B vitamin deficiency: symptoms, diagnosis and treatment

PANTOTHENIC ACID (VITAMIN B5)

GENERAL INFORMATION

Vitamin B5 ( pantothenic acid ) is a water-soluble vitamin, so it does not stay in the body for long and requires constant replenishment of its reserves. Vitamin B5 in its pure form was isolated in 1939 from the liver of mammals. Like other B vitamins, pantothenic acid is an active substance necessary for every living organism. In 1940, it was possible to elucidate the chemical structure of pantothenic acid and carry out its synthesis in the form of a calcium salt (calcium pantothenate). Pantothenic acid formula C9H1705N.

Pantothenic acid is widely distributed in natural foods of animal and plant origin, and therefore its name comes from the Greek word "pantos", which means "omnipresent". Pantothenic acid is found in all tissues of animals and plants, mainly in bound form, but is also found in free form.

The empirical formula of the compound is C9H17N O5

Despite the ubiquity of pantothenic acid in nature, a person may experience a deficiency of the substance. The abundance of white bread, semi-finished products, chips, canned foods and the lack of fresh vegetables, fruits, and meat products in the diet leads to the fact that vitamin B5 practically does not enter the body, as a result of which hypovitaminosis occurs.

Due to a deficiency of the compound, metabolism primarily suffers, digestion worsens, and the immune-protective function decreases. A person becomes susceptible to inflammatory processes - ARVI. This is due to the fact that Pantothenic acid and coenzyme A synthesized with its participation are involved in many processes: in the oxidation of fatty acids and carbohydrates, in the synthesis of amino acids, fatty acids, ketones, cholesterol, phospholipids, steroid hormones, neurotransmitters (for example, acetylcholine) and antibodies

In order for pantothenic acid to be preserved in maximum quantities in dishes, you should avoid eating frozen, canned foods, foods with a long shelf life that contain vinegar essence, and also cook in the most gentle mode: over low heat, extremely quickly under a closed lid.

Requirement of humans and animals for pantothenic acid

Establishing the exact human need for pantothenic acid is a rather difficult task due to the inability to take into account the utilization of pantothenic acid synthesized by intestinal microflora. To assess a person's need for pantothenic acid, an indirect approach was used, based on determining the content of pantothenic acid in a normal diet that does not cause any manifestations of deficiency of this vitamin. Similar studies carried out in the USA showed that a person receiving an average of about 10 mg of pantothenic acid per day with a diet containing 2500 calories and consisting of plant and animal products. A diet containing 6 mg of pantothenic acid per day is clearly insufficient. Therefore, it is believed that a dose of 10 mg per day most adequately reflects a person’s daily need for pantothenic acid.

To assess the level of pantothenic acid in the human body, determination of the concentration of pantothenic acid in the blood and its excretion in the urine is usually used. Since the data of various authors on the content of pantothenic acid in the blood and its excretion in urine are very contradictory and depend on research methods, it is currently difficult to indicate generally accepted values.

The rate of acetylation of sulfonamides in vivo can be used as a functional biochemical test to determine the body's supply of pantothenic acid. Typically, for this purpose, the animal is administered a certain dose of sulfonamide and the excretion of acetylated sulfonamide is examined in hourly urine samples. Since acetylation is carried out with the participation of acetyl-CoA, this method provides information about the body’s supply of the active form of pantothenic acid - coenzyme A. The test proposed by Quick for the release of hippuric acid with the introduction of sodium benzoate can serve for the same purposes. However, it should be borne in mind that since acetylation of sulfonamides and benzoylation of glycine (synthesis of hippuric acid by CoA) occurs in the liver, both methods described can only be used as a test to assess pantothenic acid availability when examining healthy people without any diseases liver.

PHYSICOCHEMICAL CHARACTERISTICS

Vitamin B5 is a viscous substance of light yellow color with a melting point of 80 degrees. The compound dissolves well in acetic acid, water, ethyl, and poorly in ether, amyl alcohol, and organic solvents. Calcium pantothenate, reacting with water, forms colorless crystalline salts: calcium, sodium. Vitamin B5 is thermolabile. It is especially unstable when heated in alkalis and acids, hydrolyzing with the release of a,g-dioxy-b lactone, pantolactone, b-alanine at the amide bond. In neutral solutions, calcium pantothenate and its salts are relatively stable.

Amide - pantothenamide, pantothenol - produced by B5, are formed in the process of replacing the carboxyl group with an alcohol group. The latter compound has high vitamin activity for animals and, as a result, acts as an acid antagonist for a group of microorganisms.

Another, no less valuable, substance in living nature is panthetheine, obtained by reacting calcium pantothenate with b-mercaptoethylamine (cysteamine). When oxidized, it is converted into disulfite - pantethine. The bioproduct of pantothenic acid is part of coenzyme A.

METABOLISM OF VITAMIN B5

Every day, the intestinal microflora of a healthy body synthesizes 3.4 milligrams of vitamin B5. After food intake, pantothenic acid is absorbed by diffusion directly from the intestine into the blood and tissues, where it is subsequently captured by red blood cells and actively transformed into coenzyme forms - coenzyme A and phosphopantothein. The remaining part of the substance circulates in the body in a free state. The catabolism of organic compounds of non-protein nature is based on their hydrolysis, while “waste” calcium pantothenate and its metabolites are excreted in the urine.

Vitamin B5 is sensitive to heat; heat treatment of foods rich in the beneficial compound leads to a loss of 50% of the substance. It is destroyed not only under the influence of dry heat (grill, oven), but also as a result of exposure to solutions of acids and alkalis that are used in food processing, for example, during canning and freezing.

It is important to remember that pantothenic acid is found in foods exclusively in protein form and is released with the help of enzymes.

Natural springs

If there is a lack of pantothenic acid in the body, it is enough to diversify your daily diet with food ingredients such as soybeans, brewer's yeast, green peas, apples, buckwheat, rice bran, white wheat bread, peanuts, champignons, cocoa powder, barley, flax seeds , cauliflower, asparagus, avocado, dates, dried apricots, broccoli, rye bread, garlic, pumpkin, potatoes, onions and tomatoes.

Particular attention to the listed ingredients should be paid to people who are professionally involved in sports, as well as those people who are prone to individual episodes of developing colds.

You can buy vitamins in Odintsovo at any time. It is important to remember that a diet rich in carbohydrates impairs the absorption of pantothenic acid. Canning and heat treatment of products containing vitamin B5 leads to a loss of the volume of this element in an amount of 50% or more of the original amount. During the freezing process, the amount of vitamin B5 in food ingredients is reduced by 34%.

IMPORTANCE OF VITAMIN B5

Pantothenic acid is involved in protein, fat, carbohydrate metabolism, cholesterol metabolism, the synthesis of a number of hormones, hemoglobin, promotes the absorption of amino acids and sugars in the intestines, and supports the function of the adrenal cortex. A lack of pantothenic acid can lead to damage to the skin and mucous membranes.

Vitamin B5 is a structural component of the key substance of metabolism - coenzyme A, which is involved in all types of metabolism - protein, lipid, carbohydrate, in the synthesis of hemoglobin, choline, the neurotransmitter acetylcholine, corticosteroids, adrenal hormones and in the processes of detoxification of the body by transferring acyl residues.

Considering the fact that vitamin B5 and its derivatives interact with a large number of substances inside our body, it is impossible to list them completely. However, in order to be convinced of the significance of the connection, we will consider the most significant of them. These are cholesterol, acetylcholine, fats, fatty acids, histamine, hemoglobin, amino acids, carbohydrates.

Participating in the synthesis and metabolic processes of such a variety of substances, for the proper functioning of all systems and internal organs, it is important to ensure a regular supply of calcium pantothenate in sufficient quantities.

Let's look at why the body needs vitamin B5.

1. Activity of the adrenal glands. Scientists have proven that the cortex of these organs is the most efficient gland in humans, which is capable of producing hormones for six hours a day, but for this it needs significant reserves of calcium pantothenate in order to fight pathogenic microbes and increased psycho-emotional stress. First of all, , the acid is involved in the synthesis of hormones of the endocrine glands. At the formation stage, all glucocorticoids are associated with coenzyme A, and one way or another, their production in sufficient quantities is a reliable prevention of allergies, colitis, arthritis, and heart diseases. Vitamin B5 has an anti-inflammatory effect. Participating in the course of metabolic processes in the adrenal cortex, it synthesizes glucocorticoids, which “turn on” the body’s protective reaction in the event of the introduction of foreign microorganisms.
2. Synthesis of fatty acids. As you know, these monobasic carbonic substances are necessary for the connection of fats and normal brain function. As a result, vitamin B5 normalizes metabolism and activates human mental activity. As a side effect, fat deposition in the body is regulated. Therefore, pantothenic acid is an essential vitamin for weight loss and eliminating metabolic problems.
3. The work of the nervous system. Calcium pantothenate is involved in the synthesis of mediators, hormones, neurotransmitters, which ensure the proper development of the nervous system in children, adolescents, and adults. Daily intake of 5 milligrams of vitamin B5 prevents the onset of Alzheimer's disease and senile dementia. One of the most important reactions occurring with the participation of pantothenic acid in the body human - the conversion of choline into acetylcholine, through which communication signals (impulses from the sensory organs) pass, which explains the high concentration of the beneficial compound in brain cells.
4. Maintaining immunity. Unlike vitamins A and E, which fight free radicals, bacteria, viruses, activating the body’s protective function, the biological role of pantothenic acid is the synthesis of antibodies. B5 deficiency leads to a sharp decrease in the amount of immunoglobulins, as a result, a person becomes more vulnerable to the harmful influence of pathogens from the outside.
5. Normalization of cholesterol metabolism. Calcium pantothenate inhibits the process of plaque clogging of arteries by regulating the synthesis of fatty acids. Thanks to this property, vitamin B5 is a natural “drug” that effectively fights atherosclerosis.
6. Energy production. Pantothenic acid triggers the process of lipolysis in the body - the release of triglycerides from fat cells and their subsequent burning. These procedures are accompanied by the production of additional energy, which is needed during intense physical activity and increased mental work.
7. Promotes rapid healing of wounds, tissue renewal, and restoration of the barrier properties of mucous membranes.
8. Relieves depressive disorders, forgetfulness, absent-mindedness, doubts.
9. Prevents side effects from antibiotics.
10. Reduces pain in rheumatoid arthritis.

In addition, pantothenic acid is needed to maintain healthy skin and hair. It prevents the formation of wrinkles, the premature appearance of age spots, and inhibits early gray hair. By participating in the synthesis of corticosteroids and hemoglobin, B5 has a positive effect on the fight against stress.

Calcium pantothenate is the only vitamin that can be absorbed through the skin; thanks to this property, the substance is used in the production of anti-burn medications and cosmetics.

Thus, it is extremely difficult to overestimate the positive properties of organic matter, since the slightest deficiency will immediately affect the functioning of almost all organs and systems.

HYPOVITAMINOSIS OF VITAMIN B5

Let's consider the sequence of manifestation of symptoms of pantothenic acid deficiency.

1. Fatigue, increased fatigue. The reason for the appearance of these reactions is that calcium pantothenate is consumed at the highest rate in the muscles, and the lack of the compound in the muscles leads to a decrease in the performance of the body as a whole.
2. Nervous disorders. First of all, hypovitaminosis leads to sleep disturbances. Further, as a result of chronic lack of sleep, the functioning of the central nervous system deteriorates, psycho-emotional stress occurs, burning in the toes, and depression develops.
3. Headaches, muscle pain. Athletes especially often experience pain in their muscles when they are deficient in B5. This phenomenon occurs as a result of metabolic disturbances, which lead to complete utilization of lactic acid. As a result, the athlete experiences muscle pain and feels tired, like after a hard marathon.
4. Deterioration of the condition of the skin (the appearance of dermatitis, seborrhea, eczema), hair loss, slower growth and brittleness of the nail plate.
5. Digestive disorders. In the first stages, the characteristic symptoms of pantothenic acid hypovitaminosis in the human body are lack of appetite and nausea; if the lack of organic compounds is not corrected, chronic indigestion of food, constant occurrence of diarrhea, constipation, peptic ulcer, gastritis and cholecystitis develop.
6. “Burning” attacks of pain in the legs at night (not cramps), accompanied by sharp redness of the skin in the area of ​​the feet.
7. Metabolic disorders that lead to hormonal imbalance in women. These problems are especially dangerous during menopause, as they can cause not only sudden changes in pressure, but also ataxia.
8. Slowing (rarely stopping) growth in adolescents, weight loss.
9. Exhaustion caused by indigestion and constant fatigue.
10. Weakening of the immune system, susceptibility to acute respiratory diseases.
11. Kidney dysfunction associated with improper production of various hormones. As a rule, problems with the urinary organs occur extremely rarely, in advanced stages of hypovitaminosis.
12. Diseases of the heart and blood vessels caused by impaired synthesis of glucocorticoids and cholesterol. Clogged arteries lead to the development of atherosclerosis.
13. Visual impairment (in some cases, blindness).

During World War II, “burning feet” syndrome was widespread among prisoners of war in Japanese camps, which resulted from severe disruption of a healthy diet. In addition, pantothenic acid deficiency in soldiers was accompanied by impaired mental activity, central scotoma, pallor of the optic nerves, and blurred vision. At the same time, the inclusion of 30 milligrams of a mixture of B vitamins in the diet eliminated these phenomena and relieved patients from glossitis, stomatitis, diseases of the cornea, sclera, and conjunctivitis.

FACTORS THAT CAUSE B5 DEFICIENCY

Let's consider the reasons why the body begins to experience a deficiency of the substance.

1. Long-term use of sulfonamides and antibiotics. These drugs block the synthesis of active derivatives of vitamin B5. As a result, even with an abundance of pantothenic acid in food, the body may experience a deficiency of the compound.
2. Lack of proteins and fats in the daily menu. Taking proteins and triglycerides speeds up and facilitates the absorption of calcium pantothenate. Therefore, for men, women, and children who follow vegetarianism and a raw food diet, they should carefully approach the formation of their diet in order to prevent the compound from not being absorbed.
3. Lack of vitamins B1, B2, C, which are actively involved in the synthesis of pantheine and coenzyme-A.
4. Digestive disorders (deterioration of food absorption) - malabsorption syndrome. In case of development of this disease, food with a high content of useful organic compounds passes through the body in transit (non-absorption of nutrients from food).

Pantothenic acid deficiency leads to diseases of the blood, skin, nails, duodenal ulcers, and hypoglycemia.

Considering the fact that vitamin B5 is included in many products of plant and animal origin, deficiency of the compound in the human body is a rare phenomenon, which, in most cases, occurs due to an unbalanced diet or under the influence of factors that contribute to neutralization or non-absorption useful substance.

Hypervitaminosis B5 is more common. Excess of the compound is non-toxic to humans. A single injection of 500 milligrams of calcium pantothenate intravenously does not cause side effects from the body. In rare cases, dehydration, insomnia, agitation, increased heart rate, headache, and nausea are observed.

THE BODY'S NEED FOR PANTOTHENIC ACID

Physiological needs for pantothenic acid according to Methodological recommendations MP 2.3.1.2432-08 on the norms of physiological needs for energy and nutrients for various groups of the population of the Russian Federation:

• There is no upper permissible consumption level.
• The physiological requirement for adults is 5 mg/day (introduced for the first time).
• The physiological need for children is from 1.0 to 5.0 mg/day (introduced for the first time).

Table 1. Recommended daily intake of pantothenic acid depending on age (mg):

Additional intake of calcium pantothenate is prescribed in the following cases:

• for infectious diseases;
• consumption of low-calorie foods;
• intense physical activity;
• in the postoperative period;
• during times of stress;
• people of retirement age (over 55 years old);
• for polyneuritis, neuralgia, bronchial asthma, disorders of the central nervous system, diseases of the gastrointestinal tract;
• to improve the condition of nails, hair, skin;
• during the period of antibiotic use.

Only the attending physician can determine the required daily dose of the compound.

In case of progression of dermatological diseases, one of the fundamental treatment drugs is pantothenic acid, which is prescribed in a dose significantly higher than the daily norm for a healthy person (up to 1500 milligrams per day).

To combat acne, the dosage of B5 increases to an impressive amount - up to 10,000 units per day.

Vitamin B1

Cellular energy booster that promotes growth and development. Vitamin B1 increases mental and physical performance, improves detoxification function and metabolism in the nervous system. It also improves mood, has a mild analgesic and wound-healing effect.

Vitamin B1 deficiency causes various disorders in the nervous, cardiovascular and digestive systems. To compensate for its deficiency, include buckwheat, corn, cashews, and lentils in your diet.

Main symptoms of vitamin B1 deficiency

• loss of appetite;
• violation of movement coordination;
• depression, nervousness;
• weakening of cognitive functions (memory loss);
• muscle weakness.

An extreme form of vitamin deficiency is Beriberi disease, which damages the peripheral nerves or the cardiovascular system. As a result, muscles, especially the legs, become exhausted, severe pain appears in the calves, weakness develops, and gait worsens.

Causes of Vitamin B1 Deficiency

• constant consumption of refined products (high-grade flour and products made from it, polished rice);
• increased need for vitamin (pregnancy, breastfeeding, stress, physical activity, infections);
• chronic diseases (diabetes mellitus, thyrotoxicosis, antibiotic poisoning, alcoholism);
• smoking;
• Excessive consumption of tea and coffee, as caffeine destroys vitamin B1.

If you notice that your mood has worsened, cramps have appeared in the calf muscles, and your appetite has disappeared against the background of constant stress, perform the study 95-10-201 - Vitamin B1 (thiamine) in CITILAB. The analysis helps to identify vitamin B1 deficiency, prescribe medications in a timely manner and adjust the diet.