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Vitamins and Minerals Study Guide

Fat-Soluble Vitamins
Vitamin
A
Retinoids
- animals cod
liver oil
Carotenoids
- plant dark and
colorful fruits and
vegetables
D
- ergocalciferol (2)
- cholecalciferol (3)
Fatty fish and sun!

Function

- vision
- epithelial linings
- cell-mediated
immunity
- stim rel of lysozyme
enz
- formation of steroid
hormones
- bone remodeling
- helps prevent anemia
- maintains Ca/PO4
levels
-- maintain blood
vessels, bones, muscles
- works with PTH to stim
bone resorption
(activated in liver and
kidney)

E
- Tocopherols
- Tocotrienols
Avocados, coldpressed oils

- antioxidant (edonator)
- synthesis of Vit C and
CoQ
- regul of succinate
oxidation in liver
mitochondria
- regulation of heme
synth
- thyroid fxn (+ I, Se)

K
- Phylloquinone
and
Naphthoquinone
from plants
green leafy veg
- Menaquinones
produced by bac
- Menadione injectable

- activates clotting
factors
- role in mineralization
keeping Ca in solution

Deficiency/Toxici
ty
- Nyctalopia = first
- dry mucus
membranes,
follicular
hyperkeratosis,
infections
Tox: dry lips,
decalcification

Therapeutic Uses
- bio active is betacarotene
- infections/inflamm
- beta-carotene as
supplement can
accel lung CA

- depression
(seasonal)
- mm and bone
pain
Tox: HA, nausea,
diarrhea, incr
thirst,
*hypercalcification
issues
- low deficiency
Tox: genereally
non-toxic

- breast and prostate


CA (Rs here)
- Rickets
- Some depression
- O-perosis

- deficiency is
uncommon but
can cause
bleeding and
hemmorage
Tox: very rare

- injected into
newborns
- pts on heavy doses
of blood thinners

- Alpha tocopherol is
most active and
abundant form
- as antioxidant,
immune fxn, blood

Classic Vitamin D Deficiency Rickets (children), Osteomalacia (adults)


- Rickets: bow legs, knock knees, rachitic rosaric (along ribs), deformities of spine
and pelvis, frontal bossing, sometimes convulsive tetany
- Osteomalacia: uncalcified bones, mm weakness, bone pn, fractures

Water-Soluble Vitamins
Vitamin
Function

Deficiency/Toxicit
y
- fatigue (decr
carnitine), decr
appetite, incr
infection/slow
healing, easy
bruising, bleeding
gums
- 20% insufficient
Clinical Deficiency
= Scurvy

Therapeutic
Uses
- shorten
cold/flu/asthma
- lower BP
- acidify urine with
UTIs

C Ascorbic
Acid
- ascorbate
(buffered)
dehydroascorbat
e
(oxidized)
Fresh fruits/veg

- flavonoids (plant
chemicals) found in foods
high in vit C = antiox
- antiox e- donator
- decr inflamm/help
immune
- cholesterol bile acids
and steroid hormones
- cofactor in forming
try Epi
- Enhances iron absorption
- collagen formation via
hydroxylation of proline
(stored in adrenals and
WBCs)

B1 Thiamine
- monocitrate as
enriched
- hydrochloride
as supplement
*contains sulfur
brewers yeast,
wheat germ,
nuts and seeds

- Kreb Cycle
(ribose/xylulose fructose
pyruvalte acetylCoA)
- HMP/Pentose Shunt
(TPP co-factor for
transketolase + Mg and
dehydrogenase)
- metabolizes CHO, BCAA,
FAs
- nerve impulse conduction

- Alcohol-rel
thiamine def is 3rd
MC cause of
dementia in US
- Anti-thiamine
factors see Qs
Clinical Deficiency
= BeriBeri
Tox: none known
- WernickeKorsakoff (alcohol
related) Disease
genetic, ataxia,
cognative
impairments

- absorbed as TPP
(active form)
- BeriBeri,
Alcoholism,
Alzheimers,
Wenicke-Korsakiff,
Diabetes, Chronic
neuropathic pain

B2 Riboflavin
Green veggies,
eggs, dairy

- precursor for co-enz FAD


and FMN
- E- carrier
- cofactor for folate, B6 and
niacin prod
- Helps in metabolism and

- photophobia,
tearing, itching
burning eyes, sore
throat and mouth
Clinical Deficiency
= Ariboflavinosis

- Cataracs,
genetically low
MTHFR (enz for
folate
metabolism),
migranes, PMS,

iron absorption

certain CA and
some vascular
issues

B3 Niacin
Brewers Yeast,
liver, PB
- Corn as main
staple = incr risk
of defic

- coenz for NAD and NADP


helps with
dehydrogenase
and reductase
- AA synthesis
- stress and sex hormones
- vasodialator (+ Mg,
Argenine)
- glucose tolerance factor
helps binding of insulin

- risk of liver
toxicity
- link to depression
if low in either due
to tryptophan
niacin
- indigestion,
mouth burning,
fatigue, canker
sores
- Tox: Niacin flush
and liver enz must
be tested to
monitor
Clinical Deficiency
= Pellegra

- inositol
hexaniacinate is
least toxic
- high cholesterol/
triglycerides
- intermittent
claudication

B5
Panthothenic
Acid
Found
everywhere
CoA is coenzyme
form
B6
Pyroxidine
- bioactive form
is PLP/P5P
Bananas,
watermelon,
potatoes

- forms E in Kreb Cycle


- heme formation
- synth Ach for nerve
transmiss
- Cofactor for cholesterol
conversion to steroid Hs

- no known
deficiency
- effects adrenals if
induced

- Dusulphide
supplement
panththine most
active

- Hb and AA synthesis, FA
metabolism, N/mm fxn,
synthesis of NTs
- Converts BCAAs into
alpha-ketoacid forms
(leucine, isoleucine, valine)
- formation fr glutamate
GABA and histideine
histamine and tryptophan
serotonin
(decarboxylase)

- need more with


high protein diet
- mental problems
(depression,
insomnia b/c 5HT &
melatonin), mouth
inflammation, liver
enz reduced
- sideroblastic,
micro or macro
anemia
Tox: to nervous
system, causes
sensory neuropathy

- Anemia,
CVD/homocysteine
, PMS, carpel
tunnel, depression

B7 Biotin
*contains sulfur
- synth by good
gut flora and in
many foods, v.
potent

- carboxylases
- FA synthesis from
malonyl-CoA
- Gluconeogenesis
- breaks down leucine,
metabolized AAs, modify
histones

- buildup in
methylmalonyl coA
- avidin prevents
absorption
- hairloss, brittle,
sparse hair,
seborrhetic
dermatitis (B7/B2),
neuro issues,

cholesterol
deposition
B9 Folic Acid
- bioactive form
is
tetrahydrofolate
(vitamin C req!)
Leafy greens!
(raw)
*Sulpha drugs
and anti-CA drug
methotrexate
bind folic acid

- Methyl-THF methionine
synth
- heme formation, DNA
formation
- choline synthesis
homocystine methionine
+b12, SAMe synthesis, cell
division and
replication

- enriched to
prevent neural tube
defects
- megaloblastic
anemia (also
B6/12)
- weakness, poor
growth, neural tube
defects
- Dosage is limited
because it can
mask B12
deficiency

(Low Carb diet incr


rate of NTD b/c
not enough
veggies)
- prevent NTD,
decr homocystine,
megalobastic
anemia (+ B12)

B12
Cobalamine
*contains cobalt
Animal sources

- necc for folate-dep


enzymes
(synth of methionine and
DNA)
- synth of succinyl-coA in
Kreb
- homocystine metabolism,
preserve myelin sheath
- NT synthesis

- complicated
absorption *req
HCL and intrinsic
factor
- Reliable Lab:
methylmalonyl CoA
- Common Lab:
Serum B12

-synthetic
crystalline form is
best + intrinsic
factor
- take between
meals
- pernicious
anemia, lower
homocystenie

Classic Vit C Deficiency Scurvy


- Infections, tired, bleeding and bruising, swollen gums, anemia, corkscrew hair
curls, loose teeth
- MC cause: too little in diet or increased need, increased need due to: severe stress
- Txt: oral, injectable, food or supplements improvement within 48 hrs and recov
2+wks
Classic B1/Thiamine Deficiency Beri Beri
- Juvenile BB
o Hearing deficit, eyelid ptosis, nystagmus, neurological problems, wt loss,
convulsions, fretful
- Dry BB *before heart
o Early shows parasthesias in extreme, decr DTRs, foot/wrist drop, mm pn,
weakness, constipation, fatigue, depression/mental sympt, loss of appetitie
- Wet BB *after heart
o Rapid HR/palpitations, cardiomegaly, chest pn, edema, dyspnea, pulmonary
congestion, CHF
Classic B2/Riboflavin Deficiency - Ariboflavinosis
- mouth stuff: stomatitis, cheilosis, angular stomatitis, geographic and scalloped
tongue;
anemia with pallor, seborrheic dermatitis, eye infections

Classic B3/Niacin Deficiency Pellegra


- 3 Ds: Dermatitis (Casals Collar), Dementia, Diarrhea
Classic B12/Cobalamine Deficiency Pernicious Anemia
- Glossitis, anorexia, nausea, wt loss, constipation, fatigue, weak, dizzy, headache,
palpitation (insuff) + Megaloblastic Macrocytic Anemia and chest pn, edema,
palpitations and arrhythmias
- 25% have only neurological
o Numbness, tingling, abnorm gait, mem loss, disorientation, dementia
Mineral
Calcium Ca
(dairy, soft fish
bones, leafy
greens)

- bone and teeth (as CaPosphate


(hydroxyappetite)
- blood clotting
- mm/N contraction

Deficiency/Toxicit
y
- Tetany, o-perosis,
cramping, HT,
growth stunting
Tox: incr risk of
kidney stones,
milk-alkali
syndrome

Phosphorus

- helps with bone and


teeth
- maintins CV system
- NS function
- vasodilator

Tox: diarrhea

- citrate is best form


- PMS, insomnia,
cramping, asthma
- kills staph. aureus

- HT, arrhythmias,
mm
weakness/cramps
Tox: Hyperkalemia
MC from renal tube
defects (cant
excrete)
- Heme: CVD, colon
CA
- Microcytic
Hypochromic
= Fe, Cu, Zn
- MC mineral def in
world! (Mg in US)
Tox: see Qs
- hypogonadism,
infertility, impaired
healing, decr sense
of taste, foot odor
Tox: low

- asparatate is least
irritating to GI tract,
- citrate common

Magnesium Mg
(seeds
pumpkin, bitter
chocolate)
Potassium - K
(fruits/veg)

Function

- transmits N impulses
- mm contraction
- renal function
(many systems)

Iron Fe
(oysters, dark
meat, lentils, red
wine, cast iron)

HEME: animal
NON-HEME: animal +
plant
- Hb synthesis
- E-production

Zinc Zn
(oysters, high
protein animal
foods)

- immune fxn, wound


heal
- SOD formation
- glucose tolerance factor
(production/storage)
- protein deposition
- male repro organs
- utilization of B-vit

Therapeutic Uses
- citrate is most
absorbable (req
least HCl)
- malate: bone
density
- gluconate: mm
spasm
- rickets,
osteomalacia

- anemia

- wound healing
(protein deposition,
antiox, antiinfection)
- picolinate is best
form
- kills H. pylori
- lozenge form

(sulphate) for throat


healing
- topical anti-fungal
Copper Cu
(shellfish, brazil
nuts)

- oxygenation and RBC


formation
- converts iron fr ferric to
ferrous in ETC
- collagen/elastin
formation
- melanin formation
- SOD formation
- nervous system

Chromium Cr
(brewers yeast,
molasses)

- glucose tolerance factor


(binding of insulin)
- synth of new fats from
cholesterol and invol in
lipid metabolism
*absorbed in stomach*
- prevents
demineralization of teeth
and bones
- all ingested is toxic!

Flouride F
(water/toothpast
e)

Selenium Se
(soil content,
brewers yeast)

Iodide I
(seafood,
fortified in table
salt)

- formation of
glutathionine peroxidase
(antioxidant path)
- synergistic with vit E
- protects against tox/CA
@ cellular level
- thyroid fxn
- thyroid fxn

Others:
- Boron = bone formulation
- Manganese = bone
- Molybdemum = asthma
- Gold = arthritis
- Silica = arthritis
- Classic Iron-Deficiency Anemia

- microcytic hypo,
o-perosis,
degeneration of CNS
(DA, NE)
- sparse, brittle, pale
hair
Tox: fr excess
ingestion, skin
contact Excess =
Wilsons
- not generally found
- isotope in water
contamination can
cause CA,
miscarriages etc
- periodontal disease
Tox: Fluorosis
- narrow range of
safety
- nausea/vomiting,
headache,
weakness, sweating,
diarrhea
- can progress to
spasms, seizures,
hypotension
- LT: teeth mottling
- high content in
central valley of CA
Tox: hair/nail loss,
skin disorders, CNS.
death
Classic deficiencycretinism
Tox: in fetus from
douching can be
tetarogen
Toxic goiter in adults
-

- those on diets with


high fiber, zinc
and/or low protein

- possible role in
diabetes as a GTF
- best as picolinate
or nicotinate form
- prevention of
dental caries
- o-perosis - @ right
amount (if too little
or too much can
cause o-perosis)

- experimental antioxidant
- dandruff (in
selsum blue
shampoo)
seborrheic
dermatitis
- hypothyroidism
- can kill pathogens
on the skin

Vanadium = carb metabolism


Cobalt = B12
Titanum = white coloring agent
Germanium = CVD
Bisthmus = antacid, decr diarrhea

Microcytic hypochronic RBCs


- Nails: koilonychias, ridges, splitting
Mouth: glossitis, cheilosis, stomatitis (less soreness than ariboflavinosis)
GI issues, blue sclera/pallor, incr sensitivity to cold, elevated pulse, rapid HR, dizzy
Classic Copper Toxicity Wilsons Disease
child after 5 (or at any age if ingestion/skin contact)
Binding sites are saturated and end up with excess in bloodstream, erythrocytes fill
and cause recurrent hemolytic anemia, cerebral sites fill and cause destruction of
nerve cells (tremors and contractures), kidney dysfunction, deposits everywhere,
Kayser-Fleisher ring, osteomalacia, eventual liver failure and leads to death w/o
intervention
Classic Iodine Deficiency Cretinism
If pregnancy woman is deficient infant with have goiter with compression issues
(respiration, cough, feeding) and bone and mental retardation
Can detect early on sonogram and try to intervene
-

Study Questions

What are the names for Vit C:


ascorbic acid, ascorbate (w/mineral), dehydroascobate (fully oxidized)
What are the main food sources? Fresh fruits and vegetables
Peppers, parsley, leafy greens, citrus fruits, berries *pigmented
Bowel Tolerance: gradually incr dose/take divided doses to point of soft but not
loose stool/diarrhea
Divided Doses: Take separately to max absorption, minimize side effects and mimic
eating patters
- 3g every 4hrs = max absorption
Megadose: 10X RDA for therapeutic use temporarily
Taper Off: *only Vit C Slowly decrease dosage if on high amts
(Rebound scurvy after birth)
What is the main side effect of high doses: diarrhea
What destroys Vit C in food and supplement sources:
sensitive to light, air, heat best raw/lightly cooked
destroyed by heating, microwave, irradiation
What organ stores the most Vit C: 1 = adrenals (pituitary, thymus, retina, brain)
Effect of vit C on collagen:
Cofactor for proline hydroxylase => hydroxyproline
Role in bone, hair, skin, nails, jts, conn tissue, wound healing
Effect of vit C on neurotransmitters: makes epinephrine from tyrosine
Dopamine NorE requires Vit C as cofactor for DA-5-hydroxylase

Signs and symptoms of scurvy and why?


easy bruising, mm fatigue/pn, swollen gums/teeth, decr wound healing, tender, operosis/fx, anemia, corkscrew coiled hairs
All functions related to collagen, iron absorption and immune support
Antioxidant path using vit C:
Vitamin E Vit C CoQ10 Glutathione Antioxidant Enz Superoxide
Dismutase
Glutathione
Peroxidase
Catalase
Know how vit C helps decr atherosclerosis:
as an antioxidant (electron donor) it will help fight free radicals and decrease
plaque buildup
keep blood vessels healthy by supporting collagen formation
Who is at highest risk for vit C deficiency
Smokers, Stress, Alcohol use, Dialysis
(No #s, No enzyme defect)
B Vitamins
Know all names and numbers
B1: Thiamine
B2: Riboflavin
B3: Niacin
-

B5: Pantothenic
Acid
B6: Pryoxine

Biotin (B7)
Folic Acid (B9)
B12: Cobalamine

Which Bs are enriched in foods? Which foods?


B1/Thiamine, B2/Riboflavin, B9/Folic Acid
In grains
Not: 3, 5, 6, Biotin, 12
Which food is naturally high in Bs: Brewers Yeast, Liver
What food has allithiamine: Garlic activated when crushed; forms allicin
What is clinical benefit of allicin
Decr cholesterol synth, inflamm, platelet aggregation, blood pressure
Vasodialator, bacteriocidal, anti-fungal, gastric/colorectal CA
Name 2-3 drug-vitamin B nutrient interactions
Birth control pills decr all B-vitamins
Antibiotics decr all B-vitamins (Biotin esp)
Sulfa drugs and anti-CA drug methotrexate binds folic acid macrocytic anemia
Role of B-vitamins in Kreb/Glycolysis path
Know name and signs/sympt of classic deficiencies
Basic mechanism causing s/s
#1 Cause of thiamine deficiency in the US: chronic alcohol intake with junk food
Common anti-thiamine foods:
flavonoids (citrus fruits), asparadines (flower colors), tannins (tea, coffee, betel
nuts)
Common side effects of hi Bs and how to solve them:
Nausea, Vomiting decr w/ divided doses and eating with foods
Which Bs are toxic in high amounts and the s/s
Vitamin cofactors for conversion of cholesterol to progesterone
Vit C (cholersterol to bile acids and steroid hormones)
Cheilosis: cracking, peeling blisters
Somatitis: (MC) swollen, red, sore tongue
Scalloped: swollen tongue leaves outlines of teeth on sides of tongue
Relationship of riboflavin to folic acid deficiency diseases
- B2/Riboflavin is req for formation of B6/Pyroxidine, B3/Niacin and Folate
Side effects of low tryptophan/niacin: Depression
Which food staple promotes niacin deficiency: Corn, high in leucine low in
tryptophan
Leucine inhibits an enzyme needed to make niacin from try, niacin in corn is
bound/unavail
Which nutrients cause rapid vasodialation: Niacin/B3, Magnesium, Arginine
What is glucose tolerance factor and why
A water-soluble complex containing chromium and nicotinate needed for normal
glucose tolerance

Niacin/Chromium incr glucose/insulin binding


What are acute/chronic niacin toxicity s/s
Acute: Niacin Flush (burning, itch, tingle, hot), nausea, vomiting, bloating,
flatulence, heartburn, diarrhea, hypotension
Chronic: rash, hyperpigmentation, dry skin/mouth, liver damage etc
*Tox more common with time-released form
What lab test must be done regularity when using high doses of niacin and retinol
Liver enzyme panel
How is niacin beneficial for CVD: lowers BP, cholesterol, vasodialators, raises HDL-C
Where are vitamins absorbed, how are they bound = in sm intestine, bound to
proteins
Which vitamin is req for acetylcholine: Folic Acid (choline synthesis)
Which B deficiency causes sore mm and why:
Which B deficiency causes depression and why: Niacin/B3 req for 5HT precursors
B6/Panthonic Acid b/c tryptophan 5HT
Which B deficienct causes insomnia and why: B6/Panthonic Acid b/c conversion of
5HT melatonin
Which B is necessary to form acetyl CoA: Thiamine
Which B vitamins are necessary to convert glucose to pyruvate,
To ribose
To fructose
(No treatment, RDA, food content #s, No forms of Bs)
Backup Bs:
Know where each fits into glycolysis, Kreb and/or NT pathways
Which helps convert glucose to glycogen
Which helps BCAA convert to ketoacids: B6/Panthenoic Acid
Which are toxic and to what organ system
Know commonly used meds that incr risk for deficiency: Birthcontrol, Antibiotics
Which vitamin molecule contains sulphr, colbalt?
Sulfur in Thiamine/B1 and Biotin/B7
Colbalt in B12 (Cobalamine)
Which are made by good gut flora: Vitamin K, Biotin, B12
What are 2 gut flora you are to know?
L. acidophilus and Bifidobacterium; killed by antibiotics
o Supplemented for yeast infections and to maintain proper gut flora
What food supplies high amts of B vitamins naturally Brewers Yeast

1)
2)
3)
4)
5)
-

What is advin, where is it found, what vitamin is affected -- raw egg whites,
biotin/B7
Which vitamins are necc to methionine salvage? B6/12/Folate
Methionine (limiting AA) (adenosine) SAM SAH Homocystine
(B6/12/Folate) Methionine
Also:Methionine cysteine
SAM supplemented for mild depression
Homocysteine is assoc with CVD
Why is folic acid enriched in foods? Which foods
To lower homocysteiene? Same?
To make serotonin?
What foods have highest folic acid = green leafy raw vegetables
Which 2 are most related to proper cell division and replication through DNA
What is methioninie? What trace mineral does it supply
- Potent antioxidant
What mammal milk is naturally low in folic acid and must be fortified in US: Goat
Which groups are at highest B12 deficiency risk:
Which vitamin req high stomach acid to absorb? What med increases risk of
deficienc- H2 blockers
Vitamin: B12
Mineral: Ca
Which vitamins are most related to macrocytic anemia B12
Which deficiency cause extremity paralysis
What urinary lab marker elevates with B12 deficiency: - Reliable Lab:
methylmalonyl CoA
Which vitamin helps convert dietary folic acid to bioactive THF
What is in the real food brewers yeast and what might it be recommended?
B Vitamins B1, 3, 5, 6, 12 used for Krebs Cycle as co-factors and nerve
conduction
Trace Elements Chromium and Selinium
What are the 5 stages of vit/min deficiency
Preliminary: body stores are gradually depleted
Biochemical: enzyme function is decr
Physiological: non-specific s/sx ex) memory loss and fatigue
Clinical: classic disease symptoms present
Anatomical: death if untreated
What are the 5 reasons someone might be deficient
low ingestion, absorption, utilization, excretion, needs

What are bound to vitamins to transport it across the gut lining proteins in small
intestines
What is the recommended maximum amt of SODIUM in the diet? 2400mg
Why is CALCIUM stored for use by the body and where is it stored?
Stored in bones for use + teeth
o For maintaining blood levels, blood clotting, mm contraction,
neurotransmission
What will influence the absorption and/or excretion of CALCIUM?
*Phosphorus (want 1Ca : 1PO4), Protein
o Low PO4 + High Protein = excreted
o High PO4 + High Protein = retained
o Low PO4 + Low Protein = retained
Facilitated By: Vit D, HCl, lactose, estrogen, wt-bearing exercise, pregnancy, citrate
form, unsaturated oils
Decreased By: protein, oxalates, phytates, imbalance of minerals, H2 blockers
How do you differentiate between Mg and Ca deficiency?
Mg wake during the night, cramps during exhertion and hands/feet @ rest (K
too), isolated HT
Ca cant fall asleep, cramps at night @ rest in legs/calfs, generalized HT
What vit/min will enhance nerve transmission/function?
Calcium, Phosphorus, Magnesium, Potassium
Vitamin C, B1, B5, B6, Folic (myelin), B12 (choline/purine synth)
What vit/min are necc for bone integrity? (Almost ALL!)
Calcium, Phosphorus, Magnesium, (Potassium), Zinc, Fluoride
Vit A, D, B6, B12
What vit/min will prevent anemia?
Iron, Copper, Zinc Microcytic Hypochromic, B12 Pernicious, Macrocytic
*Iron 10: Zinc 10: Copper 1
Vit A, E, C, B6, Folate, B12, Phosphorus
Who gets milk-alkali syndrome and what most commonly causes it?
Ca toxicity (MC with supplementation - carbonate) leading to loss of
kidney fxn
- hyperparathyroidism, excess VitD, overusage of Tums, too much milk
- txt: H2 blockers
Know the dietary tx for uric acid stones and calcium oxalate stones
Calcium Oxalate are MC in America
o Avoid excess Ca and oxalates, excess animal protein
Supplement with potassium citrate and increase fruits and vegetables
to increase alkaline in the diet
Uric Acid
o Avoid large doses of vitamin C (= acidity), meat, wine, concentrated fructose
Alkalinize the pH

Know common foods containing oxalates: Beets, Berries, Beans, Spinach..etc


What is the best form of calcium to prevent o-perosis and the trace element req?
Microcrystaline hydroxyapatite + Boron (Malate + Phosporus?)
best form of calcium for muscle function? Gluconate, Lactate
Know where heme and non-heme iron comes from
Heme: Animal
- Non-Heme: Animal and 100% of Plants
Know how to enhance or inhibit iron absorption
Facilitated by: vit C, HCl, ascorbic acid, fructose, citric/lactic acid, veg + redmeat
Decreased by: antacids, tea/coffee, phytates, EDTA, polyphenolics
Hazards associated with too much iron in the diet and common sources Hemosiderosis
Acute: constipation, nausea, GI tract distress (pn, cramping, bloating)
Chonic: gradual onset, homochomatosis, cardiomegaly, arrhythmia, into deposition
in testicles, deposits in tissues, cirrhosis, pancreatic failure
o Excess in blood = hemosiderosis
o MC in red wine/beer alcoholics
What are the most toxic vitamins/minerals: Vit A, D (most toxic), B3 (liver), Ca, F,
Se
What is given to children to decrease severity of measles Vitamin A
Which nutrients are required for muscle relaxation (reduction of spasms) Ca, Mg,
K
Who is most at risk for vitamin D toxicity: milk drinkers due to improper assay of
levels
How do you get adequate vitamin D without toxicity? Sun exposure!
What blood test of reccomeded to identify early iron deficiency anemia
Serum ferratin is most sensitive lab test
How do you diagnose scurcy, beriberi, hemochromatosis, ariboflavinosis, wilsons
etc? = LABS
Who is at risk for vitamin B deficiency:
birth control, diabetes mellitus, GI tract absorption issues, alcoholics, elderly,
insufficient intrinsic factor
What binds up zinc and iron phytates, caffeine (tannic acids for Fe), competing
minerals
What are the hazards of fluoride fortification
nausea, vomiting, tearing, headache, weakness, salivation, sweating, diarrhea
if severe can develop spasms, tetany, or convulsions and hypotension! SRS
BSNESS
- mottling, bone deformities, ligament calcification, calcium stones, allergies, incr
CA risk

Vit/min involved in thyroid function? = Iodine, Selenium, Vitamin E


What is depleted by common drugs like alcohol, birth control and what to take to
protect against the side effects of common durgs like aspirin, Coumadin, Tylenol
etc
Depleted:
Antibiotics Vit K, B9, B12
Alcohol B-vitamins
Birth Control B-vitamins
Protective:
Vitamin K aspirin and Coumadin
Vitamin E Tylenol
Know the benefits of allicin where is it found?
Found in crushed garlic
o Decr cholesterol synthesis, inflammation, platelet aggregation,
vasodialator/decr BP, bacteriocidal, anti-fungal, gastric/colorectral CA
Examples of non-drug anti-thiamines and anti-biotin
Anti-Thiamines: flavonoids (citrus fruit), asparadines (flower colors), tannins (tea,
coffe, wine, beer), mycotoxins (moulds), fungi, raw fish/shellfish, silkworms, certain
bacteria
Anti-Biotin: avidin (raw egg whites)
Maximum OTC dosage for folic acid, and why: 400microg, 1mg/day can mask
pernicious anemia
Co-factors for Kreb Cycle (NO?)
Most common symptom if Krebs co-factors are missing? Fatigue
What nutrients reduce homocysteine and why this is desireable
B6, B9, B12 reduct homocysteine
Homocystine is a marker for oxidative stress and increases risk of heart disease
Goiter w/ Deficiency
Low iodine and thyroxine, body incr cell growth = hypertrophy but NO limit!
Goiter w/ Toxicity
High iodine and thyroxine, body downregulates cell production but too much!
now too little thyroxine and body hypertrophies to compensate