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Nutrition 1 > Vitamins - B > Flashcards

Vitamins - B Flashcards

1
Q

Name of B1

A

Thiamine

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2
Q

Name of B2

A

Riboflavin

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3
Q

Name of B3

A

Niacin

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4
Q

Name of B5

A

Pantothenic acid

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5
Q

Name of B6

A

Pyridoxine

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6
Q

Name of B7/8

A

Biotin

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7
Q

Name of B9

A

Folate

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8
Q

Name of B12

A

Cobalamin

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9
Q

Different chemical forms of each vitamin exist, what are they called ?

A

Vitamers
They are similar in structure meaning a person deficient in B3 can be relieved with either vitamer niacinamide or nicotinic acid

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10
Q

List four functions of vitamins

A

support the immune system
regulating gene expression
supporting neurological activity
Facilitating ATP production
Manufacturing of blood cells
Regulation of hormones

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11
Q

The body cannot produce vitamins, with the exception of

A

Vitamin D

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12
Q

Provide an example of vitamins acting as co-factors

A

B vitamins are vital co-factors for the action of the CYP450 enzyme system needed for phase 1 liver detoxification

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13
Q

Define vitamin insufficiency

A

sub clinical deficiency (vague symptoms

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14
Q

Define vitamin deficiency

A

clinical - signs and symptoms of deficiency

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15
Q

Name/list the 5 stages of progression of insufficiency to deficiency of vitamins

A
  1. preliminary reduction of stores
  2. reduction in enzyme activity
  3. physiological impairment (signs/symptoms)
  4. classical deficiency syndromes
  5. Terminal tissue pathology
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16
Q

True vitamin deficiencies are rare except

A

D and B12

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17
Q

Name the active form of B1 and the mineral needed for conversion

A

Thiamine phyrophosphate (TPP)

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18
Q

How long can the body store B1

A

1 month

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19
Q

How is B1 content reduced, how is it best consumed and what impairs absorption

A

Boiling and freezing - 50%
toasting - 30%
BEST CONSUMED RAW
Absorption impaired by alcohol, tea, coffee, PCP, stress, antacids

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20
Q

Name 4 four food sources of B1

A

Yeast extract
Peas
Oranges
Nuts
Sunfower seeds
Whole grains

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21
Q

List the functions of B1 and therapeutic uses

A

ATP production: fat, protein and carb metabolism; formation of acetyl CoA

Therapeutic use: fatigue, energy production, fertility

Nervous system functioning: the aa metabolised by thiamine can be used to create neurotransmitters, eg GABA

Therapeutic use: cognitive decline, low mood, parkinsons, nerve repair

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22
Q

what are the dietary requirements of B1

A

The more carbs, eat, the more B1 needed (metabolism to create ATP)

0.4-0.5 mg / 1000 kcal

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23
Q

B vitamins work ______ and are often found _______ in nature

A

synergistically
together

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24
Q

What are the symptoms of subclinical deficiency and who is most likely to be depleted

A

Depression, irritability, fatigue, muscle weakness, memory loss, cramp, GIT disturbance.

The elderly.

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25
Q

What B vitamins are responsible for energy production

A

1, 2, 3, 12

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26
Q

What is distinctive about B2/riboflavin and turns urine yellow when consumed over what amount

A

fluorescent green/yellow compound
Over 27mg per day in supplement

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27
Q

What food sources is B2/riboflavin found and what reduces its value

A

Spinach, wild salmon, mushrooms, yeast extract, almonds, quinoa, lentils, organic eggs, meat.

Sensitive to light, and nutrient value reduced by heating and freezing.

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28
Q

Name three functions of B2 riboflavin

A

Energy production: carb/fat/protein metabolism. Krebs cycle/ Needed for FAD.

Liver detoxification - regeneration of glutathione/CYP450 enzymes

Iron metabolism

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29
Q

Name therapeutic uses for B2/riboflavin

A

anaemia
detox programme
fatigue, migraines (400mg per day)
stress

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30
Q

What is the maximum absorption value of B2/riboflavin
what supports absorption
what impairs absorption

A

27mg/day single dose

Bile salts

alcohol, antacids

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31
Q

What impairs the BIOAVAILABILITY of B2/riobflavin

A

copper, zinc, caffeine, saccharin, theophyline (in chocolate)

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32
Q

What increases the need for B2/riboflavin

A

smoking reduces levels
exercise
pregnancy
aging

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33
Q

What is the recommended dose of B2/riboflavin

A

90-400mg/day split through day

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34
Q

Name 3 signs of poor intake of B2/riboflavin

A

sores in mouth corners
red, dry, atrophic tongue
scaly dermatitis (esp around mouth, nose, eyes, ears)
red, tired, gritty eyes,
Fatigue
Deficiency - alopecia

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35
Q

What amino acid is B3 synthesised from in the body

A

tryptophan - 60mg produces 1 mg niacin

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36
Q

When does B3 become essential

A

when tryptophan metabolism is altered

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37
Q

What are the active forms of niacin/B3

A

NAD and NADP - energy carrying molecules

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38
Q

What are the two compounds with niacin activity

A

nicotinic acid
nicotinamide

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39
Q

Name food sources of B3

A

Yeast extract
mushroom
green leafy veg
salmon
sunflower seeds
avocado
peanuts
meat and poultry

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40
Q

How are recommendations for B3 stated

A

as niacin equivalents (NE). Equal to the total niacin compounds in food 1/60th of the tryptophan content of the food (ie 60mg tryptophan, body produces 1mg B3)

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41
Q

What co-factors are required to synthesise B3 from tryptophan

A

B2, B6, iron

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42
Q

what is a niacin flush

A

skin flush/itch due to supplementation. Avoid by using initial dose of 25mg with 1g vit C

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43
Q

Where is B3 absorbed and stored

A

Small intestine

liver, heart, muscles and kidney

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44
Q

Name the three functions of B3

A

energy production (NAD/NADP for stages of aerobic respiration)

Cardiovascular - lowers secretion of LDL

Insulin - glucose tolerance factor (GTF). important for insulin response.

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45
Q

Name therapeutic uses for B3

A

fatigue, alzheimers, hyperlipidaemia, insulin resistance

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46
Q

What are the signs of B3 deficiency

A

Severe: “pellagra” 4 Ds: diarrhoea, dermatitis, dementia, death. Crohns can cause. Treated with up to 500mg B3 daily by Dr.

Mild: unrelenting fatigue, vomiting, depression, canker sores, sensitive to strong light

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47
Q

What condition can be made worse by B3 supplementation

A

Gout - urate competes with niacin for excretion

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48
Q

What are the signs of B3 toxicity

A

hypotension, hyperuricaemia, flush, hypothyroidism

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49
Q

What B vitamin is needed to make coenzyme A (CoA), which goes on to form acetyl-CoA

A

B5 pantothenic acid

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50
Q

Name food sources of B5

A

In almost all foods, but richest sources include shiitake mushrooms, avocados, nuts, seeds, fish, meat

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51
Q

What is needed to synthesise B5

A

intestinal bacteria - therefore antibiotics may reduce absorption

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52
Q

What cooking processes destroys B5

A

cooking , freezing, processing - up to 80% loss

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53
Q

Name 4 functions of B5

A
  1. Energy production (metabolise fats/carb/protein; Acetyl CoA formation)
  2. Fat metabolism (fatty acid degradation and synthesis)
  3. Stress hormones (co factor)
  4. Anti histamine
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54
Q

Name therapeutic uses of B5

A

fatigue
Acne vulgaris
adrenal fatigue
Hayfever

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55
Q

What might cause depletion of B5 (toxicity rare) and what are the symptoms

A

alcohol, stress, surgery

Burning sensation in feet and tender heels, fatigue, abdominal distress

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56
Q

Name the two active forms of B6

A

Pyridoxal 5’-phosphate (PLP)
Pryridoxamine 5’phosphate (P5P)

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57
Q

Name food sources of B6

A

widely distributed
whole grains
green veg
sunflower seeds
pistachios
walnuts
bananas
lentils
avocados
meat, fish

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58
Q

What percentage of B6 is bioavailable and what synthesises it

A

75%
Intestinal flora

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59
Q

What reduces B6

A

processing, preserving, heating, light

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60
Q

What increases B6 requirements

A

excess alcohol
OCP
GIT issues

61
Q

Name four functions of B6

A

Neurotransmitter production - synthesis of GABA, dopamine, Noradrenaline, serotonin

Red blood cell formation - harm production

Methylation - lowers homocysteine

Energy production - aa metabolism, releases stored glucose

62
Q

Name four therapeutic uses of B6

A

GIT motility/carpal tunnel/morning sickness
Anaemia
CV disease
Fatigue

63
Q

What lifestyle factors increase the need for B6

A

alcohol dependence
high stress
pregnancy hormonal imbalance

64
Q

Name symptoms of B6b deficiency and state it if is common or rare

A

Rare, occurs with other deficiencies.
Poor metabolism of fatty acids, leading to skin lesions, dermatitis. Tongue inflammation, mouth ulcers, sores in corner of mouth, PMS, anaemia, drepression

65
Q

Do drugs deplete B6. Name one in particular affected by B6

A

Yes, therefore intake should be increased, eg antibiotics, chemo, OCP.
Levodopa - Parkinsons drug) is broken down by B6 therefore should not be supplemented.

66
Q

Can B6 become toxic

A

Long term supplementation of 100-200mg/day can lead to neuropathy, acne, headache

67
Q

List key functions of minerals

A

Support immune system
Regulate gene expression
Support neurological activity
Facilitate ATP production
Manufacture blood cells
Regulate hormones

68
Q

Compare fat and water soluble vitamins

A

Fat soluble:
ADEK
Soluble in fat
can be stored more readily
absorbed in SI into lymphatic system and then into blood

Water soluble:
B and C
Absorbed directly into blood
Storage in minimal except B12
Easily excreted

69
Q

Name the vitamins of Vitamin A

A

Retinol, retinal, retinoic acid

70
Q

What is retinol oxidised to

A

Retinol to Retinal to retinoic acid

71
Q

What is the key function of each vitamin A vitamer

A

Retinol: health of retina
Retinal: Vision (rod and cone cells)
Retinoic acid: Growth and differentiation of epithelial cells

72
Q

Name the two forms of vitamin A, whether they are active and the main food group they can be found in

A

Pro-vitamin A: can be converted into retinol in the SI and liver.
Carotenes/carotenoids. The most active carotenes are alpha, beta and gamma and crytpoxanthin

Pre-formed vitamin A: ACTIVE, the body can use it. Found in animal foods

73
Q

List the main food sources of Pro-vitamin A

A

Dark green, yellow, orange veg and fruit. carrots, squash, mango, spinach, sweet spud

74
Q

List the main sources of pre-formed vitamin A

A

liver, fish liver oils, egg yolk, mackerel, salmon

75
Q

Summarise the absorption of PRO-VITAMIN A

A

carotenes are converted to vitamin A only as needed.
5-60% absorption
Fats aid absorption (eg coconut oil)
Cooking/lightly steaming liberates carotenoids from cells

76
Q

Name the enzyme that converts carotenoids to retinal

A

BC01 gene. Subject to much genetic variation.

77
Q

What might reduce the conversion of carotenoids to retinal in the intestinal epithelium and liver

A

Hyperlipidaemia, liver disorder, diabetes, hypothyroidism

78
Q

What is the rate of absorption of PRE-FORMED vitamin A

A

70-90% - therefore animal food can lead to vit A toxicity

79
Q

What is the recommended maximum dose of Vit A

A

3000 mcg
higher doses are appropriate for short term only

80
Q

How is supplementation of vitamin A expressed

A

As retinol activity equivalents (RAE)
2mcg beta carotene = 1mcg retinol
Because provitamin A (Carotenes) don’t have the same Vitamin A activity as preformed vitamin A

81
Q

List functions of Vitamin A

A

VISION AND EYE HEALTH - required for rhodopsin, the light sensitive protein giving the msg of sight.

IMMUNITY - T cell proliferation and interleukin 2 secretion.
Support 1st line of immune defence

GENE EXPRESSION AND CELL DIFFERENTIATION - control of cell differentiation and turnover, regulate expression of over 500 genes
gene expression
normal development of bones teeth and skin

REPRODUCTION - spermatogenesis and egg dev. and implantation

ANTIOXIDANT

82
Q

List therapeutic uses of vitamin A

A

recurrent infections
night blindness
visual loss
senile cataracts
acne
hair loss
osteoarthritis
infertility
cancer and disease prevention

83
Q

list deficiency sign and symptoms of Vit A deficiency

A

vision impairment at night is early sign
Hyperkeratosis of skin of upper arm
reduced skin integrity
poor taste/smell
recurrent infections

84
Q

Factors affecting individual requirement for Vit A

A

DM, thyroid, liver disease
alcoholism
zinc deficiency
Poor gut health

85
Q

What drug does vitamin A interact wtih

A

Warfarin as it decreases vit K absorption

86
Q

What are the two types of vitamin D and name the active form of vitamin D

A

Ergocalciferol D2 - plants et mushrooms
Cholecalciferol D3 animal source eg sardines, cod liver oil.
BOTH MUST BE CONVERTED TO ACTIVE FORM - CALCITRIOL VIA LIVER THEN KIDNEY

87
Q

What is the optimal range of vitamin D

A

75-125 mol/L

88
Q

How long can vit D be stored in the liver

A

4 months

89
Q

For profound deficiency of vitamin D, what dosage would be prescribed

A

50,000 Iu D3 orally once weekly for 2-3 months or 3 times weekly for one month

90
Q

What is the key function of vitamin D

A

to maintain serum calcium and phosphorus homeostasis (heart and nervous system functioning)

91
Q

vitamin D actions are mediated through a nuclear transcription factor which is present in each cell. It is called…

A

Vitamin D Receptor (VDR)
It directly or indirectly regulates 100-1250 genes

92
Q

List the key functions of vitamin D

A

BONE HEALTH supports bone density

IMMUNE FUNCTION AND REGULATION enhance innate immune system, regulate T helper cells, antibacterial

GIT HEALTH VDR helps regulate mucosal inflammation. Role in commensal bacterial colonisation. stabilises tight junctions

ANTI CANCER - enhances anti tumour activity of innate immune cells. Inhibits angiogenesis

INSULIN - activates transcription of the insulin gene and increases cellular sensitivity to insulin

93
Q

List therapeutic uses of vit D

A

osteoporosis
osteomalacia
allergies
autoimmunity
infections
muscoskeletal pain reduction
INtestinal inflammation
cancer prevention
T1DM T2DM

94
Q

What vitamin must D be balanced with for proper gene transcription

A

A

95
Q

From a disease prevention approach, maintaining healthy levels of Vit A and D is crucial for correct gene expression. Explain why

A

Retinoid X Receptor (RXR) is a nuclear receptor that is activated by vitamin A. Together with VDR is forms a complex with DNA for transcription

96
Q

List Vit D deficiency symptoms

A

rickets and osteomalacia
Osteoporosis
severe asthma in children
poor immunity
non specific muscoskeletal pain and fatigue

97
Q

What are the causes of vitamin D deficiency

A

low sun exposure
excessive animal protein or Ca intake
lack of dietary fats
impaired liver functionality
elderly
poor intestinal absorption

98
Q

What drug interacts with Vitamin D

A

osteomalacia risk increased with use of barbiturates and anticonvulsants

99
Q

Name the two families of fat soluble compounds with vitamin E activity, and name which is recognised for human nutrition

A

Tocotrienols
a-tocopherol for nutrition

All have alpha beta gamma delta forms and exist in natural food

100
Q

How well does vitamin E tolerate heating and freezing

A

80% destroyed by freezing
30% destroyed by heating

101
Q

What foods are best for vitamin E

A

raw and fresh
sunflower seeds
almonds, pine nuts, Oliver oil, avocado, sweet spud, spinach

102
Q

What organ takes-up Vitamin E and what does it do with it and where is it stored

A

the liver takes-up all forms of Vitamin E and preferentially secretes a-tocopherol into circulation WITHIN lipoproteins.
Circulated everywhere and stored in adipose tissue

103
Q

Why do PUFAs increase the requirement for vitamin E

A

Because of Vitamin E’s antioxidant properties which protect the fatty acid double bonds from oxidation

104
Q

List the functions of Vitamin E

A

ANTIOXIDANT - protects the following from oxidation:
- PUFA cell membranes
- Nerve sheaths
- Cholesterol (decreases LDL oxidation)

Chain breaking antioxidant/

Vitamin C and selenium rejuvenate oxidised vitamin E

IMMUNITY - increases phagocyte activity, Differentiation of immature T cells in the thymus

ANTI-COAGULANT

ENDOCRINE
improves insulin action
Modulates oestrogen receptors

SKIN REPAIR
topical use.

105
Q

List therapeutic uses of vitamin E

A

scarring, acne
Cardiovascular, atherosclerosis
Male fertility
Menopause
Cognitive decline
Anti-cancer
HIV/AIDS
infections
DM

106
Q

What are the three types of compound that have vitamin K activity - name them and their sources

A

K1: leafy green veg. Make-up 80-90% of daily intake. Must be converted to K2

K2: synthesised by bacteria, found in fermented foods. Probiotics support intestinal production, making up around 10%. Synthesis in jejunum and ileum

K3: potentially toxic, synthetic form used in livestock

107
Q

What are the richest food sources of vitamin K

A

Nato and dark green leafy veg. Best with dietary fat eg olive oil

108
Q

What is the optimal intake of Vitamin K300-500 MCG/DAY

A

300-500 MCG/DAY

109
Q

What reduces the absorption of vitamin K

A

High vitamin a intake, aspirin. Low bile secretion, poor fat absorption

110
Q

List the functions of vitamin K

A

Blood clotting - required for formation of 4/13 clotting factors

Bone mineralisation - Osteocalcin requires K for synthesis

111
Q

Is B7/biotin toxic

A

B7 has no known toxicities

112
Q

What foods are high in biotin

A

Egg YOLK (raw whites make biotin unabsorbable), yeast, whole grains, cauliflower, sweet potato, nuts, meat, oily fish

113
Q

List the two functions of biotin

A

Gene regulation - regulate gene expression which are critical for metabolism. Particularly supportive of rapidly regenerating tissues, eg skin, hair and nails

Blood Sugar Regulation - in combo with chromium it can improve blood glucose control

114
Q

List therapeutic uses of biotin

A

dandruff, brittle nails, dry brittle hair, cradle cap
DM
PCOS

115
Q

What are the symptoms of biotin deficiency

A

dermatitis, dry scaly flaky skin, smooth pale tongue, hair thinning and loss, depigmentation

116
Q

What is the active form of B9/folate

A

THF - tetrahydrofolate

117
Q

What is folic acid

A

a synthetic supplement or fortification form not found in nature

118
Q

List food sources of folate

A

Leafy greens, asparagus , avocado, brussels, legumes, citrus, liver

119
Q

What does folate require for absorption and what happens to it after absorption

A

pancreatic enzymes
Once absorbed, a methyl group (-CH3) is added and it’s delivered to body cells

120
Q

What is the ‘folate trap’

A

B12enzyme removes the methyl group, without this the folate becomes trapped inside cells in its methyl form unable to perform its main functions (DNA SYNTHESIS AND GROWTH)

121
Q

Where is folate stored

A

50% liver

122
Q

What vitamin supplement has the most drug interactions

A

folic acid

123
Q

Why have Dietary folate equivalents (DFA) been developed

A

because bioavailability of folate varies in food compared to supplements

124
Q

Folic acid is 1.7 times more available than dietary folate - why is this problematic

A

it is less regulated and absorption is uncontrolled in the body

125
Q

What is an adverse effect of high folic acid supplementation

A

nausea

126
Q

list the functions of folate

A

Embryo health = healthy development of neural tube

Formation of RBC - without folate erythrocytes are large and immature

Cardiovascular health - methylation of homocysteine to methionine

127
Q

List therapeutic uses of folate

A

atherosclerosis
alzheimers
anaemia
prevent spina bifida

128
Q

What are the signs and symptoms of B9 deficiency

A

affects rapidly dividing cell types - GIT and blood cells, skin and digestive issues, megaloblastic anaemia.

129
Q

What factors can cause folate deficiency

A

alcoholism, OCP, aspirin use, old age.

130
Q

What two specific medications should you be wary of when using B9/folate

A

anticonvulsants
methotrexate

131
Q

What dosage of folate is recommended for preconception./conception

A

600mcg/day

132
Q

Why is better to consider using naturally occurring folates

A

folic acid can mask megaloblastic anaemia of B12 deficiency and may hasten nerve damage. Test B12 to combat.

people with MTHFR may be more susceptible to issues arising from supplementation.

133
Q

Vitamin B12, cobalamin compounds, contain what essential mineral

A

Cobalt, it’s in the centre

134
Q

What are the names of the most active forms of B12

A

METHYLcobalamin
HYDROXOcobalamin
ADENOSYL cobalamin
CYANOcobalamin

135
Q

how is B12 synthesised

A

by bacteria - but not all is absorbed. Any B12 in animal based foods originates from their ingestion of bacterial contaminated feed

136
Q

How long does B12 storage last in the liver

A

3-5 years

137
Q

Name vegan sources of B12

A

Chlorella pyrenoidosa
korean purple laver
Nutritional yeast
Nori
Shiitake and lions mane

138
Q

Name animal sources of B12

A

Meat, liver, milk, cottage and feta, eggs, fish

139
Q

List the functions of B12

A

Nervous system - myelin production; neurotransmitter production (dopamine/serotonin); choline (key for brain function)

Erythropoiesis

Methylation - homocystiene to methionine

Energy production - from fats and proteins

140
Q

List therapeutic uses of B12

A

MS
Tingling/pins and needles
Sciatica
Megaloblastic anaemia
CV disease
Alzheimers
Fatigue

141
Q

What are the causes of B12 deficiency

A

Poor nutrition
GIT/malabsorption (eg lack of intrinsic factor/HCl/coeliac

If good diet intake but deficient, would highlight methylation issue of absorption

142
Q

What is the most common cause of B12 deficiency

A

PERNICIOUS ANAEMIA - a malabsorption issue due to lack of intrinsic factor production. Or Helicobacter pylori infection

Pernicious anaemia - autoimmune attack on parietal cells in the stomach (that synthesise IF)

143
Q

What are the signs and symptoms of B12 deficiency

A

Megaloblastic anaemia - fatigue, pallor

Neurological abnormalities - tingling/numbness

144
Q

What is an accurate means of testing B12

A

test methylmalonic acid (serum or urine testing) - it indicates how B12 is used in cell metabolism.

145
Q

Is B12 considered toxic

A

no - it’s’ one of the safest vitamins

146
Q

What drug interactions are there with B12

A

OCP, alcohol excess, PPI lower B12 levels

Ca may enhance absorption

147
Q

Who is most at risk of pernicious anaemia

A

those with autoimmune disease

148
Q
A

Nutrition 1 (5 decks)

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