Vitamins and Trace Elements 389Male impotence: It is known to
increase sperm count in male patients with
impotence.
Sleep disturbances: The use of
methylcobalamin in the treatment of a
variety of sleep-wake disorders is very
promising.
Vitamin B complex preparations are
indicated in vitamin deficiency states.
Specific vitamin B preparations can be used
as per indications mentioned above in the
pharmacological write up; as an adjuvant
to antibiotic therapy; combination with
lactobacillus are indicated in aphthous
stomatitis, thrush.
Preparations of vitamin B 1 + B 6 + B 12
are indicated to prevent and treat isoniazid,
hydralazine and cycloserine induced neu-
rological disturbances, mental symptoms in
women on oral contraceptives, pyridoxine
responsive anaemia and homocystinuria,
neuropathies, subacute combined degenera-
tion, beriberi, anaemia, hepatitis, debility.
FOLIC ACID
It plays a vital role in various
intracellular reactions e.g. conversion of
serine to glycine, synthesis of thymidylate,
synthesis of purines, histidine metabolism
etc. Due to folic acid deficiency these
reactions are affected.
Deficiency symptoms: The character-
istic feature of folic acid deficiency is mega-
loblastic anaemia. Deficiency also leads to
glossitis, enteritis, diarrhoea, general debil-
ity, weight loss and sterility.
It is indicated in folic acid deficiency
states e.g. megaloblastic anaemia, tropical
and nontropical sprue, alcoholism;
adjunctive therapy in nutritional anaemias
and anaemias of pregnancy.Dosage:
Adults: Therapeutic: 5 to 20 mg daily in
divided doses.
Children: 5 to 10 mg daily in divided
doses.VITAMIN C (ASCORBIC ACID)
It functions as a cofactor in number of
amidation and hydroxylation reactions.
The active form of vitamin C is ascorbic
acid itself. The main function of ascorbate is
as a reducing agent in a number of different
reactions. Vitamin C has the potential to reduce
cytochrome a and c of the respiratory chain
as well as molecular oxygen. The most
important reaction requiring ascorbate as a
cofactor is the hydroxylation of proline
residues in collagen. Vitamin C is, therefore,
required for the maintenance of normal
connective tissue as well as for wound healing
since synthesis of connective tissue is the first
event in wound tissue remodeling. Vitamin C
is also necessary for bone remodeling due to
the presence of collagen in the organic matrix
of bones. It is also required for conversion of
folic acid to folinic acid, biosynthesis of adrenal
steroids, catecholamines, oxytocin and ADH;
metabolism of cyclic nucleotides and
prostaglandins.
Deficiency symptoms: In vitamin C
deficiency scurvy develops. It is character-
ized by ecchymosis, petechiae, swollen and
bleeding gums, subperiosteal haemorrhage,
bones are painful to touch, impaired
wound healing, anaemia, loosening of teeth
and gingivitis.