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vitamins
are organic compounds that serve as cofactors for enzymes prosthetic groups needed for a functional molecule (catalyst)
two types of vitamins
fat soluble vitamins (A, D, E, K)
water soluble vitamins (B, C)
risk factors for vitamin & mineral deficiencies
alcoholics
food faddists
chronically ill patients
malnourished patients
bulimia nervosa patients
anorexia nervosa patients
primary deficiency
occurs when an individual does not get enough of the vitamin in its food
secondary deficiency
due to an underlying disorder that prevents or limits the absorption or use of the vitamin
due to a “lifestyle factor” such as smoking, excessive alcohol consumption, or the use of medications that interfere with the absorption or use of the vitamin
examples of fat soluble vitamins
vitamin E — tocopherol, tocotrienols
vitamin K —phylloquinone, menaquinone
vitamin D — ergocalciferol, cholecalciferol
vitamin A — retinol, carotenoids, retinoic acid
A — retinoic acid retinol, carotenoids
deficiency can cause:
alopecia
headaches
papilledema
night blindness
corneal ulceration
hepatosplenomegaly
increased intracerebral pressure
vitamin D — cholecalciferol, ergocalciferol
deficiency can cause:
osteomalacia
hypocalcemia
hypercalcemia
rickets hypocalcification of teeth (severe)
E — tocopherol & tocotrienols
deficiency can cause:
ataxia
ophthalmoplegia
loss of proprioception
congestive heart failure
cancer prevention unproven
antioxidant benefit in coronary artery disease
predisposition to bleeding in patients on warfarin
K — phylloquinone, menaquinone
deficiency can cause:
bleeding disorder
abnormal bleeding tendencies
increases coagulation in patients on warfarin
examples of water soluble vitamins
C — ascorbic acid
B1 — thiamine
B2 — riboflavin
B3 — niacin
B5 — pantothenic acid
B6 — pyridoxine, pyridoxamine, pyridoxal
B7 — biotin
B9 — folic acid, folinic acid
B12 — cyanocobalamin, hydroxycobalamin, methylcobalamin
B1 — thiamine
deficiency can cause:
beriberi
drowsiness
wernicke-korsakoff syndrome
rare hypersensitive reaction shock
B2 — riboflavin
deficiency can cause:
glossitis
dermatitis
cracked lips
angular stomatitis
B3 — niacin
deficiency can cause:
liver damage
hyperuricemia
flushin, pruritus
GI disturbances
pellagra — diarrhea, dementia, dermatitis
B5 — pantothenic acid
deficiency can cause paresthesia
B6 — pyridoxine, pyridoxamine, pyridoxal
deficiency can cause:
glossitis
dermatitis
stomatitis
sensory neuropathy
peripheral neuropathy
B7 — biotin
deficiency can cause:
enteritis
dermititis
hair loss
brittle nails
B9 — folic acid, folinic acid
deficiency can cause:
megaloblastic anemia
neural tube defect of fetus in pregnancy
B12 — cyanocobalamin, hydroxycobalamin, methylcobalamin
deficiency can cause:
anemia
megaloblastic
posterior column neuropathy
C — ascorbic acid
deficiency can cause:
purpura
easy bruising
GI discomfort
predisposition to form oxalate stones
scurvy (bleeding gums, periodontal disease, poor wound healing)
antibiotics — penicillin, amoxicillin
consider taking probiotics to help restore the balance
can destroy both the good & bad bacteria in the stomach, which influences digestion like diarrhea
cholesterol-lowering statin drugs
can decrease the amount of coenzyme Q10 (CoQ10) — an important antioxidant that aids in the production of energy
diuretics — meds for heart failure, hypertension (e.g amiloride, triamterene, bumetanide)
taking potassium supplements can be helpful
this rid the body of excess fluid, which can lower blood pressure
eating bananas, which are potassium-rich, is a natural alternative
this process can lead to the depletion of potassium, which can cause abnormal heart rhythms
anticonvulsants — phenytoin
consider taking vitamin D & serum 25-hydroxyvitamin
can cause vitamin D deficiency in epilepsy patients under antiepileptic drug treatment
acid reflux medications — proton pump inhibitors, esomeprazole
can reduce the level of vitamin C plasma in some people
take vitamin C prior to the course of medication
you won’t be able to get enough via dietary intake
NSAIDS (e.g., aspirin, ibuprofen)
can cause calcium loss through the urine & can interfere with nutrient metabolism
check your vitamin D levels with your doctor as it helps improve your calcium absorption
fruits that are rich in vitamin C
apple, orange
banana, mango
lychee, pineapple
strawberry, durian
watermelon, kiwi, guava