3. Tip from Tweety
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4. VITAMINS

5. Substantial individual variation.
The adult human brain
Weight: about 3 lb (1.5 kg)
Volume of around cm3,
Substantial individual variation.

6. PROTECTION BY LOCATION
It is protected by the thick bones of the skull, suspended in cerebrospinal fluid, and isolated from the blood stream by the blood-brain barrier.

7. Susceptible to many types of damages and diseases.
Most common forms are physical damage
Closed head injuries such as a blow to the head,
A stroke, or
Poisoning by a wide variety of chemicals that can act as neurotoxins.

8. Other problems
Infection of the brain is rare because of the barriers that protect it, but is very serious when it occurs.

9. Brain is also susceptible to degenerative disorders
Like, Parkinson's disease, Multiple Sclerosis, and Alzheimer's disease.
psychiatric conditions, such as schizophrenia and depression, are widely thought to be caused at least partially by brain dysfunctions, although the nature of such brain anomalies is not well understood.
Here Vitamins come to play role

10. What are Vitamins ?
Vitamins are naturally occurring organic compounds, present in very small quantity in diet and which are essential for normal growth and health.

11. Later on it was found that
Normal metabolic functions cannot be executed without these compounds
If deficient, certain specific metabolic disorders are seen.
Participate as coenzyme in various enzyme catalyzed reaction.
Vitamins do not provide energy.

12. TILL DATE
14 different vitamins have been isolated so far and purified into crystalline form.

13. CLASSIFICATION OF VITAMINS
Based on their solubility in solvent.

14. Storage Water Soluble:
Not stored in our bodies. Must therefore be present in diet to an appreciable extent for normal health and growth.
Fat Soluble:
Are stored, if taken in excess. Stores are sufficient to meet the demand of our body for almost months, if no vitamins are taken through diet.

16. THIAMIN
B 1

17. Biochemical Role
B1 forms the coenzyme Thiamine Diphosphate also called thiamine pyrophosphate By the reaction Thiamine + ATP = TPP + AMP.
The enzyme required for this conversion is Thiamine diphosphotransferase.
TPP is coenzyme for Alfa Keto-acid Oxidative de-carboxylation.

18. Functions
Thiamin is vital for key reactions in energy metabolism, especially carbohydrate metabolism and therefore its requirement in diet is related to energy intake.
In carbohydrate metabolism, thiamin functions in oxidative de-carboxylation of pyruvic acid to form acetyl coenzyme A, which then enters kreb’s cycle.

19. Pentose Phosphate pathway
TPP is also a coenzyme for the tranketolase which is involved in PPP of glucose metabolism.
In thiamine deficiency there is accumulation of of the substrates of the reaction co-catalysed by TPP i.e. Pyruvic Acid, Lactic Acid Pentose sugar and the alfa ketoacids derivatives of Amino acids.

20. Deficiency Disease ( BERIBERI)
Deficiency disease of B1 has been divided into three syndromes on the basis of most common clinical features;
Dry beriberi with predominantly Neuromuscular symptoms
Wet beriberi, with Neuromuscular signs and Edema, less common form but fatal.
Cardiac beriberi, with cardiac decompensation

21. Beriberi

22. Deficiency Diseases
Chronic alcoholism can also lead to thiamin deficiency, the disease produced is termed wernicke’s syndrome.

23. Symptoms of Dry Beriberi
Numbness, tingling, burning pain in extremities
Pains and cramping in the leg muscles
Difficulty with speech
Problems walking
Disturbed sense of balance

24. Symptoms of Wet Beriberi
Fast heart rate
Swollen feet and legs
Enlarged heart
Enlarged and tender liver
Shortness of breath
Congestion in the lungs

25. Symptoms of Infantile Beriberi
Restlessness
Difficulty sleeping
Diarrhea
Swollen arms and legs
Muscle wasting in arms and legs
Silent cry
Heart failure

26. Systems affected by deficiency:
GIT
Nervous System
Cardiovascular System
Musculoskeletal System

27. Risk Factors for Deficiency
Alcoholism
Cirrhosis
Malabsorption
Diabetes
Kidney Diseases
Chronic Infections

28. Those at Risk are: Elderly people Nutritionally inadequate diets
Stress
Prolonged illness
Surgeries
Those who diet or fast frequently
Tobacco Users

29. Toxic effects
Human have limited toxic reaction to thiamin The sign include
Edema
Sweating
Tremors
Tachycardia
Fatty liver/ tumors and
Vascular Hypotension

31. TALK OF THE DAY

32. ROLE OF VITAMINS IN MENTAL HEALTH

33. NUTRITIONAL FACTS
Patients today often are over or well-fed but undernourished.
A growing body of literature links dietary choices to brain health and the risk of psychiatric illness.
Vitamin deficiencies can affect psychiatric patients in several ways:
deficiencies may play a causative role in mental illness and exacerbate symptoms
psychiatric symptoms can result in poor nutrition
vitamin insufficiency—defined as subclinical deficiency—may compromise patient recovery.

34. We can safely conclude that
Vitamins are necessary for healthy life.
B vitamins are required for proper functioning of the methylation cycle, monoamine production, DNA synthesis, and maintenance of phospholipids such as myelin
Fat-soluble vitamins A, D, and E play important roles in genetic transcription, antioxidant recycling, and inflammatory regulation in the brain.

36. The methylation cycle
Vitamins B2, B6, B10, and B12 directly impact the functioning of the methylation cycle.
Deficiencies pertain to brain function, as neuro-transmitters, myelin, and active glutathione are dependent on one-carbon metabolism

37. Role of the 3 essential water-soluble vitamins (B1, B2, B6, B10, B12, and C) and 3 fat-soluble vitamins (A, D, and E) in brain metabolism and psychiatric pathology is important.

38. B1 (thiamine): Glycolysis, TCA
Deficiency Rare; 7% in heart failure patients
Insufficiency % total, 12% of older women
Symptoms Wernicke syndrome, memory impairment, confusion, lack of coordination, paralysis
At-risk patients Older adults, malabsorptive conditions, heavy alcohol use.
Those with diabetes are at risk because of increased clearance
Dietary sources Fish, beans, lentils, nuts, rice, and wheat.
Raw fish, tea, and betel nuts impair absorption

39. CHEMISTRY
Thiamine is derived from substituted pyrimidine and thiazole which are coupled by a methylene bridge.
It is rapidly converted to its active form thiamin pyrophosphate (TPP) in the brain and liver by specific enzymes, Thiamin diphosphotransferase

40. Thiamin structure

42. Food sources Important sources of Vitamin B1 are: Fish, Beans,
Lentils,
Nuts,
Rice,
Meat, wheat, and milk

43. SENSITIVITY
Thiamin can be easily lost during cooking owing to its solubility in water,
Destroyed in presence of alkali and
sensitivity to prolonged exposure to heat.

44. Absorption & Metabolism
The bound forms of Thiamin are split in gastro-intestinal tract during digestion .
Absorbed mainly from duodenum and jejunum. Very little Thiamin is stored in body when thiamin intake is in excess of needs it is excreted in urine

45. Recommended Dietary Allowances
Infants less than 6 months mg/day
6 months to 1 year mg/day
1 – 3 years mg/day
4 – 6 years mg/day
7 – 10 years mg/day
11 – 14 years mg/day

46. Recommended Dietary Allowances
15 – 50 years Males 1.5 mg/day – Females1.1 mg/day
Over 60 years Males 1.2 mg/day –
Females 1.0 mg/day
Pregnant ladies mg/day
Lactating mg/day

47. RIBOFLAVIN B2

48. Major source of Energy in Living organisms
Living organisms including humans derive most of their energy from oxidation-reduction reactions.
These are processes which involve the transfer of electrons.
Flavin coenzymes participate in redox reactions in numerous metabolic pathways.

49. Major source of Energy in Living organisms
Flavins are critical for the metabolism of carbohydrates, fats, and proteins. Helps in releasing energy from carbohydrates.
FAD is part of the electron transport (respiratory) chain, which is central to energy production.

50. OTHER FUNCTIONS
B-2 is important for body growth and RBCs production
In treating anemia, adding Vitamin B-2 to iron supplements, increase its effectiveness.
Flavins also participate in the metabolism of some vitamins , minerals, drugs and toxins

51. OTHER FUNCTIONS
Riboflavin also helps to shore up the immune system by reinforcing antibody reserves, the body's first line of defense against infection.
In addition, the body uses extra riboflavin to keep tissue in good repair and speed healing of wounds, burns and other injuries.

52. Added Benefits of B-2
Carpal tunnel syndrome patients may benefit when B-2 and B-6 combination therapy is given.
Epithelial and mucosal tissues require riboflavin for their maintenance .
B-2 is also involved in oxidative degradation of short chain fatty acids.
It also has a role in transfer of oxygen from plasma to tissues.

53. B2 (riboflavin): FMN, FAD cofactors in glycolysis and oxidative pathways. B6, folate, and glutathione synthesis
10% to 27% of older adults
<3%; 95% of adolescent girls
Fatigue, cracked lips, sore throat, bloodshot eyes
Older adults, low intake of animal and dairy products, heavy alcohol use
Dairy, meat and fish, eggs, mushrooms, almonds, leafy greens, and legumes

54. Added Benefits of B-2
Riboflavin is helpful for maintaining the skin, nails, eyes, mouths, lips and tongue.
It is required for normal vision and prevention of cataracts.
Riboflavin is also thought to decrease the duration and frequency of migraine headaches in some people, When used with beta blockers

55. Riboflavin deficiency
Deficiency can result in:
Skin lesions
Light sensitivity
Eye disorders
Inflamed mouth or tongue, and
Cracks and sores at the mouth's corner.

56. Low levels of B-2 Arthritis Colon cancer Heart disease
Carpal tunnel syndrome
Multiple sclerosis
Anxiety, stress and fatigue

57. Arthritis

58. Carpal Tunnel Syndrome

59. Peshawar Medical College
Multiple sclerosis
Peshawar Medical College

60. Glossitis

61. Why Called Riboflavin ?
It is named riboflavin because of its structural similarity to Ribose (Sugar) and its relationship to the flavins.

62. Chemical structure of Riboflavin

63. Flavin Adenine Dinucleotide

64. Food Sources
The richest sources of riboflavin include organ meats such as liver, kidney and heart.
Milk, yeast, cheese, fish, eggs and dark green leafy vegetables are also rich sources.
Flour and cereals are enriched with riboflavin.

65. Absorption and Metabolism
Riboflavin is rapidly absorbed form upper part of small intestine and then phosphorylated in intestinal wall to its active form.

66. Distribution and excretion
Riboflavin is found in all cells of the body but maximum concentration is found in liver and kidneys.
With an increase in intake above needs, vitamin is excreted by kidneys.

67. Recommended Dietary Allowances (RDA)
Daily intake of 0.6 mg per 1000 calories for persons of all ages is recommended

68. RECOMMENDED DAILY INTAKE
Life stage
Age
Males mg/day
Females mg/day
Infants
0—12 months
Children
1-3
0.5
4-8
0.6
9-13
0.9
Adolescents
14-18
1.3
1.0
Adults
19+
1.1
Pregnancy
All ages
1.4
Lactation
1.6

69. Response to Physical state
Riboflavin is Heat stable but light sensitive.
It is easily destroyed by light, and foods stored in clear containers will lose their riboflavin content in a short period of time.
It can leach into cooking water

70. Deficiency of vitamin B2
Deficiency of riboflavin is one of the most common deficiency disease
A shortage of this vitamin may manifest itself as cracks and sores at the corners of the mouth, eye disorders, inflammation of the mouth/ tongue, and skin lesions.
Dermatitis, dizziness, hair loss, insomnia, light sensitivity, poor digestion, retarded growth, and slow mental responses have also been reported.