Vitamin A instructions for use. Vitamins: types, indications for use, natural sources

Nowadays, it is almost impossible to meet a person who does not know about the existence of vitamins, that they are absolutely necessary for the normal functioning of the body, that these substances are contained in various foods and that their deficiency can be compensated for by the use of synthetically prepared vitamins, available in pharmacies.

However, not everyone knows that vitamins are powerful pharmacotherapeutic agents used not only for the prevention and treatment of vitamin deficiency, but also for a wide variety of human diseases.

The purpose of these materials is to provide the population with information about vitamins that corresponds to the modern level of science, about their preventive use not only for hypovitaminosis, but also for the prevention of various diseases.

What are vitamins

Vitamins- essential nutritional factors that, along with proteins, fats, carbohydrates, mineral salts and water, ensure the normal functioning of the body. They

take an active part in the processes of synthesis and breakdown of various substances. Most of them are activated in tissues and play the role of catalysts for various reactions.

Currently, over 50 vitamins are known. However, for practical medicine, only about twelve are of greatest importance. This is due to the fact that the biological role of these substances in the body has been sufficiently well studied, their chemical structure has been precisely established, chemical synthesis has been carried out, and there are certain indications for use in medical practice. Other substances related to vitamins are still under study.

Vitamins have helped overcome many serious diseases. But it was not immediately that their healing properties became known. The discovery of vitamins occurred almost 100 years ago. The honor of their discovery belongs to the Russian scientist Lunin. In 1880, in his doctoral dissertation, he suggested that as yet unknown additional factors should exist in complete food products, which are absolutely necessary for the normal functioning of the body.

However, information about diseases associated with the deficiency of these previously unknown factors has reached us from ancient times. “Lords of the World” - the ancient Roman legionaries of Caesar, sweeping away the resistance of their northern neighbors on their way, moved uncontrollably forward. They crossed the Rhine and stayed in these places for a long time. After some time, a serious illness arose among the soldiers, the symptoms of which, judging by the description of the historian Pliny, resembled Clinical signs scurvy. Later, in the Middle Ages, during long-term siege of fortresses, both in the ranks of the besieged and in the ranks of the advancing troops, epidemics of a disease unusual for peacetime often occurred - scurvy. Those affected by the terrible disease quickly developed a feeling of fatigue, drowsiness during the day, general mental depression was observed, the face became pale, the lips and mucous membranes of the mouth turned blue. The skin took on a dirty gray tint, the gums bled and easily separated from the teeth. Even slight physical efforts caused shortness of breath and palpitations. The patients lost the ability to move and died in terrible agony. This disease was called “camp disease,” which, with the development of navigation, became a real scourge of sailors going on long voyages. During the existence of the sailing fleet, more sailors died from scurvy than in all naval battles that time.

The cause of this disease was established much later. Scurvy develops in the absence of vitamin C in the body (ascorbic acid, so named by the famous Hungarian biochemist Szent-Györgyi for its ability to eliminate scurvy, which means “scurvy”). In 1933, the structural chemical formula of ascorbic acid was precisely established. In the same year, the first synthetic vitamin C was obtained, which was no different biologically from natural vitamin C.

For thousands of years, the peoples of Asian countries suffered and died from a terrible disease that affects the nerves. They called it “beriberi”, since the patients’ gait changed dramatically, which resembled the movements of a sheep (“beri-beri” translated into Russian means “sheep”). And only at the end of the 19th century. The disease was found to be caused by polished rice. If you eat brown rice instead, beriberi can be cured. Consequently, rice bran contains a substance that is different in nature from proteins, fats, carbohydrates, and salts, which is necessary for health and the absence of which causes polyneuritis. Subsequently, the nature of this substance was studied, which was called vitamin B1.

Who hasn't heard of a childhood disease - rickets? Who doesn't know that rickets can be prevented or cured with vitamin D supplements? But relatively recently it was believed that this disease almost inevitably affects the child’s body (especially in urban conditions).

So, vitamins have biological properties that are extremely important for the development and functioning of the body, which can be used in practical medicine for the prevention and treatment of certain vitamin deficiencies, specific pathological processes of hypo- and avitaminosis that arise due to insufficient intake of the corresponding vitamins into the body. But before we move on to describing the various forms of vitamin deficiency, let’s find out what vitamins contain.

Natural sources of vitamins

Sources of vitamins for the human body are a variety of products of plant and animal origin.

Vitamin A is found in animal fats, butter, milk, cheese, egg yolk, and caviar. The main source of vitamin A is the liver fat of marine animals (whale, walrus, seal) and some fish (cod, sea bass). From these fats, medical fish oil is prepared, which contains vitamins A and D. Vitamin A as such is not found in plant foods. However, many plant foods (carrots, spinach, lettuce, parsley, green onions, sorrel, red peppers, blueberries, peaches, apricots, etc.) contain carotene, from which vitamin A is formed in the body.

Vitamin B 1 is found in yeast, germs and shells of cereals, as well as in bread made from wholemeal flour. In white bread without bran, the vitamin content is sharply reduced.

Vitamin B 2 is widely distributed in the plant and animal world. It enters the human body mainly through meat and dairy products. Contained in yeast, whey, egg whites, meat, fish, poultry, liver, kidneys, peas, germs and shells of grain crops.

Vitamin PP (nicotinic acid) is found in many foods, both animal and plant origin. The liver and kidneys are especially rich in it; in others meat products, milk, vegetables and fruits contain less of it. Cereals (barley, millet, rice, rye, etc.) and especially bran contain a significant amount of the vitamin. The product richest in nicotinic acid is yeast.

Vitamin B 6 (pyridoxine) is found in many food substances of both animal and plant origin.

Vitamin B 12 (cyanocobalamin) is found in animal products (which is why vegetarians are often deficient in this vitamin). The liver and kidneys of animals are especially rich in cyanocobalamin, 100 g of which contain tens of micrograms of the vitamin.

Vitamin B C (folic acid) is found in yeast, liver, mushrooms, spinach, cauliflower, green leaves.

Pantothenic acid (B 3) is found in all foods.

Biotin (H) is found in all foods that contain B vitamins. The liver and kidneys are richest in the vitamin.

Choline - found in the liver, brain, pancreas, white flour. Choline is also found in eggs, meat, grains and vegetables. With a normal diet, a person receives from 1.5 to 4 g of choline with food.

Lipoic acid is found in the greatest quantities in meat (beef), milk; moderate - in rice and least - in vegetables.

Vitamin C. Sources of ascorbic acid include rose hips, black currants, green walnuts, cabbage, tomatoes, citrus fruits, potatoes and other plant foods. Small amounts of vitamin C are found in animal products (liver, brains). It is interesting to note that 100 g of horseradish contains a daily dose of much-needed vitamin C.

Vitamin P is obtained from tea leaves, citrus fruits and chokeberry.

Vitamin D, along with vitamin A, is found in large quantities in the liver and adipose tissue of fish, mainly cod, as well as in the liver of seal and other marine animals. Small amounts of the vitamin are found in egg yolk, caviar, butter and milk.

Green plants are rich in vitamin E, especially lettuce and wheat germ. It is also found in meat, liver, egg yolk, butter and milk (especially summer milk).

Vitamin K is most often found in the green parts of plants. Blue alfalfa is the richest in it, and among products of animal origin - pork liver.

Vitamin deficiency

Vital important vitamins is primarily that they are specific agents used for the prevention and treatment of various pathological conditions. Such conditions are caused mainly by a discrepancy between the intake of vitamins into the human body and their consumption.

When considering the daily requirement of the human body for vitamins, the following three options for daily dosages are usually noted. Optimal doses of vitamins are the amount that is able to ensure all physiological processes at the highest level (even increased mental and physical stress does not cause vitamin deficiency).

Medium doses are able to ensure physiological processes under low physical and nervous stress, with a moderately pronounced effect on the body of temperature factors and other conditions. external environment. If the load increases, a deficiency of vitamins occurs, since their consumption in the body exceeds their intake. An initial vitamin deficiency occurs: a violation of metabolic processes, accompanied by functional failure of individual organs and systems, and a decrease in the body's reactivity. There is also a decrease in the body's endurance to physical and nervous stress, rapid fatigue, decreased resistance to infectious diseases, etc.

Minimum doses provide the body's needs only in a state of physical rest or under very light loads. If the amount of incoming vitamins is below these standards or consumption exceeds intake, severe vitamin deficiency occurs - vitamin deficiency, leading to the development of various specific pathological conditions.

It must be taken into account that in recent years in many countries there has been a tendency to increase the production of refined products. This causes certain harm to the vitamin content of food, since during processing the products are deprived of one or another amount of vitamins. Thus, a resident of England in the 14th century consumed on average 4-5 mg of vitamins per day, and currently only 1 mg (Schroeder, 1960) while simultaneously increasing carbohydrates in the diet.

In general, the more diverse and better the population eats, the less common vitamin deficiency is, especially its severe forms. An example of this is the sharp decrease in hypovitaminosis in our country. This is due to the steady growth in the well-being of the Soviet people, with the constant improvement in the nutrition of the population, both in terms of the variety of products and their usefulness. Consequently, the vitamin content of the diet also increases. From this it is clear that there are practically no pronounced forms of vitamin deficiency in our country at present. Moreover, in recent years, hypovitaminosis, i.e., the initial manifestations of vitamin deficiency in the body, occurring in cases where the need for vitamins is not fully satisfied, has also become rare. Hypovitaminosis is more common where a careless attitude to monitoring the vitamin content of nutrition is combined with increased consumption in the body due to special climatic conditions, heavy physical labor and nervous tension.

More and more data indicate the occurrence of vitamin deficiency in patients various diseases. Thus, the well-known Addison-Birmer anemia is essentially B12-vitaminosis, usually caused by atrophic processes in the gastric mucosa. That is why clinicians of various specialties carefully study the vitamin content of patients and identify the initial manifestations of hypovitaminosis.

Currently, doctors are paying special attention to latent, preclinical, vitamin deficiency of the body, which has not yet manifested itself clinically, i.e., does not have clear specific signs. However, in these cases, metabolic disorders are observed, which in one way or another negatively affect the general condition of the body: a person’s performance decreases, his resistance to diseases decreases, and the course of the existing disease worsens.

What specific conditions lead to the emergence and development of vitamin deficiency in the body?

Vitamins are actively involved in many metabolic processes by being included in enzyme systems or directly participating in various reactions of the body. More than a hundred enzyme systems are known that contain vitamins. It is necessary to emphasize once again the specificity of vitamins: they cannot be replaced by other substances. In the human body

They, as a rule, are not produced and come mainly from food. Thus, vitamins belong to the group of essential nutrients. The lack of a significant supply of vitamins in the body (with the exception of vitamins A and B 12) and their inevitable consumption in the process of metabolic reactions necessitate constant replenishment of vitamins. As many vitamins should be received as consumed. If the body receives fewer vitamins, this will affect the course of metabolic processes, the speed of biochemical reactions will sharply slow down or they will not take place at all; a metabolic disorder of one degree or another will occur, which ultimately leads to clinical manifestations of vitamin deficiency.

When the dosages of the above-mentioned minimum standards are reduced, these shifts deepen and new ones develop against their background. qualitative reactions in the form of specific pathological processes (hypo- and avitaminosis) in a more or less pronounced form. At the same time, hypovitaminosis conditions are characterized by a significant diversity of manifestations in the absence of a defined clinical picture. These conditions are caused mainly by metabolic disorders and functional failure of individual body systems.

The causes of vitamin metabolism disorders are quite diverse. It is customary to distinguish two main groups of factors leading to the development of vitamin deficiency:

1. Exogenous, external causes that determine the development of primary hypo- and avitaminosis.
2. Endogenous, internal causes leading to the development of secondary hypo- and vitamin deficiencies.

There is a third group - these are mixed hypo- and vitamin deficiencies, the development of which involves factors of both external and internal order.

There are 3 forms of vitamin deficiency: nutritional, resorption and dissimilation.

The alimentary form in its origin is purely exogenous, primary hypo- and avitaminosis, caused by insufficient content (rarely complete absence) vitamins in food. Hence, this form Hypovitaminosis is mainly caused by eating disorders. At the same time, insufficient vitamin content in food can be a consequence of both irrational selection of products (lack of vegetables or improper storage, exclusion of black bread, etc.) and improper cooking.

However, in ensuring the vitamin content of the daily diet, not only the amount of vitamins introduced is important, but also the composition of the food, on which the body’s need for vitamins depends. It has been established that even with sufficient (according to norms) administration of vitamins, signs of vitamin deficiency may appear if the ratio of individual food components is disturbed in the diet. Thus, with a predominance of carbohydrates (above positive norms) the body requires additional amounts of vitamin B 1. Consequently, if such a diet is maintained for a long time, the phenomena of B 1 deficiency can develop. At the same time, the consumption of vitamins B2 and C also clearly increases. The question of the protein content of the daily diet becomes especially important. It has been established that there is a close relationship and interdependence between food proteins and some vitamins, especially group B and vitamin C. With insufficient intake of proteins (especially complete proteins), the body’s absorption of riboflavin, nicotinic acid, and ascorbic acid is significantly impaired. In the presence of protein starvation, these vitamins do not participate in metabolic processes and are quickly excreted in the urine, which leads to the development of a corresponding vitamin deficiency. If there is insufficient amount of protein in food, the conversion of carotene into vitamin A is delayed. Excessive amount of protein in the diet also leads to significant disturbances in the vitamin balance. It has been established that under such conditions the body’s need for B vitamins, primarily pyridoxine, increases.

Increasing the amount of protein in food increases the body's need for ascorbic acid. With a lack of vitamin C, the metabolic processes of amino acids such as tyrosine and phenylalanine are disrupted. Besides, in Lately It has been established that increasing protein in food reduces the body's need for pantothenic acid. With a small amount of protein, choline deficiency may occur. Consequently, both high and low protein content in food negatively affects the metabolism of vitamins.

The same situation occurs with different fat content in food. Its deficiency leads to impaired absorption of fat-soluble vitamins, and its excess leads to a decrease in the synthesis of vitamin B2 by intestinal flora, thereby increasing the amount of riboflavin that must be administered with food.

However, quantitative violations associated with reduced content individual vitamins in prepared foods. It is this path of vitamin imbalance that most often leads to the development of both nonspecific and specific pathological processes caused by vitamin deficiency.

The main reasons for reducing the amount of individual vitamins in prepared foods are:

• improper storage of products, leading to the destruction of some vitamins (especially vitamin C);
• monotonous diet that does not provide enough vegetables, which are the main carriers of vitamins C, P, etc.;
• violation of the rules of culinary processing of products, which, together with unsatisfactory storage, can lead to a significant decrease in the amount of vitamins in prepared food;
• improper storage of prepared dishes, violation of shelf life.

In practice, the mentioned reasons rarely exist in isolation from each other. More often they are combined and lead to a sharp reduction in vitamins in the daily diet. This is the main reason for the development of the nutritional form of vitamin deficiency. Consequently, in order to prevent nutritional (or, what is the same, exogenous) hypovitaminosis, it is necessary, first of all, to take care of preserving vitamins in food. This can be achieved if certain conditions are met.

During cooking of food (provided a decoction is used), 5 to 25% of vitamin B1 is lost. A significant role in this is played by the pH of the environment: when cooked in an alkaline environment, vitamin B1 is quickly destroyed, in a neutral environment it is sensitive to heat, and in an acidic environment, vitamin B1 is quickly destroyed. B 1 is heat resistant. Therefore, when cooking food, to better preserve this vitamin, it is useful to acidify it by adding tomato puree, sorrel and vinegar. Or this example: when consuming a sufficient amount of rye bread baked from whole flour, a person’s need for vitamin B 1 is completely satisfied and the occurrence of B 1 vitamin deficiency is practically eliminated.

Vitamin B 2 (riboflavin) is destroyed in an alkaline environment and in daylight. At the same time, it is resistant to heat (during cooking, baking and canning) and freezing. It is well preserved in an acidic environment, but heating in a slightly alkaline environment within an hour causes its destruction by 50%. In the sun, milk loses 60% of riboflavin within 3 hours.

The average loss of nicotinic acid during food storage and cooking is about 30%; When cooking meat, more is lost than when frying it.

The least stable vitamin is ascorbic acid. Therefore, special attention must be paid to its safety in food. Absence fresh vegetables and fruits sharply depletes the daily diet, leading to a lack of vitamin C. However, it must be borne in mind that even in the presence of vegetables, their inept culinary processing can lead to the loss of 75-80% of vitamin C. In such cases, conditions are also created for the occurrence of hypovitaminosis conditions or significant deficiency vitamin C in the body. Ascorbic acid is easily oxidized and thus loses its biological activity. Its oxidation occurs most easily in solutions (especially in alkalis) in the presence of oxygen. Even tiny amounts of iron and especially copper, which act as catalysts, destroy vitamin C. In the summer this is not so important: there is something to compensate for the losses. And in winter and, especially, early spring, vitamin reserves of almost all sources of ascorbic acid are significantly reduced. Perhaps only pine needles accumulate a significant additional portion of vitamin C in the cold: pine and spruce needles in winter have three times more “ascorbic acid” than in summer, and cedar needles have twice as much. But who would chew pine needles?

The vitamin C content is decisively influenced by the enzyme ascorbinase: it is found in fruits and vegetables and contributes to the process of its oxidation. There are two active forms of vitamin C - ascorbic acid (reduced form) and dehydroascorbic acid (oxidized form). They transform into each other relatively easily. This is due to the exceptional role of vitamin C in the redox processes occurring in our body. But the advanced oxidation process, stimulated by the enzyme, irreversibly destroys vitamin activity. Therefore, the more ascorbicase in a particular product, the worse the preservation of ascorbic acid in it. By the way, blanching fruits and vegetables, treating them with hot water or steam is precisely intended to inactivate the work of this enzyme.

Currants are one of the champions in terms of vitamin C content, because they contain almost no ascorbinase. The vitamin is well preserved in currant berries and their processed products. In addition, currants contain quite a lot of vitamin P, which enhances the beneficial effect of vitamin C. Let us note in passing: even currant leaves, which housewives willingly put in pickles for flavor, contain 100-200 mg of vitamin C. There is almost no ascorbinase in sweet peppers, rutabaga, tomatoes, citrus fruits. Therefore, in lemons and oranges, six months after collection, 80-90% of the original amount of ascorbic acid is retained, and in the first two to three months of storage its amount even increases. It is also useful to know that the peels of citrus fruits contain two to three times more vitamin C than the pulp.

It is interesting to note that the concentration of vitamin C also depends on the type of apple: for example, Antonovka and Titovka have almost three times more ascorbic acid than other apples. The size of the fruit also plays a role (large ones are poorer in vitamins than medium ones), and the geography of growth - northern fruits are usually richer in ascorbic acid than southern ones.

Vitamin C and sun rays destroy it. So, diffused light for 5-6 minutes. destroys 64% of this vitamin in milk, and direct rays destroy more than 90%.

Vitamin C is almost completely destroyed when fruits are dried in the sun. Consequently, dried fruits often contain only traces of this vitamin. The freeze-drying method is promising in this regard, in which an average of 79% of vitamin C is retained in strawberries and raspberries. Ascorbic acid is quite stable at low temperatures, but it is quickly destroyed when thawed. Thus, cooking is always accompanied by the loss of a significant amount of vitamins. At the same time, more careful processing of products increases losses. Thus, fried potatoes retain 35% ascorbic acid, and potato casserole- only about 5%.

Proper organization of vegetable storage is of great importance for preserving vitamin C in products. Thus, their long-term storage always leads to some loss of ascorbic acid. Raw vegetables in spring usually contain half as much vitamin C as in autumn.

However, the degree of destruction of ascorbic acid depends not only on the duration of storage, but also on the average air temperature and its access to the storage. Thus, on average, over 9 months of storage of tomato products, the loss of vitamin C is at 2°-10, at 16-18° - about 20%, and at 37° - about 64%. (A.T. March, 1958). It should be noted that cabbage retains vitamin C better than other vegetables. Sour sauerkraut, stored under weight and covered with brine, almost completely retains vitamin C for 6-7 months. Freezing cabbage leads to a reduction in its content by 20-40%.

Increases the loss of vitamin C and the necessary washing of vegetables, especially cabbage. In sauerkraut, after washing in cold water, only 40% of vitamin C remains, in hot water - only 20%.

Particularly important for preserving vitamin C in food should be given to proper heat treatment of products and reducing the shelf life of prepared food.

On average, during food storage and cooking, the total loss of vitamin C reaches 60%. However, if the basic rules of heat treatment are not followed, the destruction of vitamin C can reach significantly greater proportions.

To preserve vitamin C, it is of some importance whether vegetables (including frozen ones) are immersed in cold water or boiling water when cooking. When placing vegetables in cold water or broth, the loss of vitamin is greater than when placing them in boiling water. Contact of food with oxygen in the air is reduced if cooking is carried out in a covered container. When steaming spinach and sorrel intended for green cabbage soup in a sealed container, the loss of vitamin C does not exceed 10%, while carotene is completely preserved. Loss of vitamin C is reduced if foods are covered with fat. Thus, when frying potatoes with a small amount of fat, 70-80% of vitamin C is retained. Sautéing vegetables with heated fat also protects the vitamin from destruction.

The duration of heat treatment is also important: the longer it is, the greater the loss of ascorbic acid. At the same time, the nature of the culinary processing is also of great importance. For clarity, we can provide data on the loss of vitamin C during various types of cooking.

Finally, it must be emphasized that storing prepared vegetable dishes sharply reduces their vitamin value. The loss of vitamin C in freshly prepared borscht ranges from 29 to 46%, and when storing borscht for 4 hours. - 70%. Reheating almost completely destroys the remaining ascorbic acid.

All these data indicate that ascorbic acid is retained in products and prepared foods only under certain conditions. Failure to comply with these conditions usually leads to the destruction of a significant part of the vitamin and, consequently, to a depletion of food in it.

In order to prevent hypovitaminosis, it is first of all necessary to take care of preserving ascorbic acid in food. This can be achieved if the following conditions are met.

1. The main amount of vitamin C and other vitamins in the daily diet is provided by vegetables. Hence, replacing them with other products leads to a sharp depletion of food in ascorbic acid and other vitamins. Therefore, we must strive to systematically include vegetables in the diet.
2. Fresh vegetables should be stored in warehouses without natural light, but well ventilated, with an optimal air humidity of 85-90% and a temperature of + 1 to + 3 ° C. Pickled and salted products should be stored in closed containers.
3. It is advisable to clean vegetables with the least amount of waste, immediately before cooking. Potatoes must be peeled separately for breakfast, lunch and dinner. Peeled potatoes should be stored uncut in water and not in a metal container. Sauerkraut should be stored only in brine before cooking. It is recommended to use collected and, especially, chopped greens as food as quickly as possible. So, radishes completely lose vitamin C in 3 days.
4. The residence time of vegetables in washing machines is no more than 1.5-2 minutes. Extending washing times leads to increased loss of vitamin C.
5. It is not advisable to rinse sauerkraut, since the brine contains 40% of the vitamin C found in cabbage. It should only be slightly squeezed out of the brine, which should be used when preparing borscht or cabbage soup.
6. It is recommended to immerse frozen vegetables in boiling water, since slow thawing leads to a large loss of vitamin C. Especially a lot of the vitamin is destroyed during repeated freezing and thawing.
7. When cooking food, you should use vegetable decoctions.
8. During cooking, the boil should not be violent. Vegetables should be completely covered with water or broth at all times.
9. It is necessary to abandon metal utensils without enamel. We are talking not only about pots and bowls, but also about a sieve - preferably a bast one. When processing berries for the winter, it is not recommended to pass them through a meat grinder with sugar; It is better to chop them with a wooden spoon.
10. Prepared food should be stored as little as possible and, if possible, should be distributed immediately.

In addition, in order to better preserve vitamins in food, substances that protect vitamins from destruction (stabilizers) are currently used. Stabilizers are of greatest importance for such a low-stable vitamin as ascorbic acid.

It has been established that the stability of vitamin C is increased by such food substances that, with their consistency and viscosity, reduce the diffusion of air oxygen and weaken the effect of copper ions on ascorbic acid: starch, sugar in an acidic reaction and a layer of fat on the surface of this medium.

A stabilizing effect on vitamin C of starch and starch-containing products, in particular such as potato starch, wheat and rye flour, pearl barley and oatmeal, was noted. So, dressing cabbage soup, borscht and vegetable soup wheat flour (2-4%) increases the preservation of ascorbic acid in these dishes by 14-24%. To fortify food, the vitamin industry produces special tablets containing 0.5 g of ascorbic acid each.

In order to ensure the vitamin value of food in hospitals (for children and adults), in nurseries, orphanages, children's sanatoriums and maternity hospitals Ready-made food is enriched with synthetic ascorbic acid. In accordance with the instructions of the USSR Ministry of Health, from 30 to 70 mg of ascorbic acid is added to ready-made meals for each child, and 100 mg of ascorbic acid is added to adult meals daily for a year. This measure is of particular importance, since its implementation significantly prevents the occurrence or worsening of deficiency of this vitamin in patients.

Vitamin deficiency develops not only when malnutrition. Some physiological factors are periods of rapid growth in children, periods of pregnancy and lactation, heavy physical and nervous stress, temperature factors, abrupt change climatic conditions require their increased intake into the body. This is the so-called dissimilation form of vitamin deficiency. So, if under normal conditions an adult man should receive 1.7 mg of thiamine per day, then during heavy physical work - 2.2 mg. In high mountainous areas, the daily requirement for vitamin C reaches 150 mg instead of the usual 70 mg, and for B 1 - 10 mg.

Vitamin deficiency often occurs as a consequence of various infectious processes. It has been established that the more severe the infectious-toxic process, the more vitamins are consumed by the body. For example, in severe inflammatory diseases, the body's need for ascorbic acid increases by 5-7 times compared to the normal norm. The greatest deficiency of vitamins (especially ascorbic acid) develops with a long course of infectious-toxic processes. There was even a certain parallelism between the degree of C-vitamin saturation of the body and the outcome of the disease. The use of massive doses of vitamins is not only a means of treating patients, but also a preventive measure against possible hypovitaminosis.

It is known that sulfonamide drugs and antibiotics are widely used in medical practice. Meanwhile, it has been established that long-term use of these medicinal substances leads to the occurrence of certain types of hypovitaminosis. It has been proven that streptocide, sulfadimezin, norsulfazole have antivitamin properties against nicotinic and para-aminobenzoic acids. The interaction between vitamins and antibiotics deserves special attention in this regard. Thus, chlortetracycline, tetracycline, streptomycin and other antibiotics, suppressing the intestinal flora, inhibit the endogenous synthesis of certain vitamins, negatively affect their metabolism in the body, and the conversion of vitamins into active coenzyme forms. As a result, a deficiency of certain vitamins develops.

In some cases, endogenous hypovitaminosis develops (a resorption form of vitamin deficiency), which occurs when the absorption and accumulation of vitamins deteriorates, as well as when the conversion of vitamins into active coenzyme forms is impaired. Especially often, such hypovitaminosis develops when the function of the gastrointestinal tract is impaired, for example, with persistent vomiting, long-term dyspepsia due to severe infectious diseases or food poisoning.

Diseases or injuries of the liver lead to disruption of the metabolism of vitamins, their deposition and absorption.

With the aging of the body, hypo- and vitamin deficiencies are also observed, which may depend, on the one hand, on the lack of vitamins in food, and on the other hand, on disruption of the processes of their absorption and use in the body. Currently, many authors have proven the increased need for vitamins in the body of elderly and old people.

Vitamins in the prevention of hypo- and avitaminosis

How are the issues of preventing vitamin deficiency solved in our country? Mainly by providing the population with nutritious food products. Recommended standards physiological needs in nutrients are established and approved by the USSR Ministry of Health. These standards take into account age, gender, degree of labor intensity, the degree of provision of the population with utilities, and the climatic zone of residence. Separately, the need is established for pregnant women, nursing mothers, as well as for athletes during training and competition.

As already mentioned, the needs for a number of vitamins are largely determined by the calorie content and the ratio of nutrients in diets.

However, under certain conditions, which have already been mentioned above (spring-winter period, increased stress, elderly and senile age, some diseases), the need for additional use of vitamins has been proven in order to prevent hypovitaminosis conditions in the body.

Currently in medical practice they are used with therapeutic for preventive purposes monovitamin, multivitamin and complex multivitamin preparations with amino acids and microelements, coenzyme forms of vitamins.

Monovitamin preparations. Preparations containing vitamin A are used natural origin, and synthetic drugs of this vitamin - retinol acetate and retinol palmitate. Vitamin A is of great importance for human nutrition and health: it contributes to normal metabolism, growth and development of a growing organism; ensures normal functioning of the organ of vision; provides beneficial influence on the function of lacrimal, sebaceous and sweat glands; increases resistance to diseases of the mucous membranes respiratory tract and intestines, as well as to any infection. Due to these biological properties, vitamin A is called an antixerophthalmic, anti-infective, and epithelial-protecting vitamin.

Insufficient intake of vitamin A into the body leads to the development of hypovitaminosis A, the characteristic signs of which are dry and pale skin, peeling, and keratinization. hair follicles, acne formation, dry and dull hair, brittle and striated nails. There is also a decrease in appetite and increased fatigue. Often, especially in children, diseases of the digestive tract and respiratory tract occur. The organ of vision is affected.

Preventive doses of the vitamin are established based on the daily need of the human body for vitamins, and are usually used orally in the form of pills, granules, or oil solution. For the prevention and treatment of hypo- and avitaminosis A, rickets, fish oil and fortified fish oil are used.

Vitamin B 1 is used as a specific preventive and remedy for the prevention and treatment of hypo- and vitamin B1 deficiency. Vitamin deficiency is characterized by a general loss of strength, low temperature, headaches, insomnia, pain in the limbs, shortness of breath, gastrointestinal disorders.

Vitamin B 1 is produced in tablets or dragees (thiamine chloride and thiamine bromide). Vitamin B1, along with vitamin B2, is found in purified brewer's yeast, which is used for hypovitaminosis B1, metabolic disorders, and decreased appetite; vitamin B 1 is also contained in the preparation “Gefefitin” - tablets consisting of dry yeast and phytin.

If there is insufficient intake of pyridoxine into the body, the phenomena of B6 hypovitaminosis may develop. In young children, this manifests itself in growth retardation, gastrointestinal disorders, increased excitability, convulsions, anemia; in adults - loss of appetite, nausea, anxiety, conjunctivitis, dry seborrheic dermatitis; in pregnant women - irritability, depression, insomnia, psychotic reactions, nausea and vomiting. To prevent pyridoxine deficiency in newborns, vitamin B6 is prescribed to women in the last months of pregnancy. Prevention of B6-vitaminosis also consists of prescribing pyridoxine during treatment of patients with sulfonamides and antibiotics. For this purpose, our industry produces tablets that contain antibiotics together with an appropriate dose of vitamin B 6.

Prevention of ovitamin deficiency consists in systematically providing a person with the necessary amount of ascorbic acid. Crystalline ascorbic acid and preparations containing it are used for preventive and therapeutic purposes in all cases when the body requires additional administration of this vitamin: for the prevention and treatment of scurvy, for hemorrhagic diathesis, for nasal, pulmonary and other bleeding, for infectious diseases and intoxications. The drug is also prescribed for intense physical work, mental stress, during pregnancy and lactation. Release forms: powder, dragees, vitamin C tablets with glucose (for children).

To prevent vitamin C deficiency, it is necessary to widely use wild greens and prepare infusions of pine needles and rose hips. The pharmacy chain has the following preparations from rose hips: rose hip syrup with vitamins C and P (given for preventive purposes to children); fortified rosehip syrup; tablets of vitamins P and C from rose hips; vitamin tea: tea No. 1 - rose hips and black currants; tea No. 2 - rose hips and rowan berries.

For the prevention and treatment of hypo- and avitaminosis P and for diseases accompanied by impaired vascular permeability, vitamin P preparations are used. At the same time, it is recommended to use ascorbic acid. As P-vitamin products the following preparations are used: rutin, ascorutin (tablets containing rutin and ascorbic acid), quercetin, vitamin P from the leaves of the tea plant, vitamin P from citrus fruits, vitamin P from the fruits of chokeberry (aronia), vitamin P from the aronia multivelia (buplerin) .

Not everyone knows that ordinary tea - green, black long leaf and other varieties - is a preventive measure for vitamin deficiency. It is known that tea relieves fatigue, activates thinking, and restores vigor and efficiency. This is what L.N. Tolstoy said: “I had to drink a lot of tea, because I couldn’t work without it. Tea freed those possibilities that lay dormant in the depths of my soul, giving me the opportunity to create.” However, tea is primarily a vitamin bouquet, an elixir of substances vital for the human body. Vitamins B 1, B 2, B 3, PP, K, E were found in tea. All this gives tea as a nutritious product great value, but basically it should be considered a natural preparation of such a rare combination as vitamins C and P. By quantity The vitamin C content of tea leaves is second only to rose hips. A sufficient amount of vitamin C is also contained in the finished tea product: green tea leaves contain 3-4 times more vitamin C than lemon and orange.

Prevention of D-vitaminosis (rickets) or D-hypovitaminosis (hidden rickets), accompanied by metabolic changes, irritability, motor restlessness, etc., should begin even before birth. Vitamin D regulates the exchange of phosphorus and calcium in the body, promotes the absorption of these substances by the intestines, and their timely deposition into growing bones.

Vitamin D is prescribed to a pregnant woman throughout the entire period of pregnancy (especially in the last 2-3 months), as well as in the first 7 months of breastfeeding. Human milk does not contain vitamin D in a normal diet. Only when it is abundantly administered with food or when a nursing woman is irradiated with ultraviolet rays can it be detected in noticeable quantities in milk. If a child receives a balanced diet and spends a lot of time outdoors in the summer and receives ultraviolet radiation in the winter, then such a child does not need to be given vitamin D. Before irradiation and in the first 10 days of irradiation, it is recommended to take calcium chloride. The administration of vitamin D should be supplemented by introducing juices containing other vitamins into the child’s diet. Prevention of rickets should continue during the first 2-3 years of the child’s life. If a child has suffered from rickets, then in order to prevent its recurrence in winter, vitamin D or fish oil should be given, which is even better, since it also contains vitamin A, which is also necessary for the child.

Multivitamin preparations. In nature, vitamins are found in different combinations. Plant products often contain a number of B vitamins, vitamin C, etc. Fish oil simultaneously contains vitamins A and D. Combinations of vitamins are also found in other products of animal origin. In some cases, vitamins mutually enhance the physiological effects they provide: for example, the effect of vitamin P on vascular permeability is enhanced by the action of ascorbic acid; The effect of folic acid and cyanocobalamin on hematopoiesis is mutually enhanced. In some cases, the toxicity of vitamins is reduced when used in combination; Thus, the toxicity of vitamin D is reduced by the influence of vitamin A.

Actively participating in various biochemical processes, vitamins can, when used in combination, have a stronger and more versatile biological effect. These and other features of the action of vitamins serve as the basis for their combined use for both preventive and therapeutic purposes. The use of multivitamin preparations is also dictated by the fact that in practice polyhypovitaminosis is more common than individual hypovitaminosis, although the manifestation of deficiency of one of the vitamins is the leading one.

Combining vitamins can be done either by individual selection of appropriate combinations or by combining ready-made multivitamin preparations. The following ready-made multivitamin preparations are available.

Asnitin (tablets containing ascorbic and nicotinic acids, thiamine and glucose). Used for the prevention of hypovitaminosis conditions and during significant physical and neuropsychic stress.

Tetravit (dragés containing vitamins B 1, B 2, PP and C). Prescribed for the prevention of hypovitaminosis in persons working in hot shops, at high external temperatures, heavy physical activity, accompanied by a large consumption of vitamins.

Hexavit (dragés containing 6 vitamins: A 1, B 1, B 2, PP, B 6, C). Used for the prevention of hypovitaminosis, long-term treatment antibiotics, and are also recommended for people whose work requires increased visual acuity.

Multivitamins A, B 1, B 2, B 6, PP, P, C (coated tablets). This multivitamin preparation has advantages over similar drugs A, B 1, B 2, C and Hexavit in that it contains vitamins B 6, PP, P. It is used as a prophylactic for conditions accompanied by an increased need for vitamins: increased physical and neuropsychic stress, general violation nutrition, as well as to increase the body's resistance to infectious and colds with long-term use of antibiotics.

Undevit (dragés containing 11 vitamins). It is used to improve metabolic processes and the general condition of middle-aged and elderly people, as well as in cases of premature aging.

Decamevit (coated tablets containing 10 vitamins and the amino acid methionine). Used for hypo- and avitaminosis, to improve metabolism and general condition in old and senile age, with mental and physical exhaustion, sleep and appetite disorders, during treatment with antibiotics, during the recovery period after serious illnesses.

Undevit and Decamevit belong to the group of geriatric medicines.

Gendevit is a multivitamin preparation containing vitamin A, B1, B2, B6, C, D2, B12, E, nicotinamide, calcium pantothenate and folic acid. It is used during pregnancy and lactation. During pregnancy, childbirth, and also during lactation, the woman’s body’s need for vitamins increases. This is due to increased metabolism due to neuroendocrine changes, the need to satisfy the fetus’s needs for vitamins, as well as the birth act itself. The fetus is very sensitive to vitamin metabolism already in the early stages of its development.

During the formation of the fetus, some vitamins (B 1, B 2, B 6, B 12, C, PP) pass through the placenta from the mother’s blood. Therefore, during pregnancy, these vitamins must be supplied to the mother’s body in sufficient quantities. In more late dates During pregnancy, vitamins A, D and K, which the developing fetus needs, must be introduced into the mother's body. During the feeding period, vitamins are released from the woman’s body along with milk. Therefore, the need of breastfeeding women for vitamins is increased; and during this period, just as during pregnancy, manifestations of vitamin deficiency are often observed. Vitamin deficiency in pregnant women negatively affects not only the condition of the mother, but also the development and viability of the fetus. As a result of the preventive use of vitamins by pregnant women, they reduce the number of cases of toxicosis, the risk of premature birth, improve labor, reduce the possibility of bleeding during childbirth, and also reduce the incidence of newborns.

The pharmacological properties of the drug "Gendevit" are determined by the vitamins included in its composition. Thus, vitamin A is necessary for the normal process of fertilization, for the structure and vascularization of the placenta, for the proper development of the fetus, especially in the first days of pregnancy. Vitamin B1 has a beneficial effect on the muscles of the uterus and has a positive effect on subsequent labor. Vitamin B 6 is effective in the treatment of early toxicosis of pregnancy. To successfully prevent late toxicosis of pregnancy, a combination of pyridoxine, folic acid and vitamin C is successful. The administration of vitamin C during the last months of pregnancy prevents postpartum hemorrhage. Vitamin PP is effective against early toxicosis of pregnancy and depression motor function pregnant uterus. Prescribing vitamin D to pregnant women significantly reduces the possibility of rickets in children in the first months of life. Vitamin B 12 and folic acid are important for preventing anemia in pregnant women. Vitamin E promotes fertilization, normal development fetus and lactation. Pantothenic acid is effective for toxicosis of pregnancy; in addition, the need for it increases in nursing women. Thus, B complex vitamins in combination with ascorbic and folic acids help prevent complications of pregnancy and childbirth, have a positive effect on moderate anemia in pregnant women, and enhance lactation. The use of the drug "Gendevit" for prophylactic purposes leads to a decrease in the percentage of toxicosis of pregnancy and premature birth, to an improvement in the quality of obstetric care (reducing the duration of labor, reducing the weakness of labor, reducing the possibility of bleeding during childbirth, reducing the percentage of stillbirths). When using the drug by nursing women, lactation increases and appetite increases. Children whose mothers received vitamins for preventive purposes developed better. There was a decrease in the percentage of births of hypotrophic children, the percentage of morbidity and infant mortality during the first six months of life. The use of the drug "Gendevit" for therapeutic purposes alone and in combination with other drugs leads to an improvement in general condition, increased appetite, normalization of weight and blood pressure, normalization of diuresis and a reduction in other symptoms of toxicosis, prevention of antenatal fetal death, reduction of anemia during pregnancy and postpartum.

In medical practice, natural multivitamin preparations are used: sea buckthorn oil - a mixture of carotene and carotenoids, tocopherols and unsaturated fatty acids; rose hips, carotolins and others.

Modern sport, characterized by a continuous increase in results, a great intensification of the training process, as well as the holding of many competitions in difficult climatic conditions (medium mountains, hot climates), places extremely high demands on the athlete’s body. Increased performance and acceleration of the recovery period after physical activity achieved through vitamin therapy and vitamin prophylaxis. Undevit, Decamevit, used by athletes during training and competitions, correct vitamin deficiency, often observed in these conditions.

Vitamins in the prevention of various diseases

The vital importance of vitamins for the human body is by no means limited to the prevention or treatment of the corresponding vitamin deficiency. Actively participating in various enzymatic processes, vitamins have a pronounced regulatory effect on the entire metabolic process and on functional state individual human organs and systems. A complete vitamin balance contributes to a greater extent to the process of assimilation (assimilation) and regulation of the functional state, both in normal and pathological conditions. The positive effect of vitamins on the functional state of individual organs and systems of the body, as well as on its overall reactivity, creates the possibility of their use as nonspecific (pharmacodynamic) agents.

B. A. Lavrov, the founder of Soviet vitaminology, wrote that in the future it would be advisable to use vitamins as highly reactogenic substances capable of increasing the tone of physiological processes in the body both under normal and pathological conditions.

Currently, their nonspecific pharmacodynamic effects are widely used in medical practice (for a wide variety of diseases). It has been established that some vitamins, interacting with each other, have a similar clinical and physiological effect.

Vitamin prevention and vitamin therapy are an important factor in the treatment of infectious diseases. It has been established that in the development and course of the infectious process, both the causative agent of the disease and the state of the body, its immunobiological resistance, are of great importance. The degree of saturation of the body with individual vitamins has a pronounced impact not only on the nature of the initial period, but also on the further course of the disease and its outcome. An infectious disease that occurs against the background of vitamin deficiency occurs in conditions of reduced reactivity of the body. In the future, the lack of additional fortification leads to a worsening of general hypovitaminosis also because during an infectious disease the body's need for vitamins sharply increases due to increased metabolism. The intake of vitamins from food, as a rule, decreases (a sharp decrease in the patient’s appetite, disruption of the absorption of vitamins in the intestines, disruption of their metabolism in the liver and other organs).

Vitamin C plays a particularly important role in the treatment of various infectious diseases. It has been shown that vitamin C, when exposed directly, causes a slowdown in the growth of some pathogenic bacteria and even their death. In the very initial period of upper respiratory tract disease, when there is a feeling of irritation of the mucous membrane of the nose and throat, a single dose of 1 g of ascorbic acid (two days in a row) often stops the development of the disease. If you take it a day later, this effect is not achieved, although the disease occurs in a milder form. Large doses of vitamin C (1 g each), used for 2 days, can be an effective prophylactic during an influenza epidemic.

While attaching crucial importance to vitamins C and A in the prevention and treatment of infectious diseases, one should not lose sight of the importance of other vitamins, in particular B-complex vitamins. It is known that thiamine, riboflavin, pyridoxine and nicotinic acid have a positive effect on the functional activity of the central nervous system. If we consider that immune reactions and body resistance are closely related and depend on the state of higher nervous activity and metabolism, it becomes clear positive value, which is given to these vitamins in the treatment and prevention of various infectious processes. Therefore, in the complex therapy of infectious diseases, it is recommended to use combinations of vitamins C, B1, B2, B6, PP and A. The need to include vitamins in the complex treatment of infectious diseases is also due to the fact that large doses are widely used in the treatment of these diseases sulfa drugs and antibiotics, which, as we said, disrupt the metabolism of vitamins, reduce their level in the body and, conversely, high concentrations vitamins enhance the antibacterial effect of the mentioned drugs.

Currently, the attention of practitioners is attracted to research aimed at combating various side effects of drugs. Typically, these pathological conditions arise due to the fact that in the body, saturated with drugs, the intensity of various enzyme systems that convert toxic substances into inactive products is reduced.

Considering the fact that vitamins can have a significant effect on biochemical processes, an attempt was made to use them as regulators of detoxification reactions in various poisonings. Fast fatiguability, headache, confusion in thoughts and other symptoms that occur in people after long-term use of sleeping pills (barbiturates) may be associated with a disturbance in the metabolism of ascorbic acid, and, as a consequence, with a disruption in the processes of inactivation (destruction) of drugs.

Experimental studies have shown that ascorbic acid promotes the conversion of sleeping pills into inactive breakdown products. This was confirmed by clinical observations. Vitamin B 15 reduces the toxic effects of acute and chronic poisoning with alcohol and certain drugs, with long-term use sleeping pills, antibiotics, in case of poisoning with carbon tetrachloride and dichloroethane. The positive effect of pangamic acid is due to an increase in the activity of the oxidation process and a more complete use of oxygen in cellular metabolism. There is evidence that lipoic acid also has detoxifying properties. Lipoic acid is a coenzyme that takes part in the regulation of fat and carbohydrate metabolism, affects cholesterol metabolism and is a neutralizer for poisoning with heavy metal salts. Lipoic acid and lipoic acid amide (lipamide) are used for preventive and therapeutic purposes in diseases of the heart and liver.

Currently, doctors have three coenzymes in their arsenal, which in their medicinal properties are more active than their founders - vitamins. For example, cocarboxylase is a coenzyme of enzymes involved in carbohydrate metabolism processes. Thiamine (vitamin B 1), introduced into the body to participate in biochemical processes, must first be phosphorylated and converted into cocarboxylase. The latter, therefore, is a ready-made form of coenzyme formed from thiamine during its transformation in the body. The therapeutic effect of cocarboxylase is associated with a beneficial effect on metabolic processes. The administration of the drug often helps to reduce pain during angina pectoris, slow down and normalize the rhythm during arrhythmias, relieve precomatous and comatose states in liver diseases, diabetes mellitus, etc. Riboflavin mononucleotide, like cocarboxylase, approaches the biological effect to vitamins and enzymes. Being a product of phosphorylation of riboflavin (vitamin B2), it is a ready-made form of a coenzyme formed in the body from riboflavin. In some eye diseases, the process of phosphorylation of vitamin B2 is disrupted and treatment with the vitamin becomes ineffective. The use of the finished coenzyme form gives a good therapeutic effect. In addition, riboflavin mononucleotide is used as tonic for eating disorders, neurasthenia, skin diseases.

We have already talked about the third coenzyme - lipoic acid.

Vitamins are widely used for the prevention and treatment of skin diseases. The occurrence of many skin diseases is associated with impaired activity various organs and body systems, including changes in biochemical metabolic processes in the skin. That is why in such diseases, not only the general, but also the local action of vitamins, which are contained in solutions, ointments and creams, is used. Normal exchange substances in the skin can only occur in the presence of a number of vitamins: pyridoxine, nicotinic acid, riboflavin, thiamine, pantothenic acid, etc.

Pantothenic acid normalizes activity sebaceous glands and promotes hair growth. Vitamins A, C, B 2, B 12 improve the treatment of seborrhea (dandruff). The content of ascorbic acid in the skin varies depending on age. Children have much more vitamin C in their skin than older people. A decrease in its content during aging leads to disruption of the ability of skin cells to reproduce and self-renew. Vitamin C affects sulfur metabolism in the skin. Sulfur is part of keratin and takes part in the biochemical processes that determine hair growth (B vitamins, fat-soluble vitamins A and E, vitamin F, etc. also affect sulfur metabolism in the body).

Vitamins are also necessary therapeutic agents in the treatment of eczema, furunculosis, psoriasis, and diathesis in children.

It is known that in the development of atherosclerosis, lipid metabolism disorders are of primary importance. And vitamins as metabolic regulators find their use in the prevention and treatment of this disease. Both monovitamin and multivitamin preparations are used: “Aevit” (vitamins A+E), “Aerovit” (contains 11 vitamins). There is evidence of the anti-sclerotic effect of vitamin C. Vitamin C helps to “cleanse” the walls of blood vessels from cholesterol, therefore it is recommended to take 0.5 g of vitamin C daily for preventive purposes, and for patients with atherosclerosis and those prone to it - 1 g.

Aerovit is used for preventive purposes by pilots and people in other specialties who are exposed to extreme factors (vibration, motion sickness, overload, etc.).

Pangexavit and Pentovit are used as general tonic drugs. These are multivitamins used for infectious and inflammatory processes, diseases of the skin and eyes, as well as in complex therapy for diseases of the peripheral and central nervous systems.

Thus, vitamins can rightfully be included in the arsenal of numerous medications used for the prevention and treatment of various diseases.

But are vitamins really that perfect? We have already said that often the role of biocatalysts is played not by vitamins, but by their active coenzyme forms. Meanwhile, in diseases of the liver, gastrointestinal tract and infectious diseases, vitamins are either poorly absorbed or are not converted into coenzymes. In such cases, no matter how many vitamins we use, the phenomenon of hypovitaminosis cannot be eliminated.

Some diseases require an increased content of one or another vitamin in the tissues, and the penetration of such a vitamin into these organs can be limited. There are certain enzymes in the human body that break down vitamins, turning them into inactive forms.

How do we combat these vitamin deficiencies?

Scientists have carried out chemical transformations of some vitamins, as a result of which new derivatives have been obtained that have the ability to be quickly absorbed into the blood and better penetrate the cells of various organs. These compounds turned out to be more resistant to the destructive effects of enzymes. In the cells of the body they are converted into ordinary vitamins, which ultimately go towards building the corresponding enzymes. Thus, phosphothiamine-phosphorus ester of thiamine (vitamin B 1) is more easily converted into cocarboxylase, is more deposited in body tissues, and is destroyed to a lesser extent by the enzyme thiaminase than thiamine. It is used for the prevention and treatment of B1-vitamin deficiency and as a pharmacodynamic agent for diseases of the nervous, cardiovascular systems, and digestive organs. Benfotiamine, a benzoyl derivative of thiamine, has B1-vitamin activity and has a number of advantages over thiamine: low toxicity, better absorption, better permeability through biological membranes, and is less likely to cause allergic complications.

Currently, rapidly absorbed derivatives of nicotinic acid, vitamins C and A have been obtained.

Modification (change) of the folic acid molecule led to the creation of an antivitamin - amethopterin (methotrexate), which is used in oncological practice.

The concept of hypervitaminosis

Unfortunately, there is an opinion that vitamins are completely harmless to humans. This is mistake! Like all biologically active substances, vitamins in excessively large doses can cause poisoning. Such toxic conditions are called hypervitaminosis. There are acute hypervitaminosis, which develops after a single dose of a massive dose of the vitamin, and chronic hypervitaminosis, which occurs as a result of long-term intake of increased doses of the vitamin. There are also intermediate forms between acute and chronic intoxication.

Vitamins of group D have the most pronounced toxic effect. The pathological effect and severity of intoxication depend not only on the amount of vitamin taken, but also on individual sensitivity to it.

Hypervitaminosis D is common, mainly in young children, and is usually associated with taking large doses of the vitamin in the prevention and treatment of rickets. It often develops both due to parents’ violation of doctors’ instructions (significantly exceeding the dose of calciferol) and due to leakage of the bottle, as a result of which the alcohol evaporates and the concentration of vitamin D increases.

Lack of knowledge among the population about the possible harm of large doses of vitamin and lack of alertness to the initial manifestations of intoxication are the main reasons for the occurrence of hypervitaminosis, including D.

With hypervitaminosis D, the calcium content in the blood sharply increases, which leads to the deposition of salts in the tissues of the heart, kidneys, and lungs; The nervous system does not remain unaffected. Patients with hypervitaminosis D complain of general weakness, loss of appetite, nausea, and vomiting. Often headaches, diarrhea occur, and body temperature rises. The skin takes on a grayish-yellow color, becomes dry, and begins to peel. Activities are disrupted of cardio-vascular system and kidneys. In infants, hypervitaminosis D is manifested by softening of the edges of the fontanel and occipital bones, vomiting, anxiety, and they stop gaining weight.

Hypervitaminosis A leads to the development of a severe pathological condition, the characteristic symptoms of which are headache, drowsiness, dizziness, nausea and vomiting. Cases of acute hypervitaminosis A occur among residents (visitors) of the Far North when consuming the liver of polar birds, polar bear, walrus, seal and whale. The local population has not eaten the liver of these animals for a long time; it is also prohibited to give it to dogs. A single dose of 100-500 g of such liver causes intoxication in adults.

The development of symptoms of acute hypervitaminosis A can also occur with accidental intake of a large amount of a vitamin preparation. In infants, acute hypervitaminosis A occurs within 12 hours. after taking a large dose of vitamin A. The chronic form of this condition is characterized by increased irritability, loss of appetite, and hair loss. A rash appears on the skin, cracks form, and bleeding of the mucous membranes of the lips occurs.

Hypervitaminosis A leads to vitamin C deficiency in the body and can cause scurvy. Vitamins of group B (B 1, B 2, B 6, B 12) in increased doses can also have a negative effect on the body. In some cases, patients experience severe shock. Allergic reactions that occur both with intravenous and intramuscular injection large doses of pyridoxine, cyanocobalamin and especially thiamine. There is information about possible human reactions (especially pregnant women) in response to the administration of large doses of ascorbic acid.

It must be remembered that vitamins are wonderful natural remedies- are so biologically active and diverse in their action that their uncontrolled use can cause great harm.

“If you look around with the eyes of a doctor looking for medicines, you can say that we live in a world of medicines... There is no substance in nature that would not be suitable as a medicine,” says one of the commandments of ancient Buddhist medicine. Vitamins are also medicines, and they should be used only on the recommendation and prescription of a doctor!

“Health is a gift of nature, which is not given to us forever,” said Academician of the USSR Academy of Medical Sciences, Hero of Socialist Labor E.M. Gareev in one of his speeches.

To enjoy the treasures of nature, a person must be healthy and strong. Each of us wants to live and be able to work as long as possible, without feeling the burden of old age. An assistant in the fight against premature aging of the human body, in the fight against various diseases and simply against fatigue that occurs after hard physical and mental work, are vitamins - substances absolutely necessary for the functioning of the body. Vitamins are rightfully among the main therapeutic and prophylactic agents that help Soviet healthcare solve important problems of preserving the health and working capacity of the population.

Ascorbic acid, vitamin C (in Latin scorbutus - scurvy) is the elixir of life, which is valued on all continents. Everyone has heard that vitamin C saves you from colds, so winter time Everyone is pouring heavily into tangerines and oranges, and buying sweet ascorbic acid from pharmacies and supermarkets. Why is this substance so famous?

Scientists guessed about the existence of a vitamin that is ready to resist scurvy in the mid-nineteenth century. There was an unspoken rule among sailors and doctors: to dilute the usual diet with citruses and fruits. Thanks to a sufficient amount of the substance, the body protects itself from viral infections, the immune system independently fights viruses and infections.

Several decades later, researcher Zelva began studying the composition of vitamin C, and soon managed to extract ascorbic acid from freshly squeezed lemon juice. However, in the 20s, the material and technical base did not allow further advancement in research. After a while, Albert Georgi and Charles King managed to decipher the chemical formula of the substance and developed an artificial synthesis. Since then, hundreds of scientists have devoted their work to studying the characteristics of vitamin C. Nowadays, the substance is regularly used in medicine and the beauty industry.

After the discovery of ascorbine, its use in European countries reached record levels. The government recommended that residents use the element three times a day, without understanding what the new element is useful for. Soon, medical institutions began to receive complaints about ascorbic acid hypervitaminosis, the symptoms of which are dangerous to human life. Germany and Norway introduced restrictions on the production, advertising and sale of vitamin C, which made it possible to level out the situation. People were wary of a substance that had recently been considered miracle cure from all diseases.

Restrictions on ascorbic acid still remain. In addition, in 2005, the European Court ordered manufacturers to replace the phrases “heals, prolongs” with “promotes, protects” in the instructions for the drug. Doctors undertake to regulate the dosage of the element to avoid unwanted complications.

Despite the presence of contraindications and recommendations, the biological role of vitamin C in the functionality of the body is enormous. You should carefully monitor your diet to ensure you consume enough of the substance through food and vitamin preparations.

The chemical formula of ascorbic acid is C6H8O6. The powder is no different from other vitamins: soluble in water, resistant to fat, has a sour taste, but has no odor. If stored improperly, it disintegrates and resembles a powder in its structure.

At what temperature is vitamin C destroyed? The destructive process begins at 60 degrees, and breaks down into particles at 100 degrees.

Chemists have proven that vitamin molecules are similar in composition to crystalline sugar, but there are still significant differences. Artificially derived vitamin C appeared in the food industry, which immediately became a popular food additive under the number E315. The supplement does not have the same beneficial properties as the original, although it is much cheaper.

Functions in the body

The main role of ascorbic acid in the human body is the fight against radicals and antioxidant properties. The element is the strongest antioxidant, since it protects internal organs and tissues from possible damage and the development of cancer.

What is vitamin C for? With its participation, redox processes take place in the body, synthesis is carried out, and the connective tissues. Vitamin C accelerates the healing of wounds and scars and has a positive effect on epithelial regeneration.

It is important for athletes to regularly take vitamin and mineral complexes containing ascorbic acid, since the substance normalizes energy processes and increases endurance. The synthesis of steroid hormones, the metabolism of folic acid, and natural metals cannot do without vitamin C. In bodybuilding, the substance is respected for its role in gaining muscle mass, since the level of protein absorption and processing depends on it.

The value of ascorbic acid for the body cannot be assessed. The vitamin strengthens blood vessels and increases the level of permeability of elements through their walls. The drug is prescribed for allergic reactions, since large volumes of blood stop accumulating in problem areas of the body. If vitamin C is present in the body in the right amount, inflammatory processes occur in a lighter form.

The main cause of the development of cardiovascular diseases is considered to be an increased amount of cholesterol in the body. Ascorbic acid normalizes the process of synthesis and metabolism, so oxidized cholesterol is not deposited on the walls of blood vessels. Prevention of these phenomena will help to avoid atherosclerosis, from which even young people suffer today.

Thanks to vitamin C, the absorption of calcium and iron is improved twofold, the blood is provided with an anti-anemic factor, the nervous system and joints absorb calcium better. The benefits of the substance are confirmed by research: improvements in calcium absorption occurred even in older people, when all processes slow down several times.

Oncology is considered the plague of the 21st century; statistics show that the number of cancer patients is growing relentlessly. Oncologists say that with normal levels of vitamin C in the body, a natural fight against cancer cells occurs. However, if a surplus of ascorbine forms in the body, mutating cancer cells become more resistant, even radiation therapy does not kill them.

The development of a cancerous tumor can be slowed down by injecting the substance directly into malignancy. Scientists are still conducting clinical studies to confirm this theory. In any case, cancer patients are advised to maintain vitamin C at the proper level.

Ascorbic acid frees the liver from the influence of toxins, removes copper, radioactive substances, mercury, and lead. To prevent the development of diseases of the gastrointestinal tract, ascorbine has become an indispensable tool. By controlling the level of the substance in the body, there is a chance to avoid cancer in the colon and bladder.

Acid normalizes the functionality of the nervous system, the body develops resistance to stress, and the strength to resist pathogens appears. In addition, the work of the adrenal glands is balanced and the required amount of hormones responsible for combating stress is produced. This is not all that ascorbic acid is responsible for.

It is impossible to give an objective assessment of the effect of vitamin C function. In the twenty-first century, science knows far from all the properties that a substance is rich in. Do not underestimate control over the level of ascorbic acid in the body, since its deficiency causes the development of chronic diseases.

The body, due to its characteristics, does not accumulate ascorbic acid, so you should carefully monitor its consumption. IN daily diet Products rich in vitamin C are not often present. The amount of the substance should be replenished in medicinal form. The natural vitamin is water-soluble and easily subject to heat treatment, which destroys its beneficial chemical properties. What products does it contain?

Main sources of the substance:

• rose hip;
• Bell pepper;
• melon;
• black currant;
• tomatoes;
• oranges;
• apples;
• peach;
• persimmon;
• Rowan;
• baked potato;
• cabbage;
• leafy herbs.

Previously, oranges and tangerines were considered the main fruits containing the most vitamins. Over time, scientists proved that this is not so, and nothing compares with rosehip, bell pepper and kiwi in terms of the capacity of the substance.

Among animal products, vitamin C is found only in the liver, adrenal glands and kidneys.

• mint;
• nettle;
• oats;
• parsley;
• plantain;
• raspberry leaves;
• sorrel.

These products are easily digestible, as evidenced by more than one calorie table. People who adhere to a diet do not have to worry about their vitamin levels, since their diet consists of healthy foods whose calorie content will not harm the diet.

1. Vegetables and fruits are peeled and cut immediately before consumption.
2. During cooking, vegetables are placed only in boiling water so that the organic vitamin does not dissolve in the water during heating.
3. Cooked vegetables should not be left in the broth, because everything is given up to the liquid, and the fruits become useless.
4. Fresh vegetable salads are salted and seasoned with sauces only before serving.

Vitamin C is consumed instantly after it enters the body; take care to consume the vitamin evenly throughout the day.

It is advisable to divide the daily dose into three equal portions, thus maintaining the concentration of the substance in the body constantly. Having found out what contains the most ascorbic acid, try to properly prepare and eat foods with an increased source of the substance.

If there is a lack of vitamin in the body, it is recommended to replenish the supply with medications. Release form:

• dragee;
• in tablets;
• in ampoules;
• in powder.

The form of use is determined by the attending physician depending on the nature of the disease. The instructions for use warn of possible side effects if the drug dosage is incorrect.

Ascorbic acid dragees are prescribed to children because they resemble candy and not medicine. Effervescent tablets are popular among professional athletes. One tablet, diluted in a glass, replenishes vitamin reserves and invigorates before a grueling workout. The powder is available in sachets.

An injection solution is prepared in ampoules. One ampoule contains 50, 100 mg, which allows you to administer at a time the right dose drug.

Overdose has a negative effect on the stomach and digestive tract. Pregnant women are at risk because the metabolism between the mother and fetus is disrupted. As a result, the child develops allergies, and the mother will develop problems with the gastrointestinal tract.

Daily value for humans

Scientists have not reached a consensus regarding the daily requirement of vitamin C for the human body. A common option for the average adult is 60-80 milligrams of the substance per day.

Infants are allowed to consume up to 40 mg of ascorbic acid, for children aged five - 45 mg, at fourteen years of age the daily norm increases to 50 mg.

The World Health Organization recommends using a different calculation method: 2.5 mg of the substance falls per kilogram of body weight. A 200-pound man should receive 225 mg of vitamin C per day. To replenish ascorbic acid levels for medicinal purposes, doctors increase the recommended dose three times.

1. Pregnant women – 75 mg. If you have a question, can pregnant women take vitamin C? Consult a antenatal clinic so as not to worry about the baby’s health. When planning a pregnancy, the level of ascorbine in the body is important for men and women. The daily norm does not exceed 100 mg.
2. Nursing mothers – 90 mg.
3. Smokers - 120 mg.
4. Alcoholics – 120 mg. Alcohol and nicotine accelerate the breakdown of vitamin C, which provokes the formation of a deficiency of the substance in the body.
5. Persons in constant stressful situations.
6. People living in areas with unfavorable ecology: factory emissions, exhaust gases, untreated drinking water, etc. As soon as harmful substances enter the body, ascorbic acid is used up to dispose of them. The need for vitamin increases.
7. Residents of the Far North and Southern regions. Unusual weather conditions are considered stress for the body, so residents are advised to take 40% more vitamins than other categories.
8. Women taking oral contraceptives.

Even if you belong to the group of people suffering from vitamin C deficiency, do not consume large doses of the substance at once. Divide the dose into 3 servings and take them throughout the day.

At what age is the use of ascorbic acid allowed? Vitamins without the presence of pathologies in the baby are introduced into the diet after the end of the breastfeeding period. At breastfeeding the baby receives all the necessary elements from mother's milk.

The lethal dose for humans is 60-90 tablets in a short period of time. The body does not have time to remove the substance through the urinary canal, and an overdose of the vitamin occurs.

Let us remember that since ancient times, citrus fruits were considered the only salvation from scurvy. 10 mg of ascorbic acid, which is equal to two fresh grapes or a bunch of grapes, will help prevent the development of the disease. However, this is not enough to maintain the productive functioning of the body in a world filled with negative factors: factories, exhaust fumes, dirty water, chronic stress.

Hypovitaminosis is manifested by a decrease in the functioning of the immune system, the body's vulnerability to respiratory and gastrointestinal diseases. Studies have proven that with ascorbine deficiency in schoolchildren, the body’s ability to resist pathogenic microbes has halved. Acid deficiency causes the development of serious diseases. Signs of vitamin C deficiency:

• gum sensitivity;
• loss of teeth;
• decreased visual acuity;
• varicose veins;
• the appearance of bruises;
• prolonged wound healing;
• fatigue;
• hair loss;
• obesity;
• the appearance of senile wrinkles;
• irritability;
• inattention;
• joint pain;
• insomnia;
• depression;
• apathy.

With insufficient intake of ascorbic acid for two to three months, vitamin deficiency develops.

Before taking vitamins, find out their amount in the body in order to avoid unwanted consequences from an overdose. To determine the level of vitamin C in the body, it is not necessary to undergo tests; the test can easily be carried out at home. Pull your hand tightly with a rubber band until small spots appear on the surface of the skin. The number of spots indicates the level of vitamin deficiency: the number of spots indicates the complexity of the situation. An excess of vitamin C is indicated by its presence in the urine.

You need to replenish vitamin C reserves in the body the right products nutrition, which were already mentioned above. Try to minimally process fruits and vegetables with elevated temperatures and water, since beneficial substances dissolve extremely quickly without entering the body.

Ascorbic acid is extremely beneficial for humans, but in large quantities it can cause irreparable harm. The body functions normally only when it receives the required amount of vitamins and minerals not exceeding the permissible norm. Excess and deficiency become impetus for undesirable processes that affect the overall health.

Consequences of excess ascorbic acid:

1. Diarrhea.
2. Destruction of blood cells.
3. Simultaneous consumption of vitamin C and aspirin leads to irritation of the gastric mucosa and ulcers. Aspirin causes increased consumption of ascorbic acid, which is excreted in the urine through the kidneys. Such a loss becomes the first sign of a serious vitamin deficiency.
4. A high dose of vitamin C interferes with the absorption of vitamin B12, which is used as a dietary supplement. B12 deficiency has an extremely negative effect on the body, so its level should be regularly monitored by a doctor.
5. Candies and chewing gums with a high content of vitamin C damage tooth enamel, so after eating them, be sure to brush your teeth and rinse your mouth.
6. Excessive doses of ascorbic acid slow down the functioning of the pancreas, which is dangerous for patients with diabetes and people with anemia, thrombophlebitis, and thrombosis. Vitamin C influences the formation of a separate group of hormones that put pressure on the functioning of the kidneys and arteries.

Ascorbic acid is freely available in stores and pharmacies, so you can purchase it without a doctor’s prescription.

Excess vitamin C has negative consequences that are as serious as deficiency.

The beneficial properties of ascorbic acid have become the reason for its popularity in medicine. Vitamin C-based preparations are prescribed for a wide range of diseases:

• scurvy;
• avitaminosis;
• hepatitis;
• cirrhosis;
• helminthiasis;
• ulcer;
• fracture;
• bleeding;
• diathesis;
• infectious diseases;
• dystrophy.

Doctors, having studied the patient’s medical history, increase the dosage to 1.5 g per day. Intramuscular medications are administered in case of acute vitamin deficiency; in other cases, the diet is regulated and pills are prescribed.

The famous doctor Linus Pauling became an ardent supporter of the use of vitamin C for medicinal purposes. The scientist advocated the use of the substance in the treatment of serious diseases and minor ailments, but this theory was not confirmed by research by physiologists. Some patients, after increasing the daily norm, developed serious problems caused by hypervitaminosis.

During pregnancy, additional examinations and tests are carried out, since the woman and child may be affected. It is not for nothing that there are restrictions on the use of vitamin C for pregnant women, since in the early stages its excess provokes miscarriage.

Ascorbic acid is prescribed for delayed menstruation and irregular cycle. Vitamin C is involved in the production of estrogen, the main component in the structure of the inner layer of the uterus. When there is a sufficient amount of female hormone, the uterus contracts, provoking menstruation. Thus, the substance causes menstruation and improves women's health.

Application in cosmetology

Ascorbic acid, like, is included in anti-aging cosmetics for women. Products based on vitamin C prevent the effects of free radicals on the skin of the face, which is why it is used in the manufacture of anti-aging creams.

The presence of a vitamin in the list of cosmetic ingredients does not guarantee quality, since the amount of the element used is not always enough to produce an effect. The optimal dose in cosmetology ranges from 0.3% to 10%. Professional preparations on the labels contain information about the amount of active substance and percentage components.

Due to the sensitivity of the vitamin to light and air, cosmetics based on it are produced in sealed, tinted packaging with a dispenser.

Vitamin C-based facial cosmetics perform the following functions:

• protect the skin from exposure to infrared rays;
• synthesize collagen;
• restore collagen fibers;
• slow down the aging process;
• increase skin tone;
• prevent the appearance of age spots;
• relieve inflammation;
• refresh and improve complexion;
• strengthen vascular walls.

In winter, cosmetics are not enough to replenish vitamin C reserves; it is necessary to take vitamin and mineral complexes for the skin.

Ascorbic acid is useful for hair; it makes hair shiny and silky. Liquid vitamin from the ampoule is added to ordinary shampoo or balm for washing hair. Nutrition along the entire length is provided during each wash.

Myths about vitamin C

Ever since the properties of ascorbic acid became known to mankind, the vitamin has been accompanied by myths and rumors. There are legends about the miraculous properties of the substance that are far from the real state of affairs. We invite you to familiarize yourself with popular and common myths regarding vitamin C.

1. Ascorbic acid protects against ODS. Everyone has heard that at the first signs of illness, you need to immediately take vitamin C. Doctors prescribed “ascorbic acid” to adults and children, assuring them that they would soon forget about a runny nose and cough. It is not true. The vitamin will help with colds only if it is taken as a prophylactic before the onset of the disease. Otherwise, people who take vitamin C get sick one day less than the average person.
2. Does not protect the body from toxins. The results of clinical studies amazed experienced scientists. Smokers cause irreparable harm to the health of their family members, turning them into passive smokers. If they regularly take ascorbic acid, then the consequences of smoking are much less.
3. Vitamin C does not affect cancer tumors. Scientists' opinions regarding the effect of ascorbic acid in the fight against cancerous tumors differ from each other. A couple of years ago, Marky Levine, an employee of the National Institutes of Health, proved that ascorbate helps in the fight against cancer - it destroys cancer cells. When vitamin C is injected into the tumor body, survival cancer cells decreased by half. Positive Impact The drug for cancer will have to be proven by the results of clinical products, because each organism has exceptional characteristics.
4. You can lose weight with ascorbic acid. Indeed, vitamin C improves the functioning of the body; it is possible to lose a few kilograms, but no more. To lose weight, you don't just need to take any pills, it's important to create a calorie deficit. Proper balanced nutrition, physical activity, sleep are the key healthy body. To understand how many calories are consumed and expended daily, you should keep a diary and write down each meal (weight, calorie content) in it.

Excessive consumption, like a deficiency of an element, leads to negative consequences. You should not prescribe your own dosage without first being examined by a specialized doctor.

Vitamin and antivitamin preparations.

Coenzyme preparations.

Vitamin preparations– these are medicines containing natural vitamins or their synthetic analogues or their isomers (vitamers).

Vitamin-like compounds are a group of conditionally essential nutritional factors that resemble vitamins in their physiological action, but if they are deficient, vitamin deficiency does not develop. Medicines made from such compounds are called vitamin-like drugs.

Coenzyme preparations are medicines containing synthetic analogues of coenzymes and used to correct various metabolic processes in the body. Coenzyme preparations are divided into 2 groups:

vitamin origin

non-vitamin origin

Antivitamins are derivatives of vitamins with substituted functional groups that have the opposite effect of the vitamin and partially or completely exclude vitamins from the body's metabolic reactions.

Classification of vitamin and coenzyme preparations:

Preparations of fat-soluble vitamins.

Vitamin A preparations (retinol):

retinol acetate, palmitate;

• roaccutane

Vitamin D preparations (calciferol):

ergocalciferon

oxidevit

Vitamin E (tocopherol) preparations:

tocopherol acetate

Vitamin K preparations (cartoquinones):

vitamin K 1

conachion

Preparations of water-soluble vitamins and their coenzymes

Vitamin B1 (thiamine) preparations:

Thiamine bromide (chloride)

Coenzyme preparation:

cocarboxylase

Thiamine derivatives:

phosphothiamine

benfotiamine

Vitamin B2 (riboflavin) preparations:

riboflavin

Coenzyme preparations:

flavin mononucleotides

flavinate

Vitamin B 3 preparations (pantothenic acid):

calcium pantothenate

Vitamin B 5 preparations (niacin PP):

a nicotinic acid

Coenzyme preparations:

nicotinamide

Vitamin B 6 (pyrodoxine) preparations:

pyridoxine hydrochloride

Coenzyme preparations:

pyridoxal phosphate

Vitamin B 9 (B c) preparations (folic acid):

folic acid

calcium folinate

Vitamin B 12 preparations (cyanocobalamins):

cyanocobalamin

oxycobalamin

Vitamin C (ascorbic acid) preparations:

ascorbic acid

Coenzyme preparations of non-vitamin origin

carnitane chloride

lipoic acid

• Phosphaden

Multivitamin preparations

• dekamevit

  gendevit

  macrovit

Complex preparations of multivitamins with macro- and microelements

glutamevit

complivit

• Unicap T, M

Typical mechanisms of action of vitamin preparations:

Most vitamins are converted into coenzymes in the body and are part of enzymes. Thus, they participate in carbohydrate, fat, protein and other types of metabolism. For example, vitamin B 1 (thiamine) in the form of an active form is part of cocarboxinase. Cocarboxinase is a coenzyme of: pyruvic and ketoglutaric acid dehydrogenases.

Thanks to this, thiamine preparations participate in carbohydrate metabolism, in the formation of fatty acids, and in the synthesis of a/choline nucleic acids; NAD, NADP.

Another typical mechanism of action of vitamin preparations is that vitamins can be donors or acceptors of various chemical groups and thus participate in biochemical reactions.

For example, ascorbic acid is a donor of hydrogen protons and is involved in redox processes in the body.

Some vitamins have hormone-like effects. Thus, the active form of vitamin D, together with the parathyroid hormone, regulates the metabolism of Ca and P.

The following can be distinguished basickindsvitamin therapy.

Preventive – prescribing vitamin preparations if there is a risk of developing hypovitaminosis. For example, in the winter-spring period. In these cases, the dose of the drug corresponds to the daily needs of the body. I prescribe drugs enterally.

Recently they have begun to highlight adaptive Vitamin therapy is the prescription of vitamin preparations to facilitate adaptation to unfavorable and difficult conditions. In such situations, the need for vitamins increases sharply, therefore, if they are supplied in normal quantities, hypovitaminosis may develop. In these cases, doses are used that are 2-3 times higher than the daily requirement.

Substitute vitamin therapy (etiotropic) – the prescription of vitamin preparations for the elimination and development of hypo- and avitaminosis. Doses exceed the daily requirement. Method of administration: enteral.

The next type of vitamin therapy is the use of vitamins for eliminating or reducing the negative effects of other drugs. For example, pyridoxine hydrochloride eliminates the side neurotoxic effect of the drug ftivazide.

Nonspecific (pharmacodynamic)– this is the use of vitamins in high doses in order to influence the metabolism and other processes of the patient’s body. In this case, the vitamin preparation is not prescribed to compensate for the deficiency (such patients do not have it). Vitamin preparations are prescribed as medicines that have certain pharmacodynamics and vitamin therapy is in the nature of conventional pharmacotherapy.

Let us dwell in more detail on some types of vitamin therapy. Unfortunately, we have to admit that the problem of prevention and treatment of hypo- and even vitamin deficiency has again become relevant these days.

Hypovitaminosis in recent years is characterized by 2 features:

1 they affect all age groups

2 hypovitaminosis persists in the summer-autumn period.

The main cause of hypovitaminosis in our country is known - it is the low quality of nutrition and insufficient consumption of fresh vegetables and fruits.

For the prevention and treatment of hypovitaminosis, multivitamin preparations “Undevit”, “Dekamevit”, “Makrovit”, etc. are used. When preventing vitaminosis, the dose is close to the daily requirement. Multivitamins are usually taken in winter and spring for a course of 3-8 weeks to several months. With vitamin replacement therapy, the dose usually exceeds the daily requirement. The course depends on the disappearance of clinical signs; if hidden hypovitaminosis is possible, the course is also from 1 to several months.

Adaptive vitamin therapy. There are many situations in which the need for vitamins, especially water-soluble ones, increases several times, first of all:

periods of adaptation to new or complicated living conditions

increased physical and mental stress.

Under such conditions, all enzyme systems begin to function with increased intensity. As a result, the utilization of vitamins increases and the need for them becomes higher than usual. Insufficient intake of vitamins leads to serious changes in metabolism. Persistent fatigue develops, immunity decreases, and various pathological conditions appear. To prevent this from happening, so-called vitamin therapy is carried out. In this case, doses are used that are 2-3 times higher than the daily requirement of a healthy person. Therapy is carried out in courses of 3 to 8 weeks. But perhaps longer. If necessary, courses are repeated after 3-5 months.

The need for vitamins also increases during pregnancy (2 times). A special vitamin complex has been developed for pregnant women, which contains vitamin D and folic acid, for example, “Gendevit”.

An increased need for vitamins is observed in old age. In this case, vitamins are used to stimulate the enzyme systems of an aging body. Multivitamin preparations such as “Undevit”, “Aerovit”, “Dekameviit” are also shown.

Pharmacodynamic vitamin therapy– this is the use of vitamins as medicines for diseases that do not relate to hypo- or vitamin deficiency. This is the first difference between pharmacodynamic vitamin therapy and replacement and adaptation therapy. The second significant difference is in dosing. With replacement and adaptation therapy, the dose of vitamins generally corresponds to the daily requirement and exceeds it no more than 2-3 times, i.e. remains within the physiological norm for the supply of vitamins to the body. In order to obtain a certain pharmacological effect, vitamins are taken in doses tens and sometimes hundreds of times higher than the daily norm. The pharmacodynamic properties of vitamins appear precisely when high, non-physiological doses are prescribed.

Finally, the third feature of pharmacological vitamin therapy is the prescription of one particular vitamin that has the desired pharmacological effect.

Using the pharmacological properties of vitamin preparations, it is possible to influence both metabolic processes and executive systems and organs.

It has been established that nicotinic acid has a vasodilating effect, in addition, in doses of 3 g and higher per day, it has a hypolipidemic effect (with a daily requirement of 15-20 mg).

Nicotinic acid preparations are used for hypertension, IHD, peripheral circulatory disorders. Abroad, nicotinic acid in large doses (3 g per day) is used to treat atherosclerosis.

THIAMIN (B 1 )

In medical practice, vitamin B1 is used in the form of thiamine bromide and thiamine chloride. A coenzyme drug is used - cocarboxylase and thiamine derivatives - benfotiamine and phosphotiamine. Thiamine introduced into the body in the form of a drug undergoes phosphorylation. As a result, mono-, di-, and triphosphates are formed. Of primary importance is thiamine diphosphate, which is often called cocarboxylase. Benfotiamine and phosphotiamine are also converted into cocarboxylase in the body.

Pharmacodynamics: Cocarboxinlase is part of such enzymes as -PVK dehydrogenase and -ketoglutaric acid; - trinsketolases.

Thanks to this, thiamine preparations are involved in various types of metabolism:

First of all, thiamine in the form of cocarboxylase is involved in carbohydrate metabolism: it promotes the utilization of glucose and is an insulin synergist; promotes the combustion of PVC, and therefore lactic acid and ketone bodies; helps eliminate metabolic acidosis.

Transketolase is necessary for the use of glucose in the pentose cycle and the formation of NADPH 2. NADPH 2 then participates in the synthesis of fatty acids, nucleic acids, acetylcholine proteins and other substances.

Thiamine diphosphate in brain tissue is necessary for the activity of GABA, acetylcholine and serotonin.

Application.

Thiamine is used when absorption is impaired, when the need for it increases, and for the treatment of certain diseases.

One of the indications is metabolic acidosis, including diabetes. It is better to use cocarboxylase, although thiamine is acceptable. These drugs eliminate excess PVC and normalize the composition of blood plasma and tissues.

In the complex treatment of diabetes mellitus, cocarboxylase promotes the utilization of glucose.

Heart failure (usually as an adjunct to cardiac glycosides).

Heart rhythm disturbance (cocarboxylase).

IHD (cocarboxylase).

What is the basis of the action of thiamine preparations?

Cocarboxylase affects carbohydrate metabolism, improves redox processes and energy production in the myocardium. This leads to an increase in the content of potassium and calcium ions in the heart muscle cells. As a result, the force of contraction of the heart increases and its increased excitability decreases. Arrhythmias disappear and, as a consequence, a cardiotonic effect.

Peripheral neuritis. Thiamine has a neurotropic effect. Its effect on the peripheral nervous system is especially pronounced. It promotes the synthesis of acetylcholine.

Side effect:

The main thing is allergic reactions. The most serious is anaphylactic shock. It develops more often with intravenous administration of thiamine. Therefore, thiamine should not be administered parenterally, much less intravenously, unless absolutely necessary.

THIAMIN PREPARATIONS

Cocarboxylase. This is a coenzyme formatiamine. Its pharmacological activity is somewhat different from thiamine - it is not used for the prevention and treatment of hypovitaminosis B1. Less toxic, it can be administered intramuscularly and intravenously.

Pyridoxine (B 6 ). In medicine, pyridoxine hydrochloride and the coenzyme drug pyridoxal phosphate are used. Features of pharmacokinetics: pyridoxine, administered in the form of pyridoxine hydrochloride, is converted in the body into pyridoxal phosphate. Pyridoxal phosphate plays an important role in many biochemical reactions:

participates in amino acid metabolism

necessary for the synthesis of glutamic acid

necessary for the formation of neurotransmitters, GABA, glycerol, serotonin

participates in carbohydrate metabolism

participates in the metabolism of vitamin B 12, folic acid, and the synthesis of HB.

All these functions of pyridoxine in the body determine its medical use.

Indications:

Heart failure, myocardial dystrophy. Usually together with cardiac glycosides. Pyridoxal phosphate is more effective. It activates metabolic processes and myocardial contractility. Thus, pyridoxal phosphate has a cardiotoxic effect.

Hepatitis, liver cirrhosis. Pyridoxine has a hepatotropic effect, it improves liver functions: exocrine, protein-forming, detoxification.

Some hereditary hypochromic anemias.

Epilepsy – in complex treatment. It has been established that in such patients the conversion of glutamic acid to GABA is impaired.

Radiation damage – stimulates leukopoiesis.

Adverse reactions when using antitumor drugs.

Skin diseases: psoriasis, eczema, neurodermatitis.

Toxicoses of the 1st half of pregnancy.

Side effect:

Allergic reactions

Increased gastric acidity

PYRIDOXINE PREPARATIONS

Pyridoxine

Pyridoxal phosphate- a coenzyme form of vitamin B 6 - causes almost the same effects as pyridoxine. The difference is a faster and more pronounced effect. Pyridoxal phosphate may have an effect in cases where there is resistance to the vitamin itself.

ASCORBIC ACID (VITAMIN C)

Ascorbic acid and the product of its oxidation in the body - dehydroascorbic acid - together constitute a redox system that plays an important role in tissue respiration. Participates in the synthesis of steroid hormones, in the regulation of blood clotting, and ensures collagen synthesis.

The participation of ascorbic acid in the formation of cellular and humoral immunity has been shown.

An important property of ascorbic acid is the elimination of free radicals and stabilization of biological membranes. This is due to the conversion of ascorbic acid into the monodehydroascorbic acid radical. Therefore, with a lack of ascorbic acid, lipid peroxidation is activated.

The average daily requirement is 70-100 mg. The need for ascorbic acid significantly depends on the physiological state of the body and on external conditions: it increases with increased physical and mental work, pregnancy and lactation, etc.

Indications:

State of hypoxia, metabolic and respiratory acidosis.

Severe infectious diseases

Inflammatory joint diseases, especially rheumatoid arthritis, because it stimulates collagen synthesis.

Hypochromic anemia

Side effects: They usually occur when taking high doses. Hypervitaminosis does not occur, because the excess amount is quickly eliminated from the body in the urine. But with long-term use:

vitamin C in a daily dose of 1-1.5 g. may cause a feeling of fever, headache, insomnia, anxiety, increased blood pressure

With long-term intake of vitamin C, dehydroascorbic acid accumulates, which suppresses the function of the pancreatic islets, this leads to hyperglycemia.

Excessive doses of vitamin C have immunosuppressive effects

Dehydroascorbic acid is converted in the body into oxalic acid, oxalic acid can concentrate in the urinary tract and form stones - oxalates

High doses – increase the tendency to thrombosis

High doses during pregnancy lead to miscarriages.

Vitamin products- medications whose active ingredients are vitamins or their analogues.

In medical practice they use vitamin supplements containing one or more (so-called multivitamin preparations) vitamins. Along with this, preparations containing coenzyme forms of some vitamins (cocarboxylase, pyridoxal phosphate, etc.) have become widely used. Action vitamin products primarily due to physiological role vitamins contained in them as essential nutritional factors, and therefore vitamin supplements used as preventive and therapeutic drugs for vitamin deficiency. Besides, vitamin supplements have certain pharmacological properties. Thus, nicotinic acid causes a vasodilating effect and affects the level of lipoproteins in the blood; pantothenic acid enhances intestinal motility; thiamine has moderate ganglion-blocking properties, etc. That's why vitamin supplements often used in complex therapy of a number of diseases together with specifically active drugs from other groups. Wherein vitamin supplements may enhance therapeutic activity such drugs, eliminate or reduce the side effects of some of them (for example, antibiotics, sulfonamides, etc.).

Like any medicinal substance vitamin supplements should be prescribed for certain indications depending on their pharmacotherapeutic properties, preferably against the background of a diet rich in protein, because At the same time, vitamins are retained in the body longer. On the other hand, vitamins contribute to more complete utilization of proteins. Duration of use vitamin products determined by the nature of the disease and individual tolerance to these drugs. In excessively large doses or with very long-term use, some vitamin supplements(for example, retinol, ergocalciferol) can cause acute or chronic hypervitaminosis. When signs of hypervitaminosis appear, what caused them vitamin supplements are canceled and in some cases prescribed drugs that weaken the effect of the corresponding vitamin products. So, in case of an overdose of ergocalciferol or videohol, retinol is used, and in case of an overdose of retinol, ascorbic acid is used. It must also be borne in mind that combinations of individual vitamin supplements may be incompatible. Pyridoxine and cyanocobalamin, ascorbic acid and cyanocobalamin, thiamine and nicotinic acid, thiamine with cyanocobalamin and pyridoxine should not be administered simultaneously or mixed in the same syringe. when mixed, these vitamins can be destroyed or mutually enhance each other's ability to cause allergic reactions.

Clinical and pharmacological characteristics of the main vitamin preparations are given in table .

Clinical and pharmacological characteristics of the main vitamin preparations

Bibliography: Yakovlev T.N. Therapeutic and prophylactic vitaminology, L., 1981, bibliogr.

Vitamin preparations have a very wide application:

· during pregnancy;

· for older people;

· for immunity;

· for vision;

· for children;

· in dentistry;

· for allergies;

· for depression.

Use during pregnancy.

Expectant mothers experience an increased need for vitamins, primarily vitamins A, C, B1, B6, and folic acid. It is necessary that a woman’s body is provided with all these micronutrients even before conceiving a child and throughout the entire period of pregnancy and lactation. This will save the mother and her child from many troubles and complications.

It should be remembered that during planning and management of pregnancy one must be very careful when taking vitamin A or retinol. In high dosages, this vitamin can have a teratogenic effect and provoke the development of various abnormalities in the fetus. Therefore, it is very important during pregnancy management and planning to be careful about the doses of this vitamin. The permissible dosage of vitamin A for pregnant women is 6600 IU or 2 mg per day.

Insufficient supply of vitamins to a woman during the period of conception and pregnancy can cause congenital developmental anomalies, malnutrition, prematurity, and disorders of the physical and mental development of children. That's why, when planning a pregnancy, you need to think about taking poly vitamin complexes.

Use for the elderly.

With age, changes occur in the human body that require a restructuring of nutrition. In older people, the absorption capacity of food ingredients is reduced, and energy metabolism is also reduced. In addition, chronic diseases and taking medications lead to the fact that a person regularly does not receive the substances he needs, primarily vitamins, minerals and trace elements. It has been shown that 20-30% of older people have intakes of, for example, vitamin B6 below the recommended level. And the blood levels of vitamins B1 and B2 are much lower than normal in a significant number of elderly people. Vitamins are especially important for patients undergoing treatment in hospitals. Almost a third of all patients in US clinics suffer from hypo- and vitamin deficiencies. Vitamin E deficiency was found in 80% of elderly patients, vitamin C in 60%, and vitamin A in up to 40%. On the other hand, older people who regularly take vitamin supplements lead a more active lifestyle, as evidenced by numerous medical and social studies.

Use to strengthen the immune system.

The immune system protects us from the effects of external adverse factors; it is a kind of “line of defense” against the aggressive action of bacteria, fungi, viruses, etc. Without a healthy and effectively functioning immune system, the body becomes weaker and is much more likely to suffer from viral and bacterial infections.

The immune system protects the body from own cells, whose organization is disrupted and which have lost their normal characteristics and functions. It finds and destroys such cells that are potential sources of cancer.

It has long been known that vitamins are necessary for the formation of immune cells, antibodies and signaling substances involved in the immune response. The daily need for vitamins may be small, but the normal functioning of the immune system and energy metabolism depend on the supply of vitamins. This is why vitamin deficiency accelerates the aging of the body and increases the incidence of infectious diseases and malignant tumors, which significantly reduces the duration and quality of life.

Vitamin E deficiency reduces antibody formation and lymphocyte activity. A decrease in antibody production is also possible with a deficiency of vitamins A, B5 (pantothenic acid), B9 (folic acid) and H (biotin). Folic acid deficiency reduces the speed of the immune system's response to foreign factors. Vitamin A deficiency weakens immune system body when foreign proteins enter the body. Vitamin B12 deficiency reduces the power of the immune defense response and reduces its ability to kill foreign cells. Vitamin B6 deficiency reduces the ability of neutrophils to digest and destroy bacteria.

And vice versa:

· B vitamins help stimulate the immune system during times of stress, surgery or injury.

· Taking multivitamins containing vitamins A, C, D, E, B6 helps strengthen the immune system and prevent colds and viral diseases.

· Vitamin B6 stimulates the synthesis of nucleic acids, which are necessary for cell growth and the production of antibodies to fight infection.

· Vitamin C or ascorbic acid increases the activity of macrophages in the fight against infectious agents.

· Taking vitamin E increases resistance to disease in all age groups, and it is especially useful for elderly patients.

· It has been proven that children to whom their parents regularly give vitamins are less likely to suffer from common infectious diseases, acute respiratory infections, otitis media, and sinusitis.

An important part of the prevention of acute respiratory infections and flu during the season of increased incidence is taking multivitamins. This will help avoid illness, support your body, and improve immunity.

You should pay close attention to choosing a suitable and effective drug.

Experts recommend taking medications that contain the entire spectrum of vital important vitamins, and, no less important, the complex must be of high quality and well balanced in dosage. This will guarantee the effectiveness and safety of the drug. High quality and optimal dosages of vitamins can significantly reduce the risk allergic reactions, which, unfortunately, are often encountered recently, and this, in turn, will provide the opportunity to carry out a complete preventive course.

Application for children.

Today, as always, at appointments with pediatricians, parents very often ask the question about the need to take vitamins or, conversely, the lack thereof, about the effectiveness and safety of using certain vitamin complexes in their children, as well as about what kind of vitamins they should use. should be preferred and why.

The content of vitamins in the diet can vary and depends on various reasons: the variety and type of food, the methods and periods of their storage, the nature of the technological processing of food. Eating canned foods also creates a big problem in this regard. Drying, freezing, mechanical processing, storage in metal containers, pasteurization and many other achievements of civilization reduce the content of vitamins in foods. After three days of storing food, the percentage of vitamins decreases significantly. But on average, for 9 months or more a year, residents of our country eat vegetables and fruits that are frozen, stored for a long time, or grown in greenhouses. Storing cabbage at room temperature for 1 day entails a loss of vitamin C by 25%, 2 days - 40%, 3 days - 70%. When frying pork, the loss of vitamin B is 35%, stewing - 60%, boiling - 80%.

Insufficient intake of vitamins from food leads to the development of hypovitaminosis, which does not have a clear clinical picture. Their signs may include such nonspecific symptoms as fatigue, general weakness, decreased concentration, decreased performance, poor resistance to infections, increased irritability, changes in the condition of the skin and mucous membranes.

Use for allergies.

The relevance of the allergy problem is increasing every day. Allergic diseases rank first in prevalence among all non-communicable diseases. And the number of patients suffering from allergies has tripled in the last decade alone.

Patients with allergic diseases are one of the risk groups for the development of hypovitaminosis. Patients with food allergies and atopic dermatitis, which is caused by several reasons:

First of all, hypovitaminosis is provoked by elimination measures (as one of the main methods of therapy) aimed at eliminating the effects of allergens, including, among other things, a nonspecific and/or specific hypoallergenic diet consisting of a limited list of foods. This naturally leads to the fact that the child’s daily need for vitamins is not met.

In addition, most people with allergic diseases, especially with atopic dermatitis, suffer from dysbiosis, which disrupts the absorption of vitamins from food, as well as the endogenous synthesis of B vitamins, which aggravates the manifestations of hypovitaminosis.

All of the above leads to an increased need for vitamins in children and adults with various allergopathologies.

Despite the obvious need for vitamin therapy, numerous dosage forms of vitamins and multivitamins, the choice of these drugs in patients with allergic diseases is usually difficult. The reason is the risk of allergic reactions to the auxiliary components of multivitamin complexes from certain manufacturers and to the vitamins themselves, mainly group B. This often leads to an unreasonable refusal to prescribe multivitamins to this group of patients by both allergists and pediatricians, and, as a consequence, aggravation of hypovitaminosis.

Application in dentistry.

Vitamins and related drugs are widely used for the prevention and as part of complex therapy for diseases of the maxillofacial area. Exhibiting high biological activity in very small doses, they are necessary for normal cellular metabolism and tissue trophism, plastic metabolism, energy transformation, normal functioning of all organs and tissues, maintenance of such vital functions as tissue growth and regeneration, reproduction, immunological reactivity of the body.

The main source of vitamins in the human body is food. Some vitamins (groups B and K) are synthesized by the microflora of the large intestine or can be formed in the human body during metabolism from organic substances of similar chemical composition (vitamin A - from carotene, vitamin D - from sterols in the skin under the influence of ultraviolet rays, vitamin PP - from tryptophan). However, the synthesis of vitamins in the body is insignificant and does not cover general need in them. Fat-soluble vitamins can be retained in body tissues, and most water-soluble vitamins (with the exception of vitamin B12) are not stored, so their deficiency quickly leads to deficiency and they must be supplied to the body systematically.

So, we can conclude that it is necessary to use vitamins to prevent many diseases.