Vitamins Flashcards by Carolee Horner

What is the most useful lab to assess B12 status?

MMA

Methylmalonic Acid
Serum or urine

How well did you know this?

Not at all

Perfectly

At a high level, B vitamins are cofactors for what 2 things?

Energy production
Red blood cell production

Energy production =
*turning carbs into glucose
*metabolizing fats and proteins

How well did you know this?

Not at all

Perfectly

KEDAC is an pneumonic for what?

Fat Soluble Vitamin Deficiency

Think Kodak, but misspelled to
KEDAC

He Steals the Rickshaw at Night Sky

K – Hemorarhage
E – Sterility (fertility?)
D – Rickets
A – Night blindness
C – Scurvy

How well did you know this?

Not at all

Perfectly

Cracked floor visualization is for what?

B vitamin deficiencies

Beri Cracks the Floor Playing with Papan

Thiamin – Beri beri
Riboflavin – Cracks in lips/mouth
Niacin – Pellagra (play/pellagra)
Pantothenic Acid – Paresthesia (pins/needles/acne
Pyroxidine - Anemia (microcytic)
Folate – Anemia (macrocytic)
Cobalamin – Anemia

How well did you know this?

Not at all

Perfectly

What are the 3D’s of B3?

Diarrhea
Dementia
Dermatitis

Death if it goes far enough

How well did you know this?

Not at all

Perfectly

How to differentiate between B9 and B12 deficiency

B9
no neuro symptoms
MMA normal

B12
neuro symptoms
MMA elevated
takes years to develop

How well did you know this?

Not at all

Perfectly

Major Function of Vitamin E

Anti-oxidant

others include

*protects against membrane per oxidation (membranes of RBC, muscles, nerves, retina)
*synthesis of CoQ10
*Synthesis of RNA/DNA

How well did you know this?

Not at all

Perfectly

When you think of excessive bleeding, you think of what micronutrients?

Vitamin K and E

How well did you know this?

Not at all

Perfectly

Functions of Vitamin E vs Deficiency of Vitamin E

Protects membranes against peroxidation

RBCs / Hemolyis
Muscles / Muscular dystrophy
Nerves. / Neuropathy
Retina. / Retinopathy

How well did you know this?

Not at all

Perfectly

These nutrients interact with Warfarin

K
E

How well did you know this?

Not at all

Perfectly

How are K and E partners vitamins

They kind of work opposite of each other

K def = bleeding
K tox = hemolytic anemia

E def = hemolytic anemia
E tox = bleeding

Vitamin E can interfere with K

K is trying to boost gamma-carboxylation

E is trying to inhibit gamma-carboxylation

How well did you know this?

Not at all

Perfectly

Sources of vitamin E

think oils

seeds like sunflower seeds, almonds, hazelnuts

also tomato, avocado, spinach, asparagus, swiss chard

How well did you know this?

Not at all

Perfectly

Vitamin A deficiency is often found alongside this mineral deficiency

Iron

supplementing with A in iron-deficiency anemia has better outcomes

How well did you know this?

Not at all

Perfectly

Fetal brain development think of these micronutrients

Folate
Choline

How well did you know this?

Not at all

Perfectly

Plant sources of B12

shitake mushrooms
nori
tempeh (but not soy, comes form the fermentation)

How well did you know this?

Not at all

Perfectly

When you think of B5, think of these things (3)

Everywhere
Liver
any place CoA thank B5

How well did you know this?

Not at all

Perfectly

Therapeutic/prescription dose of niacin

(what’s it used for?)

6,000 mg

hyperlipidemia

How well did you know this?

Not at all

Perfectly

Thiamin Meal

Who is it for?
What are they eating?

Alcoholic that has beriberi

Acorn squash stuffed with ground pork, rice, and sunflower seeds

1.2 and 1.1

How well did you know this?

Not at all

Perfectly

Riboflavin Meal

Who is it for?
What are they eating?

Client with sore and inflamed tongue and mouth

Beef liver and mushroom pate

Oatmeal with almond butter

How well did you know this?

Not at all

Perfectly

Niacin Meal

Who is it for?
What are they eating?

Pellagra (3D’s of B3)
Diarrhea, Dermatitis, Dementia

keeping with the D theme, we are going to dice things up and make a salad

Chix/turkey breast or tuna salad with a side of bird seed/nuts (sunflower, pumpkin, peanut)

The seagull from picmonic, think yummy…poultry

How well did you know this?

Not at all

Perfectly

Pantothenic Acid Meal (fact check)

Who is it for?
What are they eating?

Adrenaline junky (think picmonic)

Beef liver and Shitake mushroom pate

Pellagra

Bluefin tuna fish salad with eggs and greek yogurt/avocado on pita bread

(pita and pellagra)

How well did you know this?

Not at all

Perfectly

Vitamin B6 Meal

Who is it for?
What are they eating?

Friend feeling extra irritable since starting birth control

Sushi and homemade banana ‘ice cream’

Biotin Meal

Who is it for?
What are they eating?

Someone on Abx that notices hair is thinning

Eggs and lox

Scrambled eggs with smoked salmon

(avidin)

Folate Meal

Who is it for?
What are they eating?

Pregnant woman

Bean salad over mixed greens
Side of asparagus

400 (600 pregnant, 500 lactating, TUL 1000)

Vitamin B12 Meal Who is it for? What are they eating?

Older client Surf and turf Seafood buffet (2.4) pregnancy 2.6 and lactation 2.8

Vitamin C Meal Who is it for? What are they eating?

Smoker Brussel Sprout and pepper coleslaw with citrus vinaigrette and fruit salad (90, 75) smokers need 35 extra

Vitamin A Meal Who is it for? What are they eating?

Night blindness and/or skin issues Sweet potato topped with boiled and sautéed spinach, carrots, peppers Vanilla ice cream with mango (Can't see so they accidentally choose all the same color instead of a rainbow) (900,700 TUL 3000)

Vitamin E Meal Who is it for? What are they eating?

Crohn's or other fat malabsorption Trail mix and kiwi (sunflower seeds, almonds, hazelnuts, peanuts, dried mango) (15 TUL 1000)

Vitamin D Meal Who is it for? What are they eating?

Someone with bone issues who doesn't go outside Salmon, mushroom omelette Very similar to biotin meal think to add the mushrooms because mushrooms live in dark places and agoraphobics don't go outside)

Vitamin K Meal Who is it for? What are they eating?

Not for warfarin Someone on Abx with malabsorption issues Natto with a green salad (120, 90)

Liver is high in what nutrients?

Thiamin Riboflavin Niacin Pantothenic acid B6 Biotin Folate Vitamin B12 Vitamin A Vitamin D Vitamin K Vitamin C Choline Copper Iron Not In Vitamin E (have not yet gotten to minerals)

Choline Meal Who is it for? What are they eating?

A client MASLD Eggs with chx sausage and home fries (550, 425, TUL 3500)

What is a niacin equivalent?

1 mg NE = 60 mg of tryptophan = 1 mg niacin

Functions of folate (2)

DNA synthesis Cell replication

Mnemonic to remember where things are absorbed (3)

Laundry order IRON your clothes (duodenum) (iron) FOLd them (Jejunum) (folate) Put in Closet (ileum) (B12)

What is the primary site for biosynthesis of niacin from tryptophan?

Liver kynurenine pathway

Nutrients that increase during pregnancy

Vitamin A - 700 >770 Vitamin C - 75 >85 Thiamin 1.1 > 1.4 Riboflavin 1.1 >1.4 Niacin 14 > 18 Pantothenic Acid B6 Folate Vitamin B12

Nutrients that increase during lactation

Vitamin A - 700 > 770 >1300 Vitamin C - 75 > 85 > 120 Vitamin E - 15 > 15 > 19 Thiamin 1.1 > 1.4 > 1.4 Riboflavin 1.1 >1.4 >1.6 Decreases Niacin 14 > 18 >17

Calorie increases during pregnancy and lactation

1st - no increase 2nd - 340 3rd - 450 lactation = 2000-2800 lactating takes 500 calories but recommend less to facilitate weight loss

Nutrients that don't change for pregnancy

Electrolytes, Doncha Know! Sodium Chloride Calcium Phosphorus Fluoride Vit D Vit K

What micronutrients are important for Type 2 Diabetes?

Chromium Magnesium Zinc Rx depletions of Folate B12 Mag

What micronutrients are important for the microcytic anemia?

Iron Vitamin A Copper Vitamin C

What micronutrients are important for the macrocytic anemia?

Folate B12

What micronutrients are important for the pernicious anemia?

B12

When thinking of labs for microcytic anemia think…

Low

What micronutrients are important for osteoporosis? (7)

Calcium Vitamin D Vitamin K Magnesium Phosphorous Boron Vitamin C Take meds away from supplements

What nutrients are important for CVD? (11)

Fiber B6 Folate B9 B12 Calcium Magnesium Omega 3 C E Selenium Account for Rx depletions (dependent on med)

Signs and symptoms of B6 deficiency

Irritability Depression Confusion Anxiety Mouth symptoms Muscle twitching Headache Insomnia seborrheic rash

Signs and symptoms of biotin deficiency

Hair loss Dermatitis Grayish pallor Unusual fat distribution under skin Depression Lethargy Hallucinations Tingling in extremities Numbness Anorexia Nausea Muscle pain Increased serum cholesterol

Signs and symptoms of folate deficiency

Headache Irritability Difficulty concentrating Forgetfulness Heart palpitations Angular stomatitis Anorexia Weight loss

Signs and symptoms of B12 deficiency

Neurological GI Unexplained weight loss Darkening of skin, hair, nails

Nutrient tricks 1+2=3

B1, B2, B3 = whole grain sources Multiples of 3 are fortified in products because they are important for BLOOD building. B6, B9, B12

Electrolytes, most common

Sunny Places Create Many Cool Bicycle (or beach if you prefer) People Sodium Potassium Calcium Magnesium Chloride Bicarbonates Phosphorus