Exam 2: Water-Soluble Vitamins Flashcards
Vitamin C functional form
Ascorbic acid
Vitamin C is nonessential for
Most animals and plants (made from glucose and galactose)
Vitamin C IS essential for
Humans, primates, fruit bats, guinea pigs and some birds
Vitamin C function in connective tissue
- Required for collagen synthesis
- necessary for hydroxylation of proline and lysine
Vitamin C is a coenzyme for
More metabolically active tissues (adrenals, brain, liver, pancreas)
Vit C is required for conversion of _____ to _____, synthesis of _______, metabolism of ________ and absorption of ________
Dopamine to norepinephrine, synthesis of carnitine, metabolism of folate and tryptophan, absorbs non-heme iron
Vitamin C acts as an____ and can regenerate
Antioxidant, regenerate vitamin E
Can donate 2 hydrogens
Proline to Hydroxyproline requires
Vitamin C and iron via proline hydroxylase
Lysine to hydroylysine requires
Vitamin C and iron via lysyl hydroxylase
RDA for Vitamin C
Men= 90 mg Women= 75 mg Smokers= RDA + 35 mg
Smokers require more vitamin C because of
Free radicals
Characteristics of Vitamin C deficiency
Easy bruising Pinpoint Hemorrhages Bone fracture Poor wound healing Bleeding gums Tooth loss Scurvy
4 Hs of Scurvy
Hemorrhagic signs (poor wound healing)
Hyperkeratosis of hair follicles
Hypochondriasis (psychological)
Hematologic (impaired collagen synthesis and decreased iron absorption)
Scurvy can be found in people with
Poor diet, alcoholism, or drug habits
Must consume ______ vitamin C to prevent scurvy
10 mg/ day
Sources of vitamin C
- Bell peppers
- Citrus fruits and fruit juices
- Broccoli
- Dark green leafy veggies
Vitamin C is unstable due to
Oxygen, heat, and basic pH (baking soda destroys)
Cooking effects on vitamin C
- easily extracted in water
- prepared veggies refrigerated for 24 hours has lost about 50% of the vitamin C
- Frozen often contains more vit C than fresh
Thiamin functions
Coenzyme (TDP or TPP)
Noncoenzyme (TTP)
Thiamin as a coenzyme
- energy production (used by dehydrogenase)
- NADPH and pentode synthesis (part of transketolase)
Thiamin functions as a noncoenzyme in
Nervous system
- regulates sodium channels and chloride transport in nerve transduction
Thiamin requirements
Men- 1.2 mg
Women- 1.1 mg
Organs target by thiamin deficiency
Peripheral nerves, heart and brain
Thiamin sources
Yeast Pork Whole grains Enriched grains Legumes
Thiamin deficiency in nerves, heart, and the brain causes
In Peripheral nerves- numbing and paralysis
Heart- edema and fatigue
Brain- decreased alertness
Chronic thiamin deficient is called
Beriberi
Populations where beriberi is common
Where diet mostly consists of polished rice
Dry Beriberi
- low thiamin and high carb intake
- muscle weakness, extremity wasting, peripheral neuropathy, tender calf muscles
Wet beriberi
- enlarged heart, rapid heart beat, peripheral edema, high BP
Acute beriberi
- chronic infant deficiency (2-5 months)
- breastfed by mothers with poor thiamin intake
- anorexia, nausea, vomiting, lactic acidosis
Chronic thiamin deficiency in alcoholics
Wernicke- Korsakoff Syndrome
Chronic thiamin deficiency in alcoholics results in
Decreased thiamin intake
Decreased thiamin absorption
Increased thiamin utilization
Most common nutritional deficiency in alcoholics
Thiamin
TUL of thiamin
None
Raw seafood contains ______ which
Thiaminases; degrades thiamin… bad source
Which disorder is only due to a dietary deficiency of thiamin
Acute beriberi
Dry beriberi consists of low thiamin intake and
High carbohydrate intake; therefore need to eat more thiamin
Symptoms of Wernicke- Korsakoff syndrome
Psychosis/ delirium
ataxia of gait and stance, anorexia
Vomiting
Enlarged heart
Thiamin toxicity is rare but problems could be caused when:
100X the RDA is given by IV
-causes headache, convulsions, cardiac arrhythmia, anaphylactic shock
Thiamin instability is caused by
Neutral or basic pH that occurs in water during cooking
Riboflavin coenzymes
FAD and FMN
FAD and FMN coenzyme functions
- Flavin ring important for redox reactions
- Found in ETS for dehydrogenases and 1st step in beta-oxidation and Krebs
- Synthesis of niacin, folate, and B6
- Converts retinal to retinoic acid
Requirements of riboflavin
Men= 1.3 mg Women= 1.1 mg
Riboflavin Deficiency happens after
Several months of deficient intake
Riboflavin deficiency causes
Photophobia
Burning and itching eyes
Soreness of mouth (cheilosis, angular stomatitis, glossitis & magenta tongue)
Severe riboflavin deficiency inhibits
Vitamin B6 and NAD synthesis
*B vitamin deficiencies can have similar signs
Magenta tongue differentiates
Ariboflavinosis vs any other b vitamin deficiency
Riboflavin deficiency causes
Ariboflavinosis
400 mg of riboflavin can help treat
Migraines with no side effects
Riboflavin sources
- cow’s milk
- enriched grains
- almonds
- soybeans
- eggs
- meats
Riboflavin instability is caused by
Light and water during cooking
Niacin coenzymes
NAD and NADP
NAD and NADP are coenzymes for >200 enzymes that are mostly
Dehydrogenases
Most common nutritional deficiency in alcoholics
Thiamin
Vit C is required for what posttranslational modification in collagen synthesis?
Hydroxylation q
A male smoker should consume how much vitamin C daily?
125 mg
110- female smoker
Which is NOT one of the 4 H’s of scurvy?
- Hyperkeratosis
- Hypertension
- Hematologic
- Hypochondriasis
- Hypertension
T/F there is no tolerable upper intake level set for vit. C?
False
TTP is used in
Na+/Cl- transport
A good source of thiamin
Grilled pork chops
Disorder due to a dietary deficiency only
Dry Beriberi
Dry beriberi causes
Tense calf muscles
Symptoms seen with Ariboflavinosis near the mouth
Cheilosis
Angular stomatitis
Glossitis and MAGENTA TONGUE
Other Ariboflavinosis symptoms
Photophobia and corneal vascularization
Seborrheic dermatitis
Anemia
Peripheral neuropathy
NAD and NADPH function as _ ______ in redox reactions
H acceptors
NAD
Used in glycolysis, Krebs cycle, beta oxidation, and ethanol metabolism
NADPH
Used in fatty acid synthesis, cholesterol synthesis, and folate synthesis
Most of our niacin comes from
Tryptophan
60 mg tryptophan =
1 mg niacin
Pellagra was discovered by
Dr. Joseph Goldberger
3 D’s of Pellagra
Dermatitis
Dementia
Diarrhea
*DEATH
Dermatitis associated with pellagra looks like a _____ on face, neck, and extremities
Sunburn.
Dementia symptoms associated with Pellagra
Headache, memory loss, confusion, disorientation
Diarrhea is caused during Pellagra because of
Digestive abnormalities causing inflammation of mucus membrane of mouth and GI tract (glossitis, cheilosis, angular stomatitis)
Pellagra is caused by a _____ or _______ deficiency
Niacin or tryptophan
Pellagra is common where ______ is a staple in the diet
Corn
Pellagra is often found with ________
Ariboflavinosis
Having Ariboflavinosis causes Pellagra because you make niacin from tryptophan and tryptophan needs riboflavin
Niacin Toxicity
- No toxicity from dietary sources
- Gram doses can lower Triglycerides and LDL and raise HDL
Side effects of using Nicotinic Acid to lower TGs and LDL and raise HDL
Vasodilation (flushing from histamine), heartburn, liver damage, gout, impaired blood glucose
Sources of Niacin
Enriched cereals Chicken Fish Pork Beef Peanuts Yeast
Niacin instability is caused by
A basic pH and water during cooking
Vit B6 Functions as a
Coenzyme (PLP)
Pyridoxal Phosphate AKA
Vit B6
PLP is required for
Amino acid metabolism Synthesis of heme Sphingolipids in myelin sheath Steroids Niacin Neurotransmitters Histamine
Vitamin B6 requirements vary depending on
Protein intake (more protein, more B6 needed)
B6 deficiency is ____ and symptoms include:
Rare;
Dermatitis, glossitis, cheilosis, stomatitis, seizures
- Peripheral Neuropathy
- Hypochromic Microcytic Anemia
Hypochromic Microtyic Anemia is caused by a
Lack of heme synthesis
B6 toxicity causes
Nerve damage
B6 has a higher bioavailability from ______ than ____
Animal than plant
Sources of B6
- enriched grains
- meats
- nuts
- grains
B6 becomes unstable in
- basic pH
- Light
- water during cooking
Folium means
Leaf
Folate is B___
B9
Synthetic form of Folate
Folic acid
Folic acid is the _______ stable form of folate
Most stable; does. Not require digestion and is absorbed 100%
Folate contains _____ ____. _____ which are removed by _____ in the brush border
Glutamic acid residues; conjugate
Conjugase is a ____ dependent enzyme
Zinc
Conjugase inhibitors
Legumes, oranges, cabbage, chronic alcohol consumption
Folate functions as enzymes
Tetrahydrofolate, THF or TH4
Folate as an enzyme
- Donor and acceptor in 1 carbon metabolisms
- DNA synthesis and repair
- Formation of RBC and WBC
- AA metabolism
Folate coenzyme is important in
Embryogenesis
Folate is used in AA metabolism to convert
Histidine to glutamate
Homocysteine to methionine (with B12)
Without B12 THF cannot be regenerated and folate is
Trapped as 5-methyl THF
Methyl-folate trap
Folate is important for
Preventing neural tube defects
Women capable of becoming pregnant are recommended to take _______ of folic acid daily
400 mcg
The only true government required fortified vitamin
Folate
Megaloblastic Macrocytic Anemia is caused by
Folate and B12 Deficiency
Megaloblastic Macrocyticc Anemia
- Occurs in 1 month with a low folate diet
- large RBC due to inadequate DNA synthesis
- occurs with B9 and 12 deficiencies
Symptoms of Megaloblastic macrocytic anemia
Fatigue, headaches, difficulty concentrating, shortness of breath, and palpitations
Neural tube defects caused by folate deficiency
Spina Bifida
Anencephaly
Folate is not toxic with dietary intake but may become toxic with supplemental doses
- masks a b12 deficiency
- binds with zinc in GI tract, causing a ZN deficiency
Sources of folate
- dark leafy veggies
- mushrooms
- liver
- legumes
- fortified cereals (folic acid)
- orange juice
Folate instability caused by
Heat and water during cooking
Vitamin B12 AKA
Cobalamins
Active B12 coenzymes
5-deoxyadenosylcobalamin (5-deoxyadenosyl)
Methylcobalamin (CH3)
Methylcobalamin functions in
Folate pathway and homocysteine removal
Heme synthesis
Low b12 can cause
Neuropathy
Deoxyadenosylcobalamin coenzyme
Threonine and isoleucine metabolism or metabolism of odd-chain fatty acids
B12 requirements
Anyone over 50 should consume B12-fortified. Foods or supplements
B12 deficiency is caused by _____ ______
Poor absorption
- intrinsic factor required for absorption
Poor absorption of B12 happens as we age because we must have ____; acid suppressing medications decrease _____ and _____ ____
HCL; HCL and B12 absorption
Intrinsic factor is secreted from
Parietal cells of stomach
Increased difficulty of B12 absorption is caused by
-Saturated receptors which causes all B12 to go to the ileum q
Conditions that decrease B12 digestion and absorption
Zollinger Ellison syndrome. (Too much HCL)
Medications (histamine blockers, protein pump inhibitors)
Pancreatic insufficiency
Malabsorptive syndromes (Crohn’s)
Folate can get rid of hematologic symptoms of MMA but not neurological symptoms due to demyelination of nerves because of
Decreased DNA synthesis
MMA causes
Fatigue, headaches, difficulty concentrating, shortness of breath and PERIPHERAL NEUROPATHY (dif than folate!)
Pernicious anemia is a type of
Megaloblastic anemia
Pernicious anemia is a _________ condition where antibodies attack _____________ and _________ cells
Autoimmune; gastric parietal and mucosal cells
decrease HCL secretion (acholrhydria) causes
Impaired b12 release from food proteins
Impaired IF secretion causes
Inability to absorb B12
Pernicious anemia is treated with
B12 injections
Who is at risk of B12 deficiency?
Strict Vegetarians/ Vegans Elderly (15% deficient, take injections or nasal spray) Zollinger-Ellison syndrome Pernicious anemia gastritis Achlorhydria (decreased HCL) Malabsorptive conditions Patients on acid-reducing meds Pregnant women
Vegans may not develop B12 ddeficiency for
5-10 years
-tiny requirement and stored up in liver
B12 toxicity
No known toxicity
Sources of B12
Shellfish Meats Poultry Fish Dairy (5-10% lost through pasteruization) Fortified Cereals
B12 is bound to ______ in food
Protein
Instability of B12 caused by
Water during cooking
Pantothenic Acid
B5
Pantothenic acid is part of
Coenzyme A (CoA) and Acyl-carrier protein (ACP)
Pantothenic Acid use as CoA
Metabolism of carbs, lipids, and proteins
Synthesis of FA, cholesterol, and heme
Acyl Carrier Protein (ACP) contains
Pantothenic acid
Sources of pantothenic acid
Meats Poultry Egg yolk Legumes Whole grains Potatoes Broccoli Mushrooms Avocados
Pantothenic acid is stable during _____ and _______, but may be lost while ___________________
Cooking and storage; thawing frozen meats
Pantothenic acid deficiency causes
Burning feet syndrome
Burning feet syndrome
Extremely rare, causes numb toes, burning of feed, depression, fatigue, insomnia, and weakness
Biotin coenzyme functions
Bound to carboxylases
-FA synthesis, gluconeogenesis, metabolism of propionate and leucine
Biotin function as a noncoenzyme
Transcription of several enzymes
Glucokinase, phospoenol pyruvate, carboxykinase
Biotin dependent enzymes
Pyruvate carboxylase and Acetyl-CoA carboxylase
Role of pyruvate carboxylase
Pyruvate to oxaloacetate
-replenish oxaloacetate for TCA cycle; required for gluconeogenesis.
Role of Acetyl-CoA carboxylase
Acetyl-CoA to malonyl-CoA
-committed step of FA synthesis
Most common FA made
Palmitic acid
Sources of biotin
Bacteria in large intestine Peanuts Almonds Soy Eggs Dairy Sweet potatoes (More in plants than animals)
Avidin
Protein in raw egg whites that binds biotin and prevents absorption
When eggs are cooked they are denatured and its not a problem
Biotin is easily extracted
In water
Deficiency of biotin
Rare:
May occur in a person who eats lots of raw egg whites or has biotiidase deficiency
Biotinidase Deficiency
Person born with rare genetic donation of inborn error of metabolism of biotin
Symptoms of biotin deficiency
Dermatitis, anorexia, depression, alopecia, muscle pain, lethargy, hallucinations
Biotin toxicity
No toxicity reported
Choline _______ essential
Is not; we synthesize it
Lecithin makes up _____ of all phospholipids in the body
50%
Phosphatidylcholine AKA
Lecithin
Choline functions as lecithin
Cell membrane integrity Lipid transport (lipoproteins)
Choline functions as choline
Part of acetylcholine
Sources of choline
Soy
Eggs
Liver
Meats
Choline is easily extracted in
Water
Choline deficiency manifests as
Fatty liver disease
Possibly: cancer, CVD, neural tube defects, dementia
Choline toxicity symptoms
Low BP
Fishy body odor
Excessive salivation and sweating
Decreased growth
TUL of choline
3.5 g
Which B vitamins are involved in pyruvate to acetyl-CoA
Pantothenic acid
Niacin.
Thiamin
Which vitamin is NOT involved in ETS?
- Riboflavin
- Niacin
- Coenzyme Q10
- Vitamin C
- Vitamin C
Niacin synthesis requires
Riboflavin
Glossitis with magenta tongue is a clinical indication of which deficiency
Riboflavin
NAD is a coenzyme for which class of enzymes?
Dehydrogenase
Pantothenic acid is involved in fatty acid synthesis as part of
ACP
Biotin deficiency manifests as
Dermatitis
Meats are a good source of
Thiamin
Diets high in phytochemicals are protective against
CVD, cancer and other chronic diseases
Photochemical functions
Antioxidants
Hormonal activity
DNA replication
Antibacterial
Lycopne
Red
-tomatoes, pink grapefruit, watermelon
Anthocyanins
Red/purple
- berries, grapes, red wine, plums
Alpha and beta carotene
Orange
- carrots, mangos, pumpkin, sweet potato
Beta-cryptoxathin
Orange/yellow
-cantaloupe, peaches, oranges, papaya, nectaries
Lutein, zeaxanthin
Yellow/green
-spinach, avocado, honeydew, turnip greens
Sulforaphanes, indoles
Green
Cabbage, broccoli, brussle sprouts, cauliflower
Allyl sulphides
White
-onion, garlic, chives, leeks
Supplementation needed in pregnancy and lactation
Folate
Supplementation for Infants, children, and adolescents
Vitamin D
Older adults need supplementation for
B12 and vitamin D
Smokers need more
Vitamin C
Chronic alcohol intake increases needs of
Thiamin, folate, and B6
Vegans need ____supplements
B12
Diet lower than _______ Calories require supplements
1200 Cal/d
Principles of supplementation
- read the label
- can be harmful in large amounts
- individual needs should be determined
- all nutrients work together
- food is best source of nutrients
A Megadose is more than ____ times the RDA of a micronutrient
10
Large doses may cause
Deficiency in other micronutrients
Deficiencies can occur when people stop overdosing this is called the
Rebound effect
At high doses supplements behave more like
Drugs
Liver can be damaged from to much__________ vitamins
Fat soluble
High dose vitamin C. During pregnancy decreases
Infant birth weight