supplements Flashcards
vitamin C benefits
- collagen synthesis 2. wound healing 3. capillary integrity
vitamin C is bad because…
impair hepatic metabolism of acetaminophen–>system toxicity, risk of blood thinning (increase hemorrhage risk)
name ophthalmic vitamin ANTIOXIDANTS
ACE: vitamine C,E,A
d-alpha-tocopherol
most bioactive form of vitamin E! fat soluble
Vitamin E 2 forms 1) fat soluble-d-alpha-tocopherol & 2) water soluble–>acetate & succinate (easier to digest, but pee it out easily)
**bioavalability oil>acetate>succinate
what does ophthalmoplegia result from?
LACK of vitamin E
if patient LACKS APOLIPOPROTEIN B (defect in gene)–>vitamin E uptake diminished–>ophthalmoplegia result: EOM palsy that lacks the apolipoprotein B in intestine required for intestinal absorption of lipids
platelet inhibition result of high doses of what vitamin?
vitamin E
which vitamin is there a RISK OF PROSTATE CANCER & what should you add?
vitamin E & add SELENIUM
what patients should avoid vitamin A?
patients w/ PAPILLEDEMA (TOXICITY associated w. swollen optic nerve) & FORMER SMOKERS and ALCOHOLICS (risk of CANCER)
what supplement is deficient in a patient w/ XEROPHTHALMIA?
deficient in VITAMIN A (impair goblet cell functioning) –>MAJOR WORLDWIDE CAUSE OF BLINDNESS
retinitis pigments requires high doses of which vitamin?
vitamin A
ppl w/ RP are deficient in vit A->night blindness! (can’t convert retinol–>retinal)
what is the MOST POTENT vitamin?
vitamin A–>doses in MICROGRAMS (vs. mg/milligrams)
what transports xanthophyll to the retina?
vitamin A has a role
name the different ophthalmic MINERALS
zinc, copper
whats zinc’s role?
SUPPORT antioxidant enzymes, help convert retinol –>retinal, NEUROPROTECTIVE in rats w/ glaucoma (heat shock protection), CARBONIC ANHYDRASE ACTIVITY (super oxide dismutase & catalase. impt in antioxident enzymes)
what mineral is decreased in macular degeneration?
zinc
whats occurs in zinc deficiency?
*mimics vit A deficiency, Zn dependent conversion of retinol–>retinal
what is retinol compared to retinal?
retinol: alcohol based storage of vitamin A in body
retinAL: aldehyde based photopigment needed by rods & cones
does amount of zinc vs. copper?
zinc: 11mg/dose male & 8 mg/dose female
copper: ONLY 2 mg/d (*quarter or less the does given for zinc)
copper’s role?
- critical enzyme function 2. MAO formation (impt for ANS)
what is wrong with ingesting an EXCESSIVE amount of ZINC? what necessary steps should be taken?
DECREASES copper, therefore Cu supplementation required with concomitant Zn administration to prevent Cu-deficiency anemia
name antioxident pigments & what they break down into?
FOOD! –>carotenoids –>carotenes–>
lycopene –>1. alpha & beta carotenes
–>2.xanthophylls *vit A transports to retina
–>a. lutein (mesozeaxanthin)
–>b. zeaxanthin
which antioxidant pigments protect the retina? what color does it give the retina? how does it protect the retina? which is needed in a HIGHER concentration? structurally how do these 2 compare?
lutein & zeaxanthin, orange/yellow color, filters BLUE LIGHT (absorbs high energy blue light), LUTEIN needed in higher conc. (probably cuz its in peripheral retina), they’re ISOMERS,
what foods contain lutein vs. zeaxanthin?
lutein: dark green, zeaxanthin: orange-yellow
what is mesozeaxanthin?
a non-dietary ocular pigment produced from lutein in the macula following isomerization
where do u find lutein, mesozeaxanthin, & zeaxanthin? what is the ratio of L/Z in the periphery and diet? how do u know these pigments are reduced?
lutein: more peripheral
zeaxanthin: macula lutea (in pic..mesozeaxanthin is in the mucula, but it is a isomer of lutein)
periphery: L:Z=2:1
diet: L:Z=5:1
macular pigment ocular density will be reduced! patient will report seeing blue light!
what if patient has a high macular pigment optical density..what light will they see? what is the benefit of such a device?
LESS BLUE LIGHT-cuz the pigment is absorbing all the blue light
determine if the patient needs to take supplements or not
what are the effects of omega 3 fatty acids?
1) anti-inflammatory 2) anti-oxident 3) blood thinner (bleeding risk) 4) cholesterol lowering (mixed reviews) 5) helps dry eyes
what are sources of omega fatty acids? short & long chain..which one is more bioactive?
short chain: ALA 18C –>plant derived
long chain: EPA20C & DHA 22C–> eggs & cold water oily fish
**EPA & DHA more bioactive!
what is a concern of a patient w/ fish allergies?
allergies to HEAVY METAL in LONG CHAIN fatty acids (DHA & EPA)
*Test: bioavailability by formulation? most –>least
MOST! triglyceride (glyceryl) esters> FISH body oil> FREE fatty acids>ethyl esters
what’s the ratio of omega 6:omega 3 in grass vs. grain fed animal? what is the “ideal ratio” of omega 6 to 3? is omega 6 or 3 over consumed?
grass-fed O6:O3=2:1 vs. GRAIN fed O6:O3=4:1 (more pro inflammatory effects)
ideal: O6:O3
1:1 or 1:4
should get more omega 3!
**omega 6 is overconsumed! found in meat
**test: why should you use supplements in eye care?
1) macular degeneration 2) glaucoma 3) cataracts 4) RP 5) dry eyes 6)diabetic retinopathy
what are risk factors for macular degeneration?
CO-MORBIDITIES???
- smoking
- UV light
- poor diet (high BMI & carb intake)
- light eyes
- aging
- family history
- ethnicity (greater risk caucasian)
CO-MORBIDITIES: HTN (hypertension) & obesity
what supplements were added in AREDS 1? what was the result? (%)
Vitamins: beta carotene(vitamin A),C,E
Minerals: zinc, copper
result: reduced rate of advances AMD in people at high risk by 25% over 6 yrs
AREDS 2 what changed from AREDS 1?
Results of AREDS 2?
larger pop
89% taking CENTRUM SILVER
added CATARACTS
*REDUCED ZINC –>NO effect
added LUTHEIN & ZEAXANTHIN –>reduced risk by 10% (substitute beta-carotene w/ xanthophylls –>ADDITIONALLY reduced risk by 18%)
added OMEGA 3: DHA & EPA –>NO effect
results: did NOT reduce risk of developing advanced AMD
*TEST: macular degeneration supplement summary BEST DEFINED by ARED
*no A cuz its in the form of..lutein & zeaxanthin
- C –>500mg
- E–>400IU
- zinc–>80mg
- lutein –>10mg
- zeaxanthin–>2mg
- copper–>2mg
open angle glaucoma & which supplement has a NEUROPROTECTIVE role?
antioxidant therapy MAY reduce neuronal flu toxicity, no hard evidence
- Ginkgo biloba *neuroprotective role (improves cerebral blood flow)
- Marijuana
- Bilberry
CATARACTS-what % of american suffer? according AREDS 2 what supplements reduced cataract development by 30%?
50% of americans who suffer from low vision due to cataracts
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vitamin C
vitamin E
lutein & zeaxanthin
NO vit A
centrum silver: “some” benefits
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RETINITIS PIGMENTS & what does taking this vitamin in a LARGE doses cause? what cases would u take large doses of this vitamin?
degenerative, HEREDITARY eye disease, onset varies b/w ppl, night blindness
*vitamin A: 15,000 IU early-mid stage RP
intracranial hypertension large doses treatment of: -acne i.e. acutane -psoriasis -induce leukemia remission
what would u take for DRY EYE? what vitamin are u usually deficient in? what can this vitamin deficiency cause beside dry eye?
- omega 3 –>anti inflammatory benefits & replenishes tear film
- vitamin A–> deficiency–>xerosis (conj/cornea) & alopecia (eye lashes)
DIABETIC RETINOPATHY **TEST
what should u take?
- BILBERRY fruit
- vitamin D –>deficiency more common in ppl w/ non-insulin dependent diabetes (type 1), lowest in ppl w/ diabetic retinopathy
- Lutein & Zeaxanthin –>reduce amount of damage seen
