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76 Cards in this Set
- Front
- Back
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key sources of vit C in diet |
cruciferous fruit- citrus, strawberries, guava, kiwi, papaya, cantaloupe asparagus |
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How is vitamin c isolated in supplements |
rosehip |
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actions of vitamin c |
antioxidant syn of collagen, carnitine, norepinephrine essential for blood vessel, tendon, ligament, bone structure cholesterol metabolism- treatment of hypercholesterolemia and gallstones |
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what level is it prescribed in what level does it become a proxidant |
5g (antioxidant) 15g |
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what are def symptoms of vitamin c |
easy bleeding/bruising hair and tooth loss joint pain and swelling fatigue |
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Ability to process vitamin c depends on what gene |
§ourability to process VitC depends on the GSTT1 (glutathione S-transferaseT1) gene |
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What are some therapeutic indications for vitamin c |
age related macular degeneration atherosclerosis cancer common cold gallbladder disease hypertension osteoarthritis AACCGHO |
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what is it taken with for age-related macular degeneration |
vitamin c 500mg, zinc 80mg, vitamin e 400iu, beta carotene, 15mg |
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people with peripheral arterial disease have higher levels of what marker |
c-reactive protein (marker of inflammation) |
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how is it used in cancer"? |
higher doses, pro oxidants, scavenge cancer cells |
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how is vitamin c used for hypertension |
used along with conventional antihypertensive medications--> modestly decreases systolic blood pressure |
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how does vitamin c help with osteoarthritis |
reduces risk of cartilage loss and decreases disease progression |
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other indications for vitamin c |
1. iron deficiency anemia- increases absorption 2. allergies 3. constipation- osmotic effect 4. urinary tract infection 5. gingivitis 6. hypoaderenalism (norepinephrine) |
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what is the caution with vitamin c and pregnancy |
don't exceed 2g daily - greater than 3000mg can induce labour -->abortifacient in first trimester |
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Whatis the UL of Vitamin C to avoid GI distress? What is another concern with vitamin C intake? |
about 2000mg in one dose - divided you can take a higher dose Increased risk of kidney stones |
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what is the contraindication with G6PD deficiency (favism) |
G6PD deficiency is an X linked recessive inborn error in metabolism that predisposes one to hemolysis and thus jaundice. -Triggers include high dose vitamin c but also foods like fava beans and certain drugs (antimalaria, sulfa and some non-sulfa based antibiotics) and stress from bacterial and viral infections. -Testing required if administering high doses, routine testing done before Vitamin C IV of 25grams or more |
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What populations do we need to lookout for G6PD deficiency in? |
people of mediterranean and african origin |
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whats the most common enzyme def in humans |
G6PD |
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When can iron overload occur? |
in those with renal disease iron metabolic disorder – hemochromatosis |
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when would you avoid giving Vit c for testing purposes? |
Fecal occult blood tests or urine blood or urine levels -->may lead to false neg results- since it it is a reducative agent |
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good sources of vitamin b |
brewers yeast grains legumes meat B2- dairy, eggs, grains, fish |
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supplement form of vitamin b that's good |
needs to be in bioavailable (methylated) form - B9, B12, B6 especially |
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B vitamin toxicity |
generally nontoxic but a few exceptions (niacin) |
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B1- main function |
1. energy production 2. nucleic acid synthesis |
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mild B1 def looks like |
low energy weak tired muscle pain burning feet syndrome |
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severe B1 def |
BeriBeri |
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therapeutic indications of B1 |
1.reduced risk of cataracts 2.diabetic neuropathy 3.compared to placebo 4.dysmenorrhea 5.neurological conditions 6.congestive heart failure, dementia |
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dose for use in diabetic neuropathy? B1 |
high dose 100mg 3 time/day - decrease urinary albumin excretion in patients with type 2 diabetes |
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dose of b1 for dysmenorrhea |
thiamine hydrochloride 100mg daily eliminates pain with primary dysmenorrhea (90 days) |
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what neurological conditions can B1 be used for |
epilepsy sciatica trigeminal neuralgia |
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when can b1 be depleted |
alcoholism (liver damage) elderly |
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therapeutic dose of B1 |
100mg per day |
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mechanism of action for B2 |
1.energy production- redox and ETC 2.antioxidant function- glutathione reductase and xanthine oxidase 3.iron utilization and conversion of B6 to PLP 4.homocysteine metabolism in small subset of the population |
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therapeutic indications of B2 |
reduced risk of cataracts migraine headaches |
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dose for help in migraine headaches B2 |
high dose 400mg/day |
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what else can B2 be used for |
parkinson's disease hyperhomocysteinemia (high homocysteine) psoriasis some myopathies |
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what does b2 deficiency look like |
Glossitis cheilosis anemia dermatitis vascularization of cornea hypoplasia redness and swelling of mouth and throat |
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how does b3 act in the body |
redox- catabolism of fats, proteins, alcohol, energy production
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therapeutic indications for b3 |
hyperlipidemia- 500mg or higher to decrease low density lipoproteins (2nd line, 1st line in statins) 1st line- patients who need to increase HDL cholesterol and lower TGs |
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what does b3 def look like |
mild- fatigue, high cholesterol, headaches, bright red tongue,
severe- depression, memory loss, pellagra (4 D's) |
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what else is b3 used for |
diabetes, arteriosclerosis topically- acne, wrinkles orally- anxiety, ADHD, dementia addition- alcohol, opioid, LSD |
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cautions with b3 |
nicotinic acid- flushing, gut- heartburn, nausea, vomiting causes liver damage at high levels(transaminase, alcholin phosphatase) high blood glucose |
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tolerable upper limit of b3 |
35mg/day |
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specific pop to use caution with b3 |
people with liver disease diabetes (nicotinic acid) |
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what is the mechanism of action of b5 |
component of coenzymeA - krebs cycle -fatty acid syn/oxidation -syn of cholesterol -heme -acetylcholine -amino acid catabolism |
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What are some therapeutic indications of b5 |
acne vulgaris allergic rhinitis hypoadrenalism |
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who are we worried about def of b5 |
alcoholism diabetes IBD |
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what does b5 def look like |
fatigue depression anemia insomnia irritability stomach pains vomiting burning feet |
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therapeutic dose of b5 |
100-250mg |
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mechanism of action for b6 |
PLP: methylation cycle nervous system regulation RBC formation and function niacin synthesis hormone function nucleic acid synthesis |
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therapeutic indications for b6 |
1.hyperhomocystinemia- with folate 2.age related macular degeneration 3.hypertension 4.pregnancy induced nausea and vomiting 5.premenstrual syndrome |
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how is b6 related to age related macular degeneration |
preventative- taken with cyanocobalamin (b12) and folic acid (b9) |
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how is b6 given for PMS |
Pyridoxine levels of at least 50 mg daily, plus magnesium 200 mg daily -->seems to relieve PMS-related anxiety and other symptoms (breast pain/tenderness) |
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what increases likelihood of deficiency of b6 |
alcoholism higher dose contraceptive use |
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signs of b6 deficiency? |
fatigue anemia oral symptoms- ulcers in corners of mouth, inflamed tongue depression |
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what is b7 used for in the body |
hair, skin, nails |
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def of b7 symptoms |
hair loss dermatitis- cradle cap numbness and tingling of extremities brittle nails rashes around eyes, nose, mouth, genitals |
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who is at a risk of def of b7 |
alcoholism IBD, achlorhydria people on anticonvulsants eating eggs whites (avidin) |
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mechanism of action of b9 |
dna/rna syn homocysteine and b12 metabolism functioning of cns and immune system |
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therapeutic indications of b9 |
1.hyperhomocysteinemia 2.methotrexate toxicity- cancer, autoimmune diseases, stroke 3.prevention of neural tube defects and spina bifida 4.depression 5.hypertension |
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what form of b9 should be taken |
methylated |
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what else can b9 treat |
derm conditions: psoriasis, seborrheic dermatitis, vitiligo neurological conditions: ataxia, migraine, peripheral neuro pathy, restless leg syndrome
Psychiatric: Autism, dementia, depression (including postpartum) Age-related macular degeneration |
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folate deficency |
fatigue depression megaloblastic anemia hyper segmented neutrophils infertility neural tube defects increased inflammation decreased energy elevated homocysteine autoimmune conditions |
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cautions with folate |
can mask a b12 deficiency -can alleviate megaloblastic anemia but the B12 deficiency associated neurological damage can go on undetected (DEMYELINATION). Tolerable upper limit set at 1mg based on this fact. |
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what is the mechanism of b12 |
B12 plays a role in - DNA synthesis -red blood cell formation -homocysteine metabolism -synthesis of S-adenosylmethionine (SAMe) -involved in the functioning of the nervous system and immune system. |
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what is b12 used to treat? |
-hyperhomocystenemia- with folic acid and pyridoxine -pernicious anemia -derm: herpes zoster, urticaria, vitiligo -tinnitus -MSK: bursitis, muscle cramps, osteoporosis -Neurological: idiopathic facial paralysis, migraine, neuritis, peripheral neuropathy, sciatica, trigeminal neuralgia -Psychiatric: Dementia/Alzheimer’s, Anxiety, Depression -Age-related macular degeneration Diabetes -Infertility -Fatigue/Chronic fatigue syndrome |
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when is a def of b12 considered |
multiple sclerosis alzheimers chronic fatigue strict vegan diet malabsorption condition elderly |
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what does b12 def look like |
gastrointestinal symptoms megaloblastic anemia dementia tingling, numbness disorientation HC levels elevated |
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genetic variants of the FUT2 enzyme leads to decreased absorption of what |
b12 and decreased transport between cells -->important if family has history of MS |
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What are the deficiency diseases associated with each b vitamin? |
B1-beriberi B2-glossitis, ariboflavinosis B3-pellagra B5-paresthesia B6-anemia, peripheral neuropathy folate-megaloblastic anemia, neural tube defects B12-megaloblastic anemia Vit C- scurvy |
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what are some cautions with niacin |
-niacin or nicotinic acid has many undesirable side effects- -->nicotinamide doesn't have any negative side effects but also doesn't offer same lipid lowering effects |
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what increases the likelihood of def of b6 |
alcoholism higher dose contraceptive use |
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how does b7 act in the body |
brittle nails diabetes |
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what form of b9 is used in supplements and food fortification? |
folic acid (pteroylglutamic acid) |
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what genetic defect effects folate? |
defects in MTHFR lead to decreased active folate and increased homocysteine |
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what do high levels of folate do? |
>15mg/daily leads to insomnia, malaise, irritability, and GA distress |
