Nutrition

Question 1

Indications and toxic dose of vitamin A

Answer 1

Indicated for skin, infections, eye stuff. Beta-carotene can be used for dementia.

Low-temperate cooking (steaming) decreases availability. High-temperature cooking (boiling) increases it.

> 10,000IU/day is teratogenic and can cause osteoporosis
25,000IU/day is TOXIC and causes hepatotoxicity

Question 2

Tell me about vitamin B1 and B2.

Answer 2

B1: requires Mg+ to function. Used to make ATP. Deficiency BeriBeri, Wernicke’s Encephalopathy

B2: treatment for migraines, PD, skin, glossitis

Question 3

Vitamin B3

Answer 3

Used to make ATP and in fat, cholesterol and carbohydrate metabolism. Tryptophan -> niacin. Tx for: hypercholesterolemia, IHD, skin, AD, ADHD, DM1. Can cause flushing.

Deficiency -> pellagra (4 Ds: dermatitis, diarrhea, dementia and death)

> 3g/day -> TOXIC

Question 4

Which vitamins can be toxic in large doses?

Answer 4

B3, B6, B9, choline, ADEK

Vitamin A: >10,000IU/day is teratogenic and can cause osteoporosis
>25,000IU/day is TOXIC and causes hepatotoxicity
B3: >3g/day
B6: >500mg NEUROTOXIC
B9: >10mg/day: TOXIC
Choline: >20g
Carnitine >3g/day
Vitamin C >4g=TOXIC (must test for G6PD before giving high dose or -> hemolysis)
Vitamin D >40,00IU = TOXIC.
Vitamin E >1200IU possibly TOXIC

Question 5

Vitamin B5

Answer 5

COA component. For skin issues.

Deficiency: ulcers, weakness, paresthesias

Question 6

Vitamin B6

Answer 6

Used in protein metabolism and glycolysis, neurotransmission. Tx for CAD, IHD, skin, neurological, cognition, pregnancy.

Deficiency: glossitis, chelitis, increased homocysteine (freezing food decreases bioavailability)

> 500mg NEUROTOXIC

Question 7

Vitamin B7

Answer 7

CH, lipid metabolism. produced by the microbiome. For skin, nails, DM.

Deficiency caused by eating raw egg whites, anticonvulsant drugs, and antibiotics.

Only a few food sources: peanuts, mushrooms

Question 8

Which vitamins can be produced by the microbiome?

Answer 8

B7, B12, VK

Question 9

Vitamin B12

Answer 9

Tx for: IHD, neuro, skin, psych. EtOH decreases absorption (so does Metformin). High doses can result in acne.

Question 10

Choline

Answer 10

Treatment for liver dz, increased homocysteine, hyperthyroidism, and bipolar disease.

TOXIC > 20g (NV etc)

Question 11

Vitamin C

Answer 11

Needed for synthesis of collagen and carnitine. Tx: HTN, infxn, allergies, DM, exercise asthma, URIs in people in close quarters (i.e. the army barracks).

Deficiency-> scurvy.

> 4g=TOXIC diarrhea, ARF, hemolysis (in G6PD) and rebound scurvy

Question 12

Vitamin D

Answer 12

Activated in the liver and kidneys. Needed for bones, regulates Ca+, Ph-. Stored in fat, but decreased bioavailability in obesity.

Deficiency -> rickets
>40,00IU = TOXIC. Causes hypercalcemia and calciuria, renal stones, NV

Question 13

These conditions are deficiencies of what? 
Wernicke
Beriberi
Pellagra
Scurvy
Rickets
Hyperhomocysteinemia
Megaloblastic anemia

Answer 13

Wernicke, Beriberi : B1
Pellagra: B3 (4Ds)
Scurvy: VC
Rickets: VD
Megaloblastic anemia: B9, B12
Hyperhomocysteinemia: B6

Question 14

Vitamin E

Answer 14

Research says not helpful in CAD.

May help with skin, menstruation (PMS), blood, neuro, MSK

People with fat malabsorption -> risk for deficiency. Lost during cooking.

> 1200IU possibly TOXIC

Question 15

Vitamin K

Answer 15

Treatment for CA, atherosclerosis, liver disease.

Deficiency: bleeding, osteoporosis

TOXICITY: jaundice, hemolytic anemia

Lab test: prothrombin time (PT). Assesses external coagulation pathway. Also includes INR.

Normal PT: 11-13.5 seconds
Normal INR: 0.8-1.1

Question 16

Vitamin B9

Answer 16

prevents stroke by lowering homocysteine. Used in the tx of migraine, skin, CVD, psych, cervical dysplasia.

Deficiency: megaloblastic anemia. OCPs, sulfa antibiotics, and aspirin inhibit absorption.

> 10mg/day: TOXIC

Question 17

Boron

Answer 17

increases estrogen’s effect on bone. Can prevent osteoporosis and CVD

Question 18

Methionine

Answer 18

Precursor to cysteine.

Needed for carnitine and SAMe synthesis.

Tx for PD, UTIs

Question 19

Taurine

Answer 19

Cysteine with B6-> taurine

NT, supports the retina. May be depleted in chemotherapy.

Question 20

What is the different between acetyl-L-carnitine and (levo)carnitine?

Answer 20

Acetyl-L-carnitine: similar to acetylCOA

Carnitine/levocarnitine: fat shuttle.

> 3g/day is TOXIC

Question 21

Ubiquinone (CoQ10)

Answer 21

Give to people on statins

Preserves VC, VE

Question 22

What should you always supplement with in people on statin drugs?

Answer 22

CoQ10

Question 23

DMAE

Answer 23

Precursor to acetylcholine

Question 24

What the supplements which are precursors to acetylcholine and acetyl-COA?

Answer 24

DMAE

B5 is part of COA (acetyl-COA)

Question 25

Flavinoids?

Answer 25

Treatment for venous insufficiency, retinal problems, inflammation, cancer prevention.

Found in black tea, but this can increase BP, so take care in HTN

Heat-resistant; ok to cook

Question 26

PABA

Answer 26

Intermediate in folic acid synthesis. Treatment for skin issues, antifibrotic (scleroderma), ingredient in sunscreen,

Don’t use with sulfa antibiotics