1. By ,
Lekshmi.S
Pharm.D (P.B) III yr

2.  Vitamins are substances that are essential for normal
metabolism.
 Humans cannot synthesize any vitamins in the body
except some vitamin D in the skin and nicotamine
from tryptophan.
 Lack of particular vitamin may lead to a specific
deficiency syndrome
a) Primary (inadequate diet)
b)Secondary due to failure of
absorption (intestinal obstruction or chronic
diarrhoea or resection of intestine)
or to increased metabolic need
(growth, pregnancy, lactation and hyperthyroidism )

3.  Food is the best source of vitamins and minerals.
 Some people think that sub-clinical vitamin deficiency
causes much of chronic ill health and are liable to
infections.
 Excess vitamins are harmful.
 Most of the times the doctors prescribe vitamins as
supplement to drugs,which are not required.

4.  The British Medical Council says that most people
“obtain sufficient quantities of vitamins in their
diet, and it is therefore unnecessary in most cases to
take additional vitamins in the form of supplements”.

5.  The American Medical assosiation issued a statement
pointing out that: “ Healthy childrens and adults
should obtain nutrient intakes from dietary
sources.Meeting nutrient needs by choosing a variety
of foods in moderation ,rather than by
supplementation,reduce the potential risk for both
nutrient deficiencies and nutrient excess.”
 The manufacturing companies make a huge profit by
promoting them as health supplements ,growth
promoters,memory boosters,appetizers,skin
conditioners and so on.

6. Vitamin a
Uses:
 Vitamin A was the first fat-soluble vitamin identified (in 1913).
Vitamin A comprises the preformed retinoids, plus the precursor
forms, the provitamin A carotenoids .
 Vision, Immunity,Growth and development of tissues.
 Skin, hair, nails, and shields the skin from the harmful effects of
the sun's UV rays; and protects the membranes of brain cells.
RDA for vit A- 1,000 retinol eq for man and 800 retinol eq for
women
Deficiency: Night blindeness ,Xerophthalmia,keratomalacia.

7. Misuses
 Mothers administering large amounts of fish liver oils to
their children in the belief that it was good for them.
 Misguided pregnant health enthusiastic may take enough
self prescribed supplements to hazards a fetus.
 Toxic effects occur with prolonged high intake (in children
25000-5ooooo IU daily)
 Chronic signs- painful tender swellings on the long
bones, Anorexia, skin lesions, hair
loss, itching, hepatosplenomegaly, pappillodema,bleeding,
weight loss and general malaise
 Overdose may also cause outer layer of skin to peel
 The Teratology Society advices that supplements should
not exceed 8000 IU (2400 micro-grams) per day

8. VITAMIN C(ascorbic acid )
 Works as an antioxidant ,is needed for the manufacture of neurotransmitters
and cell structures,
 Helps preserve the elasticity of the skin and capillaries,
 Protects
 The lungs by preventing oxygen from converting into peroxides,
 Against bacteria and viruses, against heart and blood diseases,
 The body against the effects of pollutants (particularly the metals
lead, mercury, and aluminum) and chemical toxins (such as
formaldehyde, organic solvents, and pesticides).
 Reduces anxiety, and aids in restful sleep boosts the immune system,
 Helps wounds heal faster, helps the intestine absorb iron,
 Lowers blood cholesterol,
. Additionally, vitamin C, a natural antihistamine, increases alertness and
mental functioning, may help safeguard against and reduce the symptoms of
colds and flu.
 Deficiency : Scurvy.
 RDA- 60 -70 mg.

9.  Toxicity
 With too high a
dose, diarrhea, dizziness, gastritis, headaches, light-
headedness, nausea, and vomiting can occur, though these
may be just temporary. Rare symptoms include abdominal
pain and anemia.
 Daily dosages above 500 mg/day may deplete the level of
copper in the blood of males.
 Women taking 2000 mg or more a day may experience
fertility problems; individuals taking 2000 mg or more a
day may lower the resistance of their white blood cells to
fight one common form of bacteria,
 Those taking 3000 mg or more a day may experience
reduced levels of the amino acid cysteine in the blood.
 Dosages above 4000 mg/day can increase kidney stone
formation .
 Chewable vitamin C can lead to
severe dental erosion

10. VITAMIN D
ergocalciferol d2
cholecalciferol D3
 The best-known function of active vitamin D is to help
regulate blood levels of calcium and phosphorous.
 Vitamin D increases absorption of these minerals from
the gastrointestinal (GI) tract.
 In combination with parathyroid hormone, it enhances
their reabsorption from the kidneys and their mobilization
from bones into the blood.
 Vitamin D helps maintain calcium levels even if dietary
intakes are not optimal.
 Deficiency: Rickets, Osteomalacia
 RDA- 200IU

11. Toxicity:
 Malaise, drowsiness, nausea, abdominal
pain, thirst, constipation and loss of appetite.
 Long term effect – ectopic calcification anywhere in the
body, renal damage, renal calculi.
 Prolonged use in infants can cause mental and physical
retardation, kidney failure and death.
 Dangerous to exceed 10,000 units daily vit D in an adult
more than 12 weeks.
 Vit D supplements should be avoided in individuals
especially infants and children.
 Should not exceed 400 units a day.

12. VITAMIN B 12(cobalamin)
Anti –pernicious anemia vitamin
 Encourages RNA and DNA synthesis in nerve cells,
 Its needed for the transportation and storage of folic acid.
 Helps stabilize the brain's metabolism of carbohydrates
and proteins and its synthesis of myelin in the nerves .
 Plays an indirect role in making choline available for the
synthesis of neurotransmitters, protects against stress and
fatigue (promotes the release of energy in foods),
 Its an essential growth factor needed for healthy brain and
nerve function.
 RDA- 3µg for adults , 0.5 -1.5µg/day children.
 Deficiency- pernicious anemia, neuronal degeneration.

13. Toxicity
 Allergies to this vitamin are rare, and reactions (the
symptoms for which include acne, eczema, and a swelling
or crusting of skin around the lips) usually occur with
injections, rather than tablets.
 Rare side effects consist of itchy skin, wheezing, and
diarrhea.
 Life-threatening symptoms, usually resulting from
overdose, consist of faintness (from
anaphylaxis), hives, itching, and rash.

14. Vitamin B6
(Pyridoxine)
 Protects against stress and is needed by the brain for
transporting and metabolizing amino acids to develop
various neurotransmitters (such as
norepinephrine, serotonin, and dopamine) needed for
mental energy and memory.
 The vitamin also helps the immune system by producing
antibodies and red blood cells.
 Necessary for the proper functioning of the
thymus, spleen, and sexual organs.
 RDA- 2-2.2 mg/ day

15. TOXICITY
 Large dose of vit b6 cause severe nerve damage.
 Two B vitamins that should be avoided are vitamin
B15(pangamic acid) and vitamin b17 (laetrile)
 Laetrile contains 6% cyanide by weight , and has caused
chronic cyanide poisoning and death.
 Too much B-6 in the body can result in night restlessness a
vivid dream recall.
 More than 200 mg/day cause peripheral neuropathy
 Doses higher than 500 mg/day may be toxic, leading to
serious central nervous system problems, pain in the arms and
legs, a numbness or tingling in the hands and
feet, clumsiness, loss of balance, and difficulty in walking.
 High doses of B-6 can lead to increased susceptibility to
cadmium toxicity, cause peripheral neuropathy

16. VITAMIN E (tocopherol)
anti-sterility vitamin
 Vitamin E is a strong antioxidant, especially when
taken in conjunction with selenium.
 It also strengthens the immune system; enhances the
ability of brain cells to use oxygen;
 Increases the ability of cells to make energy; helps
preserve the lung function of elderly people;
 And it may slow the ageing process by protecting the
skin and brain cells (which have high percentages of
fat compared to the rest of the body's cells) from free
radicals (as people age, their ability to absorb E
decreases).
 RDA- 10mg for man, 8 mg for women.

17. Misuse
 No known toxicity up to 3200 IU, though it should not
be taken by those who are allergic to vitamin E.
 It can elevate blood pressure when first taken, so those
with high blood pressure or heart disease should not
take more than 200 IU
 vitamin E may cause blood clots if taken in doses
above 800 lU/day.
 symptoms are dizziness, and headaches. It may also
cause abdominal pain, diarrhea, fever, hives, chapped
lips, muscle aches, nausea, upset
stomach, fatigue, weakness, and blurred
vision, though these are rare.
 Allergies can also occur when vitamin E is used
in skin preparations, but these are extremely rare.

18. VITAMIN K phylloquinone K1
Menaquinone k2
Menadione K3
 Vitamin K helps in the activation of seven blood-clotting-
factor proteins that participate in a series of reactions to
form a clot that eventually stops the flow of blood.
 Vitamin K also participates in the activation of bone
proteins, which greatly enhances their calcium-binding
properties.
 Low levels of circulating vitamin K have been associated
with low bone-mineral density. Thus, an adequate intake
of vitamin K may help protect against hip fractures
 RDA-70-140µg/day

19. Misuses
 Prolonged consumption of megadoses of vitamin K
(menadione) results in anemia, which is a reduced level of
red blood cells in the bloodstream.
 When large doses of menadione are given to infants, they
result in the deposit of pigments in the brain, nerve
damage, the destruction of red blood cells (hemolysis), and
death.
 A daily injection of 10 mg of menadione into an infant for
three days can kill the child.
 This tragic fact was discovered during the early days of
vitamin research, when newborn infants were injected with
menadione to prevent a disease known as hemorrhagic
disease of the newborn. Today, a different form of vitamin
K is used to protect infants against this disease.

20. MARKETS
 Smith Kline Beecham advertised for Zevit : a multivitamin a
long list of indications“………mood alteration, loss of
libido, infertility, impotence, lethargy, depression”
 Abbott advertised its multivitamin with zinc as a product
that “ helps promote proper growth in children, helps
increase energy and vitality”
 Promoting vitamins as growth stimulants is a practice that
is both misleading and unethical.
 In 1992 ,UK, three vitamin manufacturer- seven seas, Raw
Power, Larkhall lab- were all prosecuted for claiming that
their vitamin products could increase children ’s
intelligence

21.  Pharmax promoted its Effico Tonic as “pick-me-up” to
“build up your appetite, restore your vitality, and allow
you to enjoy life to full again”
 In most countries , the market is littered with
ineffective products, with irrational combinations or
formulations, or with high dose vitamins posing an un
necessary threat to health and an additional financial
burden.

22. Conclusion
 Do not mislead: Vitamins may be required to
supplement an inadequate diet but never to
complement it.
 Vitamins provide a profitable market for the
pharmaceutical industry ,and a rent in the consumer’s
wallet.

23.  REFERENCES
 Multivitamins : Use or Misuse?Lt Col AS Menon*, Brig AS Narula+, Lt Col AG
Mathur#MJAFI 2008; 64 : 263-267.
 Handbook of Vitamins and Hormones R.J. Kutsky, New York: Van Nostrand-Reinbold, 1973.
 http://www.healthline.com
 AMERICAN ACADEMY OF PEDIATRICS Committee on Nutrition Vol. 107 No. 5 May
2001
 Rock Cheryl L. Multivitamin – Multimineral supplements:who use
them. Am J Clin Nutr 2007;85(suppl):2775-95.
 Goodman and Gilman’s The Pharmacological Bas Hillman, RS.
Hematopoietic agents: Growth factors, Minerals,and Vitamins: The
Vitamin B Complex and Ascorbic Acid. In:Hardman JG, Limbird
LE, Gilman AG, editors. Goodman and Gilman’s The Pharmacological
Basis of therapeutics.10th edition.McGraw Hill, 2001.1487-517.
 Biochemistry iii edition by Dr.U.Satyanarayana and Dr.U.Chakrapani

24.  Thank you…..