamin B12 storage and the site of is the site of vitamin B12 storage and the site of production of specific transport proteins).production of specific transport proteins).

5.5. Strict vegetarian diets Strict vegetarian diets (devoid of animal products).(devoid of animal products).

6.6. Cigarette smoking impairs vitamin B12 status.Cigarette smoking impairs vitamin B12 status.

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Major Symptoms of Vitamin B12 DeficiencyMajor Symptoms of Vitamin B12 Deficiency

1.1. Pernicious AnemiaPernicious Anemia: It is a case of : It is a case of megaloblastic anemia caused by megaloblastic anemia caused by atrophic gastritis and parietal cell loss atrophic gastritis and parietal cell loss and characterized by neuropathy: ease and characterized by neuropathy: ease fatigue, weakness, shortness of breath, fatigue, weakness, shortness of breath, decreased ability to concentrate, and decreased ability to concentrate, and peripheral nerve damage. peripheral nerve damage.

2.2. Neurological changes Neurological changes such as such as numbness and tingling in the hands and numbness and tingling in the hands and feet (due to diminished myelination).feet (due to diminished myelination).

3.3. Difficulty in maintainingDifficulty in maintaining balance, balance, depression, confusion, dementia, poor depression, confusion, dementia, poor memory.memory.

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4.4. Reduced platelet production Reduced platelet production (increase (increase risk of abnormal bleeding).risk of abnormal bleeding).

5.5. Impaired white blood cell Impaired white blood cell development development reduces immune responses to infection reduces immune responses to infection and/or cancer.and/or cancer.

6.6. Impaired cell replication Impaired cell replication leads to atrophy leads to atrophy and inflammation of mucous membranes in and inflammation of mucous membranes in the mouth, tongue and GIT, reduced the mouth, tongue and GIT, reduced absorption of nutrients, constipation, absorption of nutrients, constipation, anorexia, and weight loss.anorexia, and weight loss.

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Uses of Vitamin B12 in Prevention and TherapyUses of Vitamin B12 in Prevention and Therapy

1.1. Treat and prevent deficiency conditions and pernicious Treat and prevent deficiency conditions and pernicious anemia (a condition in which the body can't make anemia (a condition in which the body can't make enough healthy red blood cells).enough healthy red blood cells).

2.2. In combinationIn combination with folate with folate to treat megaloblastic to treat megaloblastic anemia.anemia.

3.3. Treatment of psychiatric/nervous Treatment of psychiatric/nervous disorders e.g. disorders e.g. dementia and memory loss, particularly in the elderly dementia and memory loss, particularly in the elderly people.people.

4.4. It is helpful It is helpful with folate with folate in prevention in prevention and therapy of and therapy of atherosclerosis associated with high levels of blood atherosclerosis associated with high levels of blood homocysteine.homocysteine.

5.5. It is helpful It is helpful with folate with folate to reduce smoking-induced to reduce smoking-induced precancerous cells in the lungs reducing risk of precancerous cells in the lungs reducing risk of lung cancer.lung cancer.

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6.6. Reduction of peripheral nerve disorders Reduction of peripheral nerve disorders e.g. e.g. neuropathy in diabetics, trigeminal neuralgias and neuropathy in diabetics, trigeminal neuralgias and

traumatic nerve injuries.traumatic nerve injuries.

7.7. Large doses (5-10 g IV) of Large doses (5-10 g IV) of Hydroxycobalamin Hydroxycobalamin used used in cyanide poisoning in cyanide poisoning where it combine with cyanide where it combine with cyanide ion to form harmless ion to form harmless Cyanocobalamin.Cyanocobalamin.

In pernicious anemia, vitamin B12 should be In pernicious anemia, vitamin B12 should be given as IM injection (100 to 1000 μg of given as IM injection (100 to 1000 μg of cyanocobalamin for 5 days followed by 100 to cyanocobalamin for 5 days followed by 100 to 1000 μg each month) till correction of blood 1000 μg each month) till correction of blood picture.picture.

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Vitamin B12 – Drug InteractionVitamin B12 – Drug InteractionSome Drugs interfere with its absorption such Some Drugs interfere with its absorption such as: as:

AlcoholAlcoholp-aminosalicylic acidp-aminosalicylic acidColchicineColchicineNeomycinNeomycinCholestyramineCholestyramineAnticonvulsants (Phenytoin)Anticonvulsants (Phenytoin)MetforminMetformin

H2 blockers include H2 blockers include cimetidinecimetidine, proton pump , proton pump inhibitors e.g. inhibitors e.g. omeprazoleomeprazole reduce secretion of reduce secretion of gastric acid and pepsin gastric acid and pepsin reduce isolation and reduce isolation and absorption of absorption of protein-bound (dietary) protein-bound (dietary) vitamin vitamin B12.B12.

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THANX