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Neurotropic B group vitamins play crucial roles as coenzymes in the nervous system. Particularly Vitamin B1 (Thiamine), Vitamin B6 (Pyridoxine) & Vitamin B12 (Cobalamin) contribute essentially to the maintenance of a healthy nervous system. Vitamin B1 acts as a site-directed antioxidant; Vitamin B6 balances nerve metabolism; Vitamin B12 maintains myelin sheaths.Their importance is highlighted by many neurological diseases related to deficiencies in one or more of these vitamins. Deficiencies of these vitamins can occur mainly in elderly individuals, diabetics, alcoholics, dialysis patients, patients with gastrointestinal diseases etc. and may lead to neurological disturbances e.g. Peripheral neuropathy. On the other hand neurological adverse effects like ataxia, sensory neuropathy etc. have been demonstrated with long-term or high dose use of these vitamins specially Vitamin B6.
Vitamins are essential constituents of human diet since they are synthesized inadequately or not at all in human body. Vitamin deficiencies affect all ages, the groups most susceptible to deficiencies are pregnant and lactating women, young children because of relatively high need, chronically ill patients and alcoholics. After gastric bypass surgery patients are at high risk of multiple vitamin deficiencies. Conversely, because of widespread use of nutrient supplements, nutrient toxicities are also gaining pathophysiological and clinical importance. Laboratory investigations play an important role in detecting subclinical deficiencies as well as probable toxicities in asymptomatic patients.
Serum folate concentrations are affected by diet whereas RBC folate is a more reliable indicator of folate status. This assay is useful for identification of folate deficiency when serum folate is normal but there is a high clinical suspicion of nutritional deficiency. It is used in the evaluation of individuals with low serum levels of both folate and iron.
25-Hydroxy vitamin D represents the main body reservoir and transport form. Mild to moderate deficiency is associated with Osteoporosis / Secondary Hyperparathyroidism while severe deficiency causes Rickets in children and Osteomalacia in adults. Prevalence of Vitamin D deficiency is approximately >50% specially in the elderly. This assay is useful for diagnosis of vitamin D deficiency and Hypervitaminosis D. It is also used for differential diagnosis of causes of Rickets & Osteomalacia and for monitoring Vitamin D replacement therapy.
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.
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. Vitamin D also helps in the homeostatic mechanisms of calcium, phosphorus and alkaline phosphatase.
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.
Deficiencies of vitamin D or vitamin B12 cause mild chronic ailments and serious diseases. Eating a well-balanced diet might not provide enough of these vitamins for individual needs. Vitamin B12 deficiencies often result from restricted diets & modern lifestyles which limit exposure to sunlight also reduce the amount of vitamin D.
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.
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.
Vitamins are essential constituents of human diet since either they are synthesized inadequately or not at all in human body. Vitamin deficiencies affect all ages, the groups most susceptible to deficiencies are pregnant and lactating women, young children because of relatively high need, chronically ill patients and alcoholics. After gastric bypass surgery patients are at high risk of multiple vitamin deficiencies. Conversely, because of widespread use of nutrient supplements, nutrient toxicities are also gaining pathophysiological and clinical importance. Laboratory investigations play an important role in detecting subclinical deficiencies as well as probable toxicities in asymptomatic patients.