Midterm 1 Flashcards
What nutrients reduce HOMOCYSTEINE?
B6
B9
B12
Why is it desirable to REDUCE homocysteine?
DECREASES the risk of HEART DISEASE
L. ACIDOPHILUS and BIFIDUS bacterium are supplemented when?
Patient on antibiotics.
Antibiotics destroys some of the NEEDED normal gut flora.
What does “Drinking in moderation” mean?
1-2 drinks per day
12-24 oz beer
1-2 oz hard liquor
8-12 oz wine
List examples of “special diets”
High fiber Low fat Liquid diet Vegetarian Diabetic Low Sodium
Vegan Diet
Plants ONLY
<1% of Population
Lacto Diet
Dairy + Plants
Ovo Diet
Eggs + Plants
Pesco Diet
Fish + Plants
Ave Diet
FOWL ONLY
Of the types of “diets” (Vegan, etc.), what are the two most common? Most rare?
MC: Lacto, Ovo
Rare: Ave
What does “Lite” mean?
Less than the normal product
- sodium
- sugar
- color
- kcals
- fat
- eTOH
What is the most common symptom when the CO-FACTORS for Kreb Cycle are missing?
Fatigue
What is the MAXIMUM OTC dosage for FOLIC ACID? Why?
Max OTC Dose = 400 mcg
Because it MIGHT mask the signs of PERNICIOUS ANEMIA
Examples of HEAT STABLE ANTI-THIAMINES
heat resistant
Flavinoids (citrus fruit)
Tannus (tea/coffee/wine)
Sodium Nitrate (preservatives)
Examples of HEAT LABILE ANTI-THIAMINES
easily destroyed by heat
Thiaminases
- Fresh water fish
- Shellfish
- Bacterial/fungi
(Eating primarily raw fish +/- beri-beri)
Examples of ANTI-THIAMINE drugs
Oxythiamin
Pyrithiamin
(Leads to weight loss, anorexia, neuro dmg)
Example of ANTI-BIOTINS
Avidin in raw egg whites
Avidin is destroyed by heating. Eat a cooked egg, it doesn’t deplete B7
Benefits of ALLICIN. Where is it found?
Kills bacteria
Lowers cholesterol
Lowers BP
Found in GARLIC + ONIONS
*Only works when combined with B1
Vitamins & Minerals depleted by ALCOHOL consumption
B1 B2 B3 B6 B9 B12
Vit C
Calcium
Zinc
Vitamins & Minerals depleted by BIRTH CONTROL PILLS
Vit A
B2
B6
B9
Vit C
Copper
Iron
Zinc
Vit ___ protects against TYLENOL side effects.
Vit E
Vit ___ protects against ASPIRIN + COUMADIN side effects.
Vit K
What are the hazards of FLOURIDE FORTIFICATION?
Teeth Mottling (brown spots on teeth) Bone deformities
(Calcium out of bone to soft tissue, Osteoporosis fractures, +/- allergies, +/- increase cancer risk)
What binds up ZINC? (Decreases absorption, enhances secretion)
**Check this.
PHYTATES Unleavened bread Cadmium Ca++ Cu
Fiber
Iron
Heavy metals
Coffee/tea/cocoa
What binds up IRON?
PHYTATES- Phytic acid (Grains)
Red wine
Grapes
Milk
Apple Juice
+/- be a problem in kids
(Antacids, tannic, phytates-from whole grain, phosvitin- egg yolks, XS minerals, chelating agents- EDTA)
*EDTA = common preservative
Who’s at RISK for Vitamin B DEFICIENCIES? (Commonly seen by chiros)
Alcoholics (B1, B2)
Vegetarians (B12)
Bitches on birth control (B2, B6, B9)
Old people
Diabetics
Hypothyroidism
Antibiotic users
Scurvy ssx
Pirates!!!!
Fatigue Anorexia Easy bruising Swollen/bleeding gums Anemia Loose teeth XS wavy hair
Def. Vit C
Dry Beri-Beri ssx
PNS - neurological Neuropathies Anorexia Weakness Foot/ankle drop - calf muscle pain
*B1 def
Wet Beri-Beri ssx
(Same as DRY ber-beri PLUS..)
Cardiac enlargement
Pitting edema
*B1 def
Hemochromatosis
Sun tanned look
Cirrhosis
Diabetes (d/t decreased glucose tolerance)
*XS Iron
Ariboflavinosis
Dermatitis (around nose, mouth) Cheilosis Eye infections Stomatitis Geographic Tongue
B2 Def.
Wilson’s Disease
Kayser-Fleisher ring of Cornea
UE Tremors
Copper in piss
*XS Copper
Rickets
Bowed legs Knocked knees Rachitic Rosara - bumps on ribs Spine/Pelvis Deficiency *End stage = Convulsions
*Vit D def.
Osteomalacia
Uncalcified bone matrix DUE TO:
- collagen formation
- muscle weakness
- bone pain
- fractures
*Vit D def.
Wernicke-Korsakoff Syndrome
All beri-beri ssx PLUS
Confusion Confabulation (inventing stories) Psychosis Memory loss Nystagmus CN 6 Paralysis (Cross eyed)
*B1 def.
Pellagra
Rough skin esp. exposed area
Casal’s Collar (rough skin around neck)
Weakness Anorexia (3 Ds) Diarrhea Dermatitis Dementia
*B3 def.
Hart Nups Dx
” heart.
Lots of TRYPTOPHAN in piss
Can’t transport or absorb AAs
*B3 def.
Pernicious Anemia
Acholorhyria 2* to HYPOthyroidism Syncope Headaches Sore/red tongue Hallucinations
*B12 def.
Blood test to identify EARLY IRON DEFICIENCY ANEMIA
Serum Ferritin Depletion Test
Most SENSITIVE lab test
How to get adequate Vit D without the risk of toxicity
Sun everyday (some say 15 minutes)
Who’s at the MOST RISK for Vit D TOXICITY?
**Check this.
People supplementing XS Vit D??
Nutrients needed for MUSCLE RELAXATION (reduction of spasms)
Magnesium
Potassium
Calcium
Nutrients made by GUT FLORA
B7
B12
Vit K
Long term antibiotic use +/- lead to destruction of good gut flora…they should be given ___ + ____ supplements to INCREASE proper gut flora.
L. Acidophilus
Bifido Bacterium
Define “divided dose”
Full dose divided equally
Taken throughout the day
Define “empty stomach”
Take 1-2 hours BEFORE or
1-2 hours AFTER a meal
Define “taper off”
Gradual decrease in dosages to
ULTIMATELY NONE
Define “back up”
Take all B Vitamins
in CONJUNCTION with
SPECIFIC dose of B Vitamin
What are kids given to DECREASE the severity of MEASLES?
Vit A
Most TOXIC vitamins and minerals?
Vit D - Most toxic vitamin
Flouride - Most toxic Mineral
Vit A
Vit B3 - Liver toxic
Calcium - “Milk Alkali Syndrome”
Selenium - really toxic
Calcium deficiency ddx
Type I Insomnia
*trouble falling asleep
Muscle cramps - NO exertion
*MC legs, calves
Magnesium deficiency ddx
Type II Insomnia
- fall asleep easily
- wake frequently
Muscle cramps WITH EXERTION
Isolated Dia/Sys HTN
XS sweat
Inc risk S. Aureus
Gestational HTN
Potassium deficiency ddx
Muscle cramps UPON exertion
“Milk Alkali Syndrome”
Calcium
Where’s B1-12, Vit A&E absorbed?
Sm. Intestine
Where’s Vit D absorbed?
Skin
Where’s Vit K absorbed?
Sm. Intestine
Gut
Vit A is bound to __ to CROSS GUT LINING.
Fat
Bile salts
Vit D is bound to __ to CROSS GUT LINING.
Bile salts
Vit K is bound to __ to CROSS GUT LINING.
Bile salts
Pancreatic juice
*Made by gut flora
Vit C is bound to __ to CROSS GUT LINING.
SODIUM dependent transport system
B1 is bound to __ to CROSS GUT LINING.
SUCKER!!! IT’S NOT BOUND TO ANYTHING!!!
B2 is bound to __ to CROSS GUT LINING.
Protein
B3 is absorbed in what forms?
Amide (Nicotinamide)
Acid (Nicotinic Acid)
B5 (Pantothenic Acid) is bound to __ to CROSS GUT LINING.
SUCKER!!! IT’S NOT BOUND TO ANYTHING!!!
B6 is absorbed as ___
Aldehyde/Alcohol form
Pyridoxal phosphate
B7 is bound to __ to CROSS GUT LINING.
Amino residue
B9 requires ___ to CROSS GUT LINING
Enzyme in Brush Border
Pancreatic secretions
Stomach enzymes
B12 requires ___ to CROSS GUT LINING.
pH < 6
Intrinsic Factor
5 reasons to be MINERAL/VITAMIN DEFICIENT.
INADEQUATE
- Ingestion
- Absorption
- Utilization (across cell membrane)
INCREASED
- Excretion
- Needs
Lacto-Ovo Diet
Dairy
Eggs
Plants