VITAMINS

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VITAMIN E

Vitamin E

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 Vitamin E
 Chemically they are tocopherol

 Among all tocopherols α-tocopherol is most

potent and widely distributed in nature.

 Cooking and food processing may destroy

vitamin E to some extent.
Sources of Vitamin E
Functions of Vitamin E

 α-tocopherol in cell membrane and cytosol

function as antioxidant.

 It is present in high concentration in

tissues which are exposed to high O2
pressure like erythrocytes, lungs, retina
etc.

 It acts as an antioxidant.
Functions of Vitamin E

 Vitamin E is involved in maintenance of muscle

tone

 Vitamin E increases synthesis of hemeproteins

 Vitamin E prevents dietary vitamin A and

carotenes from oxidative damage.
Deficiency of Vitamin E
 Deficiency is seen in severe malabsorptive disease
cystic fibrosis

 Seen in patient with lipoprotenemia who cannot

absorb or transport it

 Children shows muscular lesions, decrease muscle

creatinine, creatinuria & raised serum creatinine
kinase also called creatinine phosphokinase (CPK)
level
Deficiency of Vitamin E

 Also results in lesions of posterior white column of

spinal cord

 Symptoms include :
• Peripheral neuropathy
• Ophthalmoplegia
• Skeletal myopathy
• Pigmented retinopathy
Vitamin K

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Vitamin K
 Koagulation Vitamin

 Heat stable

 This vitamin is also synthesized by intestinal

bacteria

 Two types K1 & K2

 RDA
FAT SOLUBLE VITAMINS

VITAMIN A Discovered as a
VITAMIN D result of
VITAMIN K investigations into
VITAMIN E the cause of a
bleeding
disorder of cattle
& chicken fed on
fat free diet
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FORMS OF Vitamin K

a. Phylloquinone ( or Vitamin K1 ) in plants

b. Menaquinone ( or Vitamin K2 ) in intestinal bacterial

flora

c. Menadione ( a synthetic derivative of Vitamin K3 )

used in therapy

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 Vitamin K

Principal role Post-translational

modification of various blood clotting factors

Vitamin K serves as a coenzyme in the carboxylation of

certain glutamic acid residues present in these proteins

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Vitamin K Dependent Coagulation
Certain clotting factors/proteins require calcium to
bind for activation
Calcium can only bind after gamma carboxylation
of specific glutamic acid residues in these proteins
Vitamin K2 acts as a cofactor for this carboxylation
reaction
These proteins are known as “Vitamin K
dependent” proteins
Vitamin K Dependent Proteins

Factor II (Prothrombin)
Factor VII (Proconvertin)
Factor IX (Thromboplastin
Component)
Factor X (Stuart Factor)
Protein C & S
Osteocalcin
 Vitamin K

Vitamin K is also important for

synthesis of Bone calcium binding
proteins

Osteocalcin is present in bone. Its

synthesis is induced by Vitamin D & is
dependent on Vitamin K

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 Vitamin K Sources

Bacterial synthesis in GI tract

Leafy green vegetables
Cabbage
Egg yolk
Liver
Milk

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Deficiency of vitamin K

 Vitamin K deficiency is unusual because adequate

amounts are generally produced by intestinal bacteria
or obtained from the diet

If the bacterial population in the gut is decreased,

for example by antibiotics, the amount of
endogenously formed vitamin is depressed, and can
lead to hypoprothrombinemia in the marginally
malnourished individual.

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Why Vitamin K is injected to new born

 Placenta is inefficient at passing maternal

Vit K to the fetus

 In addition the gut of the new born is

sterile, so that the intestinal micro flora
does not provide a source of vit K for
several days after birth.
Deficiency of
vitamin K
This condition may require
supplementation with vitamin K
to correct the bleeding tendency

Certain second generation cephalosporins (for

example, cefoperazone, cefamandole, and
moxalactam) cause hypoprothrombinemia

Consequently, their use in treatment is usually

supplemented with vitamin K. 22
 Deficiency of vitamin K in the
newborn have sterile
Newborns
intestines and cannot initially
synthesize Vitamin K
Human milk provides only
one fifth of the daily
requirement for vitamin K
Single intramuscular dose of
vitamin K is recommended as
prophylaxis against
hemorrhagic disease
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Toxicity of vitamin K
Prolonged administration of large doses of
synthetic vitamin K (menadione) can produce
hemolytic anemia and jaundice in the infant,
due to toxic effects on the membrane of red
blood cells.

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Deficiency of vitamin K

 Dietary deficiency does not occur in man.

 Found in patients suffering from Liver diseases

(obstructive jaundice)

 New born/ infants and in patients with

malabsorption.
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