Vitamin

Jump to navigation Jump to search

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]


Overview

WikiDoc Resources for Vitamin

Articles

Most recent articles on Vitamin

Most cited articles on Vitamin

Review articles on Vitamin

Articles on Vitamin in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Vitamin

Images of Vitamin

Photos of Vitamin

Podcasts & MP3s on Vitamin

Videos on Vitamin

Evidence Based Medicine

Cochrane Collaboration on Vitamin

Bandolier on Vitamin

TRIP on Vitamin

Clinical Trials

Ongoing Trials on Vitamin at Clinical Trials.gov

Trial results on Vitamin

Clinical Trials on Vitamin at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Vitamin

NICE Guidance on Vitamin

NHS PRODIGY Guidance

FDA on Vitamin

CDC on Vitamin

Books

Books on Vitamin

News

Vitamin in the news

Be alerted to news on Vitamin

News trends on Vitamin

Commentary

Blogs on Vitamin

Definitions

Definitions of Vitamin

Patient Resources / Community

Patient resources on Vitamin

Discussion groups on Vitamin

Patient Handouts on Vitamin

Directions to Hospitals Treating Vitamin

Risk calculators and risk factors for Vitamin

Healthcare Provider Resources

Symptoms of Vitamin

Causes & Risk Factors for Vitamin

Diagnostic studies for Vitamin

Treatment of Vitamin

Continuing Medical Education (CME)

CME Programs on Vitamin

International

Vitamin en Espanol

Vitamin en Francais

Business

Vitamin in the Marketplace

Patents on Vitamin

Experimental / Informatics

List of terms related to Vitamin

Error creating thumbnail: File missing
Retinol (one vitamer of Vitamin A)

A vitamin is an organic compound required as a nutrient in tiny amounts by an organism.[1] A compound is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on the circumstances and the particular organism. For example, ascorbic acid functions as vitamin C for some animals but not others, and vitamins D and K are required in the human diet only in certain circumstances.[2] Vitamins are defined by their biological activity, not their structure. Thus, each "vitamin" actually refers to a number of vitamer compounds, which form a set of distinct chemical compounds that show the biological activity of a particular vitamin. Such a set of chemicals are grouped under an alphabetized vitamin "generic descriptor" title, such as "vitamin A," which (for example) includes retinal, retinol, and many carotenoids. [3] Vitamers are often inter-convertible in the body. The term vitamin does not include other essential nutrients such as dietary minerals, essential fatty acids, or essential amino acids, nor does it encompass the large number of other nutrients that promote health but that are not essential for life.

Vitamins have diverse biochemical functions, including function as hormones (e.g. vitamin D), antioxidants (e.g. vitamin E), and mediators of cell signaling and regulators of cell and tissue growth and differentiation (e.g. vitamin A) [4]. The largest number of vitamins (e.g. B complex vitamins) function as precursors for enzyme cofactor bio-molecules (coenzymes), that help act as catalysts and substrates in metabolism. When acting as part of a catalyst, vitamins are bound to enzymes and are called prosthetic groups. For example, biotin is part of enzymes involved in making fatty acids. Vitamins also act as coenzymes to carry chemical groups between enzymes. For example, folic acid carries various forms of carbon group – methyl, formyl and methylene - in the cell. Although these roles in assisting enzyme reactions are vitamins' best-known function, the other vitamin functions are equally important.[5]

Until the 1800s, vitamins were obtained solely through food intake, and changes in diet (which, for example, could occur during a particular growing season) can alter the types and amounts of vitamins ingested. Vitamins have been produced as commodity chemicals and made widely available as inexpensive pills for several decades,[6] allowing supplementation of the dietary intake.

History

Fruits and vegetables are often a good source of vitamins.

The value of eating certain foods to maintain health was recognized long before vitamins were identified. The ancient Egyptians knew that feeding a patient liver would help cure night blindness, an illness now known to be caused by a vitamin A deficiency. The advancement of ocean voyage during the Renaissance resulted in prolonged periods without access to fresh fruits and vegetables, and made illnesses from vitamin deficiency common among ship's crew.

In 1749, the Scottish surgeon James Lind discovered that citrus foods helped prevent scurvy, a particularly deadly disease in which collagen is not properly formed, causing poor wound healing, bleeding of the gums, severe pain, and death.[7] In 1753, Lind published his Treatise on the Scurvy, which recommended using lemons and limes to avoid scurvy, which was adopted by the British Royal Navy. This led to the nickname Limey for sailors of that organization. Lind's discovery, however, was not widely accepted by individuals in the Royal Navy's Arctic expeditions in the 19th century, where it was widely believed that scurvy could be prevented by practicing good hygiene, regular exercise, and by maintaining the morale of the crew while on board, rather than by a diet of fresh food.[7] As a result, Arctic expeditions continued to be plagued by scurvy and other deficiency diseases. In the early 20th century, when Robert Falcon Scott made his two expeditions to the Antarctic, the prevailing medical theory was that scurvy was caused by "tainted" canned food.[7]

In 1881, Russian surgeon Nikolai Lunin studied the effects of scurvy while at the University of Tartu in present-day Estonia.[8] He fed mice an artificial mixture of all the separate constituents of milk known at that time, namely the proteins, fats, carbohydrates, and salts. The mice that received only the individual constituents died, while the mice fed by milk itself developed normally. He made a conclusion that "a natural food such as milk must therefore contain, besides these known principal ingredients, small quantities of unknown substances essential to life".[8] However, his conclusions were rejected by other researchers when they were unable to reproduce his results. One difference was that he had used table sugar (sucrose), while other researchers had used milk sugar (lactose) that still contained small amounts of vitamin B.

In the Orient where polished white rice was the common staple food of the middle class, beriberi resulting from lack of vitamin B was endemic. In 1884, Takaki Kanehiro, a British trained medical doctor of the Japanese Navy observed that beriberi was endemic among low ranking crew who often ate nothing but rice but not among crews of Western navies and officers who were entitled to a Western-style diet. Kanehiro initially believed that lack of protein was the chief cause of beriberi. With the support of Japanese navy, he experimented using crews of two battleships, one crew was fed only white rice, while the other was fed a diet of meat, fish, barley, rice, and beans. The group that ate only white rice documented 161 crew with beriberi and 25 deaths, while the latter group had only 14 cases of beriberi and no deaths. This convinced Kanehiro and the Japanese Navy that diet was the cause of beriberi. This was confirmed in 1897, when Christiaan Eijkman discovered that feeding unpolished rice instead of the polished variety to chickens helped to prevent beriberi in the chickens. The following year, Frederick Hopkins postulated that some foods contained "accessory factors"—in addition to proteins, carbohydrates, fats, et cetera—that were necessary for the functions of the human body.[7] Hopkins was awarded the 1929 Nobel Prize for Physiology or Medicine with Christiaan Eijkman for their discovery of several vitamins.

In 1910, Japanese scientist Umetaro Suzuki succeeded in extracting a water-soluble complex of micronutrients from rice bran and named it aberic acid. He published this discovery in a Japanese scientific journal.[9] When the article was translated into German, the translation failed to state that it was a newly discovered nutrient, a claim made in the original Japanese article, and hence his discovery failed to gain publicity. Polish biochemist Kazimierz Funk isolated the same complex of micronutrients and proposed the complex be named "Vitamine" (a portmanteau of "vital amine") in 1912.[10] The name soon became synonymous with Hopkins' "accessory factors", and by the time it was shown that not all vitamins were amines, the word was already ubiquitous. In 1920, Jack Cecil Drummond proposed that the final "e" be dropped to deemphasize the "amine" reference after the discovery that vitamin C had no amine component.

Error creating thumbnail: File missing
Riboflavin (Vitamin B2)

Throughout the early 1900s, the use of deprivation studies allowed scientists to isolate and identify a number of vitamins. Initially, lipid from fish oil was used to cure rickets in rats, and the fat-soluble nutrient was called "antirachitic A". The irony here is that the first "vitamin" bioactivity ever isolated, which cured rickets, was initially called "vitamin A", the bioactivity of which is now called vitamin D.[11] What we now call "vitamin A" was identified in fish oil because it was inactivated by ultraviolet light. In 1931, Albert Szent-Györgyi and a fellow researcher Joseph Svirbely determined that "hexuronic acid" was actually vitamin C and noted its anti-scorbutic activity. In 1937, Szent-Györgyi was awarded the Nobel Prize for his discovery. In 1943 Edward Adelbert Doisy and Henrik Dam were awarded the Nobel Prize for their discovery of vitamin K and its chemical structure.



In humans

Vitamins are classified as either water-soluble, meaning that they dissolve easily in water or fat-soluble vitamins, which are absorbed through the intestinal tract with the help of lipids (fats). In general, water-soluble vitamins are readily excreted from the body. Each vitamin is typically used in multiple reactions and, therefore, most have multiple functions.[12]

In humans there are 13 vitamins: 4 fat-soluble (A, D, E and K) and 9 water-soluble (8 B vitamins and vitamin C).

Vitamin generic descriptor name Vitamer chemical name(s) Solubility Recommended dietary allowances
(male, age 19–70)[13]
Deficiency disease Upper Intake Level
(UL/day)[13]
Overdose disease
Vitamin A Retinoids
(retinol, retinoids
and carotenoids)
Fat 900 µg Night-blindness and
Keratomalacia[14]
3,000 µg Hypervitaminosis A
Vitamin B1 Thiamine Water 1.2 mg Beriberi N/D[15] Template:?
Vitamin B2 Riboflavin Water 1.3 mg Ariboflavinosis N/D Template:?
Vitamin B3 Niacin, niacinamide Water 16.0 mg Pellagra 35.0 mg
Vitamin B5 Pantothenic acid Water 5.0 mg[16] Paresthesia N/D Template:?
Vitamin B6 Pyridoxine, pyridoxamine, pyridoxal Water 1.3-1.7 mg Anaemia[17] 100 mg Impairment of proprioception, nerve damage
Vitamin B7 Biotin Water 30.0 µg Dermatitis, enteritis N/D Template:?
Vitamin B9 Folic acid, folinic acid Water 400 µg Deficiency during pregnancy is associated with birth defects, such as neural tube defects 1,000 µg Refer to deficiency of Vitamin B6
Vitamin B12 Cyanocobalamin, hydroxycobalamin, methylcobalamin Water 2.4 µg Megaloblastic anaemia[18] N/D Template:?
Vitamin C Ascorbic acid Water 90.0 mg Scurvy 2,000 mg Refer to Vitamin C megadosage
Vitamin D Ergocalciferol, cholecalciferol Fat 5.0 µg-10 µg[19] Rickets and Osteomalacia 50 µg Hypervitaminosis D
Vitamin E Tocopherols, tocotrienols Fat 15.0 mg Deficiency is very rare; mild hemolytic anemia in newborn infants.[20] 1,000 mg Template:?
Vitamin K phylloquinone, menaquinones Fat 120 µg Bleeding diathesis N/D Template:?

In nutrition and diseases

Vitamins are essential for the normal growth and development of a multicellular organism. Using the genetic blueprint inherited from its parents, a fetus begins to develop, at the moment of conception, from the nutrients it absorbs. It requires certain vitamins and minerals to be present at certain times. These nutrients facilitate the chemical reactions that produce among other things, skin, bone, and muscle. If there is serious deficiency in one or more of these nutrients, a child may develop a deficiency disease. Even minor deficiencies may cause permanent damage.[21]

For the most part, vitamins are obtained with food, but a few are obtained by other means. For example, microorganisms in the intestine—commonly known as "gut flora"—produce vitamin K and biotin, while one form of vitamin D is synthesized in the skin with the help of natural ultraviolet in sunlight. Humans can produce some vitamins from precursors they consume. Examples include vitamin A, produced from beta carotene, and niacin, from the amino acid tryptophan.[13]

Once growth and development are completed, vitamins remain essential nutrients for the healthy maintenance of the cells, tissues, and organs that make up a multicellular organism; they also enable a multicellular life form to efficiently use chemical energy provided by food it eats, and to help process the proteins, carbohydrates, and fats required for respiration.

Deficiencies

Deficiencies of vitamins are classified as either primary or secondary. A primary deficiency occurs when an organism does not get enough of the vitamin in its food. A secondary deficiency may be due to an underlying disorder that prevents or limits the absorption or use of the vitamin, due to a “lifestyle factor”, such as smoking, excessive alcohol consumption, or the use of medications that interfere with the absorption or use of the vitamin.[20] People who eat a varied diet are unlikely to develop a severe primary vitamin deficiency. In contrast, restrictive diets have the potential to cause prolonged vitamin deficits, which may result in often painful and potentially deadly diseases.

Because human bodies do not store most vitamins, humans must consume them regularly to avoid deficiency. Human bodily stores for different vitamins vary widely; vitamins A, D, and B12 are stored in significant amounts in the human body, mainly in the liver,[20] and an adult human's diet may be deficient in vitamins A and B12 for many months before developing a deficiency condition. Vitamin B3 is not stored in the human body in significant amounts, so stores may only last a couple of weeks.[14][20]

Well-known human vitamin deficiencies involve thiamine (beriberi), niacin (pellagra), vitamin C (scurvy) and vitamin D (rickets). In much of the developed world, such deficiencies are rare; this is due to (1) an adequate supply of food; and (2) the addition of vitamins and minerals to common foods, often called fortification.[13][20]

Side effects and overdose

In large doses, some vitamins have documented side effects that tend to be more severe with a larger dosage. The likelihood of consuming too much of any vitamin from food is remote, but overdosing from vitamin supplementation does occur. At high enough dosages some vitamins cause side effects such as nausea, diarrhea, and vomiting.[22][14] When side effects emerge, recovery is often accomplished by reducing the dosage. The concentrations of vitamins an individual can tolerate vary widely, and appear to be related to age and state of health.[23] In the United States, overdose exposure to all formulations of vitamins was reported by 62,562 individuals in 2004 (nearly 80% of these exposures were in children under the age of 6), leading to 53 "major" life-threatening outcomes and 3 deaths[24]—a small number in comparison to the 19,250 people who died of unintentional poisoning of all kinds in the U.S. in the same year (2004).[25]

Supplements

Dietary supplements, often containing vitamins, are used to ensure that adequate amounts of nutrients are obtained on a daily basis, if optimal amounts of the nutrients cannot be obtained through a varied diet. Scientific evidence supporting the benefits of some dietary supplements is well established for certain health conditions, but others need further study.[26]

In the United States, advertising for dietary supplements is required to include a disclaimer that the product is not intended to treat, diagnose, mitigate, prevent, or cure disease, and that any health claims have not been evaluated by the Food and Drug Administration.[26] In some cases, dietary supplements may have unwanted effects, especially if taken before surgery, with other dietary supplements or medicines, or if the person taking them has certain health conditions.[26] Vitamin supplements may also contain levels of vitamins many times higher, and in different forms, than one may ingest through food.[27]

Intake of excessive quantities can cause vitamin poisoning, most commonly for Vitamin A and Vitamin D. For this reason, most common vitamins have recommended upper daily intake amounts.

Effectiveness

Multivitamins may cause a small reduction in the incidence of cancer in men.[28] Multivitamins may not reduce cardiovascular disease in men.[29]

Governmental regulation of vitamin supplements

Most countries place dietary supplements in a special category under the general umbrella of foods, not drugs. This necessitates that the manufacturer, and not the government, be responsible for ensuring that its dietary supplement products are safe before they are marketed. Unlike drug products, that must explicitly be proven safe and effective for their intended use before marketing, there are often no provisions to "approve" dietary supplements for safety or effectiveness before they reach the consumer. Also unlike drug products, manufacturers and distributors of dietary supplements are not generally required to report any claims of injuries or illnesses that may be related to the use of their products.[30] [31]

Names in current and previous nomenclatures

The reason the set of vitamins seems to skip directly from E to K is that the vitamins corresponding to "letters" F-J were either reclassified over time, discarded as false leads, or renamed because of their relationship to "vitamin B", which became a "complex" of vitamins. The German-speaking scientists who isolated and described vitamin K (in addition to naming it as such) did so because the vitamin is intimately involved in the Koagulation of blood following wounding. At the time, most (but not all) of the letters from F through J were already designated, so the use of the letter K was considered quite reasonable.

The following table lists chemicals that had previously been classified as vitamins, as well as the earlier names of vitamins that later became part of the B-complex:

Previous name[32][33] Chemical name[32][33] Reason for name change[32]
Vitamin B4 Adenine DNA metabolite
Vitamin B8 Adenylic acid DNA metabolite
Vitamin F Essential fatty acids Needed in large quantities (does
not fit the definition of a vitamin).
Vitamin G Riboflavin Reclassified as Vitamin B2
Vitamin H Biotin Reclassified as Vitamin B7
Vitamin J Catechol, Flavin Protein metabolite
Vitamin L1[34] Anthranilic acid Protein metabolite
Vitamin L2[34] Adenylthiomethylpentose RNA metabolite
Vitamin M Folic acid Reclassified as Vitamin B9
Vitamin O Carnitine Protein metabolite
Vitamin P Flavonoids No longer classified as a vitamin
Vitamin PP Niacin Reclassified as Vitamin B3
Vitamin U S-Methylmethionine Protein metabolite

See also

References

  1. Lieberman, S, Bruning, N (1990). The Real Vitamin & Mineral Book. NY: Avery Group, 3.
  2. http://www.thefreedictionary.com/vitamin
  3. http://www.answers.com/topic/vitamer?cat=health#top See Oxford entry, accessed Jan 4, 2008.
  4. Accessed Jan 4, 2008
  5. Bolander FF (2006). "Vitamins: not just for enzymes". Curr Opin Investig Drugs. 7 (10): 912–5. PMID 17086936.
  6. Kirk-Othmer (1984). Encyclopedia of Chemical Technology Third Edition. NY: John Wiley and Sons, Vol. 24:104.
  7. 7.0 7.1 7.2 7.3 Jack Challem (1997). "The Past, Present and Future of Vitamins"
  8. 8.0 8.1 1929 Nobel lecture
  9. [1]
  10. Funk, C. and H. E. Dubin. The Vitamines. Baltimore: Williams and Wilkins Company, 1922.
  11. Bellis, Mary. Vitamins - Production Methods The History of the Vitamins. Retrieved 1 Feb 2005.
  12. Kutsky, R.J. (1973). Handbook of Vitamins and Hormones. New York:Van Nostrand Reinhold.
  13. 13.0 13.1 13.2 13.3 Dietary Reference Intakes: Vitamins The National Academies, 2001.
  14. 14.0 14.1 14.2 Vitamin and Mineral Supplement Fact Sheets Vitamin A
  15. N/D= "Amount not determinable due to lack of data of adverse effects. Source of intake should be from food only to prevent high levels of intake"(see Dietary Reference Intakes: Vitamins).
  16. Plain type indicates Adequate Intakes (A/I). "The AI is believed to cover the needs of all individuals, but a lack of data prevent being able to specify with confidence the percentage of individuals covered by this intake" (see Dietary Reference Intakes: Vitamins).
  17. Vitamin and Mineral Supplement Fact Sheets Vitamin B6
  18. Vitamin and Mineral Supplement Fact Sheets Vitamin B12
  19. Value represents suggested intake without adequate sunlight exposure (see Dietary Reference Intakes: Vitamins).
  20. 20.0 20.1 20.2 20.3 20.4 The Merck Manual: Nutritional Disorders: Vitamin Introduction Please select specific vitamins from the list at the top of the page.
  21. Dr. Leonid A. Gavrilov, Pieces of the Puzzle: Aging Research Today and Tomorrow
  22. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press, Washington, DC, 2001.
  23. Healthier Kids Section: What to take and how to take it.
  24. 2004 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.
  25. National Center for Health Statistics
  26. 26.0 26.1 26.2 Use and Safety of Dietary Supplements NIH office of Dietary Supplements.
  27. Jane Higdon Vitamin E recommendations at Linus Pauling Institute's Micronutrient Information Center
  28. Gaziano J, Sesso HD (2012-11-14). "Multivitamins in the prevention of cancer in men: The physicians' health study ii randomized controlled trial". JAMA: The Journal of the American Medical Association. 308 (18): 1871–1880. doi:10.1001/jama.2012.14641. ISSN 0098-7484. Retrieved 2012-11-16.
  29. Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M; et al. (2012). "Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial". JAMA. 308 (17): 1751–60. doi:10.1001/jama.2012.14805. PMID 23117775.
  30. Overview of Dietary Supplements
  31. Illnesses and Injuries Associated with the Use of Selected Dietary Supplements U. S. FDA Center for Food Safety and Applied Nutrition
  32. 32.0 32.1 32.2 Every Vitamin Page All Vitamins and Pseudo-Vitamins. Compiled by David Bennett.
  33. 33.0 33.1 Vitamins and minerals - names and facts
  34. 34.0 34.1 Michael W. Davidson (2004) Anthranilic Acid (Vitamin L) Florida State University. Accessed 20-02-07

General References Include:

  • Stedman's Medical Dictionary. Ed. Maureen Barlow Pugh et.al. 27th ed. Baltimore: Lippincott Williams & Wilkins, 2000.
  • Donatelle, Rebecca J. Health: The Basics. 6th ed. San Francisco: Pearson Education, Inc. 2005.

External links


Template:BranchesofFoodChemistry Template:Nutritional pathology


zh-min-nan:Bî-tá-mín bs:Vitamini bg:Витамин ca:Vitamina cs:Vitamín da:Vitamin de:Vitamine et:Vitamiinid el:Βιταμίνη eo:Vitamino eu:Bitamina fa:ویتامین fo:Vitamin gl:Vitamina ko:바이타민 hy:Վիտամին hr:Vitamini id:Vitamin is:Vítamín it:Vitamine he:ויטמין ka:ვიტამინები lv:Vitamīni lb:Vitamin lt:Vitaminas hu:Vitamin mk:Витамин ml:ജീവകങ്ങള്‍ mr:जीवनसत्त्व nl:Vitamine no:Vitamin nn:Vitamin nov:Vitamine oc:Vitamina simple:Vitamin sk:Vitamín sl:Vitamin sr:Витамини su:Vitamin fi:Vitamiini sv:Vitaminer ta:உயிர்ச்சத்து te:విటమిన్ th:วิตามิน uk:Вітаміни ur:حیاتین yi:וויטאמין


Template:WikiDoc Sources