The carotene in NVD has been reduced in this particular formulation. In some children, an orange hue developed in the skin. This side-effect is not considered harmful, but is cosmetically not desirable. The levels of antioxidants are at safe levels. The SAC considers direct addition of E the most appropriate method for keeping levels of this critical antioxidant at high-normal levels in the blood of DS children, without risk of development of excessive levels.
Folic acid is used biochemically for nucleic acid synthesis and for other one-carbon transfers.
Niacin is a part of the cofactor system that shuttles hydrogens around and seems ubiquitous in biochemical pathways. Biotin is the cofactor that is involved in carboxylation reactions involving carbon dioxide. Vitamin C is part of a strong antioxidant protocol, and is well-tolerated. Vitamin B1 is also known as thiamin, vitamin B6 is known as pyridoxine, vitamin B2 is riboflavin and vitamin B12 is also known as cyanocobalamine. B1 is involved in two-carbon metabolism and in other pathways.