# Remedy/Vitamins

Def. any "of a specific group of organic compounds essential in small quantities for healthy human growth, metabolism, development, and body function; found in minute amounts in plant and animal foods or sometimes produced synthetically" is called a vitamin.
Usage note: "deficiencies of specific vitamins produce specific disorders".
Some sources list fourteen vitamins, by including choline, but major health organizations list thirteen: vitamin A (as all-trans-retinol, all-trans-retinyl-esters, as well as all-trans-beta-carotene and other provitamin A carotenoids), vitamin B$_1$ (thiamine), vitamin B$_2$ (riboflavin), vitamin B$_3$ (niacin), vitamin B$_5$ (pantothenic acid), vitamin B$_6$ (pyridoxine), vitamin B$_7$ (biotin), vitamin B$_9$ (folic acid or folate), vitamin B$_{12}$ (cobalamins), vitamin C (ascorbic acid), vitamin D (calciferols), vitamin E (tocopherols and tocotrienols), and vitamin K (phylloquinone and menaquinones).

## Vitamin A

In nature, β-carotene is a precursor (inactive form) to vitamin A via the action of beta-carotene 15,15'-monooxygenase.
Plant carotenoids are the primary dietary source of provitamin A worldwide, with β-carotene as the best-known provitamin A carotenoid. Others include alpha-Carotene (α-carotene) and cryptoxanthin (β-cryptoxanthin).
One molecule of β-carotene can be cleaved by the intestinal enzyme β,β-carotene 15,15'-monooxygenase into two molecules of vitamin A.
Factors that determine the provitamin A activity of carotenoids:
* Species of carotene
* Molecular linkage
* Amount in the meal
* Matrix properties
* Effectors
* Nutrient status
* Genetics
* Host specificity
* Interactions between factors
Solgar Beta Carotene, 25,000 IU, includes Zeaxanthin (100 mcg), Cryptoxanthin (130 mcg), Lutein (86 mcg), Alpha Carotene (500 mcg) and Beeswax.

## Vitamin B $_1$

Thiamine, also known as thiamin or vitamin B$_1$, is found in food and manufactured as a dietary supplement and medication. Food sources of thiamine include whole grains, legumes, and some meats and fish. Grain processing removes much of the thiamine content, so in many countries cereals and flours are enriched with thiamine. Supplements and medications are available to treat and prevent thiamine deficiency and disorders that result from it, including beriberi and Wernicke encephalopathy. Other uses include the treatment of maple syrup urine disease and Leigh syndrome. They are typically taken by mouth, but may also be given by intravenous or intramuscular injection.
Thiamine is in the B complex family. It is an essential micronutrient, which cannot be made in the body. "Thiamine (vitamin B1) is synthesized only in bacteria, fungi, and plants but is an essential nutrient for animals."
Thiamine is required for metabolism including that of glucose, amino acids, and lipids.

## Vitamin B $_2$

Riboflavin, also known as vitamin B$_2$', is found in food and used as a dietary supplement. It is required by the body for cellular respiration. Food sources include eggs, green vegetables, milk and other dairy products, meat, mushrooms, and almonds. Some countries require its addition to grains.
As a supplement it is used to prevent and treat riboflavin deficiency. At amounts far in excess of what is needed to meet dietary needs as a nutrient, riboflavin may prevent migraines. Riboflavin may be given by mouth or injection. It is nearly always well tolerated. Normal doses are safe during pregnancy. Riboflavin was discovered in 1920, isolated in 1933, and first synthesized in 1935. It is on the World Health Organization's List of Essential Medicines.

## Vitamin B$_3$

"Vitamin B$_3$ ... potentially includes three different molecular forms: nicotinic acid, niacinamide, and nicotinamide riboside."
Vitamin B$_3$ is a vitamin family that includes three forms or vitamers: nicotinamide (niacinamide), niacin (nicotinic acid), and nicotinamide riboside. All three forms of vitamin B$_3$ are converted within the body to nicotinamide adenine dinucleotide (NAD). NAD is required for human life and people are unable to make it within their bodies without either vitamin B$_3$ or tryptophan. Nicotinamide riboside was identified as a form of vitamin B$_3$ in 2004.
"Niacin or nicotinate, together with its amide form nicotinamide, defines the group of vitamin $_3$ complex."
"Niacin and niacinamide, respectively, make up the vitamin B$_3$ complex."
"A part of the vitamin B3 complex, along with nicotinic acid, nicotinamide is rapidly metabolized to N-amide adenine dinucleotide (NAD)."
"Niacin and nicotinamide are two of the various forms of the vitamin B3 complex."
Inositol nicotinate, also called inositol hexanicotinate, is marketed in the United States as a "no-flush niacin" dietary supplement. This form of niacin is supposed to reduce or prevent flushing by being broken down into the metabolites niacin (nicotinic acid) and inositol at a slow rate.
The most common adverse effects of medicinal niacin (500–3000 mg) are flushing (e.g., warmth, redness, itching or tingling) of the face, neck and chest, headache, abdominal pain, diarrhea, dyspepsia, nausea, vomiting, rhinitis, pruritus and rash. These can be minimized by initiating therapy at low dosages, increasing dosage gradually, and avoiding administration on an empty stomach.
The acute adverse effects of high-dose niacin therapy (1–3 grams per day) – which is commonly used in the treatment of hyperlipidemias – can further include hypotension, fatigue, glucose intolerance and insulin resistance, heartburn, blurred or impaired vision, and macular edema. With long-term use, the adverse effects of high-dose niacin therapy (750 mg per day) also include liver failure (associated with fatigue, nausea, and loss of appetite), hepatitis, and acute liver failure; these hepatotoxic effects of niacin occur more often when extended-release dosage forms are used. The long-term use of niacin at greater than or equal to 2 grams per day also significantly increases the risk of cerebral hemorrhage, ischemic stroke, gastrointestinal ulceration and gastrointestinal bleeding, diabetes, dyspepsia, and diarrhea.

## Vitamin B $_4$

Choline is an essential nutrient for humans and many other animals. Choline occurs as a cation that forms various salts (X$^−$ in the depicted formula is an undefined counteranion). To maintain health, it must be obtained from the diet as choline or as choline phospholipids, like phosphatidylcholine. Humans, as well as most other animal species, do make choline de novo, however production is generally insufficient. Choline is often not classified as a vitamin, but as a nutrient with an amino acid–like metabolism. In most animals, choline phospholipids are necessary components in cell membranes, in the membranes of cell organelles, and in very low-density lipoproteins. Choline is required to produce acetylcholine – a neurotransmitter – and S-adenosylmethionine, a universal methyl donor involved in the synthesis of homocysteine.
Symptomatic choline deficiency – rare in humans – causes nonalcoholic fatty liver disease and muscle damage. Excessive consumption of choline (greater than 7.5 g/day) can cause low blood pressure, sweating, diarrhea and fish-like body odor due to trimethylamine, which forms in its metabolism. Rich dietary sources of choline and choline phospholipids include organ meats and egg yolks, dairy products and vegetables.

## Vitamin B $_5$

Pantothenic acid, also called vitamin B$_5$ is water-soluble and an essential nutrient. All animals require pantothenic acid in order to synthesize coenzyme A (CoA) – essential for fatty acid metabolism – as well as to, in general, synthesize and metabolize proteins, carbohydrates, and fats.
Pantothenic acid is the combination of pantoic acid and beta-Alanine (β-alanine), at least small quantities of pantothenic acid are found in nearly every food. Human deficiency is very rare. As a dietary supplement or animal feed ingredient, the form commonly used is calcium pantothenate because of chemical stability, and hence long product shelf life, compared to sodium pantothenate or free pantothenic acid.

## Vitamin B $_6$

Vitamin B$_6$ is an essential nutrient. The term refers to a group of six chemically similar compounds, i.e., "vitamers", which can be interconverted in biological systems. Its active form, pyridoxal 5′-phosphate, serves as a coenzyme in more than 140 enzyme reactions in amino acid, glucose, and lipid metabolism.
Plants synthesize pyridoxine as a means of protection from the ultraviolet-B radiation of sunlight and to participate in synthesis of chlorophyll. Animals cannot synthesize any of the various forms of the vitamin, and hence must obtain it via diet, either of plants, or of other animals. There is some absorption of the vitamin produced by intestinal bacteria, but this is not sufficient to meet needs. For adult humans, recommendations from various country's food regulatory agencies are in the range of 1.0 to 2.0 milligrams (mg) per day. These same agencies also recognize ill effects from intakes that are too high, and so set safe upper limits, ranging from as low as 25 mg/day to as high as 100 mg/day depending on the country. Beef, pork, fowl and fish are generally good sources; dairy, eggs, mollusks and crustaceans also contain vitamin B$_6$, but at lower levels. There is enough in a wide variety of plant foods so that a vegetarian or vegan diet does not put consumers at risk for deficiency.

## Vitamin B $_7$

Biotin is also called vitamin B$_7$. It is involved in a wide range of metabolic processes, both in humans and in other organisms, primarily related to the utilization of fats, carbohydrates, and amino acids. The name biotin derives from the Greek word “bios” (to live) and the suffix “-in” (a general chemical suffix used in organic chemistry).

## Vitamin B $_8$

Inositol, or more precisely myo-inositol, is a carbocyclic sugar that is abundant in the brain and other mammalian tissues; it mediates cell signal transduction in response to a variety of hormones, neurotransmitters, and growth factors and participates in osmoregulation. It is a sugar alcohol with half the sweetness of sucrose (table sugar). It is made naturally in humans from glucose. A human kidney makes about two grams per day. Other tissues synthesize it too, and the highest concentration is in the brain, where it plays an important role by making other neurotransmitters and some steroid hormones bind to their receptors. Inositol is promoted as a dietary supplement in the management of polycystic ovary syndrome (PCOS). However, there is only evidence of very low quality for its efficacy in increasing fertility in women with PCOS.
Inositol is considered a safe and effective treatment for polycystic ovary syndrome (PCOS), since it works by increasing insulin sensitivity, which helps to improve ovarian function and reduce hyperandrogenism.

## Vitamin B $_9$

Folate, also known as vitamin B$_9$ and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and storage. Folate is required for the body to make DNA and RNA and metabolise amino acids necessary for cell division. As humans cannot make folate, it is required in the diet, making it an essential nutrient. It occurs naturally in many foods. The recommended adult daily intake of folate in the U.S. is 400 micrograms from foods or dietary supplements.

## Vitamin B $_{10}$

4-Aminobenzoic acid (also known as para-aminobenzoic acid or PABA because the two functional groups are attached to the benzene ring across from one another in the para position) is an organic compound with the formula H$_2$NC$_6$H$_4$CO$_2$H.
A benefit may occur for fatigue, irritability, depression, weeping eczema (moist eczema), scleroderma (premature hardening of the skin), patchy pigment loss in the skin (vitiligo), and premature grey hair.

## Vitamin B $_{11}$

Pteryl-hepta-glutamic acid (PHGA) is Vitamin Bc-conjugate.

## Vitamin B $_{12}$

Vitamin B$_{12}$, also known as cobalamin, is a water-soluble vitamin involved in metabolism. It is one of eight B vitamins. It is a cofactor in DNA synthesis, in both fatty acid and amino acid metabolism. It is important in the normal functioning of the nervous system via its role in the myelinogenesis (synthesis of myelin), and in the maturation of red blood cells in the bone marrow.
Necessary for the production of stomach acid.

## Vitamin B $_{13}$

Orotic acid is a pyrimidinedione and a carboxylic acid and is called vitamin B$_{13}$. The compound is manufactured in the body via a mitochondrial enzyme, dihydroorotate dehydrogenase or a cytoplasmic enzyme of pyrimidine synthesis pathway.

## Vitamin B $_{14}$

"Several of the succeeding substances have been referred to as vitamins as they have been believed to be vitamins. They are no longer considered as such, and the numbers that have been assigned to them now form the ‘gaps’ in the true series of B-complex vitamins. Some of these, though not essential to humans, are essential in the diets of other organisms and others may even be toxic under certain conditions. These are Vitamin B $_4$ (can refer to chemicals choline, adenine or carnitine; choline is synthesized by human body, but not sufficiently; adenine is a nucleobase synthesized by the human body, while carnitine is essential for certain worms, but not for humans), Vitamin B $_8$ (adenosine monophosphate also known as adenylic acid or inositol), Vitamin B $_{10}$ (para-aminobenzoic acid, a component of the folate molecule produced by plants and bacteria), Vitamin B $_{11}$ (pteryl-hepta-glutamic acid, a chick growth factor), Vitamin B $_{13}$ (orotic acid), Vitamin B14 (cell proliferant, anti-anaemia, rat growth)".

## Vitamin B $_{15}$

"Vitamin B $_{15}$ (pangamic acid, also known as pangamate promoted in various forms as a dietary supplement and drug, and considered unsafe)".

## Vitamin B $_{16}$

"Vitamin B $_{16}$ (dimethylglycine, synthesized by the human body from choline)".

## Vitamin B $_{17}$

"Vitamin B $_{17}$ (pseudoscientific name for the poisonous compound amygdalin, also known as nitrilosides)".

## Vitamin B $_{20}$

"Vitamin B $_{20}$ (L-carnitine), Vitamin Bf (carnitine), Vitamin Bm (myo-inositol, also called mouse antialopaecia factor), Vitamin Bp (antiperosis factor, which prevents perosis, a leg disorder in chicks and can be replaced by choline and manganese salts), Vitamin BT (carnitine), Vitamin Bv (a type of B6 other than pyridoxine), Vitamin BW (a type of biotin other than d-biotin), and Vitamin Bx (an alternative name for both para-aminobenzoic acid and pantothenic acid) [56-60]."

## Vitamin C

In "a placebo controlled trial for six months, 40 men and women between 60 to 80 years old were administered 500 mg of vitamin C daily. This moderate dose of vitamin C modestly but significantly lowered blood pressure (Fotherby et al 2000). In another study of 514 people, plasma vitamin C levels were inversely related to blood pressure and pulse rate (Bates et al 1998). Elevated blood pressure is a risk factor for age-related atherosclerotic disease."

## Vitamin D$_3$

Cholecalciferol, also known as vitamin D$_3$ and colecalciferol, is a type of vitamin D which is made by the skin when exposed to sunlight; it is also found in some foods and can be taken as a dietary supplement.
Cholecalciferol is made in the skin following UVB light exposure. It is converted in the liver to calcifediol (25-hydroxyvitamin D) which is then converted in the kidney to calcitriol (1,25-dihydroxyvitamin D). One of its actions is to increase the uptake of calcium by the intestines. It is found in food such as some fish, beef liver, eggs, and cheese. Certain foods such as milk, fruit juice, yogurt, and margarine also may have cholecalciferol added to them in some countries including the United States.
Cholecalciferol can be taken as an oral dietary supplement to prevent vitamin D deficiency or as a medication to treat associated diseases, including rickets. It is also used for familial hypophosphatemia, hypoparathyroidism that is causing low blood calcium, and Fanconi syndrome. Vitamin-D supplements may not be effective in people with severe kidney disease. Excessive doses in humans can result in vomiting, constipation, weakness, and confusion. Other risks include kidney stones. Doses greater than 40,000 International unit (IU) (1,000 μg) per day are generally required before high blood calcium occurs. Normal doses, 800–2000 IU per day, are safe in pregnancy.
"Non-classic actions of vitamin D are being increasingly recognized because of the ubiquitous expression of the [vitamin D receptor] VDR in various organs and systems, including hematopoietic cells, such as neutrophils, monocytes, dendritic cells, and lymphocytes (3,6). Vitamin D modulates the immune response through the inactivation of the NF-κB pathway, reducing inflammation and immune cell activation (5,19). Some studies have reported that vitamin D supplementation may increase the 25(OH)-vitamin D levels and reduce the serum levels of inflammatory cytokines, such as interleukin 6 (IL-6), tumor necrosis factor (TNF-α), and MCP-1, in both pre-dialysis and hemodialysis patients (20,21)."

## Vitamin K

Vitamin K refers to structurally similar, fat-soluble vitamers found in foods and marketed as dietary supplements. The human body requires vitamin K for post-synthesis modification of certain proteins that are required for blood coagulation (K from koagulation, Danish for "coagulation") or for controlling binding of calcium in bones and other tissues. The complete synthesis involves final modification of these so-called "Gla proteins" by the enzyme gamma-glutamyl carboxylase that uses vitamin K as a cofactor. The presence of uncarboxylated proteins indicates a vitamin K deficiency. Carboxylation allows them to bind (chelate) calcium ions, which they cannot do otherwise. Without vitamin K, blood coagulation is seriously impaired, and uncontrolled bleeding occurs. Research suggests that deficiency of vitamin K may also weaken bones, potentially contributing to osteoporosis, and may promote calcification of arteries and other soft tissues.
Chemically, the vitamin K family comprises 2-methyl-1,4-naphthoquinone (3-) derivatives. Vitamin K includes two natural vitamers: vitamin K$_1$ (phylloquinone) and vitamin K$_2$ (menaquinone). Vitamin K$_2$, in turn, consists of a number of related chemical subtypes, with differing lengths of carbon side chains made of isoprenoid groups of atoms.
Vitamin K refers to structurally similar, fat-soluble vitamers found in foods and marketed as dietary supplements. "Vitamin K" include several chemical compounds. These are similar in structure in that they share a quinone ring, but differ in the length and degree of saturation of the carbon tail and the number of repeating isoprene units in the side chain (see figures in Chemistry section). Vitamin K has several roles: an essential nutrient absorbed from food, a product synthesized and marketed as part of a multi-vitamin or as a single-vitamin dietary supplement, and a prescription medication for specific purposes.
Vitamin K has no upper limit, as human data for adverse effects from high doses are not sufficient.

### Vitamin K $_1$

Vitamin K$_1$ is made by plants, and is found in highest amounts in green leafy vegetables, because it is directly involved in photosynthesis. It is active as a vitamin in animals and performs the classic functions of vitamin K, including its activity in the production of blood-clotting proteins. Animals may also convert it to vitamin K$_2$, variant MK-4. Bacteria in the gut flora can also convert K$_1$ into MK-4. All forms of K$_2$ other than MK-4 can only be produced by bacteria, which use these during anaerobic respiration. Vitamin K$_3$ (menadione), a synthetic form of vitamin K, was used to treat vitamin K deficiency, but because it interferes with the function of glutathione, it is no longer used this way in human nutrition.

### Vitamin K $_2$

Animal-sourced foods are primarily vitamin K$_2$.