Vitamin B1 (Thiamine) is an essential vitamin required for carbohydrate metabolism. It is converted in the intestine to Thiamine pyrophosphate (TPP) which is the active form of Vitamin B1. The high risk factors for thiamine deficiency include old age, long term parenteral nutrition, hemodialysis, malabsorption or alcohol abuse. Severe deficiency causes congestive heart failure (wet beriberi), peripheral neuropathy (dry beriberi), Wernicke encephalopathy (a medical emergency that can progress to coma and death), and Korsakoff syndrome (often irreversible memory loss and dementia that can follow).
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Vitamin B2 is a component of water-soluble Vitamin B complex and is crucial for metabolism and energy production through oxidative phosphorylation. People at higher risk of developing Vitamin B2 deficiency include 1) Vegetarians who consume no/ little milk 2) Pregnant and lactating women and their infants 3) Person with chronic diarrhoea or malabsorption 4) Chronic alcoholics and 5) Infants with rare inborn error of Riboflavin transporter disorder.
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Niacin (also known as vitamin B3) is one of the water-soluble B vitamins. Niacin is the generic name for nicotinic acid (pyridine-3-carboxylic acid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside [1-3].
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1,25-Dihydroxy vitamin D plays a primary role in the maintenance of calcium homeostasis. A part of circulating 25-hydroxy vitamin D is converted to 1, 25-dihydroxy form in the kidneys. Patients who present with hypercalcemia, hyperphosphatemia and low PTH may suffer from unregulated conversion of vitamin D from mono-hydroxy to dihydroxy form as is seen in granulomatous diseases like Sarcoidosis and nutritionally induced Hypervitaminosis D.
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The clinical syndrome of Vitamin D deficiency can be a result of deficient production in the skin, lack of dietary intake, accelerated losses, impaired vitamin D activation or resistance to the biologic effects of vitamin D. In addition intestinal malabsorption of dietary fat leads to Vitamin D deficiency which is further exacerbated in the presence of terminal ileal disease. Intestinal calcium absorption is also controlled by vitamin D.
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Vitamin E helps in the maintenance of biomembranes of vascular and nervous systems & has anti-oxidant properties. This assay is useful for evaluating individuals with motor and sensory neuropathies. It is also useful for monitoring vitamin E status of premature infants requiring oxygenation. It is a useful test in persons with intestinal malabsorption of lipids.
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Vitamin K is required as a cofactor for the synthesis of Factors II, VII, IX & X and protein C & S. Deficiency leads to bleeding. Warfarin acts as an anticoagulant because it is a Vitamin K antagonist
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