Vitamin Deficiencies

Vitamin Deficiencies

Plan  :

• Introduction 
• Definition
• Classification
• Etiologies
• Conclusion

Goals

• Determine the role of vitamins
• Knowing vitamin deficiencies  

Vitamin Deficiencies

1. Introduction :

• Vitamins are essential components of human life. Even if they act in very small quantities, they can partly regulate genetic expression, embryonic development, immune functions, or hemostasis. 
• Their deficiency through loss or reduced absorption will lead to vitamin deficiencies which can, in certain cases, be fatal.
• Thirteen substances meet this definition:

– Vitamin A or retinol

– Vitamin D or calciferol

– Vitamin E or tocopherol

– Vitamin K

– Vitamin C

– Vitamin B1 or thiamine

– Vitamin B2 or riboflavin

– Vitamin B3 or PP or niacin

– Vitamin B5 or pantothenic acid

– Vitamin B6 or pyridoxine

– Vitamin B8 or biotin

– Vitamin B9 or folic acid

– Vitamin B12 or cobalamin

• Their deficiency due to malnutrition, malabsorption or other etiology can result in the appearance of serious pathological phenomena .

2.  Definition :

• Lack of vitamins : is due to the absence of vitamins due to total and lasting deficiency. 
• Hypovitaminosis , also called mild, relative, inapparent avitaminosis, detected by a biological examination 

• Vitamin is an organic substance required in small quantities for the metabolism of an organism which is not synthesized in sufficient quantities by the organism.
• Digestive malabsorption problems , nutritional imbalances and many other general pathologies will lead to poor assimilation of vitamins, subsequently causing deficits or even deficiencies.

3. Classifications :

• Hydro-soluble vitamins : 

By definition, soluble in water and not stored in the body: B1, B2, B3, B4, B5, B6, B8, B9, B12, C

• Lipo soluble vitamins : 

Fat-soluble vitamins are vitamins that are soluble in fat. Since our body naturally has fat reserves, this is where the fat-soluble vitamins will be stored. A, D, E, K1, K2•

4. The role of some vitamins 

 Vitamin A , 

It is abundant in animal foods such as liver

Beef, offal. This precious molecule is responsible for improving the vision of shapes and colors as well as adapting vision to darkness.

Vitamin A is also involved in the immune response and therefore in the fight against infections. 

Vitamin A precursors are found in plants: carrots, red palm oil, orange-fleshed sweet potato, mango, papaya, green leaves.

• Vitamin D in its two forms: ergocalciferol and cholecalciferol. This vitamin is exceptional since humans are able to synthesize it under the influence of UVB, its main role is the regulation of phosphocalcic metabolism. It is especially known for helping calcium build and keep strong bones . Vitamin D is also involved in the regulation of the immune system

• Vitamin C  : it is not produced by humans nor stored in the body, its only source is exogenous intake . This vitamin is a very important antioxidant that plays the role of protector of DNA, lipids and proteins against oxidizing agents.

• Vitamin B1 or thiamine which is present mainly in cereals and brewer’s yeast.

This molecule can be synthesized inside the human body by bacteria

intestinal, but this synthesis is insufficient to cover the needs. 

Its main role is the regulation of thiamine-dependent enzymatic reactions involved in glucose metabolism and the Krebs cycle.

• Vitamin B3 or niacin , present in all foods but particularly abundant in meat and fish.

Activation of this vitamin plays a central role in redox reactions.

5. Etiologies of vitamin deficiencies:

• Exogenous : due to insufficient intake 
• Endogenous : due to poor digestive absorption

** The main vitamin deficiencies concern:

• vitamin A: night blindness and xerophthalmia
• vitamin D: rickets and osteomalacia
• vitamin C: scurvy
• vitamin B1: Beriberi
• vitamin B3: pellagra 

1. Vitamin A deficiency :

• Vitamin A deficiency causes ophthalmological damage : initially, night blindness (loss of twilight and night vision), then conjunctival or corneal lesions, accompanied by (Bitot’s) spots, pathognomonic and reversible, resulting in xerophthalmia, preceding irreversible corneal lesions leading to blindness .
• The combination of measles and vitamin A deficiency results in acute corneal necrosis or keratomalacia.

            In extreme cases, this disease can lead to perforation of the globe.

             eyepiece subsequently leading to its loss. see photo n°1

Vitamin Deficiencies

Photo #1: Changes in the white of the eye in Avitaminosis A

2. Beriberi, vitamin B1 or Thiamine : 

• Beriberi occurs in children and adults fed exclusively on rice , and in infants if the mother is deficient . 

      It is an avitaminosis with cardiac signs (wet beri-beri: damage 

       subacute or chronic cardiac disease: heart failure, myocarditis

     , pericarditis and risk of sudden death) and/or neurological (dry beriberi:

       Acute or subacute ascending axonal, sensorimotor polyneuropathy

        acute). 

           Infantile Beriberi can lead to death from heart failure.

3. Vitamin C deficiency “scurvy” :  

• Scurvy is observed in populations deficient in vegetables and fruits. 
• It is an avitaminosis combining asthenia, fleeting edema, arthralgia, hemorrhagic manifestations ( purpura, hematomas, various hemorrhages), stomatological (gingivitis, periodontal disease), disorders of the skin and appendages, cardiac disorders. 
• It causes Barlow’s disease in infants : pain in the limbs 

      lower, typical “frog” attitude, swollen, hemorrhagic gums. 

             Scurvy responsible for abnormalities of the appendages and oral manifestations 

             severe leading to periodontal lysis with a risk of tooth loss , without

            forget about cardio-respiratory and nervous manifestations. 

             The progression of scurvy without treatment is always fatal.

4. Rickets (Vit D deficiency) :

Common rickets affects children aged 6 to 24 months. 

The main cause of hypovitamin D rickets is sun deficiency, but also dietary vitamin D deficiency

            The damage is mainly osseous. It is characterized by a defect in 

            bone mineralization leading to several bone malformations and deformations

             as well as a weakening of the bone which promotes the occurrence of very serious fractures 

       especially at the growing age. 

If left untreated, this disease progresses to cachexia and then death. See photo no. 2 

Vitamin Deficiencies

                                                                      Photo #2: Rickets

5. Folic Acid or Vitamin B9 Deficiency :

• Folic acid or vitamin B9 is present in most natural foods (green vegetables, fruits, milk, meat). 
• It is destroyed by 50% by prolonged cooking. 
• The etiological factors of Vit 9 deficiency are a deficiency of intake (West Africa, India) or a deficiency of absorption : intestinal malabsorption syndrome, taking medication (pyrimethamine: Malocide®).
• Folic acid deficiency is mainly observed in children and pregnant women at the end of pregnancy.
• It is characterized by clinical signs : pallor, glossitis, diarrhea, neuropsychiatric disorders , exceptionally combined sclerosis of the spinal cord, and by macrocytic , aregenerative anemia, with medullary medulloblastoma (megaloblastic anemia).

6. Vitamin B12 deficiency :

• Vitamin B12 deficiency, which is common, has the following main etiologies: Biermer’s disease , vitamin B12 non-dissociation syndrome , vitamin B12 deficiency resulting from an absorption disorder due to gastrectomy  ,
• ileal resection, tropical sprue. 
• It is expressed by various neurological syndromes : combined spinal cord sclerosis, peripheral neuropathy , cerebellar syndrome and isolated optic neuropathy.

       A hematological assessment (CBC, myelogram), a vitamin B12 dosage and MRI

       medullary and/or cerebral constitute the key to the diagnosis

7. Avitaminosis B3 or pellagra  : 

It is characterized by the three Ds : dermatitis, diarrhea and dementia. This vitamin deficiency

      can also be fatal.

8. Mixed deficiencies :

• Mixed deficiencies are very common to explain anemia, in particular deficiencies in iron and folates, but also in vitamins B6, B12 and C.

6. CONCLUSION

 The role of vitamins seems to be underestimated, these substances found in minimal quantities in food are essential to our lives. Their intake through food is therefore essential for the harmonious functioning of our body. 

Vitamin Deficiencies

Deep cavities may require root canal treatment.
Interdental brushes effectively clean between teeth.
Misaligned teeth can cause chewing problems.
Untreated dental infections can spread to other parts of the body.
Whitening trays are used for gradual results.
Cracked teeth can be repaired with composite resins.
Proper hydration helps maintain a healthy mouth.
 

Vitamin Deficiencies