vitamins and minerals

T/F: dietary supplements are not intended to prevent, cure, diagnose, treat, or mitigate disease

• true

T/F: nutritional supplement use is intended to prevent deficiencies, replenish compromised nutrient stores, or maintain the present nutritional status

• true

T/F: nutritional supplements can be used for self-treatment of vitamin deficiencies

• false

  • PREVENT NOT TREAT DEFICIENCIES

what is the major site of nutrient absorption?

• duodenum

is it safe to consume large quantities of fat-soluble vitamins?

• no

  • can cause toxicity because excess is NOT excreted

vitamin A deficiency can lead to…

• blindness, night blindness (earliest symptom)

a significant percent of total vitamin A content should be contributed by ________

• beta-carotene

symptoms of vitamin A toxicity

• headache

• diplopia (double vision)

• N/V

• vertigo

Vitamin A and pregnancy/child bearing age

• should avoid Vitamin A doses above the DRI

  • teratogenic risk

cholecalciferol (vitamin D3) is typically

a) prescription

b) OTC

b) OTC

ergocalciferol (vitamin D2) is typically

a) prescription

b) OTC

a) prescription

vitamin D deficiency may be associated with….

• increased risk of CVD

  • HTN, CAD, cardiomyopathy

Vitamin D deficiency symptoms

• calcium abnormalities

• muscle weakness

• increased risk of falls

• CVD

• certain cancers

• psychiatric disorders

Vitamin D deficiency CAUSES

• rickets (children)

• osteoporosis (adults)

Vitamin D intake dosing for health benefits

• 25 mcg (1000 IU) daily = health benefits

Vitamin E deficiency can cause…

• disorders of fat malabsorption

• premature infants of very low birth weight

antioxidant supplementation that includes vitamin E ma be associated with…

• increased risk of congestive HF, hemorrhagic stroke, risk of fetal loss

T/F: Vitamin B deficiency in one type can increase risk for deficiency in other types of vitamin B deficiency

• true

megadoses of vitamin C may cause…

• nausea

• stomach cramps

• diarrhea

• nephrolithiasis

what medications can contribute to a vitamin B12 deficiency?

• PPIs

• H2RAs

• metformin

vitamin B12 deficiency symptoms

• neurological signs and symptoms

  • paresthesia

  • peripheral neuropathy

  • unsteadiness

  • etc

vitamin b12 malabsorption dosing

• high dose oral supplementation

  • 1000-2000 mcg daily

vitamin b12 indications

• vitamin b12 deficiency (pernicious anemia)

• supplementation

• bariatric surgery

folic acid deficiency in pregnancy has been associated with….

• an increased risk of neural tube defects in the infant

causes of folic acid deficiency

• alcohol use disorder

• malabsorption

• liver disease

• medications

what type of medications can cause folic acid deficiency

• DHF reductase inhibitors

• anticonvulsants

• sulfasalazine

symptoms of folic acid deficiency

• sore mouth

• diarrhea

• CNS symptoms

• megaloblastic anemia

USPSTF recommendations advise that all persons who could become pregnant should consume a daily…

• folic acid supplement (400-800 mcg)

typical dose for folic acid

• 1 mg daily

______ is essential for the metabolism of folates

• vitamin B12

niacin deficiency symptoms

• Pellegra

• 3 D’s

  • dermatitis

  • diarrhea

  • dementia

• neuropathy

• beefy, red tongue

niacin toxicity symptoms

• GI symptoms

• hepatotoxicity

• skin lesions

• tachycardia

• hypertension

• flushing

can Niacin ER decrease ADE?

• decreases flushing but increases gastric/hepatic ADE

uses of vitamin b6 (pyridoxine)

• nausea related to pregnancy

• migraine

what can cause vitamin b6 deficiency?

• alcohol use disorder

thiamine deficiency is primarily found in…

• chronic alcohol abusers in US

what is a potential drug interaction with thiamine (B1)

• diuretics increase the urinary excretion of thiamine

what are pseudo vitamins

• chemical structure similar to vitamins but lack the usual physiologic or biochemical actions

calcium is a major component of…

• bones and teeth

T/F: optimal calcium and vitamin D intake throughout the life cycle and weight-bearing exercise is important for bone health

• true

common causes of calcium deficiency…

• malabsorptive syndromes

• hypoparathyroidism

• vitamin D deficiency

which calcium salt has the most elemental content?

• carbonate (40%)

• citrate (21%)

calcium carbonate and phosphate salts couseling

• insoluble in water → taken with meals to enhance absorption

calcium citrate counseling

• more absorbed in basic environment → take on empty stomach

calcium doses of ____ or more should be taken in divided doses

• 500

USPSTF calcium daily intake

• should not exceed 1000mg

T/F: calcium has a potential increased risk of CVD

true

what is the gold standard iron formulation

• ferrous sulfate

  • 20% elemental iron

what ADE do all iron products cause? how to minimize?

• tend to irritate the GI mucosa

  • take with meals can decrease GI ADR BUT can also DECREASE IRON ABSORPTION

high doses of magnesium can cause

• diarrhea

T/F: phosphorous deficiency do not usually occur unless induced

• true

what population may be at the greatest risk for developing nutrient deficiency

• pediatrics

riboflavin (vitamin B2) deficiency symptoms

• ocular symptoms

  • sensitive to light / easily fatigued

iron deficiency symptoms

• pallor, easy fatigable

• spoon shaped nails

• coldness, numbness of extremities