Vitamins Pt 1 Flashcards
Reasons why people take vitamins
- Dietary insurance (most common)
- For energy (mostly a placebo)
- To prevent illness (other then AMD there is not much vitamins that do this)
- Specific medical reasons (vitamins for eyes, deficiencies)
Is natural better then synthetic and are there any exceptions
- You want to get your vitamins from your diet if you can
- Exception is vitamin B12 (at 50 years of age go for synthetic as 1/5 people will have low stomach acid so it will be more bioavailable)
Are “natural” or synthetic vitamins better in pill form
- The body can not tell the difference and the natural ones will just be more expensive
Situations ‘needing’ vitamins
- Impoverished (don’t come into pharmacies)
- Alcoholics (don’t come in)
- Pregnancy/ lactation (know what they need)
- Intense dieting (they wont listen to advice)
- Deficiencies in iron, calcium, b12, d, folate, potassium but very unlikely
Will deficiencies be discovered by a pharmacist
- Very unlikely
What do infants need
- While breast fed automatically give 400 IU vit D
- if formula fed you give none
With infant supplementation from Oct to April in northern areas (higher then Edmonton) what changes and why
- Breast fed: give 800 IU Vit D daily
- Formula-fed: 400 IU
- There is less sunshine so need more vitamin D in the winter months
Best form of vitamin D for infants
- D drops
- There is 400IU in each drop
Do infants up to 6 months need iron
- Usually have enough stores at birth
- MD assessed not Pharm
For infants after 6 months do they need iron
- No they don’t as baby foods are iron enriched (fortified)
When will an infant need iron
- If an MD requests it
- Sold behind the counter and don’t give unless a MD made the decision
- Given 15 mg when deemed deficient
Are children vitamins good
- They have a lot less vitamins and often no minerals, pick whichever one has the most types of vitamins/ minerals
- Sometimes simply go with the character they like
What do young girls need to focus on
- Calcium and iron intake
Why do teen girls need to increase calcium and iron intake
- If they get a lot of calcium in early years then there risk of developing osteoporosis in there late years is minimized
- Iron for monthly losses
Do we want 100% of our vitamins from supplements
- No we don’t it is a marketing tactic
- We want to get most of our vitamin// minerals from our diet and use vitamins to top up our needs
Why is there a difference in vitamins in seniors then adults
- Declining smell/ taste = less appetite
- Loneliness/ live alone= eat less
- Health status= more chronic conditions and less dexterity
- Changing needs= need less of some Bs, vit A, iron
Why do seniors need more calcium and vitamin D and IU/mgs
- They intake less calories
- Calcium: 31-50=-1000mg, 51-70=1200 mg, >70=1200 mg
- Vitamin D: 31-50=600IU, 51-70=600IU, >70= 800 IU
- These changes are not to much to worry about
What changes in regards to vitamin B12 when you get >50
- Under 50 you need 2.4 ug (micrograms), but when you get over 50 it is recommended you take 2.4 ug of supplemented vit B12
This is because you have a 1/5 chance of having lower stomach acid and the supplemented version is more accessible
RNI for vitamin B12 in seniors
- 2.4 ug
- Although you want it to be synthetic to allow it to be more accessible
Where do we get our vitamin D from
- 10% from food and 90% from sunlight
- It is a two step process in both
- Getting vitamin D from the sun: sunlight hits cholesterol in the skin and then a 2 step process from liver to kidney
- Getting vitamin D from food starts in gut and then transported to liver and then kidney
Can I take all of my vitamin D for the week at 1 time
- Yes you can
- If you take 400 IU a day you can take 2800 IU
Tolerable Upper daily limit for vitamin D
- 4000 Iu for adults
- Not where toxicity kicks in but rather where there should be 0 symptoms
What form of vitamin D is used in all supplements
Vitamin D3
Is cod liver oil a good source of vitamin D
- No it isnt although has a lot of vitamin a
- Has 2600 IU of vit A, 200 IU of vit D
Is vitamin B12 toxic
- Virtually non toxic
Vitamin B12 RNI
RNI is 2.4ug
What is pernicious anemia:
causes a lifelong vitamin B12 deficiency, they can take injections once a month but they can now take it oral instead
Are tablets of 1000 ug of vitamin B12 safe
- Yes as it is a water soluble drug so virtually non toxic
- It is overkill but almost non toxic
Is under the tongue (sublingual) b
- It is overkill but almost non toxic
Is under the tongue (sublingual) better then oral
- Not proven to be of any value
What vitamin is almost automatic with pregnant women
- Folic acid
What is the best folic acid drug
- Materna
- It is a drug delivery system for folic acid and maybe iron
4 big vitamin concerns for child bearing years (and amount taken)
Iron (18 mg), folate (400 ug), calcium (1000 mg), Vitamin D (600 IU)
4 big vitamin concerns for pregnancy and amount
- Iron (27mg),
- Folate (400 ug supplement in addition to foods),
- calcium (1000 mg, no change from child bearing years, unless <18 years of age then +300 mg which is an extra glass of milk),
- vitamin D (600 IU, no change from child bearing years)
How much iron does health canada state to have in a prenatal vitamin
16-20 mg
What causes nausea within pregnancy vitamins
- People believe it is the iron
- B vitamins or the coating can be nauseating, although calcium and iron people believe this.
Moring sickness happens and throwing in a pill of matterna can make this occur
8. Is prescription prenatal vitamins better
- B vitamins or the coating can be nauseating, although calcium and iron people believe this.
Is prescription prenatal vitamins better
- It has more iron 35mg (this does not mean it is better)
- Vitd, calcium
- Has 1.1 mg of folate (you only need 0.4 mg of folate and anything over 1 needs a prescription)
- This is a not better then the shelf rather is made to be Rx so it could get paid by insurance if prescribed
Spina Bifida and what causes it
- During 3rd and 4th week of fetal development
- Defect in the spine
- It occurs when folate is low within the mother
what % of pregnacys are unplanned and why is it recommended for all women of child baring years take a multivitamin
50% of pregnancy’s are unplanned and this is why mulit-vitamins are recommended to all women of child bearing years (so they have folate in there system in case of accident)
How long should you take folate and iron supplements before during and after pregnancy
- Pre conception: folic acid for 3 months (doesn’t always happen)
- Pregnancy: duration for both folic acid and iron
- Post delivery: 6 weeks for folic acid
What is the effect on tolerability of prenatal multivitamins in pregnancy due to iron content
- Study done which tested low elemental iron (35mg) to high elemental iron (60mg)
- Mean adherence in both groups was about half
- Conclusion: iron content was not a major determinant of adherence to prenatal vitamins (the size of vitamin B could be the issue)
What is better natural or supplement for calcium
- Natural (eg. Milk) is better but if this doesn’t work should take a supp
How much should calcium should females take (4-8, 9-13, 14-18, 19-50, 51+)
- 4-8: 1000mg
- 9-13: 1300 mg
- 14-18: 1300 mg
- 19-50: 1000 mg
- 51+: 1200 mg
Side effects of calcium and how much do you need to take to see side effects
- Need to take up to 2500mg per day to start seeing them
- Constipation is a side effect
How to take a calcium supplement
- Give with food, acid in the stomach helps with absorption
How much calcium to give in one serving
- Max amount per serving is 500mg: the gut can only handle 500 mg at a time so anything more then this it will just go through The body and not be used
Common calcium products
- Carbonate (40% elemental)
- Caltrate
- Citracal (20%)
- Most money and not better (fancy words for lactate of gluconate): coral, chelated, natural source, dolomite
different calcium salts and amount of element in each
- Carbonate: 43%
- Lactate: 13%
- Gluconate: 9%
- Citracal: 20%
What is the benefit of citracal calcium
- Is it believed to aid with lower stomach acid as it is more accessible calcium
- For PPI users (less stomach acid), elderly (less stomach acid), taking without food
- Could legit just take carbonate with food
