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Menopause Practice > Ch10: Vitamins, Minerals and Other Dietary Supplements > Flashcards

Ch10: Vitamins, Minerals and Other Dietary Supplements Flashcards

1
Q

Vitamin A is necessary for heath of …(4)

A

Skin, vision, bone growth, immune function

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2
Q

Vitamin A deficiency is associated with…

A

Eye problems, night blindness and conjunctival dryness

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3
Q

2 forms of vitamin A

A

Retinol, preformed vitamin A

Beta carotene, provitamin A

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4
Q

DRI for vitamin A for women >50y

A

700 mcg, 2330 IU

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5
Q

Populations at risk for vitamin A deficiency and malabsorption (3)

A

Pancreatic insufficiency
Cystic fibrosis
Fat malabsorption condition

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6
Q

Prolonged high doses of vitamin A may cause…(3)

A

Bleeding from gums
Dry or sore mouth
Drying, cracking, or peeling of lips

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7
Q

Vitamin A food sources (13)

A

Liver, eggs, sweet potato, pumpkin, carrots, spinach, collards, kale, turnip greens, egg yolk, milk, cheese, butter

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8
Q

UL for vitamin A

A

3000mcg, 10,000IU

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9
Q

Excessive intake of vitamin A may…

A

Stimulate bone loss, increase risk of hip fracture
Counteract effects of calcium supplements
Cause hypercalcemia, hair loss, hepatotoxicity

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10
Q

Vitamin B1

A

Thiamin

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11
Q

Vitamin B2

A

Riboflavin

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12
Q

Vitamin B3

A

Niacin

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13
Q

Vitamin B5

A

Pantothenic acid

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14
Q

Vitamin B6

A

Pyridoxine

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15
Q

Vitamin B9

A

Folic acid

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16
Q

Vitamin B12

A

Cyanocobalamin

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17
Q

Vitamin B1 food sources (4)

Thiamin

A

Whole grain products, meat, fish, fortified foods

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18
Q

Populations at risk of vitamin B1 deficiency (5)

Thiamin

A

Chronic alcohol use, malnutrition, history of bariatric surgery, heart failure, history of critical illness

Associated with dementia

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19
Q

DRI for vitamin B1

A

1.1 mg

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20
Q

UL for vitamin B1

A

None

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21
Q

Vitamin B2 food sources (4)

Riboflavin

A

Eggs, meat, dairy, fortified foods

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22
Q

Populations at risk for vitamin B2 deficiency (3)

Riboflavin

A

Vegan
Vegetarian diets
Pregnant women

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23
Q

Vitamin B3 food sources (5)

A

Meat, fish, poultry, enriched and whole-grain breads, fortified cereals

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24
Q

DRI for vitamin B3

Niacin, niacinamide

A

14 mg

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25
Q

AEs of vitamin B3 intake

A

Flushing, itching, GI discomfort

More common with therapeutic dose used for hyperlipidemia, rather that nutritional dose

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26
Q

Vitamin B6 food sources (4)

A

Fish, organ meats, potatoes, fruit

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27
Q

DRI for vitamin B6

Pyridoxine

A

1.5 mg

Increased if taking cyclosporine, antiepileptics or theophylline

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28
Q

UL for vitamin B6

Pyridoxine

A

100 mg

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29
Q

Populations at risk for vitamin B6 deficiency (3)

A

Chronic renal insufficiency, autoimmune disease, alcohol use

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30
Q

Vitamin B9 food sources (4)

Folate, folic acid

A

Dark leafy greens, nuts, seafood, fortified foods

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31
Q

DRI for vitamin B9

A

400 mcg

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32
Q

UL for vitamin B9

A

1000 mcg

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33
Q

Populations at risk for vitamin B9 deficiency

Folate, folic acid

A

Chronic alcoholics, malabsorption syndromes

34
Q

Vitamin B12 food sources (5)

Cyanocobalamin

A

Fish, seafood, egg yolk, milk, fermented cheeses

35
Q

Populations at risk of vitamin B12 deficiency (5)

Cyanocobalamin

A

Alcoholism, gastritis with achlorhydria, lack of intrinsic factor (pernicious anemia), gastrectomy, older adults.

36
Q

DRI for vitamin B12

A

2.4 mcg

May need to be increase in women taking metformin, PPIs

37
Q

Vitamin C food sources (6)

A

Citrus fruits, peppers, broccoli, cabbage, tomatoes, potatoes

38
Q

DRI for vitamin C

A

75 mg

110 mg in smokers

39
Q

Populations at risk for deficiency

A

Smoker, secondhand smoke, restricted diets, malabsorption syndromes

40
Q

UL for vitamin C

A

2000 mg

41
Q

Deficiency in vitamin C causes…

A

Scurvy, extreme weakness, lethargy, easy bruising, bleeding

42
Q

High dose of vitamin C can cause…

A

Kidney stones/oxalate stones, diarrhea, iron overload, exacerbation of hemochromatosis

43
Q

Biologically inactive vitamin D

A

D3, cholecalciferol
Synthesized in skin via photochemical reaction between 7-dehydrocholesterol and UV light
Transported to liver and hydroxylated to 25(OH)D

44
Q

Functional indicator for vitamin D status

A

25-hydroxyvitamin D, 25(OH)D

Cholecalciferol (D3) is transported from skin to liver and hydroxlyated to 25(OH)D

45
Q

Calcitriol

A

Final hydroxylation in kidney, 1,25-dihydroxycholecalciferol

Instrumental in calcium metabolism and balance

46
Q

Vitamin D2

A

Ergocalciferol
Produced synthetically by irradiation of product of ergot mold
D3 more potent that D2 by a factor of at least 4

47
Q

UL for vitamin D

A

4,000 IU

48
Q

Optimal range for 25(OH)D levels

A

Minimum 20-30 ng/mL
Optimal 30-44 ng/mL
Without additional benefit >60 mg/mL
1ng/mL rise for every 100IU per day of additional cholecalciferol (D3)

49
Q

Food sources for vitamin D

A

Oily fish such as salmon, mackerel, wild-caught fish, eggs and fortified foods such as milk and orange juice.

50
Q

Food sources for vitamin E (5)

A

Nuts, seeds, vegetable oil, vegetables, wheat germ

51
Q

DRI for vitamin E

A

15 mg, 22.5 IU

52
Q

UL for vitamin E

A

1500 IU, 1000 mg/d
However, increased risk of hemorrhagic stroke at 400 IU qod
Therefor, avoid >400 IU/day in people taking medication that increase risk of bleeding.

53
Q

Population at risk of vitamin E deficiency (3)

A

Very few, extremely limited diets, fat malabsorption conditions

54
Q

Food sources for vitamin K1

A

Phylloquinone

Green leafy vegetables

55
Q

Food sources for vitamin K2 (4)

A

Menaquinone

Meat, eggs, dairy, fermented soy

56
Q

Contraindication for vitamin K supplement

A

Women taking warfarin and other vitamin-K dependent anticoagulants

57
Q

Factors that limit calcium absorption (6)

A

Dietary: oxalic acid (spinach, rhubarb, certain green vegetables), phytates (wheat bran, soy protein isolates), tannins (tea)
Vitamin D deficiency
Estrogen deficiency
Increasing age due to decrease in intestinal absorption
Decreased gastric acid production
Malabsorptive disorders

58
Q

DRI for calcium

A

1000 mg for <50y

1200 mg for >50y

59
Q

UL for calcium

A

2000-2500 mg/d

60
Q

Populations at risk for inadequate calcium intake (3)

A

Lactose intolerant
Vegetarian diet
Poor eating habits

61
Q

Foods containing 300 mg calcium

A

8 oz serving of milk/yogurt

1.5 oz cube of hard cheese

62
Q

DRI for iron

A

18 mg/d for menstruating women

8 mg/d after menopause

63
Q

Populations at risk for iron deficiency anemia (5)

A 
End-stage kidney failure
Chronic infectious disorders
Inflammatory disorders
Malignancy
GI malabsorption diseases: celiac disease, Crohn disease
64
Q

Signs of iron deficiency anemia (5)

A 
Fatigue, weakness
Decrease work performance
Difficulty maintaining body temperature
Decreased immune function
Glossitis
65
Q

Food sources for iron (8)

A

Organ meats, beef, turkey, clams, oysters, oatmeal, beans, fortified foods

66
Q

Symptom of phosphorus deficiency

A

Bone pain

67
Q

Populations at risk for low phosphorus levels (4)

A

Excessive urinary loss
Excessive use of antacids
Poor diet
Intestinal malabsorption

68
Q

Food sources for phosphorus (10)

A

Milk, yogurt, ice cream, cheese, soft drinks, peas, meat, eggs, some cereals and breads

69
Q

Symptoms of selenium overdose

A

Hair and nail brittleness and loss

70
Q

Symptoms of boron overdose

A

Nausea, vomiting and diarrhea

71
Q

AEs and interactions from coenzyme Q10

A

Nausea, epigastric pain, heartburn, headache, fatigue

Lower blood pressure

72
Q

Coenzyme Q10 and CHF, HTN, statin-induced myopathies, migraine, breast cancer

A

CHF: not recommended as therapy
HTN: effective as adjunctive therapy, unclear as single therapy
Statin-induced myopathies: no sig benefit
Migraine: may prevent, may take up to 3 months to see benefit
Breast ca: limited studies, no sig difference in level of fatigue

73
Q

Omega 3 fatty acids

A

3 major dietary polyunsaturated fats

(1) alpha-linolenic acid: plants such as flaxseeds and walnuts, canola, soy, dairy products and some red meat
(2) eicosapentaenoic acid and (3) docosahexaenoic acid: fish oil and algae, mainly fatty fish such as salmon, sardines, herring, mackerel, black cod and bluefish

74
Q

Omega 6 fatty acids

A

Polyunsaturated fatty acids (3)
linoleic acid: plant-based oil such as corn, safflower, soybean, and evening primrose seed
gamma-linoleic acid
arachidonic acid
Most American diets have 10x more omega 6 than omega 3.

75
Q

AEs and interactions from fish oil supplements

A

Heartburn, nausea, dyspepsia, loose stools, bad breath, fishy aftertaste
Potential to slow blood clotting and increase bleeding by decreasing platelet aggregation (stop using fish oil supplements before surgical procedures)

76
Q

AEs and interactions from glucosamine and chondroitin

A

No serious AES
Use caution with shellfish allergies, supplements obtained from chitin, extracted from marine exoskeletons
May increase anticoagulation effects of warfarin

77
Q

Fish oil and CVD, Alzheimer’s, and depression

A

CVD: lowers triglycerides in those with very high baseline levels, no affect of HDL-C, ?improve BP, prevent arrhythmia, decrease platelet aggregation
Alzheimer’s: may be protective, need larger and longer clinical trials
Depression: nonsignifcan efficacy in meta-analysis

78
Q

S-adenosylmethionine (SAM-e) and depression, osteoarthritis, and liver disease

A

Depression: not well-studied
Osteoarthritis: studies not adequately sized and too heterogenous to make conclusions
Liver disease: limited data, cannot yet suggest for clinical practice

79
Q

AEs from S-adenosylmethionine

A

Generally well-tolerated

Occ GI upset, nausea, dry mouth, headache, dizziness, restlessness, insomnia

80
Q

Melatonin and circadian rhythm sleep disorders, insomnia, nocturnal blood pressure, benzodiazepine withdrawal

A

Circadian rhythm disorders: may shift circadian rhythm, ie. shift work, jet leg, dementia
Insomnia: improve sleep latency and duration, no effect on quality
Nocturnal blood pressure: inconsistent results
Benzodiazepine withdrawal: limited studies, no sig effect

81
Q

AEs and interactions from melatonin

A

Abdominal cramps, hangover effects, dizziness, fatigue, irritability, impaired balance
High doses may exacerbate depression
Use cautiously with other CNS depressants/sedatives/anxiolytics due to possible additive effect
May impair antiHTN effect of nifedipine
Conflicting reports of increased insulin resistance with DM

82
Q

Dosing of melatonin

A

0.5 to 5 mg daily
Taken 1.5-2h prior to going to bed
Generally safe for short-term use, <3 months
Quick release for initiating sleep/sleep latency
Sustained-release for sleep duration/sustain sleep

Menopause Practice (5 decks)

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