Water-Soluble Vitamins

Introduction

• Water-soluble vitamins include: B-complex group and vitamin C.
• These vitamins are not stored in the body in significant amounts and are excreted in urine, making it important to have a regular daily intake.

Vitamin B1 (Thiamine)

Importance

• Thiamine is essential for converting carbohydrates metabolism and plays a key role in maintaining the function of the nervous, cardiovascular, and musculoskeletal system.
• The Daily Requirements of an infant: 0.2-0.3 mg/day.

Sources

• Breast milk, infant formula, whole grains, legumes, nuts.

Deficiency

• The initial symptoms are nonspecific and may include fatigue, abdominal discomfort, anorexia, depression, and irritability.
• Wet Beriberi: cardiomyopathy with Congestive Heart Failure with generalized edema.
• Dry Beriberi: paresthesia, foot and wrist drop, peripheral neuritis, loss of deep tendon reflexes, loss of vibration ses, muscle atrophy, and can lead to nerve degeneration if not treated.
• Wernicke’s encephalopathy: Neurological disorder characterized by: ophthalmoplegia, ataxia, and confusion.
  
  

Vitamin B2 (Riboflavin)

Importance

• Riboflavin is important for energy production and metabolism. It also helps maintain healthy skin and eyes.
• The Daily Requirements of an infant: 0.3-0.4 mg/day.

Sources

• Breast milk, formula milk, eggs, green vegetables, fortified cereals.

Deficiency

• Ariboflavinosis: cheilosis (cracks at the corner of the mouth), and sore tongue.
• In severe cases: anemia and cataracts.

Vitamin B3 (Niacin)

Importance

• Niacin helps in energy production, and cellular metabolism.
• It also plays a role in maintaining the health of the digestive system, skin, and nervous system.
• The Daily Requirements of an infant: 2-4 mg/day.

Sources

• Breast milk, formula milk, Meat, fish, poultry, whole grains, and fortified cereals.

Deficiency

• This occurs in areas where corn is used as the primary grain; corn does not contain sufficient amounts of niacin
• Pellagra: Characterized by diarrhea, dermatitis, and dementia.

Vitamin B6 (Pyridoxine)

Importance

• Vitamin B6 is an important coenzyme, mainly involved in protein metabolism.
• It also supports cognitive development and immune function.
• The Daily Requirements of an infant: 0.1-0.3 mg/day.

Sources

• Breast milk, formula milk, poultry, fish, potatoes, and non-citrus fruits.

Deficiency

• Cause: metabolic defects, isoniazid overdose.
• Irritability, depression, confusion, and seizures (responsive to B6).

Vitamin B12 (Cobalamin)

Importance

• Vitamin B12 is essential for RBC synthesis, brain development, and DNA synthesis.
• The Daily Requirements of an infant: 0.42-0.5 µg/day.

Sources

• Breast milk, infant formula.
• Animal products such as meat, eggs, dairy, and fortified cereals.

Deficiency

• The most common cause in children is ileal disease (Crohn disease, short bowel syndrome).
• Megaloblastic anemia and neurological damage.
• Other symptoms include: developmental delays, lethargy, and weakness.

Folate (Vitamin B9)

Importance

• Folate is critical for cell division, DNA synthesis, and red blood cell production.
• The Daily Requirements of an infant: 65-80 µg/day.

Sources

• Breast milk, formula milk, leafy greens vegetables, fortified cereals, and citrus fruits

Deficiency

• Deficiency is a primary cause of hematologic problems, including leukocyte and cellular immune dysfunction.
• Folate deficiency is the second most common cause of nutritional anemia.
• Deficiency causes Megaloblastic anemia, characterized by fatigue and weakness.
• This deficiency is especially likely in:
  • An infant or child who consumes goat’s milk.
  • Patients with ileal resection—typically from necrotizing enterocolitis, Crohn disease, or intussusception

Excess

• High folate intake can mask vitamin B12 deficiency, potentially leading to neurological damage.

Vitamin C (Ascorbic Acid)

Importance

• Vitamin C is an antioxidant and is essential for collagen synthesis, wound healing, immune support, and the absorption of iron from plant-based foods.
• The Daily Requirements of an infant: 40-50 mg/day.

Sources

• Breast milk, formula milk, citrus fruits, berries, tomatoes, and green leafy vegetables

Deficiency

• Vitamin C (ascorbic acid) deficiency, also known as Scurvy, is rare in developed countries
• Vitamin C deficiency mostly occurs in children between 6 months and 2 years of age.
• Initial symptoms are nonspecific and include irritability, digestive disturbances, and anorexia.
• Manifestations of Scurvy
  1. Follicular hyperkeratosis, perifollicular hemorrhages, and “corkscrew-coiled” hairs.
  2. Mucocutaneous manifestations: petechiae, purpura, and gingival hemorrhage.
       
  3. Hematological manifestations: 75% of the patients have normochromic, normocytic anemia, hemarthrosis.
  4. Bone manifestations: brittle, and fragile bones.On X-ray: white lines of Frankel (a dense band at the growing metaphyseal end, involving the provisional zone of calcification)
      

Excess

• High doses can lead to nausea, diarrhea and increase the risk of kidney stones formation.

Summary