Vitamins and Minerals EXAM 2 Flashcards
Recommended Dietary Allowance (RDA)
daily dietary intake that is sufficient to (97 to 98 percent) healthy individuals
-most often on the label of dietary products
SUMMARIZE
-all water soluble, fat soluble
-Vitamins w/o toxicities
-Vitamins associated with alcoholics, diarrhea, malabsorption
-Vitamins for bone growth
Estimated Average Requirement (EAR)
a nutrient intake value that is estimated to meet the requirement of 50% of the healthy individuals in a group
Adequate Intake (AI)
-used when the RDA and EAR can’t be determined
-labeled with an Asterisk, whereas the other two are bold
- a value based on observed or experimentally determined approximations of nutrient
intake by a group (or groups) of healthy people
Tolerable Upper Intake Level (UL):
-the highest level of intake without experiencing adverse events to almost all individuals in the general population
-the more the UL is exceeded the higher the risk for adverse effects
How are water-soluble vitamins excreted?
Through the urine
->therefore the chance of experiencing overdose or toxicity is low
What is the pathway of fat-soluble vitamins?
- lymphatic system
- general circulation
- concentrate in the lipid tissues
drug-food or drug-drug interactions with fat-soluble vitamins may cause deficiency
Difference between Fat-soluble and water-soluble vitamins
-Fat-soluble vitamins are available longer in the body and they concentrate in the fat-tissue
-water-soluble rapidly excreted through urine
What are the fat-soluble vitamins?
Vitamin A, D, E, K
What is the function of Vitamin A
(Retinol and Beta-carotene)
-normal growth and tooth development, and eye functioning in the conjunctiva, retina, and cornea
What are the Deficiency symptoms of Vitamin A
dry eye, night blindness
Toxicities associated with Vitamin A
-increased risk of bone fractures
-increased cancer risk with beta-carotene supplementation in smokers and former smokers —congenital birth defects
-headache, and diplopia (double vision)
-deficiencies and toxicities not often seen in the US bc the food is rich in Vitamin A
Source of Vitamin A
dark green, red, and orange vegetables
Function of Vitamin B1
(Thiamine)
-formation of acetyl CoA in Krebs cycle to regulate myocardial and nerve function
-carbohydrate metabolism (higher carb intake requires more Vitamin B1)
Patient population to find deficiency of Vitamin B1
-alcoholics
-malabsorption syndromes
-chronic diarrhea
Toxicities associated with Vitamin B1
Lack of Vitamin B1
-peripheral neuritis
-weakness
-Wernicke’s encephalopathy (confusion)
-cardiac dysfunction
Treat with supplements - 100% of the daily recommended intake value
Sources of Vitamin B1
legumes (beans, peanuts, peas), enriched cereals and breads, pork, and beef
Function of Vitamin B2
Riboflavin
-maintenance of cellular growth !!
-vision !!
-mucous membranes
-hair, skin, and nail
Symptoms of deficiency of Vitamin B2
ocular symptoms:
-light sensitivity
-easy eye fatigue
-blurred vision
Patient population to look out for in Vitamin B2
Patients with the need for increased cell growth
-Pregnant (prenatal vitamin)
-Wound-healing
Toxicities of Vitamin B2
-Considered non-toxic
-causes yellow-orange urine discoloration (water-soluble)
Function of Vitamin B3
(Niacin)
electron transfer agent for aerobic respiration of cells
How does the body produce Vitamin B3
1/2 from tryptophan-containing proteins
rest from preformed niacin
Patient population deficient in Vitamin B3
-Alcoholics
-poorly nourished geriatric
-individuals with a restrictive diet
Symptoms associated with Vitamin B3 deficiency
Pellagra - the three “D’s” !!!
-Dementia, diarrhea, and dermatitis
-Glossitis with beefy red tongue (inflammation of the tongue)
-Rash that is crusty and scaly with blackish pigmentation
Toxicities associated with Vitamin B3
nausea/vomiting, diarrhea, hepatotoxicity, skin rash, tachycardia,
hypertension, flushing sensation around the face
Function of Vitamin B6
(Pyridoxine)
-cofactor for more than 60 enzymes (e.g. decarboxylases, synthetases, transaminase, and hydroxylases)
-heme production and metabolism of homocysteine
-Possible treatment of carpal tunnel syndrome (neural disorder - hand), premenstrual syndrome (PMS), and depression
Deficiencies of Vitamin B6 (Pyridoxine)
-alcoholism
-severe diarrhea
-restrictive diets
-malabsorptive syndromes
-drugs (isoniazid and penicillamine)
-genetic diseases
Symptoms of deficiency in Vitamin B6 (Pyridoxine)
-convulsions (seizure) impairment in decarboxylating glutamate to GABA
-peripheral neuritis
-anemia
Toxicities of Vitamin B6 (Pyridoxine)
at high doses can causes a severe sensory neuropathy
Functions of Vitamin B9 (Folic acid)
-cell division !! (cancer patient)
-DNA production !!
-brain and spinal cord development !! (pregnant)
-amino acid metabolism
Patient population prone to Vitamin B9 deficiency
-cancer patients
-pregnants
Which Vitamin requires enzymatic conversion via methylenetetrahydrofolate reductase (MTHFR)?
Vitamin B9 (Folic acid)
Symptoms of Vitamin B9 deficiency
-sore mouth
-diarrhea
-forgetfulness
-irritability
-Neural tube defects in pregnancy
Patient population for Vitamin B9 deficiency
-Alcoholics
-patients with malabsorption and liver disease
-No known toxicities
Recommend Vitamin B9 intake for pregnant women
400 mcg
could be higher with a prescription
Function of Vitamin B12 (Cobalamin)
-active in all cells - bone marrow, CNS, and GI tract
-fat, protein, and carbohydrate metabolism
-methylation reactions and cell division
-metabolism of folates and lipids
-formation of myelin
LIPIDS
Patient population associated with Vitamin B12 deficiency
-older than 50y
-vegeterians
Symptoms of Vitamin B12 deficiency
-neurologic signs and symptoms
(e.g. Paresthesia (burning sensation in the hand), peripheral neuropathy, unsteadiness, poor muscular coordination, mental confusion, agitation, and hallucinations)
-Pernicious anemia (autoimmune disorder decreasing VB12 absorption): may need Fe as well
-NON-TOXIC
Deficiency of which Vitamin is associated with Pernicious anemia?
-rare autoimmune disorder impairing Vitamin B12 absorption
-Vitamin B12
Function of Vitamin C (Ascorbic Acid)
-biosynthesis of hydroxyproline (precursor of collagen, osteoid, and dentin)
-assists in the absorption of nonheme iron from food
Symptoms of Vitamin C deficiency
-symptoms of fatigue, hemorrhage, petechiae, swollen hemorrhagic gums (scurvy), impaired wound healing, and bone changes
Toxicities of Vitamin C
-nausea, diarrhea, stomach cramps, and nephrolithiasis (kidney stones)
The overuse of which drug can be confused with the side effects of Vitamin C overuse?
Acetaminophen (Tylenol)
Sources of Vitamin C
Fresh fruits and vegetables
Functions of Vitamin D3 (Cholecalciferol)
-properties of a hormone and vitamin
-formation of bones and mineral homeostasis
-Involved in maintaining serum calcium levels (w/ parathyroid hormone, phosphate, and calcitonin)
Patient population associated with Vitamin D3 deficiency
-patients with GI diseases
-patients with renal failure
-inadequate sunlight exposure
-dark skin pigmentation
Signs and symptoms of Vitamin D3 deficiency
-calcium abnormalities, muscle weakness, increased risk of falls
-increased risk of cardiovascular disease and certain cancers
Toxicities associated with Vitamin D3
-anorexia (vitamin D3 deficiency)
-hypercalcemia (increased levle of calcium in the blood)
-soft tissue calcification (calcium build-up -> hardens the soft tissue)
-kidney stones
-renal failure
-increased risk of certain types of cancer
What is the prescription option for Vitamin D?
Vitamin D2
Function of Vitamin E (Alpha-tocopherol)
-antioxidant (prevent oxidative damage)
-heme formation, collagen formation, steroid metabolism
Toxicities associated with Vitamin E
-congestive heart failure
-hemorrhagic stroke
-fetal loss when given to prevent preeclampsia (high BP during pregnancy)
Deficiencies of Vitamin E (Alpha-tocopherol)
-Only seen in premature infants and patients with fat malabsorption diseases
-Symptoms: peripheral neuropathy, intermittent claudication (muscle pain due to lack of O2), muscle weakness, and hemolytic anemia
