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    Vitamins

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    Mary
    The document discusses the digestion and absorption of fat-soluble vitamins A, D, E, and K and water-soluble vitamins B12, B1, B2, B3, B6, C, folate, biotin, and pantothenic acid. It describes where vitamins are found in foods, their roles in the body, deficiency symptoms, and how they are absorbed and transported inside enterocytes and through the body.

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    Vitamins

    Uploaded by

    Mary
    35 views37 pages
    The document discusses the digestion and absorption of fat-soluble vitamins A, D, E, and K and water-soluble vitamins B12, B1, B2, B3, B6, C, folate, biotin, and pantothenic acid. It describes where vitamins are found in foods, their roles in the body, deficiency symptoms, and how they are absorbed and transported inside enterocytes and through the body.

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    Vitamins notes

    Original Title

    8. Vitamins

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    The document discusses the digestion and absorption of fat-soluble vitamins A, D, E, and K and water-soluble vitamins B12, B1, B2, B3, B6, C, folate, biotin, and pantothenic acid. It describes where vitamins are found in foods, their roles in the body, deficiency symptoms, and how they are absorbed and transported inside enterocytes and through the body.

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    © All Rights Reserved
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    35 views37 pages

    Vitamins

    Uploaded by

    Mary
    The document discusses the digestion and absorption of fat-soluble vitamins A, D, E, and K and water-soluble vitamins B12, B1, B2, B3, B6, C, folate, biotin, and pantothenic acid. It describes where vitamins are found in foods, their roles in the body, deficiency symptoms, and how they are absorbed and transported inside enterocytes and through the body.

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    HMP200/UPC203/VMP200/DEC/2019

    DIGESTION AND
    ABSORPTION OF
    VITAMINS
    WHAT ARE VITAMINS?
    Organic dietary micronutrients
    Vital physiological/Biochemical roles
    Critical for human nutrition
    Cannot be synthesized endogenously
    Intermediary metabolism
    Organ systems specific metabolism
    No direct supply of energy
    Necessary for Life, health, & growth
    FAT-SOLUBLE VITAMINS
    A
    D
    E
    K
    Ingested as esters
    Cholesterol esterase
    Fat intake necessary for their absorption by
    enterocytes
    FAT-SOLUBLE VITAMINS
    Incorporated into micelles

    Malabsorption

    Lack of pancreatic lipolytic enzymes

    Obstruction of bile duct

    Obstructive jaundice

    Exocrine pancreatic disorders


    VITAMIN A (RETINOL)
    (Yellow veg & fruits)
    Constituent of visual pigments
    Retinal pigment
    Necessary for fetal development
    Necessary for cell development throughout life
    DEFICIENCY SYMPTOMS:
    Follicular hyperkeratosis
    Night blindness
    Dry skin
    VITAMIN D (1, 25-CHOLECALCIFEROL)
    (Fish, liver)
    Increased intestinal absorption of calcium &
    phosphate
    Hormonal control of calcium & phosphate
    metabolism
    Physiology of bone
    DEFICIENCY SYMPTOMS
    Rickets, bone demineralization & resorption
    VITAMIN E (α-TOCOPHEROL)

    (Milk, eggs, meat, leafy veg)

    Antioxidants & Cofactors

    DEFICIENCY SYMPTOMS

    Peripheral neuropathy

    Ataxia

    Spinalcerebellar dysfunction
    VITAMIN K

    (Leafy Green Veg)

    Blood clotting

    Necessary for synthesis of prothrombin &


    factors VII, IX, & X

    DEFICIENCY SYMPTOMS

    Hemorrhagic diseases
    ADEK-DIGESTION & ABSORPTION

    Gastric Acidity & proteolysis release ADEK from


    association with proteins

    Pancreatic & brush border membrane carboxyl ester


    hydrolases liberate free ADEK from their esters

    Incorporated into emulsion droplets, multilamella &


    unilamella vesicles & mixed micelles
    INSIDE THE ENTEROCYTES
    Free ADEK or attached to carrier proteins diffuse to
    SER

    ADEK are associate with lipid droplets that form


    chylomicrons & VLDLs

    Translocation through Golgi & secretory vesicles for


    exocytosis into lymph

    From systemic blood circulation ADEK enters liver by


    receptor-mediated endocytosis of chylomicrons
    MALABSORPTION OF ADEK MAY BE CAUSED BY:

    Malabsorptive surgery

    Drugs that impair TAG hydrolysis (Orlistat)

    Drugs that bind to bile acids (Cholestyramine)

    Impaired hepatobiliary function (reduction of bile


    acids)

    Unabsorbable dietary fat substitutes

    Impaired hepatic function


    WATER SOLUBLE VITAMINS
    VITAMIN B12 (CYANOCOBALAMIN/COBALAMIN)
    (Liver, meat, eggs, milk)
    RECOMMENDED DIETARY ALLOWANCE (RDA)- 2 µg

    Coenzyme in in amino acid metabolism

    Stimulates erythropoiesis

    DEFICIENCY SYMPTOMS

    Pernicious anemia (megaloblastic anemia)


    VITAMIN B1 (THIAMINE)

    (Liver, unrefined cereal grains)

    Cofactor in decarboxylation of pyruvate & α-keto acids

    DEFICIENCY SYMPTOMS

    BERIBERI

    NEURITIS
    VITAMIN B2 (RIBOFLAVIN)

    (Liver, milk)

    Constituent of flavoproteins

    DEFICIENCY SYMPTOMS

    Hyperemia of nasopharyngeal mucosa

    Normocytic anemia

    Glossitis

    Cheilosis
    VITAMIN B3 NIACIN (NICOTINIC ACID)

    (Yeast, lean meat, liver)

    Constituent of nicotinamide adenine dinucleotide


    (NAD+) & nicotinamide adenine dinucleotide phosphate
    (NADP+)

    DEFICIENCY SYMPTOMS

    PELLAGRA (skin, GI tract, & brain)


    VITAMIN B6 (PYRIDOXINE)

    (Yeast, wheat, corn, liver)

    Coenzyme in transamination for synthesis of amino acids

    DEFICIENCY SYMPTOMS

    STOMATITIS

    GLOSSITIS

    NORMOCYTIC ANEMIA

    CONVULSIONS

    HYPERIRRITABILITY
    VITAMIN C (ASCORBIC ACID)

    (Citrus fruits, leafy green veg)

    Coenzyme in formation of hydroxyproline used in collagen

    Maintains prosthetic metal ions in their reduced form

    Scavenges free radicals

    DEFICIENCY SYMPTOMS

    SCURVY
    FOLATE (FOLIC ACID)
    (Leafy green veg)
    (RDA)- 180 to 200 µg
    PREGNANCY: 400 µg
    Used to synthesize purines and thymine
    Coenzyme for “1-carbon” transfer
    Involved in methylating reactions
    DEFICIENCY SYMPTOMS
    MEGALOBLASTIC ANEMIA
    SPRUE
    NEURAL TUBE DEFECTS IN CHILDREN BORN TO
    FOLATE-DEFICIENT WOMEN
    BIOTIN

    (Egg yolk, liver, tomatoes)

    Coenzyme in carboxylation reactions

    DEFICIENCY SYMPTOMS

    NEUROLOGIC CHANGES

    DEMATITIS

    ENTERITIS
    PANTOTHENIC ACID
    (Eggs, liver, yeast)
    Constituent of CoA
    Necessary for carbohydrate metabolism
    Necessary fat metabolism involving acetyl-coA
    Necessary for amino acid synthesis
    DEFICIENCY SYMPTOMS
    ABDOMINAL PAIN, VOMITING, NEUROLOGIC SIGNS
    DEMATITIS
    ENTERITIS
    ALOPECIA
    ADRENAL INSUFFICIENCY
    VITAMINS B12
    (CYANOCOBALAMIN/COBALAMIN)
    MEAT, FISH, SHELLFISH, EGGS, MILK

    LARGE BODY STORES ~ 5 mg

    DAILY ADULT REQUIREMENT - 2 µg (micrograms)

    DELIVERED THROUGHOUT THE BODY

    EXCESS SECRETED BY LIVER INTO BILE

    ENTEROHEPATIC CIRCULATION
    PRIMARY FUNCTION OF VIT B12

    SERVE AS A COENZYME FOR


    HOMOCYSTEINE:METHIONINE METHYLTRANSFERASE

    TRANSFERS METHYL GROUP FROM


    METHYLTETRAFORATE TO HOMOCYSTEINE FORMING:

    METHIONINE &

    TETRAHYDROFOLATE
    PRIMARY FUNCTION OF VIT B12

    COENZYME IN REDUCTION OF RIBONUCLEOTIDES TO


    DEOXYRIBONUCLEOTIDES

    PROMOTION OF FORMATION OF ERYTHROCYTES,


    PROMOTION OF FORMATION MYELIN

    DEFICIENCY SYMPTOMS

    PERNICIOUS ANEMIA (MEGALOBLASTIC ANEMIA)

    NEUROLOGICAL DYSFUNCTION

    PSYCHOLOGICAL ABNORMALITIES
    8 STEPS SHOWING THE PROCESS OF ABSORPTION OF VIT

    B12

    1. Cobalamin (CBL) bound to protein in food

    2. Gastric acid & pepsin release from dietary protein

    3. Gastric glands secrete haptocorrin, which then binds to CBL

    4. Gastric parietal cells secrete intrinsic factor (IF)


    VIT B12 IN THE STOMACH

    BOUND TO PROTEINS

    PEPSINS

    LOW GASTRIC pH

    VIT B12 COMPLEX WITH HAPTOCORRIN

    VIT B12 CAN’T COMPLEX WITH IF


    8 STEPS SHOWING THE PROCESS OF OBSORPTION OF VIT

    B12

    5. The pancreas secretes proteases & HCO3- - (alkaline secretion)

    6. CBL is released after the proteolytic degradation of haptocorrin

    7. The IF-CBL complex forms

    8. Ileal enterocytes absorbs IF-CBL complex


    VIT B12 IN THE PROXIMAL SMALL INTESTINE

    HAPTOCORRIN DEGRADED BY PANCREATIC


    PROTEASES

    VIT B12 COMPLEX WITH IF

    HIGHLY RESISTANT TO ENZYME DEGRADATION


    ABSORPTION OF VIT B12 BY ENTEROCYTES IN THE ILEUM

    SPECIFIC RECEPTORS

    BINDS ONLY VIT B12-IF COMPLEX

    SELECTIVE/SPECIFIC RAPID BINDING

    REQUIRES Ca2+

    NOT ENERGY DEPENDENT


    INSIDE THE TERMINAL ILEUM ENTEROCYTES

    Uses energy to absorb CBL-IF complex across the apical

    membrane

    CBL-IF dissociates

    CBL-Transcobalamin II (CBL-TCII)

    Portal circulation

    Storage or secretion into the bile


    CAUSES OF VIT B12 DEFICIENCY

    STRICT VEGETARIAN DIET

    NO GASTRIC PARIETAL CELLS

    NO HCL & IF

    POOR ABSORPTION OF VIT B12


    CAUSES OF VIT B12 DEFICIENCY

    BACTERIAL OVERGROWTH

    BACTERIAL BINDING & METABOLISM OF VIT B12

    CROHN DISEASE-AFFECTING ILEUM

    ILEAL RESECTION
    PERNICIOUS ANEMIA/MEGALOBLASTIC ANEMIA

    Atrophy of gastric mucosa

    Autoimmunity against parietal cells

    Absence of parietal cells

    Lack of HCI & IF

    Elevated plasma gastrin levels

    Deficiency of CBL
    PERNICIOUS ANEMIA/MEGALOBLASTIC ANEMIA

    Enlarged circulating RBCs

    Peripheral neuropathy

    Memory impairment, demetia, depression

    Impaired senses of touch, vibrations. Temperature

    Weakness, ataxia

    PARENTERAL ADMINISTRATION OF CBL


    Thank you

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