VITAMIN DEFICIENCY

DISEASES
PYRIDOXINE & FOLATE

By-
V.Janarthanan
II-MBBS
PYRIDOXINE :
Vitamin B6
>Pyridoxine, pyridoxal , pyridoxamine
&their 5'-
phosphate derivatives
 RDA :

Infants – 0.3 – 0.6 mg

Children – 1.0 – 1.4 mg
Males – 1.7 – 2.0 mg
Females – 1.4 – 1.6 mg
Pregnancy – 2.2 mg
Lactation – 2.1 mg
 SOURCES :
• Plants contain vitamin B6 in the form of pyridoxine
• Animal tissues contain PLP and pyridoxamine
phosphate
• The vitamin B6 contained in plants is less
bioavailable than that from animal tissues
• Rich food sources of vitamin B6 include legumes,
nuts, wheat bran, and meat, although it is present in
all food groups.
 COENZYMES :
• 5'-Pyridoxal phosphate (PLP)

• Cofactor for more than 100 enzymes involved in

amino acid metabolism

• Also involved in heme and neurotransmitter

synthesis and in the metabolism of glycogen,
lipids, steroids, sphingoid bases, and several
vitamins, including the conversion of tryptophan
to niacin.
 DEFICIENCY :
• Seborrhea
• glossitis
• convulsions
• neuropathy
• depression
• confusion
• microcytic anemia
 ETIOLOGY :
• Niacin intake/day - <0.2 mg

• Alcoholism, isoniazid

• Deoxypyridoxine, methoxypyridoxine

• Isoniazid, L-dopa, penicillamine, and cycloserine

interact with PLP due to a reaction with carbonyl
groups
 CLINICAL PICTURE :
• Epithelial changes, as seen frequently with other B
vitamin deficiencies

• In infants, diarrhea, seizures, and anemia have been

reported

• Microcytic, hypochromic anemia

• Inflammation and elevated C-reactive protein levels.

 LAB DIAGNOSIS :
• low plasma PLP values (<20 nmol/L).

ADD-ONS :
 Used to treat carpal tunnel syndrome, premenstrual
syndrome, schizophrenia, autism, and diabetic
neuropathy but have not been found to be effective

 Vitamin B6 should not be given with L-dopa

 Pyridoxine should be given concurrently with

isoniazid to avoid neuropathy
 TREATMENT :
• 50 mg/d

• 100–200 mg/d are given if vitamin B6 deficiency

is related to medication use
 TOXICITY :
• The safe upper limit for vitamin B6 has been set at
100 mg/d.

• Severe sensory neuropathy, leaving patients

unable to walk.

• Some cases of photosensitivity and dermatitis

have also been reported.