This document discusses three hematinic vitamins - iron, vitamin B12, and folic acid. It provides details on how iron is absorbed and distributed in the body, factors that can impede absorption, and effects of deficiency. For vitamin B12, it outlines that it is intricately linked to folate metabolism and involved in various metabolic processes. It notes manifestations of deficiency for both vitamins B12 and folic acid. Finally, it discusses uses of vitamins B12 and folic acid, particularly for megaloblastic anemia.
7. Iron
Iron is absorbed all over the intestine.
Absorbed
Directly
At luminal membrane- divalent metal transporter1(DMT1)
Basolateral membrane ferroportin (FP)
Iron is distributed
as haemoglobin in erythrocytes
Stored as ferritin and haemosiderin in liver spleen bone marrow
as myoglobin in muscles
as parenchymal iron in reticuloendothelial cells
as transferrin which are iron
-binding blood plasma glycoprotein
8. Factors impeding iron absorption
Antacids
Egg
Phytates (in maize and wheat)
Tetracyclines
Presence of other foods in the stomach
Mucosal block (ferritin curtain)
the gut has a mechanism of preventing entry of excess iron in the body
10. Effects of deficiency
Megaloblastic anaemia
Spina bifida of the foetus in case of pregnant women
Adverse effects:
Allergy
Anaphylaxis
12. Vitamin B12 :
Cyanocobalamin and hydrocobalamine
referred to as vit B12
Vit B12 is intricately linked to folate metabolism
Involved in protein synthesis
Involved in DNA production
Involved carbohydrate and lipid metabolism
Is utilised in thymidylate synthesis
13. Vitamin B12
required for the
the conversion of homocysteine to methionine
conversion of methylmalonyl-CoA to succinyl CoA
interconversion of leucine and beta leucine
Manifestations of deficiency :
Megaloblastic anaemia
Epithelial damage
Neural tube defect
General weakness
16. Folic Acid
Source:
liver, cereals, nuts, green vegetables
Pharmacokinetics:
Administered through oral or parenteral routes.
Absorbed from the proximal jejunum.
Widely distributed and stored in the liver
Function of Folic acid
It is the parent compound of folates
folates act as a cofactor in the formation of purine and pyrimidine
which is essential for DNA synthesis. Folate cofactor is also needed
in the formation of thymidylic acid.
17. Uses of vitamin B12 and folic acid
Megaloblastic anaemia:
Nutrtional folate deficiency
Increased demand-pregnancy, lactation, infancy, severe iron
deficiency
Pernicious anaemia (folate deficiency)
Malabsorption syndrome- tropical sprue coeliac disease,
Antiepileptic therapy causes megaloblastic anaemia
Prophylaxis of folate deficiency
Methotrexate toxicity are countered