Fat Soluble Vitamins e and K

FAT SOLUBLE
VITAMINS
-E AND K
V.NIKITHA SURYA
ROLL NO-241
VITAMIN E
 There are eight related
fat soluble substances
with vitamin E activity.
 The most important dietary
form is α-tocopherol.
Most imp dietary form => alpha-tocopherol
Rich: sunflower oil
Important: vegetables, nuts, seed oils , meats, cereal
grain
No RNI
Safe intake => 4mg(men) and 3mg(women)
Absorption, Transportation and
Storage
 VitaminE is absorbed in small intestine along with fats
with the help of bile salts.
 From the intestine, vitamin E is transported as
chylomicrons to the liver.
 From the liver, vitamin E is transported to other tissues,
mainly to adipose tissues and muscles. Adipose tissues
muscle and liver store vitamin E to a significant amount.
METABOLIC ACTIONS
 It prevents oxidation of polyunsaturated fatty
acids in cell membranes by free radicals.
 It helps maintain cell membrane structure.
 It affects DNA synthesis and cell signalling.
 It is involved in the anti inflammatory and immune
systems.
DEFICIENCY OF VITAMIN-E
• Human deficiency is
rare and has been
described only in
premature infants
and in
malabsorption
Premature infants:· Transfer of vitamin E from
maternal blood occurs during last few weeks of
pregnancy·
Premature infants will have vitamin E deficiency·
Impaired absorption: Seen in conditions such as·
abetalipoproteinemia (fat malabsorption), obstructive
jaundice and intestinal diseases such as celiac sprue.
Clinical features
Hemolytic anemia or macrocytic anemia seen in
premature infants
In adults, increased susceptibility of erythrocytes for
hemolysis under oxidative stress
Muscle weakness and proteinuria is seen
Contd..
Peripheral neuropathy -areflexia, ataxic gait, and
decreased vibration and position sensations..
Ophthalmoplegia, skeletal myopathy, and pigmented
retinopathy, visual scotomas
Treatment
Symptomatic : 800-1200 mg of alpha-tocopherol per day.
Abetalipoproteinemia : 5000-7000 mg/d.
Children with symptomatic deficiency : 400 mg/d orally
of water-miscible esters;
alternatively, 2 mg/kg per d may be administered
intramuscularly.
VITAMIN K
The name “K” comes from the German/Danish word
koagulations vitamin (clotting vitamin).
•Vitamin K is supplied in the diet mainly as vitamin K1
(phylloquinone) in the UK, or as vitamin K2
(menaquinone) from fermented products in parts of Asia.
Vitamin K2 is also synthesised by bacteria in the colon
•Vitamin K is primarily supplied by diet (green vegetables
like spinach and broccoli).
ABSORPTION
•Vit K is a fat soluble vitamin.
•Pancreatic and biliary function need to be intact for
proper vitamin K absorption.
•Dietary vitamin K is protein-bound and requires
pancreatic enzymes in the small intestine for liberation.
•Bile salts then solubilize vitamin K into luminal micelles
for absorption.
FUNCTIONS OF VITAMIN K
Vitamin K plays an important role in coagulation by
acting as a cofactor for the post-translational
carboxylation of coagulation factors II, VII, IX, and X.
Without carboxylation, coagulation reactions occur
slowly and hemostasis is impaired.
DEFICIENCY
Deficiency develops because of inadequate diet, use of
broad spectrum antibiotics, liver and pancreatic
disorders.
A patient not taking orally and is put on broad spectrum
antibiotics can develop Vit K deficiency in as little as 1
week.
CLINICAL FEATURES
There are no specific clinical features. Bleeding can
occur at any site.
Vitamin K deficiency is common in the newborn and can
manifest as hemorrhagic disease of the newborn. Hence,
parenteral Vit K is given routinely to newborns.
LABORATORY FINDINGS
In mild vitamin K deficiency only the PT is prolonged.
In severe Vit K deficiency both PT and aPTT are
prolonged, but PT is more prolonged than aPTT.
TREATMENT
Vitamin K should be replaced parenterally either
subcutaneously or intravenously.
A single dose of 15 mg will completely correct laboratory
abnormalities in 12–24 hours.

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FAT SOLUBLE

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