Fat Soluble Vitamins and Health

1. Fat Soluble Vitamins and Health

2. Vitamin A D E K • These fat soluble vitamins work as a family • They reside in membranes

3. Vitamin A • First identified as an essential growth factor found in animal fats and fish oils • Plant carotenoids also have vitamin a activity

4. Vitamin A in the Body • Vitamin A is used in two forms. • Retinal in the eye. • Retinoic acid in other tissues. • Retinyl Palmitate as a vitamin A storage form. • Beta Carotene from vegetables and fruits consists of two vitamin A molecules joined at the tail. • Enzymes allow symmetric cleavage to yield two molecules of vitamin A.

5. Vitamin A Eye • Eye uses vitamin a as retinal

6. Vitamin A Retinoic Acid Hormone like growth factor Used by epithelial cells

7. Vitamin A Function • Gene Transcription • Interact with nuclear receptors including receptors of thyroid, vitamin d, and insulin • Vision health and function • Maintenance of healthy tissue especially mucus membranes and skin • Immune function • Hormone production and balance • Cholesterol metabolism • Fertility and fetal tissue development • Cardiovascular health • Antioxidant

8. Vitamin A Deficiencies • Fetal abnormalities of eyes, lungs, gut, and immune. • Night blindness, clouding and malformation of cornea, corneal degradation, and dry eyes. • Weak immunity, direct and dysfunctional mucus membranes. • Keratinization of epithelial tissues, eyes, lungs, urogenital, and GI. • Skin disorders, acne, eczema, psoriasis. • Infertility • Diabetes, hormone imbalancesof thyroid, adrenal, sex hormones. • Weak teeth and bones

9. Vitamin A Excess/Toxicity • Anorexia, nausea/vomit, and diarrhea. • Headache, blurred vision, decrease coordination, and insomnia. • Dry hair, skin, and mucus membranes. • Weak teeth and bones. • Birth defects • Dosing greater than 1.75 mil iu, or chronic use greater than 2.8K iu/d. • Liver and kidney disease, smokers, and malnourished. • Synthetic vitamin a, accutane, retin A.

10. Toxicity of Vitamin A in Arctic Animals • Their Livers are Loaded with Toxic Levels of Vitamin A

11. Vitamin A Dosing • RDA AI (Recommended Dietary Allowance, Adequate Intake) • Age 1-3 years……………………. 1,000 iu/day • Age 4-8 years……………………..1,320 iu/day • Age 9-13 years…………………. 2,000 iu/day • Age 14-18 years females…… 2,300 iu/day • Age 14-18 years pregnant…. 2,500 iu/day • Age 14-18 years lactating……4,000 iu/day • Age 14-18 years male………… 3,000 iu/day • Age 19+ years female………… 2,300 iu/day • Age 19+ years pregnant…….. 2,600 iu/day • Age 19+ years lactating……… 4,300 iu/day • Age 19+ years male……………. 3,000 iu/day

12. Vitamin A Levels • Quest Diagnostic Labs levels • 38-98 mcg/L

13. Vitamin D • Finally in the press and on the minds of a greater number of even conventional practitioners. • More like a “hormone” than a vitamin.

14. Forms of Vitamin D • D2 ergocalciferol produced by invertebrates, yeast, fungus, plants. • D3 cholecalciferol produced in the skin of vertebrates via ultraviolet B (UVB). Small amounts occur naturally in fatty fish, eggs, and meats. • Free

15. Vitamin D Production • Provitamin D3 is a precursor of cholesterol found in the skin. • UVB converts it to vitamin D3. • D3 is transferred from blood to liver where it is transformed to 25 hydroxy D3 (calcidiol). • 25 hydroxy D3 is transferred to the kidneys for transformation to 1,25 hydroxy D3 (calcitriol) the active form of vitamin D. • 1,25 hydroxy D3 is also produced by the Immune system for immune activation and modulation.

16. Vitamin D Function • Vitamin D has receptors throughout the body. • Brain • Genes • Immune System • Membranes • Bones • Skin • Heart and vasculature • Lungs • Intestines • Liver • Hormone sensitive tissues, breast, ovaries, prostate • antioxidant

17. Vitamin D and Genes • Vitamin D modulates gene expression by modulating gene of transcription proteins. • Vitamin D receptor is a part of Nuclear Receptor superfamily of steroid/thyroid hormone receptors (works closely with hormones). • Vitamin D receptor is found in cells of most organs.

18. Vitamin D Calcium Metabolism • Vitamin D helps orchestrate calcium/phosphorus levels and ratios along with vitamin A and K, and parathyroid hormone. • Calcium flux across a membrane is more than bone metabolism. • Calcium flux is also an integral part of muscle function, cardiovascular function, clotting, energy production and cell signaling.

19. Vitamin D Cell Function • Vitamin D is involved in cell proliferation, differentiation, and apoptosis (programmed cell death). • Shares many functions as vitamin A.

20. Vitamin D Immune • Vitamin D as calcitriol is synthesized by immune cells for local activity against invaders • D3 increases natural killer cell function, a major soldier in fighting cancers, viruses, fungus and yeast. • D3 increases phagocytic activity of macrophages. • D3 increases macrophage production of cathelicidin, an antimicrobial peptide. • D3 is required for proper function of HLA.DRB1 a major histocompatability gene needed to distinguish self from nonself (autoimmunity).

21. Vitamin D Bones • D3 increases calcium absorption across the gut mucosa. • D3 increases calcium transport to bones. • D3 interacts with vitamin A and K as well as parathyroid hormone to regulate calcium/phosphorus levels and ratios. • D3 modulates osteoclast/osteoblast activity at the bone. • D3 speaks with other hormones via the super family of hormone receptors.

22. Vitamin D Deficiency • Bones, rickets, osteomalacia, osteoporosis, bad teeth • Auto immunity, rheumatoid arthritis, jra, lupus, MS, parkinsons, dementias including Alzheimer, autoimmune thyroid (graves, hashimotos). • Cancers breast, prostate, lung, colon, pancreas • Cardiovascular disease, hypertension. • Insulin resistance/diabetes. • Infections , flu, pneumonias, colds. • Mood disorders, depression, seasonal affect. • Hair and skin health.

23. Multiple Sclerosis

24. Vitamin D Deficiency Causes • Lack of outdoor activity. • Sunblock use (carotenoids are plants sunblock, they do concentrate in the skin). • Malabsorption. • Liver disease. • Kidney disease. • Age decreases conversion. • Obesity decreases production. • Synthetic D2 supplementation, decreases D3 amount and increases 1,25 OH D3 degradation.

25. Vitamin D Toxicity • Not established thought to b 50,000iu/day. • Symptoms reflect those of high calcium. • Anorexia, nausea/vomit, cramps GI and extremities. • Polydipsia/uria, renal failure. • Weakness, nervousness. • Itch • Pregnancy can result in retardation, facial abnormalities.

26. Vitamin D3 Dosing • AI infant and children 200iu/day. • AI adults 600-800iu/day. • CHM 4,000- 6,000iu/day (monitored).

27. Tanners • Whole body minimum erythema dosing (minimum amount to redden but not burn the skin) is equivalent to 10,000-25,0000iu dosing of vitamin D3. • Sunlight is preferred, but difficult for Northerners. • Tanning bulbs can be used to approximate sunlight, but the ballasts control the amount of EMF. • Use electronic or high frequency ballasts are preferred to old magnetic or choke ballast.

28. Vitamin E • Vitamin E is a generic name given to a family of essential fat soluble antioxidants 4 tocopherols (alpha, beta, gamma, and delta), and 4 groups of tocotrienols. • D Alpha tocopherol has the greatest activity. • They reside in membranes where they work to protect against oxidation of these delicate fats by free radicals produced by the energy producing machinery of our cells.

29. Vitamin D Levels • QDL 20-100 ng/ml for 25 OH D3 (best for evaluating stores) • Usual levels 10-55. • CHM levels as low as single digits in the home bound, summer levels 30’s, nonsummer 20’s. • When used as a medication experts on the average desire higher levels of 80-100. • Require close monitoring by a professional.

30. Vitamin E Function • Principally as the resident antioxidant in membranes loaded with delicate double bond fats. • Enhance immune function. • Regulates platelet function. • Aids in red blood cell formation. • Involved in vitamin K use. • ? Function as a signaling molecule?

31. Vitamin E Sources

32. Vitamin E Deficiencies • Cardiovascular disease (majority of vitamin E found in LDL fraction of cholesterol) • Cancer • Alzheimers • Cataracts

33. Vitamin E Levels and Dosing • QDL 5.7-19.9 mg/L • AI 22.5 iu/day • Average intake 11.4iu/day females 15iu/day males • Optimum 100-400iu/day

34. Overdoses and Toxicity of Vitamin E • Doses greater than 800-1500iu/day may increase mortality due to all causes. • Possible mechanisms, altered beta oxidation reducing the ability to burn fat for energy, or inability to burn dangerous fats? • Bleeding may be a possibility especially in those deficient in vitamin K.

35. Vitamin K • Essential FSV involved in post translational modification of proteins involved in clotting and bone metabolism. • K1(phylloquinone, phytomenadione, phytonadione) found in vegetables, avocados, and kiwi. • K2 (menaquinone, menatetrenone) produced by GI flora, found in eggs, meats, dairy, and natto(fermented soy beans).

36. Vitamin K Function • Blood clotting regulation. • Bone metabolism. • Calcium/phosphorus levels and ratios modulation. • Modulation of activities of other FSV. • Antioxidant. • Antiemetic pregnancy hyperemesis

37. Vitamin K Deficiencies • Bleeding. • Osteopenia/osteoporosis. • Calcification of atherosclerotic plaques. • ?Cancers? (decrease cirrhosis to liver cancer) • Medications, warfarin, aspirin, dilantin, cholestyramine, and antibiotics. • Liver and gall bladder disease. • Malabsorption (inflammatory bowel, cystic fibrosis)

38. Vitamin K Levels and Dosing • QDL 80-1160 pg/ml • US DRI AI females 90mcg/d, pregnancy 65mcg/d, males 120mcg/d. • Ideal per Dr. Cees Vermeer 45-185 mcg K2/d

39. Vitamin K Levels and Dosing • QDL 80-1160 pg/ml • US DRI AI females 90mcg/d, pregnancy 65mcg/d, males 120mcg/d. • Ideal per Dr. Cees Vermeer 45-185 mcg K2/d

40. Polyunsaturated Fatty Acids • Omega 3 Fats, flax seed oil, small amounts converted to EPA and DHA, fish oils, long chain fats with multiple double bonds. • Omega 6 Fats, sunflower, safflower, walnut, hemp etc., small amounts converted to GLA, found in evening primrose, borage, and black currant.

41. Prostaglandins • Local hormones made from EFAs in membrane • PGE1 (healing PG)promotes blood flow, decreases inflammation, promotes repair, decreases blood clotting, decreases membrane leakiness • PGE2 (inflammatory PG)promotes inflammation, clotting, membrane leakiness, vasoconstriction • PGE3 from the omega 3 fats reduces the release of inflammatory arachadonic acid from the cell membrane. • Lay a strong foundation with omega 6:3 ratios of 2:1 to 4:1.

42. Prostaglandin Cascade

43. Prostaglandin Flow • Omega 3 fats modulates the release of inflammatory arachadonic acid (PGE2) from the membrane via prostaglandin E3 (PGE3). This decreases inflammation but does not promote healing. • Omega 6 fats can be gated to flow toward the inflammatory PGE2 pathway, or toward the healing PGE1 pathway. The gate is controlled by sugar, infection, toxin, and allergen. The less “bad guys” the more peace, prosperity, and healing takes place. The more “bad guys” the more war is waged

44. Take Home Message • BOTTOM LINE • Eat a great organic diet, rich in multicolored fruits and vegetables, complex nonprocessed nuts, seeds, grains, beans, and lentils, clean proteins from animals and fish. Balance 2 tablespoons of EFA/d. Take Vitamin A 5,000 -10,000 iu/wk, Vitamin D 4,000iu/d, Vitamin E 100iu/d, Vitamin K 100-200mcg/wk, Evening Primrose 1 caps 40mgGLA/wk, EPA 800mg/month, plenty of organic butter and olive oil daily. Replace carbohydrates with oils to regulate insulin. These are general guidelines for the healthy members of the population I take care of. For individual needs especially for addressing illness please see a nutritionally trained professional.

45. DoNot Forget the Fluff!! • Laughter • Joy • Community • Tranquility • Love

47. JOY

48. COMMUNITY