Vitamins Flashcards
What is the RDA for Vitamin A?
Retinol Activity Equivalents
RAE 900 mcg/d (M)
700 mcg/d (F)
What is the AI for Vitamin D
19-70 year olds 15 mcg/d
What is the AI for Vitamin K
120 mcg/d (M)
90 mcg/d (F)
excess vitamins A & E antagonize vitamin K
What is the RDA for Vitamin E
15mg/d
may not be the optimal level
What is the RDA for Thiamin (B1)
- 2 mg/d (M)
1. 1 mg/d (F)
What is the RDA for Riboflavin (B2)
- 3 mg/d (M)
1. 1 mg/d (F)
What is the RDA for Niacin (B3)
NE: Niacin Equivalents
16 NE/d (M)
14 NE/d (F)
also 15 mg/d
What is the RDA for B6?
1.3-1.7 mg/d
need varies with protein intake
What is the RDA for B12
2.4 mcg/d
What is the RDA for Folate
400 mcg/d for adults
What are reliable dietary sources for Vitamin A
animal food sources: liver, fish, fish oil, fortified milk, dairy, eggs
carotenoids: dark green veg and yellow-orange veg
What are reliable dietary sources for Vitamin D
animal products: eggs, milk, butter, fatty fish, fish liver oils (D3) fortified milks and cereals (D2)
What are reliable dietary sources for Vitamin K and non-food sources?
Plant foods: green leafy vegetables, broccoli, peas, green beans, vegetable oils, animal tissue, liver milk
intestinal bacteria
What are reliable dietary sources for Vitamin E
Plant Oils: vegetable oil, olive oil, sunflower oil, safflower oil, nuts, seeds, wheat germ
What are reliable dietary sources for Vitamin C
Lemons, limes, organes, red peppers, broccoli
What are reliable dietary sources for Thiamin
Enriched grains (rice) and whole grains, fortified cereals, pork, hotdogs, luncheon meat
What are reliable dietary sources for Riboflavin
Milk products yogurt and cheese-sunlight can destroy riboflavin which is why milk is often in a light-block bottle
enriched or whole grains, liver
What are reliable dietary sources for Niacin
All protein containing foods: beef, pork, poultry, fish, milk, eggs, nuts, peanut, butter, whole and enriched grains
What are reliable dietary sources for B6
Meat fish poultry
whole grains NOT ENRICHED GRAINS
bananas and potatoes
What are reliable dietary source for B12
Organ meat, seafood, meat, poultry, eggs, cheese, milk, fortified cereals
What are reliable dietary source for Folate
Fortified breakfast cereals, grain products, leafy green vegetables, beans, legumes, orange juice, liver
What are the Fat Soluble Vitamins
Vitamins ADEK
What are the Water Soluble Vitamins
Vitamin C, B6, B12, thiamin (B1), riboflavin (B2) niacin (B3) and Folate
How are the status of each vitamin assessed?
Vitamin A: measured in serum-retinal
Vitamin D: measured in serum-25-OH-D
Vitamin E: measured in serum-vitamiin E; also functional test: erythocyte hemolysis
Vitamin C: measured in serum-ascorbic acid
Vitamin K: functional test: measure blood clotting-prothombrin time
Thiamin: Functional assay: transketolase activity in RBC-blood
Riboflavin: Functional assay: gluathione reductase activity in RBC-blood
Niacin: no functional test: measure metabolites in urine
Vitamin B6: Functional test: erythrocyte transketolase, plasma PLP-blood, urinary 4-pyridoxic acid-urine
Vitamin B12: measured in serum-B12, also methymalonic acid-urine
Folate: plasma, serum, RBC, levels (blood) and FIGLU excretion (urine)
Classic Vitamin A deficiency
- Xeropthalmia: irreversible blindness; disease progression: night blindness, decreased mucus production (dryness bacterial invasion), development of Bitot’s spots conjuctiva xerosis, keratomatacia, softening of the cornea, scarring;
- Follicular hyperkeratosis: disease progression, keratin, a protein is normally present in the outer layers of skin (protects the inner layers, maintains moisture), normal epithelial cells in the underlying skin lyaers are replaced with keratinized cells, hair follicles become plugged with keratin, bumpy rough and dry skin,
- impaired immunity;
- poor growth
Classic Vitamin D deficiency
Can be due to:
Low or no exposure to sunlight
-being North of the equator- we can not get vitamin D from skin November-March
-wearing sunscreen or not having any unexposed skin
Decreased Milk Consumption
Fat Malabsorption
Skin Pigmentation
1. Rickets: inadequate bone mineralization (in children) symptoms: bow-legged, outward bowed chest, knobs on ribs, delayed closing of fontanel; rapid enlargement of head, muscle spasms
2. Osteomalacia: symptoms: loss of calcium, soft flexible brittle deformed bones, bending of spine, bowed legs, occurs most often in women, people with diseases of the kidney, stomach, gallbladder, intestine, liver,
AT RISK: older people who stay indoors, women, people with diseases of kidney gallbladder stomach liver
Classic Vitamin K deficiency
- Hemmorrhage (excessive bledding)
- Bone and Hip fractures
AT RISK: newborns have inadequate vitamin K stores and and no gut bacteria therefore get a shot of vitamin k shortly after birth
Also people who take certain anticoagulants, those of have impaired fat absorption, low intake of green vegetables-older adults
Classic Vitamin E deficiency
Anemia is low RBC count
1. Hemolytic Anemia: rupture of RBC membranes
2. Peripheral Neuropathy: due to membrane peroxidation of nerve cells
AT RISK: premature infants and individuals with fat malabsorption
Classic Vitamin C deficiency
- Scurvy: lack of Vit C for 20-40 days symptoms begin when body pool is at 300mg, fatigue, petichiae (pinpoint hemmorhages, bleeding gums, poor wound healing, joint pain
- Anemia
- Atherosclerotic plaques
- Depression
AT RISK: alcoholics, elderly men, individuals with low F/V intake, and smokers
Classic Thiamin Deficiency
- Beriberi “I can’t I can’t” peripheral neuropathy, a. Dry beriberi: weakness, nerve degeneration, irritability poor arm/leg coordination, loss of nerve transmission
b. Wet beriberi: edema, enlarged heart, heart failure
AT RISK: occurs where polished rise is the only stable, occurs within 7 days on a thiamin deficient diet - Wernicke-Korsakoff Syndrome: Involuntary eye movement, double vision, Ataxia: staggering poor muscle coordination, mental confusion “drunken stuppor” when no alcohol present
AT RISK: alcoholics: alcohol diminishes thiamin absorption and increases thiamin excretion coupled with a poor quality diet
Classic Riboflavin Deficiency
- Ariboflavinosis
a. Glossitis: inflammation of tongue so that the deep grooves disappear and the tongue appears more smooth
b. Cheilosis: cracks at the corner of of the mouth
deficient within 2 months
AT RISK: Alcoholics, phenobarbitol use, those without milk intake
Classic Niacin Deficiency
- Pellagra: affects skin, GI tract and CNS, sun exposure worsens condition
Symptoms:diarrhea, dementia, dermatitis, death
Cause: (Meat (fatback protein poor) Maise (corn as main staple in diet) molasses)
occurs in 50-60 days prevented with protein adequate diet
AT RISK: alcoholics, diseases that impair food intake, hartnup disease (disordered trp metabolism) corn as main staple prepared without Alkali, soda lime
Classic B6 deficiency
- Microcytic Hypochromic Anemia: small cells with litter color.
- Seborrheic dermatitis
- Convulsion
- Depression,
- Confusion,
- Reduced immune response,
- Peripheral nerve damage,
AT RISK: alcoholics, infants, elderly, renal patients
Classic B12 deficiency
- Pernicious Anemia: due to absorption failure rather than low intake, due to a lack of intrinsic factor which in turn reduces absorption of B12 available from food. It looks similar to megoloblastic anemia which is caused by low folate.
- Nerve degeneration
- Parasthesia
- Dementia
Irreversible damage - Elevated homocysteine: high levels cause heart disease.
AT RISK: elderly (gastric dysfunction- atrophic gastritis and hypochlohydria). Alcoholics, Gastrectomy patients, intestina tapeworm, strict vegetarians
Classic Folate deficiency
- Megaloblastic anemia: similar symptoms of vitamin B-12 deficiency-huge cells with two copies of everything except DNA. It is a failure of cells to divide without the second copy of DNA. If you take additional folate, DNA will synthesize but it could be masking a B12 deficiency or low intrinsic factor this problem will not be resolved.
- Neural tube defects (NTD) low folate in early pregnancy. Spina Bifida, Anencephaly, increased intake recommended for all women of childbearing age.
3.Elevated risk of heart disease (due to elevated homocysteine levels which can be due to low folate.
Folate B6 & B12 together can lower Hcy levels - Increased cancer risk.
AT RISK: pregnant women, alcoholics, elderly, use of certain medications (aspirins, antacids, oral contraceptives)
Vitamin A Toxicity
Hypervitaminosis A
1. acute: ingestion of 100 x RDA within a short periods (days), intestinal upset, headache, blurred vision, muscular uncoordination
2. chronic: larger intake of vitamin A over longer period, bone/muscle pain, hip fracture, skin disorders, headache, dry skin, hair loss, increased liver size double vision
3. teratogenic: causes spontaneous abortions or birth defects,
AT RISK: pregnant women must limit intake of vitamin A
2. Hypercatonemia: high amounts of carotenoids in the blood stream , turns skins yellow-orange