Botanicals and Supplements Flashcards
What are the 3 claims that can be made regarding dietary supplements?
1) Nutrient claim - addresses a deficiency 2) Health claim - reduce risk of disease or health condition (need FDA pre-approval) 3) Structure-Function claim - May affect/maintain body structures/functions
Are there risks for excessive intake of vitamins?
Yes. U-shaped curve: risk at very low and high levels
Which Vitamins are not recommended for any supplementation (other than deficiency)?
A, C, E
Toxicity associated with vitamin A
First trimester birth defects
CVD/Osteoporosis
Lung cancers in smokers
Reasons for Vitamin D supplementation
Older adults/institutionalized
limited exposure to sunlight
Dark skinned individuals
GI disorders
Toxicity associated with Vitamin D
Hypercalcemia
Vascular tissue calcification
Damage to heart, blood vessels and kidneys
Nausea, vomiting, weight loss
Toxicity associated with Vitamin E
Increase in all cause mortality
Increased blEEding with anticoagulants
Reasons for Vitamin K supplementation
All newborns get IM vitamin K to prevent hemorrhagic disease of the newborn
Toxicity associated with Vitamin C
GI issues
Kidney stones
Reasons for Vitamin B1 (Thiamine) supplementation
Chronic alcoholics
Wernicke-Korsakoff Syndrome (Emergent!)
Reasons for Vitamin B12 supplementation
Elderly (decreased absorption)
Vegans and vegetarians
Alcoholics
Pernicious anemia
GI malabsorption disorders
Reasons for Folate supplementation
Women of childbearing age to prevent neural tube defects
Reason for melatonin supplementation
Insomnia/Jet lag, changing sleep patterns
Reason for Fish oil supplementation
Decreased CVD, BP, HR, CHD death, sudden cardiac death
Reason for Co-enzyme Q10 supplementation
For rare genetic deficiency in CoQ10 biosynthetic enzymes
Improves heart health, migraines
Why should doctors discuss dietary supplement usage with patients
They are pharmacologically active
They can be toxic
Discussion may uncover unspoken medical concerns
May be interactions with drugs
What is commonly used herbal medication is a CYP inducer?
St. Johns Wort induces CYP450 enzymes and reduces levels of several drugs including:
- protease inhibitors
- oral contraceptives
- cyclosporin
Use of aloe vera supplementation
Wound healing
Laxative
Osteoarthritis
Use of bitter orange supplementation and associated adverse effects
Uses: Nausea, Constipation, Weight loss
Adverse effects: increased HR, BP; Stroke/MI with caffeine Interacts with MAOI, inhibits gut 3A4
Use of black cohosh
Menopausal symptoms
Use of cranberry
UTIs
Use of Echinacea
Colds/Flu Immune booster
Use of Ephedra and associated adverse effects
Used for: colds, fever, flu and weight loss
Adverse effects: increased risk for CVD/stroke death *Additive with stimulants*
Use of feverfew
Fevers, headaches, migraines
Use of garlic
High cholesterol
High BP
Use of ginger
GI upset, nausea
CVD/inflammation
Rheumatoid arthritis
Use of ginkgo
Memory loss
Sexual dysfunction
Headache
Fatigue
Tinnitus (Mawp…… Mawp…. Mawp)
Use of Ginseng
Increased mental/physical performance
Immune booster
Erectile dysfunction
Lower blood glucose
Use of Hawthorn
Heart disease
CHF/High BP
Angina
Interacts with digoxin/nitrates and BP meds
Use of Horse chestnut and associated adverse effects
Uses: Chronic venous insufficiency, varicose veins, and hemorrhoids
Adverse effects: Raw seed contains poisonous toxin that may exacerbate kidney disease
Use of Kava and associated adverse effects
Uses: insomnia, anxiety, depression, ADHD
Adverse effects: liver damage, muscle spasms
Use of milk thistle
Liver protection, jaundice/cirrhosis, high cholesterol, diabetes
Use of Saw malmetto
BPH
Use of St. Johns wort and associated adverse effects
Uses: depression, anxiety, sleep disorders, heart palpitations, wound healing, chronic fatigue, migraine
Adverse effects: Photosensitization, serotonin syndrome, CYP inducer decreases concentration of many drugs
Use of valerian
Sleep disorders, anxiety, depression
Use of yohimbe and associated adverse effects
Sexual dysfunction, erectile dysfunction, athletic performance, weight loss
Adverse effect: increase BP, HR, anxiety, insomnia, kidney failure
Thunder god vine was demonstrated to be efficacious for treating what disease?
Rhematoid arthritis
Non-inferiority to methotrexate
