THE B IN B VITAMINS STANDS FOR BUMMER
I always mix up the stupid B vitamins and their actual names vs their number, and I told my internal med attending this and now I have to do a mini presentation tomorrow about B vitamins. So here is the handout I came up with, all basically from Step 1 First Aid.
B VITAMINS ARE COOL YEAH!
Vitamin B1 (th1am1ne)
- What does it do: cofactor for all the things in glucose breakdown
- Deficiency: impaired glucose breakdown = ATP depletion. Wernicke-Korsakoff. Beriberi (wet/dry). Seen in folks whose primary diet is husked white rice. Dx = increase RBC transketolase following thiamine administration
Vitamin B2 (riboflavin/r2b2)
- What does it do: component of FAD and FMN (source of e-), cofactors, kind of a big deal
- Deficiency: cheilosis, corneal vascularization, magenta-colored tongue
Vitamin B3 (niacin/sunglasses cat face—> B3 )
- What does it do: NAD+ and NADP+, redox rxns, Derived from tryptophan. Synth from B2 and B6. Used to tx dyslipidemia (lowers VLDL/raises HDL)
- Deficiency: glossitis. Pellagra (anything that decreases tryptophan absorption or inc metabolism) = diarrhea, dementia, dermatitis
- Excess: facial flushing, hyperglycemia, hyperuricemia
THERE IS NO B4!!!
Vitamin B5 (pantothenate/5 pants)
- What does it do: essential component of CoA and other things
- Deficiency: dermatitis, enteritis, alopecia, adrenal insufficiency
Vitamin B6 (pyridoxine/siX)
- What does it do: synthesis of lots of things (neurotransmitters, heme, molecules) and cofactor of transamination
- Deficiency: convulsions, hyperirritability, peripheral neuropathy, microcytic sideroblastic anemia, cheilosis/stomatitis. MCC etoh and isoniazid.
Vitamin B7 (biotin/ALMOST has 7 letters)
- What does it do: Cofactor for adding 1-carbon group
- Deficiency: dermatitis alopecia, enteritis, fasting hypoglycemia. Can be caused by eating too many raw egg whites (avidin binds biotin).
WHO NEEDS B8 NOT YOU
Vitamin B9 (folic acid/9 months of pregnancy)
- What does it do: converted to THF; synthesis of nitrogenous bases for DNA/RNA.
- Deficiency: macrocytic megaloblastic anemia, hypersegmented PMNs, glossitis, NO NEUROLOGIC SX. Increased homocysteine, normal methylmalonic acid. MCC deficiency in US, dt etoh or pregnancy.
10 and 11 ARE SILLY NUMBERS!!!
Vitamin B12 (cobalamin but who calls it that let’s be real)
- What does it do: cofactor for important things
- Deficiency: macrocytic megaloblastic anemia, hypersegmented PMNs, parathesias, subacute combined degeneration of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts. Increased homocysteine AND methylmalonic acid.