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Dermatitis, glossitis, diarrhea |
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Common symptoms of B-complex deficiencies |
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Night blindness, dry skin |
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Arthralgias, fatigue, headaches, skin changes, sore throat, alopecia |
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Pyruvate dehydrogenase
Alpha-ketoglutarate dehydrogenase
Transketolase
Branched-chain AA dehydrogenase |
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Enzymes requiring thiamine as a cofactor |
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Impaired glucose breakdown > ATP depletion, brain and heart affected first |
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Wernicke-Korsakoff syndrome
Beriberi |
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Thiamine deficiency: alcoholism and malnutrition |
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Confusion, ophthalmoplegia, ataxia |
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Memory loss, confabulation, personality change |
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Cofactor in oxidation and reduction |
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Cheilosis (inflammation of lips, scaling and fissures at corners of mouth), corneal vascularization |
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Vitamin B2 (riboflavin) deficiency |
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Constituent of NAD+, NADP+, used in redox reactions. |
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Synthesis requires vitamin B6 |
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Hartnup disease (decreased tryptophan absorption)
Malignant carcinoid syndrome (increased tryptophan metabolism)
INH (decreased vitamin B6) |
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Vitamin B3 (niacin) deficiency
Three Ds: dementia, diarrhea, dermatitis |
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Vitamin B5 (panthotenate) |
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Essential component of CoA and fatty acid synthase |
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Dermatitis, enteritis, alopecia, adrenal insufficiency |
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Cofactor used in transamination, decarboxylation reactions, glycogen phosphorylase, cystathionine synthesis, and heme synthesis |
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Required for the synthesis of niacin from tryptophan |
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Convulsions, hyperirritability, peripheral neuropathy, sideroblastic anemias |
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Deficiency induced by INH and oral contraceptives |
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Cofactor for homocysteine methyltransferase and methylmalonyl-CoA mutase |
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Macrocytic, megaloblastic anemia, hypersegmented PMNs |
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Found in animal products, synthesized only by microorganisms |
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Malabsorption (sprue, enteritis, Diphyllobothrium latum)
Lack of intrinsic factor (pernicious anemia, gastric bypass surgery)
Absence of terminal ileum (Crohn's disease) |
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Causes of vitamin B12 deficiency |
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Macrocytic, megaloblastic anemia without neurologic symptoms |
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Most common vitamin deficiency in the U.S. |
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S-adenosyl-methionine (SAM) |
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Regeneration of methionine
Conversion of NE to epinephrine
Phosphocreatine synthesis |
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Cofactor for carboxylation enzymes |
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Pyruvate carboxylase
Acetyl-CoA carboxylase
Propionyl-CoA carboxylase |
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Carboxylation enzymes requiring biotin |
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Excessive ingestion of raw eggs |
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Scurvy > vitamin C deficiency |
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Swollen gums, bruising, anemia, poor wound healing |
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Antioxidant
Facilitates iron absorption by keeping it in reduced state |
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Necessary for hydroxylation of proline and lysine in collagen synthesis |
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Necessary for dopamine beta-hydroxylase, which converts dopamine to NE |
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D2 > ingested from plants, used as pharmacologic agent |
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D3 > consumed in milk, formed in sun-exposed skin |
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Antioxidant that protects erythrocytes and membranes from free-radical damage |
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Synthesized by intestinal flora |
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II, VII, IX, X, proteins C & S |
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Clotting factors requiring vitamin K |
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Neonatal hemorrhage with increased PT and PTT |
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Delayed wound healing, hypogonadism, decreased adult hair (axillary, facial, pubic), dysgeusia, anosmia |
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