Vitamins and Minerals Flashcards
What are the fat-soluble vitamins?
Vitamins A, D, E, and K
What are the water-soluble vitamins?
Vitamins B (1, 2, 3, 5, 6, 7, 9, 12) and C
Fat-Soluble Vitamins Characteristics
- Well-retained in body
- Stored in fatty tissue
- Takes time to become deficient
- Toxicity more likely due to slow clearance
Water-Soluble Vitamins Characteristics
- Not well-retained in body (except B12)
- Less likely to cause toxicity (readily cleared from body)
Vitamin A (Retinol) Signs of Deficiency
- Dermatitis
- Night blindness
- Bitot’s spots
- Poor wound healing
Vitamin D Signs of Deficiency
- Osteomalacia
- Osteoporosis
- Rickets (weakening of bone when young)
- Muscle weakness
- Poor growth/development
Vitamin E Signs of Deficiency
- Hemolysis
- Peripheral neuropathy
- Skeletal muscle atrophy
Vitamin K Signs of Deficiency
- Bleeding
- Elevated prothrombin time
Vitamin B (1, 6, 9, 12) Signs of Deficiency
Vitamin B1 (Thiamine)
- Early: anorexia, fatigue, depression, impaired memory
- Late: Paresthesia (burning/prickling of limbs), Wernicke’s encephalopathy
Vitamin B6 (Pyridoxine)
- Limb numbness, convulsions, microcytic anemia
Vitamin B9 (Folic acid)
- Macrocytic anemia, neural tube defects (of embryo)
Vitamin B12 (Cobalamin)
- Spinal cord degeneration, peripheral neuropathy, macrocytic anemia
Vitamin C (Ascorbic Acid) Signs of Deficiency
- Scurvy (bleeding, poor wound healing)
At Risk Populations for Mineral Deficiencies
- Chronic illnesses
- Elderly
- Vegetarian/vegan diets
- Pregnant women
Hypocalcemia Signs
- Muscle cramps
- Weakness
- Tachycardia
- Seizures
- Osteopenia risk
Hypercalcemia Signs
- Constipation
- N/V
- Weakness
- Confusion
- Kidney stones
Calcium Correction Equation
Correct for calcium when albumin is low:
Ca corrected = Ca serum + (0.8 * (4-albumin))
Hypomagnesemia Signs
Moderate
- Tremors
- Fatigue/weakness
- Hypokalemia
Severe
- Seizures
- Arrhythmias
Hypermagnesemia Signs
Moderate
- Usually asymptomatic
Severe:
- Muscle weakness
- Dysrhythmias
- Delirium
Hypokalemia Signs
- Muscle cramps
- Dysrhythmias
Hyperkalemia Signs
- Usually asymptomatic
- Fatal EKG changes (vfib)
Mg2+ and K+ Regulation
- Correct hypomagnesemia FIRST
- Then correct potassium
Special Pop: Eating Disorders (Supplementation)
- Nutritional rehab (be cautious of refeeding syndrome)
- Restore weight gradually
Special Pop: Alcohol Use Disorder (Supplementation)
- Replace fluids and electrolytes
- Restore fat-soluble vitamins (ADEK)
- Supplement thiamine (prevent Wernicke’s encephalopathy → IV>PO)
- Supplement folic acid (prevent macrocytic anemia)
Special Pop: Pregnancy (Supplementation)
- ***Folic acid
- ***Iron (AE: constipation → use stool softener)
- Prenatal vitamin (calcium, vitamin D, iodine)
Special Pop: Neonates (Supplementation)
- Breast milk preferred but doesn’t meet all nutritional requirements
If breastfed, supplement with…
- Vit D 400 IU/day
- Iron 1mg/kg/day
If fed Vit D and iron-fortified formula then you’re gucci
- Whole milk AE: GI bleeding, anemia, metabolic acidosis
Special Pop: Elderly (Supplementation)
- Potassium
- Calcium
- Vit D
- Dietary fiber
- Vit B12 (important for cognitive function and RBC production)
- q monthly B12 inj available for people with poor PO adherence
Special Pop: Macular Degeneration (Supplementation)
- Vitamin A (role in retinal pigment cells)
- Vitamins C and E (antioxidants)
AREDS
- Vit C
- Vit E
- Zinc
- Copper
- Beta-carotene (vit A precursor)
AREDS2 (slightly better than AREDS)
- Same as above except lutein & zeaxanthin instead of beta-carotene
Not omega-3 tho stay safe xD
Drug-Nutrient Interactions w/ Vitamins
- Long-term Rx and OTCs can cause micronutrient deficiencies
- Greatest risk in children and older adults
Examples:
1. ABX x Vit K deficiency
2. H2A x Vit B12 and Ca2+ malabsorption
3. Isoniazid x B3 and B6 deficiency
4. Methotrexate x folic acid deficiency (supplement needed but DON’T TAKE ON THE SAME DAY)
5. PPI x B12, iron, and Ca2+ malabsorption
6. Diuretics x Mg2+, K+, Zn2+ losses
