8b. Vitamins - Water Soluble Flashcards
What is the alternative name for vit B1?
Thiamine
What is the active form of B1?
Thiamine pyrophosphate
What mineral is needed to convert B1 to thiamine pyrophosphate?
Magnesium
What impairs the conversion of B1 to thiamine pyrophosphate?
Alcohol
How long can B1 stores in the body last?
1 month
What can easily reduce B1 content in food?
Processing - milling, chopping, canning, adding sulphites, baking soda
What percentage of B1 content is reduced by boiling/freezing?
50%
What percentage of B1 is lost during toasting?
30%
Examples of B1 food sources
Wholegrains
Nuts
Seeds
Yeast extract
What are the main functions of B1?
Energy production
Nervous system functioning
What are the functions of B1 in energy production?
Carb, fat, protein metabolism
Formation of acetyl-CoA
What are the functions of B1 in nervous system functioning?
Acetyl-CoA is a precursor to acetylcholine
Neurotransmitters e.g. GABA are created by amino acids metabolised by B1
What are the therapeutic uses of B1 in energy production?
Fatigue
Supporting energy production in increased need
Fertility
What are the therapeutic uses of B1 in nervous system functioning?
Cognitive decline/memory loss Alzheimer's Parkinson's Nerve repair Low mood
What can impair B1 absorption?
Alcohol Tea Coffee OCP Stress Antacids
What are the signs/symptoms of B1 deficiency?
Fatigue Muscle weakness GIT disturbance Depression Irritability Beri beri
What is B2 also known as?
Riboflavin
What colour is B2?
Florescent green/yellow
What can reduce the food content of B2?
Light
Heating/boiling
Freezing
Examples of B2 food sources
Wholegrains Nuts Seeds Yeast extract Spinach Eggs
What are the functions of B2?
Energy production
Liver detoxification
Iron metabolism
What are the functions of B2 in energy production?
Carbs, fats, protein metabolism
Krebs cycle
Beta-oxidation
Constituent of FAD and FMN energy carriers
What are the functions of B2 in liver detoxification?
Phase 1 liver detoxification via CYP450 enzymes
Regeneration of glutathione
What are the functions of B2 in iron metabolism?
Main requirement for Fe metabolism
What are the therapeutic uses of B2 in energy production?
Fatigue
Migraines
Stress
What are the therapeutic uses of B2 in liver detoxification?
Liver detoxification programmes
What are the therapeutic uses of B2 in iron metabolism?
Anaemia
What helps increase intestinal absorption of B2?
Bile salts
What decreases bioavailability and absorption of B2?
Alcohol Antacids Caffeine Copper Zinc Theophylline (choc) Saccharin
What can reduce B2 levels in the body?
Smoking
Heavy exercise
Pregnancy
Ageing
What are the signs/symptoms of B2 deficiency?
Fatigue Weakness Poor concentration Depression Sores at mouth corners Red, dry atrophic tongue Scaly dermatitis
What is the alternative name for B3?
Niacin
What are the B3 vitamers?
Nicotinic acid
Nicotinamide
What are the active forms of B3?
Nicotinamide adenine dinucleotide (NAD)
Nicotinamide adenine dinucleotide phosphate (NADP)
How is B3 synthesised in the body?
From tryptophan
How much tryptophan produces 1mg of B3?
60mg
Examples of B3 food sources
Nuts Seeds Yeast extract Spinach Eggs Meat Fish
What reduces B3 in foods?
Cooking
What are the co-factors that B3 needs to be synthesised?
B2
B6
Iron
What is niacin flush?
Skin flush and itch due to supplementation
How can you try to avoid niacin flush?
Initial dose of 25mg
Then gradually increase
Take with 1g vit C
Where is B3 mostly stored?
Liver
Heart
Muscles
Kidneys
Where is B3 absorbed?
Small intestine
What are the functions of B3?
Energy production
Cardiovascular
Insulin
What are the functions of B3 in energy production?
Glycolysis
Acetyl-CoA formation
Krebs Cycle
Fatty acid oxidation
What are the functions of B3 in CV health?
Lowers secretion of LDL
Vasodilatory (lowers BP)
What are the functions of B3 in insulin?
Glucose-tolerance factor (GTF) which plays an important role in insulin response uses B3
What are the therapeutic uses of B3 in energy production?
Fatigue
Supporting energy production in increased need
Alzheimer’s
What are the therapeutic uses of B3 in CV health?
CV disease
Hyperlipidaemia
What are the therapeutic uses of B3 in insulin?
Diabetes 2 and 1
PCOS
What are the signs/symptoms of B3 mild deficiency?
Fatigue Vomiting Depression Indigestion Mouth ulcers Sensitivity to strong light Red tongue
What are the signs/symptoms of B3 severe deficiency?
Pellagra: Diarrhoea Dermatitis Dementia Death
What conditions can occur with high levels of B3?
Hypotension
Hypothyroidism
Flush
Hepatotoxicity
Why can B3 supplementation worsen gout?
B3 competes with urate for excretion
What is the alternative name for B5?
Pantothenic acid
Examples of B5 food sources
Nuts Seeds Avocados Shiitake mushrooms Meat Fish
How is B5 made?
By intestinal bacteria
What could reduce the synthesis of B5?
Antibiotics
What percentage of B5 is lost during processing, cooking and freezing?
Up to 80%
What are the functions of B5?
Energy production
Fat metabolism
Stress hormones
Antihistamine
What are the functions of B5 in energy production?
Carb and protein metabolism
Acetyl-CoA production
What are the functions of B5 in fat metabolism?
Synthesis of fatty acids
Degradation of fatty acids
What are the functions of B5 in stress hormones?
Acetyl-CoA makes neurotransmitters
Co-factor for stress hormones
(so used up quickly when stressed)
What are the therapeutic uses of B5 in energy production?
Fatigue
Supporting energy production in increased need
What are the therapeutic uses of B5 in fat metabolism?
Acne vulgaris
What are the therapeutic uses of B5 in stress hormones?
Adrenal fatigue
PMS
Stress
Hormonal dysfunction
What are the therapeutic uses of B5 in antihistamines?
Allergies
Hay fever
In what situations is there an increased need for B5?
Antibiotics
Alcoholics
Prolonged stress
Recent surgery
What are the deficiency signs/symptoms of B5?
Fatigue
Burning sensation in feet
Tender heals
Abdominal distress
What is the alternative name for B6?
Pyridoxine
What are the active forms of B6 called?
Pyridoxal 5’-phosphate (PLP)
Pyridoxamine 5’-phosphate (P5P)
Examples of B6 food sources
Wholegrains Nuts Seeds Avocados Meat Fish
Where in the body is B6 synthesised?
Small intestine
What reduces the bioavailability of B6?
Processing
Preserving
Heating
Light
What factors increase B6 requirements?
Alcohol OCP GIT issues Stress Pregnancy Antibiotics Chemotherapy
What are the functions of B6?
Neurotransmitter
Energy production
RBC production
Methylation
What are the neurotransmitter functions of B6?
Synthesis of GABA, dopamine, noradrenaline, serotonin
What are the energy production functions of B6?
Amino acid metabolism
Releases stored glucose
What are the RBC formation functions of B6?
Haem production
What are the methylation functions of B6?
Lowers homocysteine
What are the therapeutic uses of B6 in neurotransmitter production?
GIT motility Carpal Tunnel Syndrome Morning sickness Lactation PMS
What are the therapeutic uses of B6 in energy production?
Fatigue
What are the therapeutic uses of B6 in RBC production?
Anaemia
What are the therapeutic functions of B6 in methylation?
CV disease
What are the signs/symptoms of B6 deficiency?
Skin lesions Dermatitis Tongue inflammation Sores corner of mouth Anaemia Fatigue Depression Hormonal imbalance
Which drug is depleted by B6?
Levodopa
What is the alternative name for B7?
Biotin
Why does raw egg consumption deplete B7 availability?
Raw egg whites contain a protein called avidin
Makes biotin unavailable
Why do cooked eggs not affect B7 availability?
Protein avidin becomes denatured during cooking
Examples of B7 food sources
Wholegrains
Nuts
Yeast extract
Egg yolk
What are the functions of B7?
Gene regulation
Blood sugar regulation
What are the functions of B7 in gene expression?
Regulates gene expressions
Supports rapidly regenerating tissues e.g. skin, nails, hair
What is the function of B7 in blood sugar regulation?
Improves blood glucose control (with chromium)
What are the therapeutic uses of B7 in gene expression?
Brittle nails
Dry/brittle hair
Dandruff
What are the therapeutic uses of B7 in blood sugar regulation?
Diabetes
PCOS
What are the signs/symptoms of B7 deficiency?
Dermatitis Dry, scaly, flaky skin Hair loss/thinning Depigmentation Smooth pale tongue
What can reduce the production of B7?
Antibiotics
What diet may enhance B7 synthesis and absorption?
Vegetarian
What may inhibit the absorption of B7?
Anticonvulsant drugs
Alcohol
What is the alternative name for B9?
Folate
What is the active form of B9?
Tetrahydrofolate (THF)
What is folic acid?
The synthetic form of folate
Examples of food sources of B9
Leafy greens
Avocado
Legumes
Liver
What does the absorption of B9 need?
Adequate pancreatic enzymes
What is needed to release B9 from cells?
Vit B12
removes methyl group
What is the ‘folate trap’?
Where a lack of B12 means it’s unable to remove the methyl group from the folate, and the folate becomes trapped inside cells in its methyl form
Unable to perform its functions
When B9 supplementation is required, when is it advisable to recommend the methylated form of B9?
People with low B12
People with methylation issues
What are the functions of B9?
CV health
Embryo health
Formation of RBC
What are the functions of B9 in CV health?
Methylation of homocysteine to methionine
What are the functions of B9 in embryo health?
Required for the healthy development of neural tube
What are the functions of B9 in RBC development?
Erythrocyte synthesis
What are the therapeutic uses of B9 in CV health?
Atherosclerosis
Alzheimer’s
What are the therapeutic uses of B9 in RBC formation?
Anaemia
What are the therapeutic uses of B9 in embryo health?
Prevent spina bifida
What are the signs/symptoms of B9 deficiency?
Anaemia
Skin issues
Digestive issues
What factors can lead to a B9 deficiency?
Alcohol OCP Diuretics Aspirin GIT disorders Diets low in green leafy veg Old age
Who should consult their GP before B9 supplementation?
Those on methotrexate
Those on anticonvulsants
What is the dosage of B9 for preconception/conception care?
600mcg/day
What are the safety considerations around B9?
Naturally occurring B9 is safe Folic acid (synthetic) supplements have the most drug interactions of all vits High folic acid supplementation can mask B12 deficiency
What is the alternative name for B12?
Cobalamin
What are the active forms of B12?
Methylcobalamin
Hydroxycobalamin
Cyanocobalamin
Adenosyl cobalamin
How long can B12 be stored in the liver?
3-5 years
Examples of B12 food sources
Nutritional yeast Shiitake mushrooms Eggs Fortified cereals Meat Fish
What are the functions of B12?
Nervous system
Energy production
RBC production
Methylation
What are the functions of B12 in the nervous system?
Myelin sheath production
Neurotransmitter production
Choline for brain function
What are the functions of B12 in energy production?
Energy production from fats and proteins
What are the functions of B12 in RBC production?
Erythropoiesis
What are the functions of B12 in methylation?
Conversion of homocysteine to methionine
What are the therapeutic uses of B12 in the nervous system?
Tingling/pins and needles
Sciatica
MS
What are the therapeutic uses of B12 in energy production?
Fatigue
What are the therapeutic uses of B12 in RBC production?
Megaloblastic anaemia
What are the therapeutic uses of B12 in methylation?
CV disease
Alzheimer’s
Why can a poor diet lead to B12 deficiency?
Lack of B12 rich foods
Diet rich in highly processed, nutrient depleted foods
Why can GIT issues cause a B12 deficiency?
Lack of IF Low hydrochloric acid production Low pancreatic enzymes SI issues e.g. Crohn's, coeliac High alcohol
If a client has a good dietary intake of B12, yet is deficient, what could be the possible cause?
Absorption issue
Problem with methylation
What is the most common cause of B12 deficiency?
Malabsorption due to inadequate IF
What is B12 deficiency due to lack of IF called?
Pernicious anaemia
What is pernicious anaemia?
AI attack on the parietal cells in stomach
that make IF
What are the signs/symptoms of B12 deficiency?
Fatigue Breathlessness Pallor Tingling Numbness Loss of balance Decreased reflexes
What is the best way of testing B12?
Testing MethylMalonicAcid
Which drugs lower B12 levels?
OCP Metformin Excessive alcohol PPIs H2 receptor antagonists
What may be used to enhance B12 absorption?
Calcium
What is the alternative name for vit C?
Ascorbic acid
Why are humans more susceptible to disease than animals?
Humans can’t synthesise vit C; animals can
Does vit C need to be modified by the body in order to function?
No
Examples of vit C food sources
Fresh, raw fruit/veg Peppers Kiwi Blackcurrants Berries Rosehips
What in citrus fruits prevents the browning of apples/pears?
Ascorbate oxidase
Where is vit C absorbed?
Mouth
SI
How is vit C transported into cells?
By glucose transporters
What implications does high blood glucose levels have for vit C uptake?
Can inhibit uptake
Where does vit C concentrate storage?
Adrenal glands
WBC
Thymus
Pituitary glands
What factors increase the breakdown or excretion of vit C?
Stress Viral illnesses Alcohol Smoking Heavy metals Aspirin OCP Burns Infections
What are the functions of vit C?
Anti-oxidant Collagen synthesis Cholesterol lowering Endocrine functions Energy production Iron absorption Neurotransmitter synthesis
What are the AO functions of vit C?
Protects proteins, fats, carbs, RNA and DNA from free radicals
Recycles other AOs e.g. vit E, glutathione
Upregulates interferons, NK cells, T-cells
What are the cholesterol lowering functions of vit C?
Conversion of cholesterol to bile acids
What are the iron absorption functions of vit C?
Enhances iron absorption by protecting it from oxidation
What are the endocrine functions of vit C?
Synthesis of thyroxine and adrenal steroid hormones
What are the collagen synthesis functions of vit C?
Vit C is a co-factor in collagen synthesis
Important for forming strong tendons, ligaments and bones, repairing wounds, improving gum health
What are the neurotransmitter synthesis functions of vit C?
Co-factor for production of serotonin
What are the energy production functions of vit C?
Transport of long chain fatty acids into the mitochondria for ATP production
What are the therapeutic uses of vit C as an AO?
Cancer CV disease Alzheimer's Asthma/COPD Cataracts Immune support
What are the therapeutic uses of vit C as a cholesterol lowerer?
CV disease
What are the therapeutic uses of vit C in iron absorption?
Anaemia
What are the therapeutic uses of vit C in endocrine functions?
Adrenal fatigue
Hypothyroidism
What are the therapeutic uses of vit C in collagen synthesis?
OA Cartilage injuries Ligament injuries Gum disease Fracture repair Blood vessels
What are the therapeutic uses of vit C in neurotransmitter synthesis?
Weak digestion
What are the therapeutic uses of vit C in energy production?
Fatigue
Chronic fatigue
What are the signs/symptoms of vit C deficiency?
Bleeding gums
Pinpoint haemorrhages under skin
What are the signs/symptoms of scurvy?
Haemorrhaging from inadequate collagen synthesis Muscle degeneration Rough, brown scaly skin Wounds don't heal Fractures develop
What happens to the adrenal glands during stress?
They release vit C with other hormones into the blood
Does stress raise vit C needs?
Yes
likely due to additional free radical damage
What are the subclinical symptoms of vit C deficiency?
Susceptibility to infections Poor wound healing Fatigue Skin and gum degeneration Petechiae
What can unabsorbed vit C from high doses cause?
Bowel intolerance (Gastric discomfort and diarrhoea)
Should high doses of vit C be given in 3rd trimester of pregnancy?
No
Baby will become accustomed to high doses that are unsustainable when born
Is vit C toxic?
No, even at high doses
In which situations should we be mindful of recommending high doses of vit C?
Haemochromatosis (iron overload) as high dose
vit C will increase absorption of Fe
Kidney disease and those with gout tendency
are prone to forming kidney stones
What drug interactions should be considered with vit C?
May reduce effectiveness of warfarin, statins, some cancer drugs
Increases oestrogen therapy effects
Skews diabetes test results