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Friday, October 28, 2011

A Family Doctor's Tale - VITAMIN B6 DEFICIENCY

DOC I HAVE Vitamin B6 Deficiency

Vitamin B6(pyridoxine) Deficiency is a medical condition caused by the deficiency of the human body of Vitamin B6 as a result of inadequate dietary intake or impaired absorption.

Vitamin B6 is present in all living human tissues as an important  enzymes in amino acid metabolism

Functions of Vitamin B6:
1.It is converted to pyridoxal phosphate a co-enzyme of a seies of enzymes that atalyze tramination, decarboxylation and deamination of amin acids.

Vitamin B6 is found primarily in
1.animal sources - red meat, liver, milk, egg yolks
2.vegetable sources: Vitamin B6 is found in fresh green and yellow vegetables, cereals

It is rare as a isolated Vitamin B6 deficiency.

Optimal requirements of Vitamin B6 are:
1.adults and children above puberty: 1 mg to 2 mg daily
Pregnant mother and elderly may need double the amount.
2.Infants and children before puberty: 0.5 mg to 1 mg daily

Causes:
Vitamin B6 Deficiency occurs
1.when there is Vitamin B6 deficiencies due to
a.diet - starvation,lactating mothers should take more Vitamin B6
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
c.alcoholism
d.medications such as isoniazid, hydralazine, cycloserine and penicillamine

2.Severity of Vitamin B6 deficiency is inversely related to age.
It is more common in elderly people.

Symptoms:
1.Vitamin B6 Deficiency is a silent disease in the early stages.
People with Vitamin B6 Deficiency often do not know that they have the condition.

2.Skin changes - seborrheic dermatitis of nose, mouth

3.Mucosal changes -oral erosions of the buccal lining

3.peripheral neuropathy

Diagnosis:
1.Blood Vitamin B6 levels are low

Treatment:
The goal of Vitamin B6 Deficiency treatment is the prevention of peripheral neuropathy and skin lesions.

Therefore, prevention of Vitamin B6 Deficiency is as important as treatment. Vitamin B6 Deficiency treatment and prevention measures are:

Medications:
Vitamin B6 supplements
1.Vitamin B6 is given at 5 mg per day orally until the response is adequate.

2.prevention of Vitamin B6 deficiency in people taking isoniazid, hydralazine, cycloserine and penicillinamine

3.Patients with homocystinuria
Side effects are:
1.Vitamin B6 does not give side effects because being water soluble it is excreted easily in the urine if large doses are ingested

2.It should not be given in patients taking levodopa because it antagonizes the effects of the drug.
Prognosis:
1.good response to treatment in Vitamin B6 deficiency in early stages.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin B6 Deficiency.

Prevention:
take more red meat, liver, egg yolks, cereals and fresh green vegetables.

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