Common Vitamins and Minerals Flashcards
What are the different types of calcium supplements available? How much elemental calcium do they contain?
Calcium carbonate has 40%
Calcium citrate has 21%
Calcium lactate has 18%
Calcium gluconate has 9%
How much calcium should a person take?
For optimal absorption, calcium doses should not exceed 500mg of elemental calcium
If a higher amount of calcium supplement is needed, should be divided throughout the day (BID to TID dosing)
Describe calcium carbonate
Best calcium absorption occurs in an acidic environment, and therefore should be taken with meals Cheapest option Often first line Well tolerate Major side effect: constipation
Describe calcium citrate
Increased absorption compared to calcium carbonate, especially in patients with a high gastric pH
Recommended for patients on proton pump inhibitors or H2 blockers, inflammatory bowel disease or absorption disorders (e.g., bariatric patients)
May be taken on an empty stomach
Have less elemental calcium versus carbonate, therefore more doses may be required
Do calcium supplements contain lead?
Natural preparations from oyster shells or bone meal may contain some lead, but not likely an issue as calcium blocks lead absorption
Do calcium supplements contain magnesium?
Some calcium supplements may also contain magnesium for potential laxative effect
What happens if a person takes too much calcium?
Excess ingestion of calcium potentially may cause kidney stones, milk-alkali syndrome or renal insufficiency
What schedule are iron supplements?
Preparations containing more than 30 mg of elemental iron are schedule II
Death and accidental poisoning has occurred in children who ingested small amounts (200 mg)
In what form are iron supplements?
All dietary iron must be reduced to ferrous form (therefore ferrous iron is absorbed more readily than ferric form)
Where does absorption of iron occur?
Most of iron absorption occurs in the distal duodenum and proximal jejunum
Are enteric-coated or sustained-release iron supplements good options?
No, because iron is release further down the intestinal tract and not absorbed
Should everyone take iron supplements?
Iron supplementation should only occur under the advice of a health care provider when there is known or suspected iron deficiency or an increased need for iron
Why is excess iron bad?
Excess iron is stored in tissues and organs, which may lead to cirrhosis and/or heart failure
What are the classic formulations of iron available?
Ferrous gluconate (12% elemental iron) Ferrous sulfate (20% elemental iron) Ferrous fumarate (33% elemental iron)
What are the newer formulations of iron available?
Heme-iron polypeptide (Proferrin; hemoglobin from bovine red blood cells)
Polysaccharide iron complex (Triferexx, FeraMAX 150; ferric iron complex with hydrolyzed starch, unproven claim that i causes less GI irritation)
How should iron be taken? Why?
Iron salts should be taken on an empty stomach
Foods such as cereals, dietary fibres, tea, coffee, eggs and milk may impair absorption
If stomach irritation occurs, may be administered with food
Suggest to start with low doses, then gradual increase to recommended dose
What are the different drug interactions of iron?
Antacids, proton pump inhibitors, calcium supplements and antibiotics (quinolones, tetracyclines)
What are the side effects of iron?
GI side effects: abdominal discomfort, nausea/vomiting, diarrhea/constipation (likely directly related to the amount of elemental iron)
Do B vitamins help relieve stress and increase energy?
High amounts of B vitamins are found in energy drinks and supplements
B vitamins are helpful to release energy from foods
Our diet supplies all required B vitamins and extra is excreted in the urine
If someone is looking for B vitamins to relieve stress, what is suggested instead?
Reducing caffeine, alcohol and smoking
Exercise
Sufficient sleep
Relaxation techniques (guided imagery, meditation)
Will B vitamins reduce the risk of skin cancer?
Recent ONTRAC Study found that niacinamide may help high-risk patients who already have non-melanoma skin cancer
In the study, they found a decreased risk of skin cancer by 23%
Benefit was not demonstrated in patients without skin cancer
Not a replacement for current recommendations for sun protection
What is AMD?
Age-related macular degeneration
Leading cause of poor vision in people over 60 years old and of adult blindness
Loss of central vision, yet peripheral vision is unaffected
What causes AMD?
Results from the deterioration of the macula
Macula is a small are at the centre of the retina in the back of the eye, purpose is to permit seeing fine details clearly
What are the symptoms of AMD?
Decrease in sharp, straight ahead vision need for driving,reading, recognizing faces and looking at detail