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154 Cards in this Set
- Front
- Back
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Functions / Mechanisms of Action Vitamin A |
1. Vision 2. Cell differentiation 3. Growth 4. Immunity 5. Skin development 6. Bone development 7. Reproduction 8. Antioxidant |
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Synergistic relationships Vitamin A |
Vit A can correct iron deficient anemia |
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Antagonistic relationships Vitamin A |
Vit A decreases potassium Beta carotene decreases Vit E Protein and zinc decrease vitamin A |
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Deficiency Vitamin A |
Dry eye, stunted growth, infections, keratinization, night blindness |
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Toxicity Vitamin A |
Nausea, vomiting, DB vision, liver damage Teratogenic |
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Assessment of Vitamin A |
Blood retinol levels |
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Functions and Mechanisms of Action Vitamin D |
1. Bone growth and maintenance 2. Blood levels - Ca and phosph balance 3. Cellular differentiation 4. Immunity |
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Synergistic relationships Vitamin D |
Calcium - vit D's MAIN ROLE is to stimulate calcium absorption from intestine Phosph Vitamin K |
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Antagonistic relationships Vitamin D |
Iron deficiency Magnesium deficiency (can impede vit D status) |
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Deficiency Vitamin D |
Rickets (children) Osteomalacia (adults Secondary hyperparathyroidism |
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Toxicity Vitamin D |
Calcinosis (calcium / phosphate deposits in soft tissue) Hypercalcemia |
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Assessment Vitamin D |
Serum 25 OH D3 |
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Cholecalciferol (D3) |
found in skin and animals, biologically inactive |
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Calcidiol |
25 OH D3 Best assessment in serum |
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Calcitriol |
1,25HOD3 Formed in kidney from calcidiol (25OHD3) |
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Ergocalciferol |
Vitamin D2 - present in plants, biologically inactive |
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Functions / Mechanisms of Action Vitamin E |
1. Antioxidant ( cell membranes, aging) 2. Immunity 3. Prevents blood clots |
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Synergism with other nutrients Vitamin E |
Vitamin C (helps regenerate) Selenium (via GPX - helps to regenerate vit E) CoQ 10 (helps regenerate) Synergies w vitamin A (in lungs) |
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Deficiency Vitamin E |
Rare - can cause neurological d/o (2/2 decreased nerve transmission) |
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Toxicity Vitamin E |
Bleeding |
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Forms & sources of Vitamin K (K1, K2, K3) |
K1 - phylloquinone - from plants K2 - menaquinone - from bacteria and animals K3 - menadione - manmade - supplements - banned in US |
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Functions and Mechanisms of Action Vitamin K |
1. Blood clotting 2. Bone health 3. Other functions - ex: phagocytosis, cell signaling, cell proliferation) |
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Who is at risk for deficiency? Vitamin K |
Long term antibiotics Liver disease Fat malabsorption issues Infants |
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Deficiency
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Rare - bleeding and bruising |
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Toxicity Vitamin K |
Rare - Anemia |
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Antagonistic interactions (nutrients and drugs) Vitamin K |
Coumadin, Warfarin, Antibiotics Excess vitamin E Excess vitamin A |
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Functions and Mechanisms of Action Vitamin C |
1. Collagen synthesis 2. Carnitine synthesis 3. Catecholamine synthesis (Epi, Dop, NE) 4. Antioxidant 5. Pro-oxidant 6. Immunity |
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Synergistic Relationships Vitamin C |
Iron Vitamin E (can regenerate vit E) |
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Deficiency Vitamin C |
Scurvy, S/S: bleed, poor wound healing, hair, teeth loss, joint pain, swelling and fatigue |
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Toxicity Vitamin C |
Abdominal cramping Diarrhea |
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Assessment Vitamin C |
Leukocyte Vitamin C |
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Assessment Vitamin E |
Serum / plasma vitamin E |
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Assessment Vitamin K |
Prothromin time (PTT), platelet count, platelet function, coagulation factor tests, fibrinogen, von Willebrand factor and d-dimer |
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Active form of Vitamin B1 |
Thiamin diphosphate (TDP) |
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Functions / Mechanisms of Action Vit B1 |
Energy metabolism (TDP, coenzyme for pyruvate dehydrogenase complex and pentose phosphate pathway) |
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Synergistic nutrients Vitamin B1 |
Requires Magnesium and ATP (phosph?) for synthesis |
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Antagonistic nutrients Vitamin B1 |
ETOH and Tannins decrease absorption |
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Deficiency Vitamin B1 (also ... who is at increased risk?) |
Increased risk: ETOH abuse, elderly, HIV / AIDS, diabetics, bariatric surgery Dry beri beri (neuropathy, burning feed, abnormal reflexes, muscle pain / weakness) Wet beri beri (involves CV system / edema, rapid heart rate) Wernicke's encephalopathy |
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Toxicity Vitamin B1 |
No TUL Toxicity only reported from TPN |
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Functions / Mechanisms of Action Riboflavin |
Energy metabolism (FAD (for ETC) and FMN precursor) Metabolism of drugs / toxins Antioxidant co-factor (glutathione reductase / peroxidase, xanthine oxidase) |
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Synergistic relationship with nutrients Riboflavin |
Required for B3, B6, B9 and Iron |
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Antagonistic relationship with nutrients Riboflavin |
ETOH decreases absorption Copper, zinc, manganese |
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Deficiency
Riboflavin
Which other nutrients are affected? |
Ariboflavinosis - chelossis (sores / cracked mouth) , glossitis (tongue inflammation), mucous membrane edema, dermatitis, pre-eclampsia, ETOH abuse, trauma
Affects B3, B6, B9 and Iron levels |
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Assessment Riboflavin |
Erythrocyte glutathione reductase activation coefficient |
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Functions / Mechanisms of Action Niacin |
Energy metabolism (NADH precursor / all NAD type molecules) - 400+ reactions in energy metaolism DNA synthesis |
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Interactions - Synergistic Niacin |
Tryptophan creates - depends on B6 and Iron |
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Interactions - Antagonistic Niacin |
Anti - TB drugs & immunosuppressants |
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Deficiency Niacin |
Pellagra (dermatitis, diarrhea, dementia) Assoc with general malnutrition (anorexics, obese, homeless, high corn / low meat diet) |
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Toxicity Niacin |
Niacin flush - liver damage, impaired glucose tolerance |
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Functions / Mechanisms of Action Panthotenthic Acid |
1. Protein, Energy and Carb Metabolism Precursor to CoA (THINK acetyl-CoA, succinyl-CoA, malonyl-CoA, fatty acyl CoA, cholesterol and hormone synthesis, melatonin, acetylcholine, Hgb) 2. Metabolism of nucleic acids |
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Interactions - Antagonistic Panthotenthic Acid |
Birth Control Shares a transporter with biotin and lipoic acid |
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Deficiency Panthotenthic Acid |
General malnutrition Burning feet syndrome |
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Functions / Mechanisms of Action Vitamin B6 |
1. PROTEIN FAT AND CARB METABOLISM 2. Nervous system functions / NT (serotonin, dopa --> dopamine, GABA, etc) 3. Hgb syntheiss and functions 4. Trp metabolism (to B3) 5. Hormone function (steroids, estrogen, testost) 6. Nucleic acid synthesis 7. Cofactor for 100+ reactions (amionotransferases, phosphorylases) |
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Coenzyme / Active form of B6 |
PLP Pyridoxyl 5' Phosphate |
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Interactions - Synergistic Vitamin B6 |
Zinc is required for intestinal absorption |
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Interactions - Antagonistic Vitamin B6 (drugs) |
NSAIDs, birth control |
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Deficiency Vit B6 |
RARE (alcoholics) Fatigue, cheilosis, glossitis, somatitis, neurlogical problems, dermatitis) |
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Toxicity Vitamin B6 |
Neuropathy |
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Assessment Vitamin B6 |
Plasma Hcys Elevated amino acids OAs - KYNA, XANTHAN |
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Functions / Mechanisms of Action Biotin |
1. Protein / Fat / Carb Metabolism --->Coenzyme for carboxylases (acetyl-CoA carboxylase, pyruvate CoA carboxylase, propinoyl coA carboxylase, methylcrotonyl-CoA carboxylase) 2. Gene expression 3. Hair, skin and nails |
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Interactions - Antagonistic Biotin |
Avidin in raw egg whites Anticonvulsants |
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Deficiency Biotin |
RARE (alopecia, rash, 'fat face' hallucinations, anorexia) |
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Sources Biotin |
Liver, soybeans, egg yolk Intestinal bacteria |
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Functions / Mechanisms of Action Folate |
1. DNA (nucleic acid precursors) 2. RBC formation 3. Activates B12 4. Methylation reations 5. Brain development and functions 6. Amino acid metabolism (cys, met, serine, glyc, his) 7. Metabolism of Hcys |
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Interactions - Synergistic Folate |
Vitamin C |
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Interactions - Antagonistic Folate |
Zinc deficiency will cause folate deficiency Anticonvulsants interfere |
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Deficiency Folate |
Alcoholics, smokers, pregnant, women, cancer Megaloblastic anemia, NT defects CVD, cancer |
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How does folate interact with B12? |
MTHFR is riboflavin dependent enzyme (catalyzes reduction of 5,10 methylenetetrahydrofolate --> 5-methyltetrahydrofolate) |
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Functions B12 |
1. DNA 2. RBC formation 3. Activates folate 4. Succinyl CoA synthesis 5. Metabolism of Hcys to methionine and glutathione 6. NERVE FUNCTION 7. Coenzyme for methionine synthase and L-methylmalonyl-CoA mutase |
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Interactions - Antagonistic B12 |
B12 def can trap folate PPIs reduce |
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Deficiency B12 |
Megaloblastic anemia Pernicious anemia Neurologic disorders Stomach inflammation Increased risk: elderly (IF), vegan, vegetarians |
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Functions / Mechanisms of Action Calcium |
1. Electrolyte 2. Bone health 3. Blood clotting 4. Nerve conduction 5. Muscle contraction 6. Vasoconstriction / dilation 7. Hormone secretion (insulin) |
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Functions / Mechanisms of Action Phosphorous |
1. Electrolyte 2. Bone and teeth formation (Phosph salts - as hydroxyapatite) 3. Acid / base balance 4. Energy formation (through phosphorylation (ex - ATP, CrP) 5. Cell membrane (phospholipids) 7. Hemoglobin |
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Functions / Mechanisms of Action Magnesium |
1. Electrolyte 2. Energy production (required by ATP) 3. Nucleic acid synthesis 4. Glutathione synthesis 5. Cellular signlaing 6. Structural role in bone, cell membranes and chromosomes 7. Ion transport (K+, Ca) - affects nerve & mm contractions |
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Functions / Mechanisms of Action Sodium |
1. Electrolyte 2. Nutrient absorption / transport (chloride, aa, glucose, H20) 3. Maintain blood volume / pressure 4. Nerve impulse transmission, muscle contraction and cardiac function |
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Functions / Mechanisms of Action Chloride |
1. Electrolyte 2. Forms HCl 3. Maintains pH balance |
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Functions / Mechanisms of Action Potassium |
1. Electrolyte 2. Maintains membrane potential (conduction of nerve impulses and muscle contraction) - HEART 3. Co-factor for pyruvate kinase (in carb metabolism) |
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Interactions - Synergistic Calcium |
Increased absorption - vitamin D, sugar alcohols, protein, pregnancy, childhood Magnesium deficiency can impair PTH secretion (and cause hypocalcemia) |
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Interactions - Antagonistic Calcium (what affect does Ca have on nutrients? which nutrients increase Ca losses or decrease absorption? |
Supplemental calcium can: -decrease phosphorous -decrease Fe absorption Increase Ca losses - with Na and caffeine Decreased absorption - with phytates, fiber, oxalates, Iron, phosphorous, fatty acids (binds in SI - can reduce LDL / inc HDL) Pb accumulation with low Ca intake |
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Deficiency Calcium |
Hypocalcemia Tetany (mm twitching, tingling, numbness) Rickets, Osteoporosis |
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Toxicity Calcium |
Hypercalcemia Calification of soft tissue, kidney stones Constipation |
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Assessment Calcium |
Blood is maintained in narrow range Assess hair or BMD |
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Interactions - Synergistic Phosphorous |
Vitamin D increases absoprtion Phytates are high in phosphorous |
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Interactions - Antagonistic Phosphorous |
Phytates are high in phosph - but absorption decreases with Calcium and Zinc |
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Deficiency Phosphorous |
Rare - weak bones, teeth, fatigue, joint pain, renal disease |
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Toxicity Phosphorous |
RARE - diarrhea, nausea / vomiting Hypocalcemia - tetany |
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Interactions - Synergistic Magnesium |
Vitamin D increases absorption Calcium - Mg needed for PTH Dietary protein increases Mg retention |
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Interactions - Antagonistic Magnesium |
Decreased absorption: phytates, fibers, unabsorbed FAs, ZINC & IRON |
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Deficiency Magnesium |
Increased risk - post-op patients Neuromuscular d/o - weakness, tetany, delirium, convulsions Other associated problems - CVD, CKD, spasms, tremors, hallucinations, decreased PTH |
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Toxicity Magnesium |
Unlikely - renal disease, diarrhea, dehydration |
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Interactions Chloride |
Few known |
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Deficiency Chloride |
Diarrhea, sweating, convulsions, metabolic acidosis, FTT |
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Toxicity Chloride |
Fluid retention, altered acid / base balance |
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Interactions - synergistic Potassium |
Magnesium required for optimal potassium (Mg deficiency can cause hypokalemia) |
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Deficiency Potassium |
Hypokalemia - mm weakness, cramping, hypoventiliation, tetany, rhabdomyalysis, |
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Toxicity Potassium |
Hyperkalemia Usually assymptomatic until cardiac toxicity - flaccid paralysis |
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Interactions - antagonistic Potassium |
Licorice contains glycyrrhizic acid (similar affects to aldosterone) - will increase urinary excretion of potassium |
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Interactions - Antagonistic Sodium |
Laxatives, prolonged anions in the gut will decrease absorption Calcium |
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Deficiency Sodium |
Hyponatremia - lethargy, confusion, mm twitching, excessive sweating, cramps, shock, coma |
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Toxicity Sodium |
LV hypertrophy HTN, edema, osteoporosis |
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Functions / MOA Iron |
1. O2 transport / storage 2. ETC and energy metabolism (cytochromes - ETC and detox) 3. Antioxidant (Catalase req Fe, Peroxidase protects against H202) 4. Pro-oxidant (free iron) 5. DNA synthesis (growth, reproduction, healing, immune fix) |
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Interactions - Synergistic Iron |
Vit C Deficiencies of Copper and Vitamin A can cause/exacerbate anemia Nickel Sugars, amino acids increase absorption |
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Interactions - Antagonistic
Phosphorous |
Phytates are high in phosph - but absorption decreases with Calcium and Zinc
Magnesium
Aluminum |
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Toxicity Iron |
Hemochromatosis - deposits in soft tissues Iron-loading anemia (thalassemia, sideroblastic anemia) |
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Hepcidin |
Regulates iron homeostasis by inhibiting release of iron from cells into plasma |
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Functions / MOA Copper |
1. Energy production (ETC - cyt C oxidase) 2. Antioxidant (ceruloplasmin, SOD) 3. Connective tissue formation 4. Iron metabolism 5. Nervous system / NT - converts dopa ---> NE, maintains myelin sheath 6. Melanin pigment formation 7. Gene expression |
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Interactions - Antagonistic
Magnesium |
Decreased absorption: phytates, fibers, unabsorbed FAs,
ZINC & IRON
Boron and phosphorus |
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Interactions - Antagonistic Copper |
Zinc Phytates |
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Deficiency Copper |
Hypochromic anemia - bone abnormalities, hypo-pigmentation CVD, pulmonary dysfunction |
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Toxicity Copper |
RARE - nausea / vomiting, diarrhea, hematuria, hepatic necrosis Wilson's disease - accumulation of copper |
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Assessment Copper |
Serum, urine, ceruloplasmin and RBCs |
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Functions / MOA Selenium |
Selenoproteins used in 1. Antioxidants (glutathione peroxidase, thioredoxin reductase) 2. Iodine metabolism (iodothyronine deiodinase) |
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Interactions - Synergistic
Selenium |
Iodine (Se needed for thyroid) Vit A, C, E |
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Interactions - Antagonistic Selenium |
Lead will decrease Iron deficiency will decrease Se Copper decreases GPx activity (via selenium) Heavy metals (mercury) and phytates decrease absorption |
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Deficiency Selenium |
Keshan disease Kashin-Beck Cretinism Cardiac myopathy, hypothyroidism, decreased immunity, decreased growth |
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Toxicity
Selenium |
Selenosis - GI upset, hair loss, white blotchy nails, breath odor (garlic), irritability |
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Functions / Mechanisms of Action Chromium |
Potentiates insulin |
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Interactions - Synergistic Chromium |
Vitamin C Amino acids and picolinate increase absorption |
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Interactions - Antagonistic Chromium |
Antacids and phytates decrease absorption Iron can become displaced with supplementation |
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Deficiency Chromium |
Insulin resistance Hyperinsulinemia High cholesterol |
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Toxicity Chromium |
renal / liver dysfunction |
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Chromodulin |
may be able to potentiate insulin action, hence improving tissue sensitivity to insulin |
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Functions / Mechanisms of Action Iodine |
1. Thyroid hormone 2. Growth and development 3. Metabolism 4. Fetal nervous system |
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Interactions - Synergistic Iodine |
Selenium and Zinc (needed for T4 --> T3) Iron & Vitamin A needed for thyroid function |
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Interactions - Antagonistic Iodine |
Goitrogens Halogens (flouride, bromide, chloride) |
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Deficiency Iodine |
Goiter, cretinism, mental retardation, brain damage Hypothyroidism |
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Functions / Mechanism of Action Manganese |
1. Antioxidant (Mn SOD in mito) 2. Metabolism (metalloenzymes and transferases, urea cycle, glutamate --> glutamine) 3. Bone development 4. Wound healing / collagen synthesis |
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Interactions - Antagonistic Manganese |
Iron, magnesium, calcium and zinc inhibit |
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Deficiency Manganese |
RARE - only with malnutrition - impaired growth, CNS dysfunction, skeletal deformity |
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Toxicity Manganese |
Inhaled - causes neurlogical problems, liver failure is at high risk |
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Functions / MOA Molybednum |
1. Oxidation reaction cofactors (sulfite oxidase, S-containing AAs met and cys, xanthine oxidase, DNA/RNA breakdown, drug metabolism) |
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Interactions - Antagonistic
Molybednum |
COPPER Iron Silicon |
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Functions / MOA Flourine |
Bone and teeth mineralization |
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Interactions - Synergistic Flourine |
phospahate and sulfate increase absorption |
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Interactions - Antagonistic Flourine |
Calcium, protein, chloride, magnesium, antacids (aluminum) decrease absorption |
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Deficiency Flourine |
Dental carries, altered bone formation |
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Toxicity Flourine |
Fluorosis - change in bone / teeth / nerves Mottling of teeth |
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Functions / Mechanisms of Action Arsenic |
1. Formation of methyl groups (SAMe) 2. Growth 3. Gene expression |
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Interactions - Antagonistic Arsenic |
Decreases selenium and iodine uptake in thyroid |
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Deficiency
Arsenic |
Decrease growth, conception rate |
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Toxicity Arsenic |
Blackfoot disease - anemia, carcinogenic, encephalopathy, renal / liver damage |
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Functions / Mechanisms of Action Boron |
1. Bone / Joint function 2. Cellular membrane stability and function 3. Steroid and Vitamin D metabolism 4. Calcium metabolism 5. Immune function |
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Interactions - Synergistic
Boron |
Potentiates estrogen / testosterone
Calcium |
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Interactions - Antagonistic Boron |
Magnesium |
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Functions / Mechanisms of Action Nickel |
1. Enhances body's use of iron 2. Nucleic acid structure 3. Fat metabolism |
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Interactions - Synergistic Nickel |
Iron |
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Interactions - Antagonistic Nickel |
Vitamin E Impairs enzyme function relative to iron, zinc, copper |
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Functions Silicon |
Formation of bone, CT, cartilage, collagen |
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Interactions - Antagonistic Silicon |
Protects against aluminum Molybednum |
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Deficiency Silicon |
Less flexible bones, skull deformation, collagen decreases |
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Toxicity Silicon |
Kidney stones |
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Functions Vanadium |
Mimics insulin Formation of cAMP |
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Interactions - Antagonistic Vanadium |
Competes with zinc, copper, iron, chromium, chloride, phosphate |
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Functions Cobalt |
B12 production |
