Vitamins and Minerals

Question 0

Vitamin A - Name/Function/Source/Deficiency/Toxicity

Answer 0

Name - Retinol
Function - Important for vision + epithelial growth + antioxidant + (functions in the eye by recycling Rhodopsin
Source - B-Carotene which is converted to Retinol in the SI + Leafy Veggies + Liver + Eggs
Deficiency - Night blindness (Nyctalopia) + Dry/Scaly Skin + Xerophthalmia (dry eye) + corneal degeneration + immune suppression
Toxicity - Arthralgias + Skin Changes + Bone Pain + Tertogenic (cleft palate + cardiac) –> Used in acne treatment - check pregnancy first
D

Question 1

Vitamins - Water and Fat Soluable

Answer 1

Water Soluble (8 B's + C) - Thiamine (B1) + Riboflavin (B2) + Niacin (B3) + Pantothenic Acid (B5) + Pyridoxine (B6) + Biotin (B7) + FOlate (B9) + Cobalamin (B12) + Vitamin C (Ascorbic Acid) 
Fat Soluble - A (Retinol) + B + E (Tocopherol) + K

Question 2

Vitamin D - Name/Function/Source/Deficiency/Toxicity

Answer 2

25-OH-D3 = Storage vs. 1-25-OH-D3 (Calcitriol) = Active
Function - Intestinal absorption of phosphate + calcium + balances body calcium + PTH function
Source - Plant = D2 vs. Animal = D3 –> Sunlight converts to storage form
Deficiency - Leads to Rickets (children bone pain/deformity + osteomalacia (adult bone pain/weakness) + Hypocalcemia Tetany
Toxicity - Hypercalcemia + hypercalciuria + loss of appetite

Question 3

Vitamin E - Name/Function/Source/Deficiency/Toxicity

Answer 3

Name - Tocopherol (Fat Soluble) - Incorpoerated into VLDL – E for Erythrocytes
Function - Antioxidant + protects membranes + can enhance warfarin effect
Source - Vegetable Oils + Liver + Eggs + Nuts
Deficiency - Hemolytic Anemia + Muscle Weakness + Posterior column spinocerebellar tract demylination - Similar to B12 deficiency but without megaloblastic anemia

Question 4

Vitamin K - Name/Function/Source/Deficiency/Toxicity

Answer 4

Name - Vitamin K - K for Coagulation
Function - Promotes clotting by helping as a cofactor to increase recycling (needed for Factors II, VII, IX, and X) - Inhibited by warfarin
Sources - K1 from Veggies + K2 from intestinal bacteria synthesis + K3 from Synthetic Sources
Deficiency - Problems with clotting/hemmorhage –> Very low at birth (poor placental transfer) + no intestinal bacteria to create –> Shot given at birth –> Also seen after extended anti-biotic use
Toxicity - Possible link to hemolytic anemia (being studied)

Question 5

Vitamin C - Name/Function/Source/Deficiency/Toxicity

Answer 5

Name - Ascorbic Acid - Water Soluble
Functions - Aids with stabilization of collagen + bile acid/steroid synthesis + antioxidant + iron absorption/reduction
Defeciency - Scurvy - Swollen gums + brusing + anemia + poor wound healing + weak immune system + corkscrew hair (all due to collagen) - No conversion of proline to lysine
Vitamin C causes sCurvy due to lack of Collagen
Toxicity - Nausea/vomiting + diarrhea + fatigue + increase risk of iron toxicity

Question 6

Vitamin B1 - Name/Function/Source/Deficiency/Toxicity

Answer 6

Name - Thiamine - Water Soluble - Active Form = TTP
Function - ATP Enzymes - Cofactor for A-Ketogluterate DH + Transketolase + Pyruvate DH — Also needed for Ach synthesis + Branched chain DH
Deficiency = BeriBeri + Wernicke-Korsakoff + Impaired Glucose Breakdown - Wet BB (Cardiac) + Dry BB (Neurologic) + WK - Confusion/Ataxia/Opthalmoplegia
Seen in Malnutrition/Alcoholism

Question 7

B2 - Name/Function/Source/Deficiency/Toxicity

Answer 7

Name - Riboflavin - Water Soluble - FAD + FMN - riboFlavin + B2 - Gives 2 ATP
Function - Cofactor of Succinate DH in TCA Cycle + FAD Synthesis
Deficiency - 2(B2) C’s - Cheilosis (inflammation of the lips/scaling of the corners of the mouth) + Corneal Vascularization

Question 8

B3 - Name/Function/Source/Deficiency/Toxicity

Answer 8

Name - Niacin - NAD/B3 - 3 ATP
Function - NAD + NADP Synthesis + Derivied from tryptophan - Needs riboflavin + pyridoxine - Lowers VLDL + Raises HLDL
Deficiency - 3D’s of B3 - Glossitis leads to Pellagra (3Ds) - Diarrhea + Dementia + Dermatitis (Casal’s Necklace)
Toxicity - Facial flushing (excess prostaglandins) + Hyperglycemia

Question 9

B5 - Name/Function/Source/Deficiency/Toxicity

Answer 9

Name - Pantothenic Acid - Water Soluble
Function - Key cofactor for CoA and FA Synthase
Deficiency - Rare - Associated with neurological problems and adrenal insufficiency

Question 10

B6 - Name/Function/Source/Deficiency

Answer 10

Name - Pyridoxine - Water Soluble
Function - Converted to pyridoxal phosphate - Used as a co factor for enzymes - In transanimation (AST/ALT) + decabroylation enzymes + glycogen phosphorylase + hem/histamine/niacin synthesis + neurotransmitter/myelin synthesis
Deficiency - Convulsions, hyperirratability, peripheral neuropathy, anemia

Question 11

B7 - Name/Function/Source/Deficiency/Toxicity

Answer 11

Name - Biotin - Water Soluble
Function - Co-enzyme in carboxylase reactions (E.g. pyruvate carboxylase) –> Helps add carbons from CO2
Deficiency - Rare - Only after raw eggs (Avadin reduces the availability of biotin + high dose antibiotics - Causes dementia

Question 12

B9 - Name/Function/Source/Deficiency/Toxicity

Answer 12

Name - Folate/Folic Acid - Water Soluble -
Function - Converted to THF - Co enzyme for 1-carbon transfer/methylation reactions - Important for the production of DNA
Source - Folate from Foliage (leafy greens)
Deficiency - Macrocytic Anemia - No neurological symptoms (vs. B12) + most common us vitamin deficiency - Common in alcoholics and pregnant women - Drugs can cause (Methotrexate + Sulfonamides)
US Provides Folic Acid substitution during pregnancy to prevent neural tube defects

Question 13

B12 - Name/Function/Source/Deficiency/Source of Deficiency

Answer 13

Name - Cobalamin - Water Soluble
Function - Cofactor for homocystine methyltransferase (Methionine to Cysteine) + the conversion of Methyl Malonyl CoA to Succinyl CoA for odd #FA breakdown
Source - Found in animal products (synthesized by microorganisms) - Stored in large pools (years)
Absorption Process (possible defects in each step) - Binds R protein (released in the mouth) in the stomach - Travels to doubdenum - trypsin cleves the R Protein - IF binds (released from the stomach) - IF/B12 complex absorbed in the ileum
Gastric bypass and Crohn’s cause problems with B12
Deficiency - Significant neurologic damage + Pernicious/Macrocytic/megaloblastic anemia + Methylmalonyl CoA build up + Folate Trap Hypothesis - can’t get folate back to THF after the methyl is added (no recylcing) -

Question 14

Zinc - Function/Storage/Source/Deficiency/Toxicity

Answer 14

Function - Healing + Taste/Smell + Proper Function of Immune System + Growth/Development (Pregnancy)
Source - Nuts/Beans (Oysters = Best) - High Fiber reduces absorption
Deficiency - Delayed wounding healing + growth retardation + delayed sexual maturation
Deficiency Causes - Acrodermatitis Enteropathic (AE) - AR + Rare/Fatal - Standard Symptoms vs. Acquired AE (diet Deficiency E.g. Parenteral Nutrition TPN)
Toxicity - UL Limit = 40mg/day - Diarrhea + cramps + nausea + vomiting + impaired copper absorption (shared protein)

Question 15

Copper - Function/Storage/Source/Deficiency/Deficiency Causes/Toxicity/Antidote

Answer 15

Function - Alternates between 2 oxidation states + ENZYME Ceruloplasmin + Iron metabolism + superoxide dismutase + cytochrome c + lysyl oxidase
Sources - Animal bsaed food + Legumes + Cocoa
Copper Deficiency - Relatively Uncommon - microcytic anemia (vs. Macrocytic in B12/Folate) + leukopenia + low serum ceruloplasmin + Myelopathy + Peripheral Neuropathy
Deficiency Causes - Zinc OD + Bariatric Surgery + malabsorption
Copper Toxicity - Wilson’s Disease + Hemodialysis - AR Disorder - Brian/Liver Lesions - Parkinsonian Symptoms + Kayer-Fleicher Ring (Golden brown corneal ring)

Question 16

Selenium - Function/Storage/Source/Deficiency/Toxicity

Answer 16

Function - Most relevant antioxidant + Selenoproteins + Immuno/Thyroid Function
Sources - Meat/FIsh + Whole Grains + Brazil Nuts**
Storage - Stored as selenomethionine vs. selenocystine (active form)
Deficiency - Predisposition to CVD due to fibrous cardiac tissue + certain cancers - China had a problem (low soil levels - Supplemented)
Toxicity - Primarily GI Impact - Nausea + Diarrhea + Garlic Breath***
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Question 17

Iodine - Function/Storage/Source/Deficiency/Toxicity

Answer 17

Function - Essential for Thyroid Processing + TH Production (Cell Metabolism)
Sources - Key is Iodized salt (US supplement program)
Deficiency - Impaired growth/mental retardation + Goiter + Significant damage to the fetus
Toxicity - Possibility of increased papillary cancer (Japan)

Question 18

Iron - Function/Storage/Source/Deficiency/Toxicity

Answer 18

Function - Essential for Hemoglobin + Myoglobin + Cytochromes (ETC)
Sources - Meat + Poultry + Fish + Nuts + Legumes + Foliage
Storage - Stored in Ferritin (in intestinal epithelial cells) - Active form is Transferrin) - If body doesn’t need iron it is lost when the cells die
Iron Deficiency - Most common in women age 16-49 - Not needed in elderly - Causes fatigue + weakness + cold + pica + pallor + conjunctiva + microcytic anemia
Iron Toxicity - UL = 45 mg/day - Can cause nausea + vomiting + Impaired absorption of other minerals - hemochromatosis is to much iron damaging the organs - Primary = inherited vs. secondary = acquired

Question 19

Heme vs. Non-Heme Iron

Answer 19

Heme Iron - Animal - simply enters the cell for absorption and incorporation into ferritin
Non-Heme Iron - Plant - Must be reduced by the brush border before absorption - Impacted by outside factors
Increasing Non-Heme Absorption - Increased Demand + Vitamin C+ Gastric Acid
Decreasing Non-Heme Stores - Low demand - whole grains - Oxalic acid in veggies + tea/coffee