Vitamins and Minerals - The Magic Elixir…if wisely used!

Vitamins

Introduction
Understand the Concept of Daily Vitamins and Minerals Requirements
A glance at Vitamins and Minerals Vital Functions
Vitamin A
Vitamin D
Vitamin E
Tocotrienols: A more potent Vitamin E
Vitamin K
Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B5
Vitamin B6
Folic Acid
Vitamin B12
Vitamin C

Minerals

Iodine
Iron
Calcium
Magnesium
Selenium
Molybdenum
Zinc
Copper
Chromium
Phosphorus
Potassium
Recent Updates
References

Introduction

Vitamins are complex chemicals that are vital for general well being. Unlike animals, human can produce vitamins n the body, thus must be gained from daily diet. They are 13 major vitamins namely Vitamin A, C, D, E, K, and the 8 B complex vitamins- thiamine (B1), riboflavin (B2), niacin (B3), folic acid, biotin (vitamin H), pantothenic acid (B5), pyridoxine (B6), and cobalamin (B12). Vitamins provide zero calories, thus they would not make you fatter.

Vitamins A, D, E, and K are fat-soluble vitamins. They are absorbed from the intestine into the bloodstream together with fat (in fact, a healthy gastrointestinal tract is critical for good absorption for all vitamins). Deficiency of these vitamins may occur due to impaired absorption of fat or too little from the diet. Vitamins A, D, E, and K are stored in the liver and reserves of some of them, which may last for several years. Thus, too much of these vitamins could be harmful as they cause build up to a harmful level in the body if excessive.

Vitamin B and C are water- soluble vitamins. Most of them are stored in the body for a very short period of time and rapidly excreted by the kidneys if excessive amount of these vitamins are taken in excess. However, vitamin B12 is exceptional as it is stored in the liver and may hold up to four year's supply. These vitamins are easily lost in cooking. So, uncooked foods rich in these vitamins must be eaten regularly. Otherwise, they must be supplemented through some form of health food supplement. An overdose of water-soluble vitamins are not common, except for large dosages of vitamin C and pyridoxine (B6). Overdose adverse reactions of these vitamins are not life threatening, and are usually reversible once the intake is reduced.

Minerals are elements, which are essential in trace amount for general well being. People with intestinal diseases, are usually supplemented with minerals as a result of reduced absorption of minerals from the diet. Among the essential minerals are calcium, magnesium, iron, iodine, phosphorus, copper, and zinc. Other mineral such as selenium is gaining interest among nutritionists and biochemist in the area of its potent antioxidant property.

Understand the Daily Vitamins and Minerals Requirements

Our daily vitamins and minerals requirements are based on the   guidelines called Recommended Dietary Allowances (RDAs). The  basis of RDA is the minimum daily requirement necessary for  preventing deficiency. However, individual requirements may  vary. The RDAs are in fact several times the minimum requirement and do not cover individual due to acquired or  inherited disease. RDAs are designed to cover the needs of 95%  of population concerned generally.

A glance at Vitamins and Minerals Vital Functions

Vitamin A

Vitamin A need not to be replenished daily, as it can be stored in your body. 90% of the vitamin A is stored in the liver with the rest stored in the kidney and adrenal gland. Vitamin A presents in two forms- preformed vitamin A (retino from animal origin) and provitamin A (carotene from plant origin- the carotenoid). Integrity of the intestinal mucosa and the overall nutritional status of the individual are key to influence the bioavailability and digestion of vitamin A and carotenoids. The overall absorption of dietary vitamin A is 80-90%, but is only 50-60% for beta-carotene. Absorption of both vitamin A and beta-carotene fall at higher doses.Signs of Vitamin A deficiencies:

• Loss of appetite
• Retardation of growth
• Nervous system disorders
• Skin disorders
• Defective reproduction
• Night blindness
• Xerophtalmia
• Blindness
• Increased infection (respiratory tract in particular)
• Keratinization of epithelial tissues
• Nephritis
• Metaplastic and spongy bones
• Cysts of endocrine and other glands

• Promote growth, strong bones, healthy skin, hair, teeth and gums
• Aid in the treatment of hyperthyroidism
• Aid in the treatment of emphysema
• Help in treating acne and open ulcers (topical application)
• Aid in the treatment  of many eye disorders

• Dosage ranging from 10,000 I.U to 25,000 I.U
• Xerophthalmia
• Night blindness

Recommended Daily Intake/Allowances (RDI/RDAs):

• Fish liver oil, liver
• Milk, margarine,  and dairy products
• Eggs
• Carrots, green and yellow vegetables
• Yellow fruits
  

Toxicity

Dosage more than 100,000 I.U per day for many months for adults  and dosage more than 18,500 I.U per day for infants
Symptoms: hair loss, nausea, vomiting, diarrhoea, scaly skin,  blurred vision, rashes, bone pain, irregular menses, fatigue, headaches, and enlarged liver
Reversible once the intake is reduced to RDA status

Vitamin D

Generally, there are two most prominent members of Vitamin D namely ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Ergocalciferol is the principal form of vitamin D that is derived from a common plant steroid, is the usual dietary source of vitamin D. Cholecalciferol is the form of vitamin D produced by human body when the skin is exposed to ultraviolet light.Both vitamin D2 and D3 are stored in body fat.  In the liver, they are metabolized to 25-hydroxyvitamin D, and then to 1,25-dihydroxyvitamin D (biologically functioning vitamin D). Vitamin D’s main function is to increase the efficiency of intestinal calcium absorption, and to mobilize calcium stores from bone in order to maintain homeostasis of calcium and phosphorus concentrations along with two peptide hormones, calcitonin and parathyroid hormone (PTH).Signs of Vitamin D deficiencies:

• Rickets in children
• Severe tooth decay
• Senile osteoporosis
• Osteomalacia (demineralization of adult skeleton) in adults- especially among night shift workers when exposure to sunlight is minimal
• Muscle weakness
• Bony deformities
• Neuromuscular irritability with muscle spasms of the larynx and hands
• Generalized convulsions and tetany

• Maintaining the homeostasis (normal physiological range) of calcium and phosphorus in the body- helps in managing osteoporosis
• Optimize utilization of calcium and phosphorus for strong bones and teeth
• Along with Vitamin A and C, it can aid in preventing cold
• Aid in treatment of conjunctivitis

• Metabolic bone disorders due to inborn and acquired disorders
• Rickets in children
• Osteomalacia in adults
• Severe liver failure (25-hydroxyvitamin D3 is used)

Recommended Daily Intake/Allowances (RDI/RDAs):
(Assumption: sufficient exposure to sunlight)

• Milk with fortified vitamin D
• Fatty fish (salmon and mackerel)
• Cod liver oil, fish liver oil
• Egg yolks

• Hypercalcemia, kidney stones, and soft tissue calcification with dosage in excess of 5,000 – 10,000 I.U per day.
• Tolerable Upper Limit: 1000 I.U for baby 0- 12 months, older children and adult, including pregnant and lactating women at 2000 I.U per day.

Vitamin E

Vitamin E includes eight naturally occurring compounds in two classes namely tocopherols and tocotrienols. Among the 8 isomers of tocopherols, alpha-tocopherol is the most effective vitamin E as a potent antioxidant. Lately, a more powerful antioxidant group, the tocotrienols are gaining interest among researchers in the antioxidant arenas. Although vitamin E is fat-soluble, water-soluble vitamin E is now available commercially. Usually, 20-40% of orally ingested tocopherol are absorbed. As the dose increases, the percentage of absorption decreases. Water-soluble vitamin E is twice more effective absorbed than the fat-soluble one.

Signs of Vitamin E deficiencies:

• Neurological abnormalities
• Immunological abnormalities
• Hemolytic anemia
• “Clinkers” in the form of brown ceroid alike pigment  in the uterus, lymph nodes, spleen, liver, kidney, brain, muscles, body fat, walls of blood vessels, and the sex, adrenal, and pituitary glands. This pigment is the result of oxidized unsaturated fatty acids
• Premature birth
• Pulmonary embolism (80% of stroke patients are grossly deficient in vitamin E)
  In general, vitamin E deficiency occurs rarely in human.

• Antioxidant property keep you looking younger by retarding cellular aging
• Protect your lungs against pollutants by working together with vitamin A
• Prevent blood clots and aid in preventing coronary thrombosis
• Prevent baby’s red blood cells breakdown (leading to jaundice)
• Aid in alleviating fatigue
• Minimize and prevent thick scar formation (topical use)
• Help accelerate healing of burns
• Lower blood pressure through its diuretic property
• Alleviate leg cramps
• Necessary for the formation of the nucleus of each body cell, including RNA and DNA
• Reduce the demand for oxygen thus aid in preventing rapid cells breakdown
• Prevent premature birth
• Prevent hernias
• Prevent and reverse calcium deposition in soft tissue due to mobilization of calcium from bones
• Increase the number, quality, and motility of sperm
• Prevent defective newborn
• Prevent congenital heart abnormalities if given Vitamin E daily from early babyhood
• Lower LDL cholesterol (particularly the tocotrienols)
• Retard breast cancer cell growth by tocotrienols
• Increase uptake of iodine and protein-bound iodine thus preventing abnormal thyroxin production- preventing goiter
  

• Heart attack prevention
• Nephritis
• Phlebitis
• Varicose veins

Recommended Dietary Allowances (RDAs):

Requirement for vitamin E increases with higher intakes of polyunsaturated fatty acids (PUFA). The recommended ratio as follow:

E (mg)/PUFA (g) = 0.4

Polyunsaturated fatty acids inhibit vitamin E absorption!
Ideal intake is depending on factors such as other antioxidants, age, environmental pollutants, and physical activity.Food source:

• Soybean, Safflower, Corn, Sunflower seeds,
• Nuts, Whole grains, Wheat Germs

• Relatively safe
• Adverse events can be seen at doses as high as 3200mg per day
• Contraindicated when a coagulation defect is present due to vitamin K deficiency or in individuals with anticoagulant drugs.

Tocotrienols

A more potent Vitamin ETocotrienol is a novel antioxidant in the treatment of hypercholesterolemia (high cholesterol) and cancer. Tocotrienols are a form of vitamin E with an unsaturated side chain, rather than a saturated side-chain of the more common tocopherols. The TRF fraction contains 80% tocotrienols and 20% alpha-tocopherol. In the early isolation of vitamin E from plant oils, the proposed term tocopherols were used to name the initial four compounds that shared similar structure. Tocopherol also known as vitamin E, which plays an important role as the major lipid soluble antioxidants, which protect our bodies against free radical damage. A wealth of studies exist on vitamin E's role in reducing the risk of developing heart disease and other debilitating illnesses with as little intake as 100 I.U. daily.

In addition to the four tocopherols, another related series of compounds, tocotrienols, have been discovered which are less widely distributed in nature. While tocopherols are predominantly found in corn, soybean and olive oils, tocotrienols are particularly rich in palm, rich bran and barley oils. Therefore, vitamin E is the term used for eight naturally occurring essential fat-soluble nutrients: alpha, beta, delta & gamma tocopherols plus a class of compounds related to vitamin E called alpha, beta, delta and gamma tocotrienols. Interestingly, tocotrienols have been shown to elicit powerful antioxidant, anti-cancer and cholesterol lowering properties. Some studies have confirmed that tocotrienol activity as an antioxidant, anti-cancer and cholesterol reducing substance to be much stronger than tocopherols, have ranked them to be the most important class of nutritional compounds for the prevention and treatment of disease.Tocotrienol and Cholesterol Lowering With a strong relationship between atherosclerosis and cholesterol, much attention has been given by pharmaceutical companies namely Merck-Sharp-Dome(MSD), Bristol-Myer-Squibb(BMS), Novartis and Warner Lambert to develop new cholesterol lowering agents of which have turned the entire company around significantly with products namely Zocor(simvastatin), Pravachol(pravastatin), Lescol(fluvastatin) and Lipitor(atorvastatin) respectively.

The global lipid lowering agents market (prescription market) is now being valued at US$6-7 billions and will reach US$10 billions in year 2001. Malaysia market is now valued at US$ 7 millions and estimated reaching US$10 million by year 2002. Over-the-counter market estimated at least 2-3 times higher than the prescription market base and it will grow with CAGR of 20-25% annually.Unfortunately, all the lipid-lowering drugs somehow exert adverse effects to some extent though insignificant. To complete this arsenal of non-toxic beneficial nutrients, tocotrienols have demonstrated significantly important activity in regulating the synthesis of cholesterol and acting as a potent antioxidant and anti-tumor agent.The mechanism by which tocotrienols exert their cholesterol lowering effect involves the suppression of the enzyme, HMG-CoA reductase (similar to the effect by the blockbuster statins: Zocor, Pravachol and Lipitor), responsible for its synthesis. Therefore, tocotrienols decrease the liver's capacity to manufacture cholesterol.

In a double blind, crossover study, serum concentration of total cholesterol and thromboxane (a potent inducer of platelet aggregation and vasoconstriction) decreased significantly in only those subjects given a natural, palm derived tocotrienol mix. Astonishingly, some of the participants had lowered their cholesterol by 31% in only 4 weeks when given 200mg gamma tocotrienol. The study concluded that gamma tocotrienol was the most potent cholesterol inhibitor of all the tocotrienols. LDL cholesterol is reduced more effectively than tocopherols with tocotrienol.Tocotrienols were shown to cause a decrease in thromboxane levels in humans by 20-26% and a decrease in platelet aggregation. While both tocopherols and tocotrienols offered significant protection against damage to the arterial wall, tocotrienols had a much stronger lipid lowering effect.Therefore, a combination of alpha tocopherol and tocotrienols is the best approach to treating atherosclerosis and hypercholesterolemia since both compounds have similar yet different roles to play.Tocotrienol an Breast Cancer While tocotrienols have only marginal vitamin E activity, their antioxidant effects are considerably better. This is particularly important since the tocotrienols unsaturated side chain allows for more efficient penetration into tissues that have saturated fatty layers such as the brain and liver.

Tocotrienols appear superior to tocopherols due to their better distribution in the fatty layers of the cell membrane. Aside from the basic free radical scavenging effect, antioxidant function is also associated with lowering DNA damage, tumor formation and other parameters of cell damage. Supplementation of tocotrienols in rats induced with a potent liver cancer agent demonstrated that the tocotrienols prolonged the impact of the cancer agent. Cell damage to the liver was significantly in the untreated group versus the tocotrienols treated group.However, other animal studies, focusing on mammary cancer, revealed that animals fed corn oil or soy bean oil based diets had significantly more tumors than those fed a tocotrienol rich palm oil diet when exposed to carcinogens. The results clearly noted that the tocotrienol rich palm oil did not promote chemically induced mammary cancer. The researchers believe that the anti-proliferative and cell-killing qualities of tocotrienol may eventually translate to clinical benefits in the prevention and treatment of breast cancer.

Palm oil is the richest known source of tocotrienols. No other common edible oil (except rice bran oil) contains this form of Vitamin E in significant amount Tocotrienols have greater physiological efficiency in inhibiting the growth of human and mice tumor cells than tocopherols. Tocotrienol inhibited cancer cell proliferation and induced cell death at lower concentrations. Breast cancer is most frequently diagnosed cancer among women in the US. Between 1985-1995, 240,000 breast cancer patients were diagnosed and treated in US hospitals. On average, at least 2400 patients are treated yearly.

Prof K.K. Carroll and Guthrie (1997) from University of Western Ontario, Canada showed that tocotrienols inhibit proliferation and growth of both estrogen receptor-negative MDA-MB-435 and -positive MCF-7 human breast cells in culture. Gamma tocotrienols is 3 times more potent in stopping the growth of human breast cancer cultured-cells than Tamoxifen (a drug widely used in the treatment of breast cancer). When used together with Tamoxifen, the combination was found to be 45 times as potent. No significant toxicity of TRF has been noted so far. In a study, tocotrienol at 600mg (five capsules, reformulated higher concentration) bid are well tolerated. Studies are planned to determine whether tocotrienol concentrations associated with tumor control preclinically are achievable in vivo.

Vitamin K

Vitamin K is a coenzyme, which catalyzes the posttranslational conversion of specific glutamyl residues to gamma-carboxyglutamyl (Gla)- proteins. Gla-proteins are essential for blood clotting (factors II, VII, IX, and X; proteins C,S, and Z) and regulation of tissue mineralization (osteocalcin, matrix Gla protein), and cell proliferation. Deficiency usually occurs in infants as a result of low vitamin K intake from breastfeeding coupled with impaired fat absorption and use of drugs such as phenobarbital and diphenylhydatoin during pregnancy can lead to vitamin K deficiency in new born. Extensive use of oral antibiotic treatment can lead to deficiency in older children and adults as the ecology of the intestinal bacteria flora is disrupted. Signs of Vitamin K deficiencies:

• Severe cerebral hemorrhage in infants during the first three to four months after birth / the newborn
• Progression of osteoporosis
• Progression of atherosclerosis

• Promote proper blood clotting
• Helps in retarding atherosclerosis
• Beneficial in osteoporosis prevention
• Aid in reducing excessive menstrual flow

• Cooked dark green vegetables (spinach, cauliflower, and broccoli are the best sources for vitamin K contributing 200, 136 and 177 micrograms per 100g fresh respectively)
• Fermented soy foods
• Kiwi, cabbage, soybean, canola, and olive oils
• Margarine and mayonnaise

• No toxic effects for large amounts of phylloquinone or menaquinones
• Menadione (2-Methyl-1,4-naphthoquinone) is toxic in human (not in use) causes hemolytic anemia, hyperbilirubinemia, and kernicterus in infants

Vitamin B1

Vitamin B1 or Thiamin is found in high concentrations in skeletal muscles, the heart, liver, kidneys and brain. It has to be replenished daily. The total amount in adult is about 30mg with the biological half-life of 15 days.  The need for this vitamin increases during illness, stress and surgery. Signs of Vitamin B1 deficiencies: Wet beriberi (involving cardiovascular system-peripheral vasodilation, biventricular myocardial failure, sodium and water retention, edema and acute fulminant cardiovascular collapse) and dry beriberi (cerebral/and or Wernicke-Korsakoff syndrome- confusion, ataxia of gait, and neuropathy) Vitamin B1 has several key functions:

• Promote growth
• Aid digestion
• Enhance mental attitude
• Normal function of nervous and cardiovascular systems
• Aid in treatment of herpes zosters

• Dosage for deficiency management: 50-100mg/day
• In the case emergency, injection is used for 1-2 weeks, followed by oral administration.

• Lean pork
• Legumes and yeast
• Oatmeal, bran
• Milk
• Most vegetables

Toxicity

• Excess intake is excreted through urine
• No known toxicity is reported with oral thiamin
• Few reports with the intravenous preparation
• Symptoms: tremors, herpes, edema, nervousness, rapid heartbeat, and allergies

Vitamin B2

Vitamin B2 or Riboflavin has to replenished daily, as it is stored in our body. Riboflavin participates in oxidation-reduction reactions in numerous metabolic pathways and in energy production via the respiratory biochemical chain. It plays a vital role in the activities of several enzymes. Signs of Vitamin B2 deficiencies:

• Weakness
• Sore throat, hyperemia, and edema of the pharyngeal and oral mucous membranes
• Angular stomatitis
• Glossitis
• Seborrheic dermatitis
• Corneal vascularization
• Normocytic anemia associated with pure red cell hypoplasia of the bone barrow

• Breakdown and utilize carbohydrates, fats and proteins in the production of energy
• Needed for utilization of other B vitamins and for production of hormones by the adrenal glands
• Aid in growth and reproduction
• Promote healthy skin, hair and nails
• Alleviate eye fatigue

• Ariboflavinosis due to diverse causes such as inadequate dietary intake, decreased assimilation, rare genetic defects in the formation of specific flavoproteins, and hormonal disorders due to certain drugs
• Treatment of neonatal jaundice with phototherapy

• Milk, eggs
• Cereals and grains
• Liver
• Lean meats
• Green vegetables particularly broccoli

• Excessive intake does not appear to have harmful effects
• Prolonged use of large amount of riboflavin alone may deplete other B vitamins

Vitamin B3

Vitamin B3 or Niacin (nicotinic acid or nicotinamide) is essential in the form of coenzymes - NAD and NADP, which responsible for cellular oxidation and reduction in the process of energy production. This vitamin is rapidly absorbed from the stomach or the intestine. Signs of Vitamin B deficiencies:

• Pellagra ( literally, rough skin)- Sore, red, cracked skin areas exposed to sun, friction or pressure, inflammation of the mouth and tongue, dementia, and diarrhoea
• Abdominal pain and distention
• Nausea
• Anxiety and depression

• Necessary for the production of energy from blood sugar
• Proper functioning of nervous systems
• For healthy skin
• Normal digestive system
• Production of sex hormones (estrogen, progesterone, and testosterone)

• Nicotinic acid in doses of 1.5-3 gram per day regulates dyslipidemia
• Nicotinamide acts as a tumor-specific radiosensitizer (vasorelaxtion and increased tumor oxygenation)

• Yeast
• Liver
• Cereals and legumes
• Milk
• Green leafy vegetables
• Fish

• Large doses of nicotinic acid produce flushing of the skin, hyperuricemia, and hepatic abnormalities
• Tolerable Upper Intake Level of niacin = 3mg/day for adults
• Transient itching, tingling and headache
• Large doses of niacin may aggravate peptic ulcer
• 2 g daily of niacin may increase the risk of gout, liver damage and high blood sugar levels leading to nervousness and thirst.

Vitamin B5

Vitamin B5 or pantothenic acid is vital in the activities of many enzymes.  This vitamin however, can be synthesized in the body by intestinal flora. The FDA's RDA is 10mg per day for adults.Signs of Vitamin B5 deficiencies:

• Low blood sugar levels
• Doudenal ulcers
• Depression
• Sleep disturbances
• cardiac instability
• Abdominal pain
• Increased insulin sensitivity
• Decreased serum potassium
• Failure to induce eosinopenia
• Frequent respiratory infections
• Fatigue, headache, nausea and abdominal pain
• Numbness and tingling in the limbs/burning feet
• Muscles cramps
• Faintness, confusion and lack of coordination

• Essential for the production of energy from sugars and fats
• Manufactured of fats, corticosteroids, and sex hormones
• Optimize utilization of other vitamins
• Proper function of nervous system and adrenal glands
• For normal growth and development
• Aid in wound healing
• Enhance immune system
• Reduce adverse and toxic effects of many antibiotics

• 1000 mg per day has been found effective in reducing the pain of arthritis
• Reduce allergies when use together with vitamin C

• Almost all vegetables
• Liver, kidney, heart
• Fish
• Eggs
• Yeast and wheatgerm
• Cereals
• Royal jelly

• No toxic effects even at 1000mg per day
• Intake of 10-20gram per day can cause diarrhoea

Vitamin B6

Vitamin B6 is actually a group of substances comprises of pyridoxine, pyridoxinal, and pyridoxamine that are closely related and function together. About 70-80% of the vitamin B6 in the body is located in muscle bound to glycogen phosphrylase, an enzyme responsiblle for the releasing glucose from glycogen. About 10% is located in the liver. There is some evidence that it can be synthesized by the intestinal bacteria flora when diet rich in cellulose is supplemented.B6 is one of the most versatile enzyme cofactors - as component approximately 120 enzymes including at least one entry in 5 out of 6 major enzyme classes (Enzyme Nomenclature).Signs of Vitamin B6 deficiencies:

• Alterations in the function of  nervous system
• Seizures
• Dermatitis
• Glossitis
• Cheilosis
• Angular stomatitis
• Anemia

• Metabolisms of amino acids and neurotransmitter
• Breakdown of glycogen to form glucose- source of energy
• Required for proper absorption of vitamin B12
• Necessary for the production of hydrochloric acid and magnesium
• Essential for the production of antibodies
• Optimize assimilation of protein and fat
• Aid in converting tryptophan to niacin in the body
• Promote proper synthesis of anti-aging nucleic acids
• Reduce night muscle spasms, leg cramps, hand numbness, neuritis in the extremities
• As a natural diuretic

• 50-300mg doses are used for therapeutic purposes
• Lower plasma homocysteine
• Use with other drugs which have the side-effect of altering vitamin B6 metabolism
• 50mg given with other B vitamins from day 10 of menstrual cycle to day 3 of the following cycle may help relieve the premenstrual syndrome
• Infants: 2-15mg daily

• White meat
• Bananas
• Whole grains

• No fatal toxic effects
• Prolonged use of daily doses of over 500mg may damage the nervous system causing unsteadiness, numbness, and awkwardness of the hands

Folic Acid

Other names include folacin, vitamin M, folate sodium and folates. A varied diet containing fresh fruit and vegetables usually provides sufficient amounts. Thus deficiency is rare. Supplements are often given during pregnancy and breast -feeding. Folic acid is recommended for people on hemodialysis, psoriasis, severe alcoholism, impaired intestinal absorption and liver disease.  People on anticonvulsant drugs, anti-malaria drugs, estrogen containing contraceptives, corticosteroids, and suphonamide antibacterial drugs should be supplemented with folic acid.Signs of  folic acid deficiencies:

• Low number of red blood cells (anaemia)
• Fatigue
• Loss of appetite
• Nausea
• Diarrhoea
• Hair loss
• Mouth and tongue sore
• Poor growth in infants and children

• Essential for the formation of nucleic acids- the genetic material of cells
• Responsible for growth and reproduction
• Vital for the formation of red blood cells by the bone marrow
• Proper function of the central nervous system

• Anemia is treated at dosage of 15mg of folic acid daily together with vitamin B12

Food source:

• Green. leafy vegetables
• Mushrooms
• Liver
• Oranges
• Egg yolks

• Non-toxic at excessive doses
• May worsen the symptoms of Vitamin B12 deficiency associated with anemia (vitamin B12 has to be supplemented when therapeutic folic acid is used)

Vitamin B12

Vitamin B12 although is water soluble, but is stored in the liver. Commonly known as the  "red vitamin". It is also called cyanocobalamin. Absorption is best combined with calcium intake. A diet low in B1 and folic acid often hides a vitamin B12 deficiency. B12 deficiency is common among the vegetarian. Deficiency may take more than 5 years to appear once body stores have been depleted; sometimes deficiency will take place after 20 years as vitamin B12 is secreted in bile and subsequently reabsorbed. Liver can store up to 6 years supply. Signs of  B12 deficiencies:

• Anemia (megaloblastic, pernicious, macrocytic)
• Neutrophil hypersegmentation
• Elevated serum and urinary methylmalonic acid
• Elevated serum and urinary homocysteine
• Potentially irreversible peripheral neuropathy due to demyelination of spinal cord, brain, optic and peripheral nerves
• Dementia
• Poor attention span
• Depression
• Atrophic gastritis

• Essential for formation of genetic material of cells
• For growth and development
• Formation of red blood cells from bone marrow
• Maintaining a healthy nervous system

• Bowel disorders such as coeliac disease and steatorrhoea
• Pernicious anemia

• Liver, kidney and lean meats
• Fish
• Chicken
• Egg
• Milk and dairy products

• Doses up to 200 mg per day is still safe with no toxicity produced in human subjects
• Allergic reaction may occur rarely in some individual when given in injection form.

Vitamin C

Vitamin C is commercially known as ascorbic acid, L-ascorbic acid, calcium ascorbate, and sodium ascorbate. High levels of vitamins are found in the liver, leukocytes, brain, kidney, pancreas, adrenal and pituitary glands. Adrenal and pituitary glands have the highest concentrations of vitamin C among the organs. A healthy diet usually contains sufficient quantities of vitamin C. However, the demand for vitamin C varies from individuals. Vitamin C is used up more rapidly after a serious injury, major surgery, burns, and in extremes of temperature; polluted environment and smokers.Vitamin C is excreted in every 2-3 hours, which is depending on the amount of food in the stomach. Thus, if to take vitamin C supplement, it is recommended to take a time-release tablet in order to maintain optimal level of vitamin C in the blood stream. If to consume more than 750mg vitamin C daily, mineral magnesium should be supplemented to prevent kidney stone formation.Vitamin C is air sensitive and easily oxidized. Unstable to heat and highly soluble in water, and it can easily be destroyed by prolonged storage, overcooking and processing of foods.Signs of Vitamin C deficiencies:

• Clinical scurvy characterized by swollen, bleeding gums, loosening of the teeth, capillary hemorrhaging, including bleeding into joints, tender and painful extremities, poor wound healing, weakness and fatigue
• Nosebleeds
• Bones fracture easily and teeth become loose
• Anaemia
• Shortness of breath and palpitations

• Essential in the synthesis of collagen connective tissue protein for growth and maintenance of bones, teeth, gums, ligaments and blood vessels
• Important  for the synthesis of neurotransmitters for normal nerve function
• Necessary for the formation of adrenal hormones/steroid hormones
• Essential in the conversion of cholesterol to bile acids
• Enhance iron bioavailability
• A potent antioxidant in preventing degenerative diseases, such as cataracts, certain cancers and cardiovascular diseases
• Reduce effect of many allergy-producing substances
• Enhance effectiveness of drugs used to treat urinary tract infections
• Act as a natural laxative

• Prevention and treatment of scurvy
• Possible use include wound healing, high blood pressure, cold and immune function

• Citrus fruit, berries, tomatoes, leafy green vegetables, and etc.

• Doses > 1g per day may cause diarrhoea, nausea, and stomach cramps
• Kidney stone may develop in excessive intake > 1 g per day due to oxalate formation
• Excess vitamin C could predispose premature infants to hemolytic anemia as a result of fragility of their red blood cells