Thiamine
Deficiency: Beriberi and W-K syndrome seen in alcoholism and malnutrition
Function: in TPP, a cofactor for oxidative decarboxylation of alpha keto acids (pyruvate, alpha-ketoglutarate) and a cofactor for transketolase in the HMP shunt.

Dry Beriberi: polyneuritis, muscle wasting

Wet Beriberi: high-output cardiac failure (dilated CM), edema

Found in leafy green veggies
Deficiency: night blindness, dry skin
Funciton: constituent of visual pigments
Excess: arthralgias, fatigue, headaches, skin changes, sore throat, alopecia, get excess from eating polar bear liver and isoretinin Tx
Other: can be of benefit in measles infection, all-trans retinoic acid is used to Tx PML and is through to induce maturation of leukemic cells.

Riboflavin

Deficiency: angular stomatitis, cheilosis, corneal vascularization

Function: cofactor in oxidation and reduction (FADH2)

FAD and FMN are derived from riboFlavin

Deficiency: Pellagra (dermatitis, diarrhea, dementia and beefy glossitis). Deficiency can be caused by Hartnup disease (↓Trp absorption), malignant carcinoid syndrome (↑Try metabolism) and INH (↓B6)

Function: constituent of NAD+, NADP+, and derived from Tryp using B6

Pantothenate

Deficiency: dermatitis, enteritis, alopecia, adrenal insufficiency

Function: constituent of CoA and a component of fatty acid synthase

Deficiency: convulsions, hyperirritability, peripheral neuropathy. Can be induced by INH or OCPs.

Function: converted to pyridoxal phosphate, a cofactor used in transmination (AST, ALT), decarboxylation and heme synthesis. Also a necessary cofactgor in the synthesis of delta-aminolevulinic acid which is increased in lead poisoning.

Deficiency: macrocytic, megaloblastic anemia; neurologic Sx (optin neuropathy, subacute combined degeneration, paresthesia), glossitis

Funtion: cofactor for honocycteine methylation (transfers CH3 groups as methylcobalamin) and methylmalocyl-CoA handling. Stored in liver 9large pool). Synthesized only by microorganisms

Deficiency is usually caused by malabsorption (sprue, enteritis, diphyllobothrium latum), lack of IF or absence of terminal ileum (crohns). Use schilling test to detect deficiency. Abnormal myelin is seen in B12 deficiency, possibly dues to decreased Met or increased methylmalonic acid from metabolism of accumulated methylmalonyl-CoA

Defective intestimal and renal absorption of Trp which is necessary for nicotinic acid, serotonin, melatonin.

Clinical: malabsorption of trp, niacin deficiency. Most children are asymptomatic but some experience photosensitivity and pellagra-like skin rashes. Neurological-mainly ataxia and all Sx wax and wane

Lab: main finding is amino aciduria restricted to the neutral amino acids (alanin, serine, threonine, valine, leucine, isoleucine, pehnylalanine, tyrosine, trp, his). The urinary excretion of proline, hydroxyproline and agrginine remain unchanged which differentiates it from other causes of generalized aa aciduria such as Facnconi syndrome.

most common vitamin deficiency in US. Cuses macrocytic, megaloblastic anemia (no neuro sx).

Function: coenzyme (THF) for 1C transfer; involved in methylation rxns and important for the syntsis of notrogenous bases in DNA and RNAs. Drugs that cuse deficiency: EtOH, methotrexate, OCPs, trimethoprim, 5-FU

FOLate comes from FOLiage

PABE is the folic acid precursor in bacteria. Sulfa drugs and dapsone are PABA analogs

Deficiency: dermatitis, enteritis, caused by antibiotic used, ingestion of raw eggs

Function: cofactor for carboxylations:

1. Pyruvate → oxaloacetate

2. Acetyl-CoA → melonyl-CoA

3. propionyl-CoA → methylmalonyl-CoA

Deficiency: scurvy.

Function: necessary for hydroxylation of proline and lysine in collagen synthesis. Facilitates iron absorption by keeping Fe in the 2+ states. Necessary cofactor for dopamine → NE

also keeps THF in reduced form so deficiency may produce macrocytic anemia