Table 31-2.

Characteristics of Vitamin Deficiencies

Vitamin Purpose Deficiency Comments Source
WATER SOLUBLE
Thiamine Coenzyme in ketoacid Beriberi: polyneuropathy, Inborn errors of lactate Liver, meat, milk,
(B1) decarboxylation (e.g., calf tenderness, heart metabolism; boiling milk cereals, nuts,
pyruvate → acetyl-CoA failure, edema, destroys B1 legumes
transketolase reaction) ophthalmoplegia
Riboflavin FAD coenzyme in Anorexia, mucositis, Photosensitizer Milk, cheese,
(B2) oxidation-reduction anemia, cheilosis, liver, meat, eggs,
reactions nasolabial seborrhea whole grains,
green leafy
vegetables
Niacin (B3) NAD coenzyme in Pellagra: photosensitivity, Tryptophan is a precursor Meat, fish, live,
oxidation-reduction dermatitis, dementia, whole grains,
reactions diarrhea, death green leafy
vegetables
Pyridoxine Cofactor in amino acid Seizures, hyperacusis, Dependency state: Meat, liver, whole
(B6) metabolism microcytic anemia, deficiency secondary to grains, peanuts,
nasolabial seborrhea, drugs soybeans
neuropathy
Pantothenic CoA in Krebs cycle None reported Meat, vegetables
acid
Biotin Cofactor in carboxylase Alopecia, dermatitis, Bowel resection, inborn Yeast, meats;
reactions of amino acids hypotonia, death error of metabolism,* made by intestinal
and ingestion of raw eggs flora
B12 Coenzyme for 5-methyl- Megaloblastic anemia, Vegans; fish tapeworm; Meat, fish, cheese,
tetrahydrofolate peripheral neuropathy, short gut syndrome; eggs
formation; DNA synthesis posterior lateral spinal transcobalamin or
column disease, vitiligo intrinsic factor
deficiencies
Folate DNA synthesis Megaloblastic anemia; Goat milk deficient; drug Liver, greens,
neural tube defects antagonists; heat vegetables,
inactivates cereals, cheese
Ascorbic Reducing agent; collagen Scurvy: irritability, purpura, May improve tyrosine Citrus fruits, green
acid (C) metabolism bleeding gums, periosteal metabolism in preterm vegetables;
hemorrhage, aching bones infants cooking destroys it
FAT SOLUBLE
A Epithelial cell integrity; Night blindness, Common with protein- Liver, milk, eggs,
vision xerophthalmia, Bitot spots, calorie malnutrition; green and yellow
follicular hyperkeratosis; malabsorption vegetables, fruits
immune defects
D Maintain serum calcium, Rickets: reduced bone Prohormone of 25- and Fortified milk,
phosphorus levels mineralization 1,25-vitamin D cheese, liver;
sunlight
E Antioxidant Hemolysis in preterm May benefit patients with Seeds, vegetables,
infants; areflexia, ataxia, G6PD deficiency germ oils, grains
ophthalmoplegia
K Post-translation Prolonged prothrombin Malabsorption; breastfed Liver, green
carboxylation of clotting time; hemorrhage; elevated infants vegetables; made
factors II, VII, IX, X and protein induced in vitamin by intestinal flora
proteins C, S K absence (PIVKA)

*Biotinidase deficiency.
CoA, coenzyme A; FAD, flavin adenine dinucleotide; G6PD, glucose-6-phosphate dehydrogenase; NAD,
nicotinamide adenine dinucleotide.