WATER

SOLUBLE
VITAMINS
GVHD: TS. Phạm Thị Hoàn
hoanpt@hcmute.edu.vn
 MAIN CONTENTS

01 02
B VITAMINS VITAMIN C
 01
B VITAMINS
Chemical
Structure
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Vitamin B1 - Thiamine

• Distributed widely in the body, particularly in the heart liver

and kidney
• Alcohol inhibits absorption
• Limited storage, excess excreted in the urine
 Thiamine - Functions
Part of coenzyme thiamin pyrophosphate (TPP)
Involved in removal of CO2 groups in energy metabolism.
Promotes the conversion of Pyruvate (3C) to Acetyl CoA (2C) plus CO2.
In TCA cycle helps convert 5C compound to 4C compound

Occupies a special site on the membrane of nerve cells

Processes in nerves and muscles depend on B1
 Thiamine - deficiency
• Inadequate energy intake increases the risk of
nutrient deficiencies- including B1
• Alcoholism is often a precipitating condition
• Deficiency associated with the disease beriberi
• 3 types:
o Dry beriberi
o Wet beriberi
o Infantile beriberi Wet beriberi
Thiamine – RDI / Assessment

Beriberi’s
Infants Children Adults
patients

0.3 - 0.5 0.5 - 1.0 1.0 - 3.0 10 - 25mg of injection

mg/day mg/day mg/day or
10 - 50mg orally/day
Assessment:
• Dietary intake
• Biochemical tests (Urine & TPP test)
Thiamine – Food Sources
Vitamin B1 present in all
natural foods: unrefined
cereals, organ meats, nuts
legumes, bakers flour…
Vitamin B2 - Riboflavin

• Riboflavin is involved in energy metabolism.

• Flavin mononucleotide (FMN) and flavin

adenine dinucleotide (FAD) are the
coenzyme forms.
Riboflavin - Functions
 Riboflavin - deficiency
• No notable deficiency disease
• Inflammation of mucosa of lips (viêm niêm mạc môi)

• Angular stomatitis - cracks at corner of mouth (nứt ở

khóe miệng)

• Scaly dermatitis around nose (viêm da có vảy quanh mũi )

• Smooth purplish-red tongue (lưỡi mịn màu đỏ tía)
Riboflavin – Food Sources

B2 present in natural foods:

• Dairy, meat and eggs,
• Cereals and fruits
Vitamin B3 - NIACIN: nicotinic acid

• Mostly found in blood cells,

kidney, brain and liver

• Little storage, excess intake

excreted in urine
NIACIN - Functions
• Part of coenzymes NAD (nicotinamide adenine dinucleotide)
& NADH (Nicotinamide adenine dinucleotide phosphate)

• Central in energy transfer reactions. Metabolism of

carbohydrates, lipids, protein & alcohol.
 NIACIN - deficiency
Diets high in corn → deficiency disease (pellagra)
• Skin - dermatitis, casal's necklace
• GI tract - inflammation, diarrhoea
• Nervous system – anxiety (lo lắng), dementia
(sa sút trí tuệ), delirium (sa sút trí tuệ).
NIACIN – RDI
• Tryptophan can be converted to niacin in liver & kidney

(60 mg tryptophan = 1 mg niacin = 1 mg NE)

• Related to energy intake

Men 18-20 mg/day
Women 12-14 mg/day
 NIACIN – Food Sources
B3 present in natural foods:
• Milk, eggs, meat, poultry and fish
• Whole-grain, breads and cereals
• Nuts and all protein-containing
foods.
 02
VITAMIN C
 Vitamin C - Ascorbic acid

• Readily absorbed
• Excretion varies with intake. Massive doses can't

raise plasma levels above about 1.4 mg/dL

• Reducing agent
Vitamin C - Functions
Collagen synthesis Immune function
Protein component
of connective tissue

Synthesis of
Neurotransmitters Antioxidant Activity
Dopamine Reacts, removes
Norepinephrine active oxygen species
Serotonin
Vitamin C – Other Functions
• Bile acid synthesis

• Enhances absorption of iron (reduces iron to more

absorbable ferrous form/ chelates with ferrous ion to
make it more soluble)

• Pro-oxidant Activity: Reduces metals to their pro-

oxidant forms
 Vitamin C - deficiency Anaemia, muscle
weakness, fatigue may
result from decreased synthesis
Scurvy of the neurotransmitter
norepinephrine

Defective collagen Delayed

synthesis wound healing

Tendency of blood
vessels to bleed Bruising
Pinpoint haemorrhages on arms, legs
Bleeding in the gums and joints
 Vitamin C - deficiency
Young children- excess cow’s milk

Newborn infants, Institutionalized

mum had high intake- Groups
elderly- 30% low
develop rebound at risk blood levels
scurvy after birth

Chronic alcoholics
 Vitamin C - Toxicity
Toxicity is low
Regularly consuming more than 1-2 g/day
• GI symptoms: stomach inflammation, diarrhoea, nausea,
abdominal cramps (viêm dạ dày, tiêu chảy, buồn nôn, đau quặn bụng)
• Rebound scurvy on withdrawal
• Increase absorption of iron may cause problems: individuals
with iron overload (thừa sắt)
• Oxalate kidney stones (> 8g/ day)
Vitamin C and Coronary Heart Disease (CHD)
Prevention
• Prospective studies indicated that deficient intakes of vitamin
C associated with increased risk of cardiovascular disease (CVD)

• Pooled analysis of 9 studies found that adults who took > 700
mg/day of supplemental vitamin C had 25% lower risk of CHD
than those who did not take supplements
Vitamin C and Coronary Heart Disease (CHD)
Treatment

• Treatment with vitamin C results in improved dilation (sự

giãn nở) of blood vessels in individuals with atherosclerosis
(xơ vữa động mạch)

• Several studies have demonstrated a blood pressure

lowering, effect of vitamin C supplementation
Vitamin C and Cancer
Prevention
• Higher intakes of vitamin C are associated with decreased
incidence of cancers of mouth, throat and vocal chords,
esophagus, stomach, colon-rectum, and lung.
• Vitamin C supplementation may be useful addition to
standard H. pylori (Helicobacter pylori) eradication therapy in
reducing the risk of gastric cancer
Vitamin C and Cancer
Treatment

• No results from controlled clinical trials indicating that

vitamin C would adversely affect the survival of cancer
patients
Vitamin C and the common cold
• Vitamin C supplementation did not decrease the incidence (tỷ
lệ mắc bệnh) of colds.

• In a subgroup of marathon runners, skiers and soldiers

training in the Arctic, doses ranging from 250 mg-1 g/day
decreased the incidence of colds by 50%.
Vitamin C - RDI
• USA - 60 mg/day

• FAO and UK - 30 mg/day

• Australia
Men: 40 mg/day
Women : 30 mg/day
Pregnancy: +30 mg/day
Lactation: +40 mg/day
 THANKS!
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