Peran zat gizi

dalam
pengobatan
Sajiman, S.KM., M. Gizi

Vitamin
Sajiman, S.KM., M. Gizi

Vitamin A
Vitamin A can be found in many fruits, vegetables, eggs,
whole milk, butter, fortified margarine, meat, and oily
saltwater fish.
It can also be made in a laboratory.
Vitamin A is used for treating vitamin A deficiency.
It is also used to reduce complications of diseases such as
malaria, HIV, measles, and diarrhea in children with vitamin
A deficiency.

Uses
Vitamin A deficiency. Taking vitamin A by mouth is effective
for preventing and treating symptoms of vitamin A
deficiency.
Vitamin A deficiency can occur in people with protein
deficiency, diabetes, over-active thyroid, fever, liver
disease, cystic fibrosis, or an inherited disorder called
abetalipoproteinemia.

 Possibly Effective for:

Breast cancer. Premenopausal women with a family history of breast
cancer who consume high levels of vitamin A in their diet seem to have
reduced risk of developing breast cancer. It is not known if taking vitamin
A supplements has the same benefit.
Cataracts. Research suggests that high intake of vitamin A in the diet is
linked to a lower risk of developing cataracts.
Diarrhea related to HIV. Taking vitamin A along with conventional
medicines seems to decrease the risk of death from diarrhea in HIVpositive children with vitamin A deficiency.
Malaria. Taking vitamin A by mouth seems to decrease malaria
symptoms in children less than 3 years-old living in areas where malaria
is common.
Measles. Taking vitamin A by mouth seems to reduce the risk of measles
complications or death in children with measles and vitamin A deficiency.

 Precancerous lesions in the mouth (oral leukoplakia). Research suggests

that taking vitamin A can help treat precancerous lesions in the mouth.
Recovery from laser eye surgery (photoreactive keratectomy). Taking
vitamin A by mouth along with vitamin E seems to improve healing after
laser eye surgery.
Complications after pregnancy. Taking vitamin A seems to reduce the risk
of diarrhea and fever after pregnancy in malnourished women.
Complications during pregnancy. Taking vitamin A by mouth seems to
reduce the risk of death and night blindness during pregnancy in
malnourished women.
Eye disease affecting the retina (retinitis pigmentosa). Research suggests
that taking vitamin A can slow the progression of an eye disease that
causes damage to the retina.

Dosing
Recommended Dietary Allowance (RDA) levels for
children and adults have been established:

children 1 to 3 years, 300 mcg/day (1000 units);

4 to 8 years, 400 mcg/day (1300 units);
9 to 13 years, 600 mcg/day (2000 units);
men 14 years and older, 900 mcg/day (3000 units);
women 14 years and older, 700 mcg/day (2300 units);
pregnancy 14 to 18 years, 750 mcg/day (2500 units);
19 years and older, 770 mcg/day (2600 units);
lactation 14 to 18 years, 1200 mcg/day (4000 units);
19 years and older, 1300 mcg/day (4300 units).

Vitamin D
Vitamin D can be found in small amounts in a few foods,
including fatty fish such as herring, mackerel, sardines and
tuna.
To make vitamin D more available, it is added to dairy
products, juices, and cereals that are then said to be
fortified with vitamin D.
But most vitamin D 80% to 90% of what the body gets is
obtained through exposure to sunlight. Vitamin D can also
be made in the laboratory as medicine.

 Vitamin D is used for preventing and treating rickets, a disease that is

caused by not having enough vitamin D (vitamin D deficiency).
Vitamin D is also used for treating weak bones (osteoporosis), bone
pain (osteomalacia), bone loss in people with a condition called
hyperparathyroidism, and an inherited disease (osteogenesis
imperfecta) in which the bones are especially brittle and easily
broken.
It is also used for preventing falls and fractures in people at risk for
osteoporosis, and preventing low calcium and bone loss (renal
osteodystrophy) in people with kidney failure.
Vitamin D is used for conditions of the heart and blood vessels,
including high blood pressure and high cholesterol. It is also used for
diabetes, obesity, muscle weakness, multiple sclerosis,
rheumatoid arthritis, chronic obstructive pulmonary disease (COPD),
asthma, bronchitis, premenstrual syndrome (PMS), and tooth and
gum disease.

 Low levels of phosphate in the blood due to an inherited

disorder called familial hypophosphatemia. Taking vitamin D
(calcitriol or dihydrotachysterol) by mouth along with
phosphate supplements is effective for treating bone
disorders in people with low levels of phosphate in the blood.
Low levels of phosphate in the blood due to a disease called
Fanconi syndrome. Taking vitamin D (ergocalciferol) by mouth
is effective for treating low levels of phosphate in the blood
due to a disease called Fanconi syndrome. Low blood calcium
levels due to low parathyroid hormone levels. Low levels of
parathyroid hormone can cause calcium levels to become too
low. Taking vitamin D (dihydrotachysterol, calcitriol, or
ergocalciferol) by mouth is effective for increasing calcium
blood levels in people with low parathyroid hormone levels.

 Softening of the bones (osteomalacia). Taking vitamin D

(cholecalciferol) is effective for treating softening of the
bones. Also, taking vitamin D (calcifediol) is effective for
treating softening of the bones due to liver disease. In
addition, taking vitamin D (ergocalciferol) is effective for
treating softening of the bones caused by medications or
poor absorption syndromes.
Psoriasis. Applying vitamin D or calcipotriene (a synthetic
form of vitamin D) to the skin treats psoriasis in some
people. Applying vitamin D to the skin together with cream
containing drugs called corticosteroids seems to be more
effective for treating psoriasis than using just vitamin D or
the corticosteroid creams alone.

 A bone disorder called renal osteodystrophy, which occurs in

people with kidney failure. Taking vitamin D (calcifediol) by
mouth manages low calcium levels and prevents bone loss
in people with kidney failure. However, vitamin D does not
appear to reduce the risk of death or bone pain in people
with kidney failure.
Rickets. Vitamin D is effective for preventing and treating
rickets. A specific form of vitamin D, calcitriol, should be
used in people with kidney failure.
Vitamin D deficiency. Vitamin D is effective for preventing
and treating vitamin D deficiency.

 Bone loss in people taking drugs called corticosteroids.

Taking vitamin D (calcifediol, cholecalciferol, calcitriol, or
alfacalcidol) by mouth prevents bone loss in people taking
drugs called corticosteroids. Taking vitamin D alone or with
calcium seems to improve bone density in people with
existing bone loss caused by using corticosteroids.
Preventing falls in older people. Researchers have observed
that people who do not have enough vitamin D tend to fall
more often than people who do. Taking a vitamin D
supplement seems to reduce the risk of falling by up to
22%. Higher doses of vitamin D are more effective than
lower doses. One study found that taking 800 IU of vitamin
D reduced the risk of falling, but lower doses did not.

 Also, vitamin D, in combination with calcium, but not

calcium alone, may prevent falls by decreasing body sway
and blood pressure. Taking vitamin D plus calcium seems to
prevent falls more significantly in women than men and in
older people living in hospitals or residential care facilities
than those living in community dwellings.
Osteoporosis (weak bones). Taking a specific form of vitamin
D called cholecalciferol (vitamin D3) along with calcium
seems to help prevent bone loss and bone breaks.

Dosing
BY MOUTH:
For preventing osteoporosis and fractures: 400-1000 IU per day has been used for
older adults. Some experts recommended higher doses of 1000-2000 IU daily.
For preventing falls: 800-1000 IU/day has been used in combination with calcium
1000-1200 mg/day.
For preventing multiple sclerosis (MS): long-term consumption of at least 400 IU
per day, mainly in the form of a multivitamin supplement, has been used.
For preventing all cancer types: calcium 1400-1500 mg/day plus vitamin D3
(cholecalciferol) 1100 IU/day in postmenopausal women has been used.
For muscle pain caused by medications called "statins": vitamin D2 (ergocalciferol)
or vitamin D3 (cholecalciferol) 50,000 units once a week or 400 IU daily.
For preventing the flu: vitamin D (cholecalciferol) 1200 IU daily.

Thiamin (B1)
Vitamin B1 is found in many foods including yeast, cereal
grains, beans, nuts, and meat.
Thiamin is often used in combination with other B vitamins,
and found in many vitamin B complex products.

Uses
Metabolic disorders.
Taking thiamine by mouth helps correct metabolic disorders associated
with genetic diseases, including Leigh's disease, maple syrup urine
disease, and others.

Thiamine deficiency.
Taking thiamine by mouth helps prevent and treat thiamine deficiency.

Brain disorder due to thiamine deficiency (Wernicke-Korsakoff

syndrome).
Thiamine helps decrease the risk and symptoms of a specific brain
disorder called Wernicke-Korsakoff syndrome (WKS).
This brain disorder is related to low levels of thiamine (thiamine
deficiency) and is often seen in alcoholics.
Between 30% and 80% of alcoholics are believed to have thiamine
deficiency.
Giving thiamine shots seems to help decrease the risk of developing WKS
and decrease symptoms of WKS during alcohol withdrawal.

 Cataracts.
High thiamine intake as part of the diet is associated with a reduced risk
of developing cataracts.

Kidney disease in people with diabetes.

Early research shows that taking high-dose thiamine (100 mg three times
daily) for 3 months decreases the amount of albumin in the urine in
people with type 2 diabetes. Albumin in the urine is an indication of
kidney damage.

Painful menstruation (dysmenorrhea).

Early research suggests that taking thiamine for 90 days stops pain
associated with menstruation in girls 12-21 years-old.

Dosing
The daily recommended dietary allowances (RDAs) of
thiamine are:

Infants 0-6 months, 0.2 mg;

infants 7-12 months, 0.3 mg;
children 1-3 years, 0.5 mg;
children 4-8 years, 0.6 mg;
boys 9-13 years, 0.9 mg;
men 14 years and older, 1.2 mg;
girls 9-13 years, 0.9 mg;
women 14-18 years, 1 mg;
women over 18 years, 1.1 mg;
pregnant women, 1.4 mg; and
breast-feeding women, 1.5 mg.

BY MOUTH:
For adults with somewhat low levels of thiamine in their
body (mild thiamine deficiency):
the usual dose of thiamine is 5-30 mg daily in either a single dose or
divided doses for one month.
The typical dose for severe deficiency can be up to 300 mg per day.

For reducing the risk of getting cataracts:

a daily dietary intake of approximately 10 mg of thiamine.

Riboflavmin (B2)
Riboflavin can be found in certain foods such as milk, meat,
eggs, nuts, enriched flour, and green vegetables.
Riboflavin is frequently used in combination with other B
vitamins in vitamin B complex products.
Vitamin B complex generally includes vitamin B1 (thiamine),
vitamin B2 (riboflavin), vitamin B3 (niacin/niacinamide),
vitamin B5 (pantothenic acid), vitamin B6 (pyridoxine),
vitamin B12 (cyanocobalamin), and folic acid.

Uses
Preventing and treating riboflavin deficiency and conditions
related to riboflavin deficiency.
Cataracts, an eye disorder.
People who eat more riboflavin as part of their diet seems to have a lower
risk of developing cataracts. Also, taking supplements containing
riboflavin plus niacin seems to help prevent cataracts.

High amounts of homocysteine in the blood

(hyperhomocysteinemia).
Taking riboflavin for 12 weeks seems to reduce homocysteine levels by up
to 40% in some people with this condition.

Migraine headaches.
Taking high-dose riboflavin (400 mg/day) seems to significantly reduce the
number of migraine headache attacks

dosing
The daily recommended dietary allowances (RDAs) of
riboflavin (Vitamin B2) are:

Infants 0-6 months, 0.3 mg;

infants 7-12 months, 0.4 mg;
children 1-3 years, 0.5 mg;
children 4-8 years, 0.6 mg;
children 9-13 years, 0.9 mg;
men 14 years or older, 1.3 mg;
women 14-18 years, 1 mg;
women over 18 years, 1.1 mg;
pregnant women, 1.4 mg; and
breastfeeding women, 1.6 mg.

 BY MOUTH:
For treating low levels of riboflavin (riboflavin deficiency) in
adults: 5-30 mg of riboflavin (Vitamin B2) daily in divided
doses.
For preventing migraine headaches: 400 mg of riboflavin
(Vitamin B2) per day. It may take up to three months to get
best results.
For preventing cataracts: a daily dietary intake of
approximately 2.6 mg of riboflavin (Vitamin B2) has been
used. A combination of 3 mg of riboflavin (Vitamin B2) plus
40 mg of niacin daily has also been used.

Vitamin B5 (Pantothenic acid)

Pantothenic acid is a vitamin, also known as
vitamin B5. It is widely found in both plants and
animals including meat, vegetables, cereal grains,
legumes, eggs, and milk.

Uses
Pantothenic acid deficiency.
Taking pantothenic acid by mouth prevents and treats
pantothenic acid deficiency.

Piridoksin
Pyridoxine is a vitamin. It can be found in certain foods such as
cereals, beans, vegetables, liver, meat, and eggs. It can also be made
in a laboratory.
Pyridoxine is used for preventing and treating low levels of pyridoxine
(pyridoxine deficiency) and the tired blood (anemia) that may result.
It is also used for heart disease; high cholesterol; reducing blood levels
of homocysteine, a chemical that might be linked to heart disease;
and helping clogged arteries stay open after a balloon procedure to
unblock them (angioplasty).
Women use pyridoxine for premenstrual syndrome (PMS) and other
menstruation problems, "morning sickness" (nausea and vomiting) in
early pregnancy, stopping milk flow after childbirth, depression related
to pregnancy or using birth control pills, and symptoms of menopause.

Pyridoxine is also used for Alzheimer's disease, attention deficit-hyperactivity

disorder (ADHD), Down syndrome, autism, diabetes and related nerve pain,
sickle cell anemia, migraine headaches, asthma, carpal tunnel syndrome,
night leg cramps, muscle cramps, arthritis, allergies, acne and various other
skin conditions, and infertility.
Pyridoxine is also used for dizziness, motion sickness, preventing the eye
disease age-related macular degeneration (AMD), seizures, convulsions due
to fever, and movement disorders (tardive dyskinesia, hyperkinesis, chorea),
as well as for increasing appetite and helping people remember dreams.
Some people use pyridoxine for boosting the immune system, eye infections,
bladder infections, and preventing cancer and kidney stones.
Pyridoxine is also used to overcome certain harmful side effects related to
radiation treatment and treatment with medications such as mitomycin,
procarbazine, cycloserine, fluorouracil, hydrazine, isoniazid, penicillamine,
and vincristine.

Dosing
The daily recommended dietary allowances (RDAs) of vitamin B6
are:

Infants 0-6 months, 0.1 mg;

Infants 7-12 months, 0.3 mg;
Children 1-3 years, 0.5 mg;
Children 4-8 years, 0.6 mg;
Children 9-13 years, 1 mg;
Males 14-50 years, 1.3 mg;
Males over 50 years, 1.7 mg;
Females 14-18 years, 1.2 mg;
Females 19-50 years, 1.3 mg;
Females over 50 years, 1.5 mg;
Pregnant women, 1.9 mg;
and breast-feeding women, 2 mg.

BY MOUTH:
For vitamin B6 deficiency in adults: the typical dose is 2.525 mg daily for three weeks, then 1.5-2.5 mg per day as
maintenance treatment.
For vitamin B6 deficiency in women taking birth control pills:
the dose is 25-30 mg per day.
For symptoms of premenstrual syndrome (PMS): the daily
dose is 50-100 mg. Doses as high as 500 mg per day have
been used, but daily doses over 100 mg don't appear to
have additional benefit, and may increase the risk for
harmful side effects.

 For hereditary sideroblastic anemia: initially 200-600 mg per day

is used, decreasing to 30-50 mg daily after improvement.
For kidney stones: 25-500 mg daily has been used.
For treating tardive dyskinesia: 100 mg per day has been
increased weekly up to 400 mg per day, given in two divided
doses.
For preventing macular degeneration: 50 mg daily in combination
with vitamin B12 (cyanocobalamin) 1000 mcg, and folic acid
2500 mcg.
For nausea during pregnancy: 10-25 mg pyridoxine three or four
times daily has been used; alternatively, 75 mg of sustainedrelease pyridoxine combined with 12 mcg vitamin B12
(cyanocobalamin), 1 mg folic acid, and 200 mg calcium
(PremesisRx) is used daily as an FDA-approved prescription
product for nausea during pregnancy.

Asam Folat
Folate and folic acid are forms of a water-soluble B
vitamin.
Folate occurs naturally in food, and folic acid is
the synthetic form of this vitamin.
Since 1998, folic acid has been added to cold
cereals, flour, breads, pasta, bakery items,
cookies, and crackers, as required by federal law.
Foods that are naturally high in folate include
leafy vegetables (such as spinach, broccoli, and
lettuce), okra, asparagus, fruits (such as bananas,
melons, and lemons) beans, yeast, mushrooms,
meat (such as beef liver and kidney), orange
juice, and tomato juice.

use
Folate deficiency. Taking folic acid improves folate
deficiency.
Kidney disease.
About 85% of people with serious kidney disease have high levels of
homocysteine.
High levels of homocysteine have been linked to heart disease and
stroke. Taking folic acid lowers homocysteine levels in people with
serious kidney disease.

High amounts of homocysteine in the blood

(hyperhomocysteinemia).
High levels of homocysteine have been linked to heart disease and
stroke. Taking folic acid lowers homocysteine levels by 20% to 30% in
people with normal to slightly elevated homocysteine levels.
It is recommended that people with homocysteine levels greater than 11
micromoles/L supplement with folic acid and vitamin B12.

 Reducing harmful effects of a medicine called methotrexate.

Taking folic acid seems to reduce nausea and vomiting, which are
possible side effects of methotrexate treatment.

Birth defects (neural tube defects).

Consuming high amounts of folate in the diet and taking folic acid
supplements during pregnancy reduces the risk of neural tube birth
defects.

Age-related vision loss (age-related macular degeneration).

Some research shows that taking folic acid with other vitamins including
vitamin B6 and vitamin B12 reduces the risk of developing age-related
vision loss.

Depression.
Limited research suggests that taking folic acid along with
antidepressants seems to improve symptoms in people with depression.

 High blood pressure.

Research suggests that taking folic acid daily for at least 6 weeks
reduces blood pressure in people with high blood pressure.
However, taking folic acid with blood pressure medication does not seem
to lower blood pressure any more than taking just the medication alone.

Gum problems due to a drug called phenytoin.

Applying folic acid to the gums seems to prevent gum problems caused
by phenytoin. However, taking folic acid by mouth does not seem to
improve symptoms of this condition. Gum disease during pregnancy.
Applying folic acid to the gums seems to improve gum disease during
pregnancy.

A skin discoloration disorder called vitiligo. Taking folic acid

by mouth seems to improve symptoms of vitiligo.
Reducing the risk of pancreatic cancer.

Dosing
The adequate intakes (AI) for infants :
65 mcg for infants 0-6 months and
80 mcg for infants 7-12 months of age.

The recommended dietary allowances (RDAs) for folate in

DFE, including both food folate and folic acid from fortified
foods and supplements are:

Children 1-3 years, 150 mcg;

Children 4-8 years, 200 mcg;
Children 9-13 years, 300 mcg;
Adults over 13 years, 400 mcg;
Pregnant women 600 mcg; and
breast-feeding women, 500 mcg.

 The tolerable upper intake levels (UL) of folate :

300 mcg for children 1-3 years of age,

400 mcg for children 4-8 years,
600 mcg for children 9-13 years,
800 mcg for adolescents 14-18 years, and
1000 mcg for everyone over 18 years of age.

BY MOUTH:
For folic acid deficiency: the typical dose is 250-1000 mcg
(micrograms) per day.
For preventing neural tube defects: at least 400 mcg of folic
acid per day from supplements or fortified food should be
taken by women capable of becoming pregnant and
continued through the first month of pregnancy. Women
with a history of previous pregnancy complicated by such
neural tube defects usually take 4 mg per day beginning
one month before and continuing for three months after
conception.
For reducing colon cancer risk: 400 mcg per day.

 For treating high levels of homocysteine in the blood:

0.5-5 mg (milligrams)/day has been used, although 0.8-1
mg/day is appears to be more effective.
In people with end-stage renal disease, high
homocysteine levels may be more difficult to treat, and
doses of 0.8-15 mg/day have been used. Other dosage
plans such as 2.5-5 mg 3 times weekly have also been
used. Doses higher than 15 mg daily do not seem to be
more effective.
For improving the response to medications for depression:
200-500 mcg daily has been used.
For vitiligo: 5 mg is typically taken twice daily.

 reduction of toxicity associated with methotrexate therapy

for rheumatoid arthritis (RA) or psoriasis: 1 mg/day is
probably enough, but up to 5 mg/day may be used.
For preventing macular degeneration: folic acid 2.5 mg,
vitamin B12 (cyanocobalamin) 1000 mcg, and vitamin B6
(pyridoxine) 50 mg daily.

Niacin
Niacin and niacinamide are forms of Vitamin B3.
Vitamin B3 is found in many foods including yeast,
meat, fish, milk, eggs, green vegetables, beans,
and cereal grains.
Niacin and niacinamide are also found in many
vitamin B complex supplements with other B
vitamins.

Uses
High cholesterol. Only niacin seems to lower
cholesterol, not niacinamide.
Some niacin products are FDA-approved prescription
products for treating high cholesterol.
These prescription niacin products typically come in high
strengths of 500 mg or higher.
Dietary supplement forms of niacin usually come in
strengths of 250 mg or less. Since very high doses of
niacin are required for high cholesterol, dietary
supplement niacin usually isnt appropriate.

 Treatment and prevention of niacin deficiency,

and certain conditions related to niacin deficiency
such as pellagra.

Dosing
The daily recommended dietary allowances (RDAs) of niacin
are:

Infants 0-6 months, 2 mg;

Infants 7-12 months, 4 mg;
Children 1-3 years, 6 mg;
Children 4-8 years, 8 mg;
Children 9-13 years, 12 mg;
Men 14 years and older, 16 mg;
Women 14 years and older, 14 mg;
Pregnant women, 18 mg; and Lactating women, 17 mg.

The maximum daily dose of niacin is: Children 1-3 years, 10

mg; Children 4-8 years, 15 mg; Children 9-13 years, 20 mg;
Adults, including Pregnant and Lactating women, 14-18 years,
30 mg; and Adults, including pregnant and breast-feeding
women, older than 18 years, 35 mg.

 The maximum daily dose of niacin is:

Children 1-3 years, 10 mg;

Children 4-8 years, 15 mg;
Children 9-13 years, 20 mg;
Adults, including Pregnant and Lactating women, 14-18
years, 30 mg;
Adults, including pregnant and breast-feeding women,
older than 18 years, 35 mg.

 For high cholesterol:

The effects of niacin are dose-dependent. The biggest increases in HDL
and decreases in triglycerides occur at 1200-1500 mg/day. Niacins
greatest effects on LDL occur at 2000-3000 mg/day.

To prevent heart disease in people with high cholesterol:

Niacin 4 grams daily.

For preventing and treating vitamin B3 deficiency:

Doses of nicotinic acid and niacinamide are considered equivalent.
For mild vitamin B3 deficiency, niacin or niacinamide 50-100 mg per day
is used.
For pellagra in adults, niacin or niacinamide 300-500 mg daily is given in
divided doses.
For pellagra in children, niacin or niacinamide 100-300 mg daily is given
in divided doses.
For Hartnup disease, niacin or niacinamide 50-200 mg daily.

 For reducing fluid loss caused by cholera toxin:

Niacin 2 grams daily.

To prevent type 1 diabetes in high-risk children:

Sustained-release niacinamide 1.2 grams/m (body surface area) per day.

To slow disease progression of newly diagnosed type 1 diabetes:

Niacinamide 25 mg/kg daily.

For treating osteoarthritis:

Niacinamide 3 grams per day in divided doses.

For reduced risk of cataracts:

A daily dietary intake of approximately 44 mg of niacin.

For preventing Alzheimers disease:

17-45 mg of niacin from food and multivitamins.
Food sources high in niacin include meat, fish, beans, nuts, coffee, and
fortified grains and cereals. Note that there is no reliable evidence that taking
a stand-alone niacin supplement will help to prevent Alzheimers disease.

VITAMIN B 12
Vitamin B12 is a vitamin. It can be found in foods such as
meat, fish, and dairy products. It can also be made in a
laboratory.
Vitamin B12 is also used for memory loss; Alzheimers
disease; boosting mood, energy, concentration and the
immune system; and slowing aging. It is also used for
heart disease, lowering high homocysteine levels (which
may contribute to heart disease), male infertility, diabetes,
sleep disorders, depression, mental disorders, weak bones (
osteoporosis), swollen tendons, AIDS,
inflammatory bowel disease, asthma, allergies, a skin
disease called vitiligo, preventing cervical and other
cancers, and skin infections

Uses
Inherited Vitamin B12 deficiency (Imerslund-Grasbeck
disease). Injecting vitamin B12 as a shot for 10 days
followed by monthly injections for the remainder of life is
effective for treating people with an inherited disease that
results in poor absorption of vitamin B12.
Pernicious anemia. Injecting vitamin B12 as a shot, as well
as taking through the nose or by mouth, is effective for
treating low red blood cell counts caused by poor absorption
of vitamin B12.
Vitamin B12 deficiency. Taking vitamin B12 by mouth,
through the nose, or as a shot is effective for treating
vitamin B12 deficiency.

 Cyanide poisoning. Administering hydroxocobalamin

(Cyanokit), a natural form of vitamin B12, as a shot for a
total dose of up to 10 grams is likely an effective treatment
for cyanide poisoning. Treatment of cyanide poising with
hydroxocobalamin (Cyanokit) has been approved by the U.S.
Food and Drug Administration (FDA).
High level of homocysteine in the blood
(Hyperhomocysteinemia). Taking vitamin B12 by mouth,
along with folic acid and sometimes pyridoxine (vitamin B6),
can lower blood levels of homocysteine.

Dosing
The recommended dietary allowances (RDAs) of vitamin B12
are:

Infants 0-6 months, 0.4 mcg;

infants 7-12 months, 0.5 mcg;
children 1-3 years, 0.9 mcg;
children 4-8 years, 1.2 mcg;
children 9-13 years, 1.8 mcg;
older children and adults, 2.4 mcg;
pregnant women, 2.6 mcg;
and breast-feeding women, 2.8 mcg.
Because 10% to 30% of older people do not absorb food-bound vitamin
B12 efficiently, those over 50 years should meet the RDA by eating foods
fortified with B12 or by taking a vitamin B12 supplement. S
upplementation of 25-100 mcg per day has been used to maintain
vitamin B12 levels in older people.

 By Mouth
For vitamin B12 deficiency or pernicious anemia: cyanocobalamin doses
of 300-10,000 mcg (microgram) daily have been used. However, some
evidence suggests that the most effective oral dose is between 647-1032
mcg/day.
For high blood levels of homocysteine: vitamin B12 500 mcg in
combination with 0.5-5 mg folic acid and 16.5 mg pyridoxine has been
used.
For preventing age-related macular degeneration (AMD): vitamin B12 1
mg, folic acid 2.5 mg, and pyridoxine 50 mg daily has been studied.

APPLIED TO THE SKIN:

For atopic dermatitis (eczema): a specific vitamin B12 0.07% cream
(Regividerm) applied twice daily has been used.
For psoriasis: a specific cream (Regividerm, Regeneratio Pharma AG,
Wuppertal, Germany) containing avocado oil plus vitamin B12 0.7
mg/gram applied for 12 weeks twice daily has been used.

Vitamin C
Some animals can make their own vitamin C, but people
must get this vitamin from food and other sources.
Good sources of vitamin C are fresh fruits and vegetables,
especially citrus fruits.
Vitamin C can also be made in a laboratory.

uses
Vitamin C deficiency.
Taking vitamin C by mouth or injecting as a shot prevents and
treats vitamin C deficiency, including scurvy.
Also, taking vitamin C can reverse problems associated with
scurvy.

Iron absorption.
Administering vitamin C along with iron can increase how much
iron the body absorbs in adults and children.

A genetic disorder in newborns called tyrosinemia.

Taking vitamin C by mouth or as a shot improves a genetic
disorder in newborns in which blood levels of the amino acid
tyrosine are too high.

Dosing
The daily recommended dietary allowances (RDAs) are:
Infants 0 to 12 months, human milk content (older recommendations
specified 30-35 mg);
Children 1 to 3 years, 15 mg;
Children 4 to 8 years, 25 mg;
Children 9 to 13 years, 45 mg;
Adolescents 14 to 18 years, 75 mg for boys and 65 mg for girls;
Adults age 19 and greater, 90 mg for men and 75 mg for women;
Pregnancy and Lactation: age 18 or younger, 115 mg; ages 19 to 50
years 120 mg.
People who use tobacco should take an additional 35 mg per day.

 Do not take more than the following amounts of

vitamin C:

400 mg per day for children ages 1 to 3 years,

650 mg per day for children 4 to 8 years,
1200 mg per day for children 9 to 13 years, and
1800 mg per day for adolescents and pregnant and
breast-feeding women 14 to 18 years, and
2000 mg per day for adults and pregnant and lactating
women.

 For scurvy:
100-250 mg once or twice daily for several days.

For treating the common cold:

1-3 grams daily.

For preventing kidney damage related to contrast media used

during diagnostic tests:
vitamin C 3 grams is given before coronary angiography and then 2 grams is
given after the procedure in the evening and again the following morning.

For tyrosinemia in premature infants on high protein diets:

100 mg of vitamin C.

For reducing protein in the urine of patients with type 2 diabetes:

vitamin C 1250 mg with vitamin E 680 IU daily for 4 weeks.

For preventing complex regional pain syndrome in patients with

wrist fractures,
vitamin C 500 mg daily for 50 days.