Vitamin B Introduction and its Deficiency

Vitamin B1 (Thiamine)

A water-soluble vitamin is thiamine. For the utilization of carbs, it is crucial. All naturally occurring foods include thiamine, albeit in trace amounts. If their mother's thiamine status is adequate, milk is a significant source of thiamine for babies. Cereal, which makes up between 60 and 85 percent of the overall supply, is the principal source of thiamine in a diet.

Deficiency

Beriberi

• Dry beriberi: The nerve involvement-characterized dry type. Irritability, exhaustion, and emotional disorders are among the symptoms.
• Wet beriberi: Heart involvement is a characteristic of the moist type. Palpitations, tachycardia, dyspnea, and edema are among the symptoms.
• Infantile beriberi: Infants between the ages of 2-4 months commonly develop infantile beriberi. The mother of the afflicted child typically breastfeeds him or her and frequently exhibits symptoms of peripheral neuropathy.

Treatment

• Thiamine injections 50–100 mg/day IM or IV, followed by 5–10 mg/day, for three days.
• Give food that contains thiamine.

Prevention

• Encourage the community to eat well-balanced, varied diets that incorporate foods high in thiamine.
• People were advised to give up all alcohol.
• Encourage folks to consume parboiled or coarsely ground rice instead of highly polished, fine food.
• Supplementaion of high-risk groups directly.

Vitamin B2 (Riboflavin)

Vitamins in the B category include riboflavin. It is essential for cellular oxidation. It functions as a co-factor in several enzymes important for energy metabolism. The natural foods that are highest in it are milk, eggs, liver, kidney, and green leafy vegetables. Pulses and cereals have more riboflavin after germination.

Deficiency

Angular Stomatitis

The most frequent condition linked to riboflavin deficiency is angular stomatitis, which usually affects children who are underweight.

Causes

•  Decreased dietary intake.
•  Malabsorption

Sign and Symptoms

• Cracking at the mouth's incline
• Glossitis: a sore and crack at the mouth's corner.
• The tongue swells and turns purple.
• Seborrhea, pruitis, and scaly dermatitis.
• Photophobia, dry eyes, and eye burning.
• Deficiency is typically detected right before and during the monsoon season.

Treatment

• Riboflavin 20mg/day in divided doses at first, then lower amounts as the healing process progresses.
• Give food that contains riboflavin.

Prevention

• Eat a range of foods high in riboflavin, including milk, green leafy vegetables, eggs, liver, kidney, and other organ meats, to prevent deficiency.

Vitamin B3 (Niacin)

The metabolism of carbohydrates, fats, and proteins depends on niacin, also known as nicotin acid. Additionally, it is necessary for the skin, intestines, and nervous system to function normally. Whole grains of cereal, pulses, groundnuts, liver, and other egg organ meats supply it.

Deficiency

Pellagra

Niacin deficiency causes the nutritional disease pellagra, which is widespread among the poor who mostly relied on maize for food.

Sign and Symptoms

The three Ds of dementia, dermatitis, and diarrhoea have collectively been referred to as the illness.

• The dermatitis is bilaterally symmetrical and affects the skin on the exposed regions of the body, particularly the neck, face, hands, and legs.
• The lesion is erythematous and resembles a severe sunburn. It may proceed to vesiculation, cracking, exudation, and crusting, as well as ulceration and, occasionally, secondary infection.
• Glositis, dysphasia, and nausea are frequently present alongside the diarrhea.
• Severe mental disturbances, such as sadness, agitation, and delirium, are possible.

Treatment

• Nicotinamide is administered orally for 14 days in doses of 100mg 8hrly.

Prognosis

• If left untreated, the illness can be fatal in four to five years.

Prevention

• Pellagra is a disorder that can be avoided.
• Everyone agrees that a healthy, well-balanced diet that includes milk and/or meat is a crucial component of both prevention and treatment.
• Because pellagra is a disease of poverty, it is crucial to avoid absolute reliance on maize or sorghum.

Vitamin B 6 (Pyridoxine)

There are three different types of vitamin B6 (pyridoxine): pyridoxine, pyridoxal, and pyridoxamine. It is crucial for the metabolism of carbohydrates, lipids, and amino acids. It is present in a variety of foods, including milk, meat, fish, eggs, liver, whole grains, and vegetables.

Deficiency

Peripheral neuritis

Peripheral neuritis is related to pyridoxine deficiency. A lack of riboflavin prevents pyridoxine from being used to its full potential. INH, an antituberculosis medication, is known as an antagonist, and patients on INH are frequently given pyridoxine supplements (10mg per day).

Causes

• Reduce your food consumption.
• Taking a medication, such as an oral contraceptive, isoniazid, or penocillamine hydralazine.

Sign and Symptoms

• The limbs' tingling sensation.
• Hyperaesthesia and nervous system impairment.
• Muscle spasm.
• Seizures in a newborn.
• A compromised immune system.

Treatment

•  Pyridoxine 20-50 mg/day for 14 days.

Prevention

• It is important to educate people about nutrition.
• Use of pyridoxine-rich foods on a regular basis, such as meat, beans, nuts, and whole grains
• Give the patient receiving INH a daily dosage of 10 mg pyridoxine.

Vitamin B12 (Preparation cyanocobalamine)

A cobalt atom is a complex organometallic molecule found in vitamin B12. Cyanocobalamine, a comparatively affordable preparation, is used therapeutically. Megaloblastic results from a lack of either vitamin B12 or folate, which work together to create DNA. The biological function of vitamin B12 in the formation of fatty acids in myelin is distinct from that of folate.

Sources

Liver, kidney, beef, fish, eggs, milk, and cheese are all excellent sources. Vegetarian diet does not include vitamin B12. Additionally, bacteria in the colon produce it. Vitamin B12 is more heat stable than folic acid.

Deficiency

Megaloblastic anemia

Megaloblastic anemia, a demyelinating spinal cord lesion, and infertility are all linked to vitamin B12 deficiency.

Causes

• Vitamin B12 nutritional deficit can develop in a patient who follows a strict vegetarian diet and consumes no animal products.
• Red blood cells are small in number and do not contain much hemoglobin. White blood cells and platelets are also produced in less quantity.
• Because they require an extra amount of their vitamin and frequently do not get enough supply in their diet, pregnant and lactating women, infants, and adolescents are particularly susceptible to this disease.

Sign and Symptoms

• Skin, mucous membranes, hand palms, and conjunctiva are all pale.
• Tachycardia
• Cardiac enlargement
• Edema
• Lassitude, exhaustion, and gasping for air when active.
• Palpitations and ear and head aching.
• Nausea and headache
• Insomnia

Treatment

• Determine the cause, then address it.
• Blood transfusion if anemia is severe.
• Boost your folate and vitamin B12 intake.
• Advice to consume foods high in vitamin B13, such as milk, liver, fish, eggs, and kidney.

Prevention

• Pregnant women receive an iron, folic acid, and vitamin B12 supplement.
• Determine the source of anemia quickly and treat it.
• Education about nutrition.

REFERENCE

Ambika Rai, Kabita Dahal. Community Health Nursing II. Kathmandu: Makalu Publication House, 2012 (reprint).

Dr.Suwal S.N. & Tuitui R. (2063) A Textbook of Community Health Nursing, 1st edition, Vidyarthi Prakashan (P). Ltd. Kamalpokhari, Kathmandu

Endres J.B & Rockwell R.E. (1985), 2nd edition, Food, Nutrition & the Young Child, Times Mirror/ Mosby College Publishing, Toronto, USA

HealthLine. 2005. 2017 http://www.healthline.com/desktop-article/symptoms-of-vitamin-b-deficiency?m=0&variation=nolb&stickytmr2=true&stickytimelb1=3&stickydepthtmr2=25&lazyloadscrolldepth=40

Medscape. 1994. 2017 http://www.medscape.com/viewarticle/719043