Water soluble vitamins Flashcards
Energy releasing
B1 Thiamine, B2 RIboflavin, B3 Niacin
Sources B1, B2, B3
B1 T: whole grains, lean pork legumes
B2 R: Liver and wheat germ, DAIRY (UV destroys it!) meats and poultry
B3 N: Tryptophan is precursor so milk and eggs in large quantities can be enough, meats, poultry, fish, legumes, PNB
B1 thiamine defic
Beriberi
- dry: paralytic/nervous (periph neuropahty, atrophy, foot drop, LE weakness)
- wet: cardiac with edema, CHF
Wernicke-Korsakoff (cerebral beriberi)
- ocular, ataxia, confusion (can be unmasked by EtOH)
B1 thiamine (4 risks for defic)
EtOH
Anorexia nervosa (and refeeding after starvation)
Bariatic surgery
Elderly, renal dialysis, thos eon high carbs diets
B2 riboflavin defic
Oral-ocular-gential syndrome
Cheilosis (cracks in lips)
Increased vasc of conjunctive
LACK OF DAIRY
B3 niaicin (risks for defic)
Dietary restiction (corn as proetein source)
Malabsorption
Alcoholism
Metabolic shunting (carcinoid tumor –> incr 5HT –> decr tryptophan –> no precursor to niaicin
B3 niacin (defic)
Pellagra “the 4 Ds” - after months of poor intake
Dermatitis (symmetric, aggrav by sun/heat, LOOKS AWFUL, scaly rash)
Dementia
Diarrhea
Death
Hematopoietic Vits
Folate (folic acid) - 1-carbon transfers, homocyst–>methionine
B12 (cobalamin)
Folate source
Foliage! deep greens, OJ, whole grains - but easily destroyed by cooking
Folate (risks for defic)
Pregancy, EtOH
Chronic hemolytic anemia
DDIs
Folate (signs of defic)
MACROcytic anemia
Hypersegmented neutrophils (more that 5-6)
Glossitis, irritability
Homocysteinemia (more in plasma as folate converts homocysteine to methionine)
Neural tube defects
Folate (RDA)
women of child bearing age: 400-800 ug/d to prevent neural tube defects (spina bifida etc.)
otherwsie RDA = 400
B12 cobalamin fxn
methylation, 1- carbon transfers
ODD CHAIN FATTY ACID metabolism
and MORE, LOOK AT THIS
B12 cobalamin source
ONLY ANIMAL PRODUCTS, synthesized in soil bacteria
Low turnover rates, LOW AT THIS
B12 (4 risks for defic)
Inadequate IF for absorption or Ab to IF
Gastric atrophy
Ileal resection
Breast fed infant of defic mother (eg, vegan, veggie mom)
B12 defic signs
MACROcytic anemia, hypersegged segs
BUT differenitates from folate as B12 has NEURO SX
So don’t treat megaloblastic anemia should NOT be treated with folate unless B12 defic has been ruled out
Vit C (fxn)
Reverisible antioxidant
Co-substrate in hydroxylation - makes COLLAGEN SYNTHESIS
Reduction of Fe3+ –> F3 2+
Important in LEUKOCYTE FXN
Vit C (sources)
fruit and veg!
Absorption & HOMEOSTASIS
B12 CAN BE STORED IN LIVER unlike others
IF needed for absorption FROM distal ileum into portal circulation
Vit C defic signs
SCURVY - defective collagen Hemorrhagic Hyperkeratosis Hypochondriasis (depression, weakness) Hematologic abnormality
Vit C defic risks
ASD kids and see others
Vit C megadoses?
V little evidence for colds
CLINICAL PEARLS?
ADD THEM IN
