Objectives • Explain the difference between vitamins, minerals, trace elements, and supplements. • List the water soluble vitamins. • List the fat soluble vitamins. • List common minerals and trace elements required for proper cellular functioning. • Explain common drug interactions involving nutritional supplements. • Identify common diseases or conditions caused to excess or deficiency of required nutrients.
More Objectives • Explain the function or role of various vitamins, minerals, electrolytes, and nutritional supplements. • List the common chemical abbreviations used for the most common trace elements and minerals. • Demonstrate familiarity with both the common and scientific names for common vitamins and nutrients.
So, what are they? • Vitamins, minerals, trace elements, and many supplements are required for normal cellular function. • Can function as cofactors, hormones, growth factors, and much more.
Why Care? Nutritional deficiencies can cause: • Nonspecific complaints • Abnormal bone function • Neurological damage • Inability to build, repair tissue • Change in energy level • Intellectual impairment • Muscle wasting • Obesity • Emaciation • Loss of hair • Delayed healing of wounds
What’s the Difference? Vitamins & Herbals Minerals, Electrolytes, & Trace Elements Inorganic Found in living and nonliving sources. Can NOT be produced by the body. Also required for normal cellular functioning. • Organic • Found in living organisms. • Can sometimes be synthesized by body. • Required for normal cellular functioning.
Regulation of Vitamins, Minerals, & Supplements • The FDA does regulate vitamins and other supplements. • Vitamins & Minerals must meet standards of purity and potency. • Nutritional combinations and herbal supplements are regulated as FOOD, they do not have to comply with the same standards of purity and potency. • READ THE LABEL
Why do we need vitamins? • Vitamins are essential for our body to do what it needs to and to build and maintain the various structures of our body. • B12 • Myelin Sheath • Blood cell development • B6 • Metabolism • Neurotransmitter Development • And many other functions & vitamins
Vitamins General Facts • Regulated by FDA • Monitored for purity. • RDA (Recommended Daily Allowance) • Average amount needed daily to prevent deficiencies. • Drug Interactions • Toxicities & Side Effects • Pregnancy
Classification of Vitamins Fat Soluble Water Soluble B vitamins and C Renal Elimination Generally fewer toxicities Not typically stored in the body. Extracellular Receptors Drug interactions with diuretics. • A, D, E, and K • Hepatic & Renal Elimination • Stored in the body. • More toxicities than water soluble. • Intracellular Receptors • Drug interaction: • Mineral Oil • HMG-CoA Reductase Inh • Laxatives • Lipase Inhibitors
Fat Soluble Vitamins A, D, E, & K
Vitamin A • Vitamin A—beta-carotene or retinol • Four functions: • Visual pigment for rods in retina of eye • Protects against cancer in skin, respiratory and digestive tracts, bladder, breast • Stimulates immune system to fight against infections • Antioxidant; soaks up free radicals.
Vitamin A (cont’d) • Vitamin A necessary for bone growth, renal function, digestive activity, normal reproductive function. • Sources: dairy products, liver, fish, yellow and green fruits and vegetables.
Hypervitaminosis A • Symptoms: headache, vomiting, skin peeling, loss of appetite, irritability, wasting away of bone mass • Fatal cases: destruction of the liver • Birth defects: mother ingests large amounts of Vitamin A during first 3 months of pregnancy
Vitamin D • Two precursors: • Cholecalciferol (D3): produced by skin in UV light • Ergocalciferol (D2): result of UV radiation on yeast ergosterol found in bread and milk • Calciferol converts to calcitriol in kidney
Vitamin D (cont’d) • Calcitriol—increases phosphorus absorption and calcium intake • Sources—dairy food: • Milk, eggs, cheeses (ergocalciferol) • Deficiency: rickets, osteomalacia, osteoporosis
Hypervitaminosis D • May cause hypercalcemia. • Toxic effects include: calcium deposits, convulsions, even death. • Drug interactionsm include: digitalis, thiazide diuretics, mineral oil.
Vitamin E • Essential for normal metabolism and protection of skin, eyes, tissues, muscles • Protects red blood cells from damage • Sources—whole grains: • Wheat, rice, nuts, corn, vegetables, dairy products
Vitamin E (cont’d) • Deficiency: anemia, cardiovascular disease • Hypervitaminosis E: cases have not been documented in literature • Drug interactions: mineral oil
Vitamin K • Phytonadione • Forms blood coagulation factors • Sources: • Wheat, legumes, egg yolks, milk, broccoli, spinach • Produced by certain intestinal bacteria • Deficiency—increased tendency to bleed
Water Soluble Vitamins Vitamins B & C
Vitamin B • Sources: • Vitamin B is in peas, beans, red meats, flour, yeasts. • Deficiencies can go unnoticed for years. • Vitamin B enables cellular functioning of body system.
B Vitamins—Sources, Function, and Deficiency States VitaminChemical NameFood SourcesFunctionDeficiency B1 Thiamine Grains, cereals, Metabolism Beriberi beans, pork, (wet and/or and liver dry forms) B2 Riboflavin Cereals, eggs, Maintains Discolored dark green mucous tongue and vegetables, membranes, dry scaling milk, liver metabolic and fissuring energy of the lips pathways B3 Nicotinic Nuts, beans, Fat synthesis, Diarrhea, acid pea, wheat, protein dementia, rice, grains metabolism depression, and electron skin transport discoloration B5Pantothenic Vegetables, Coenzyme Fatigue, acid cereals, headaches, yeast, liver nausea, muscle spasms
B Vitamins—Sources, Function and Deficiency States (cont’d) VitaminChemical NameFood SourcesFunctionDeficiency B6 Pyridoxine Meat, liver, Amino acid Skin chicken, and fatty acid disorders, salmon, trout, metabolism depression, beans, rice, nausea, whole grains impaired vision and nerve function B9 Folic acid Green Production Nerve vegetables of red blood damage and liver cells B12Cyanocobalamin Meats, liver, Formation of Pernicious chicken, red blood anemia, dairy products cells megaloblastic anemia
Vitamin B1 • Thiamine important for: • Maintenance of body system • Carbohydrate metabolism • Well-being of nervous and cardiovascular system • Deficiency: beriberi, anorexia, constipation, nausea, mental confusion, depression
Vitamin B2 • Riboflavin important for: • Metabolism of carbohydrates • Proper growth and maintenance of the body
Vitamin B2(cont’d) • Deficiency: anemia; depression; tongue, mouth, eyes, skin may dry out; headaches; burning sensations in skin; cracking in corners of mouth; seborrheic dermatitis
Vitamin B3 • Nicotinic acid (niacin) • Used in tissue respiration and metabolism • Reduces low-density lipoproteins (LDLs) • Releases histamine and causes vasodilation • Necessary for lipid metabolism, proper nerve functioning, maintenance of cells
Vitamin B3(cont’d) • Deficiency: pellagra • Symptoms: • Diarrhea, weakness, lethargy, dermatitis, dementia, sores in mouth, GI problems
Vitamin B5 • Pantothenic acid • Affects body metabolism. • Used to synthesize fatty acids, steroid hormones, molecules for carbohydrate and protein processes. • Produced by bacteria in GI tract of animals. • Deficiency causes headache, sleep disturbances, muscle cramps, fatigue.
Vitamin B6 • Pyridoxine • For metabolism of carbohydrates, proteins, fats in diet • Absorption of B12, production of amino acids • Deficiency: skin problems, stomatitis, seizures; causes dwarfism, blindness, dementia, depression, osteoporosis
Vitamin B6(cont’d) • Agents that may cause pyridoxine deficiency include penicillamine and isoniazid. • Drug interaction: • Levodopa (L-DOPA) for Parkinson’s disease
Vitamin B7 • Biotin • Important for activities of enzymes. • Break down fatty acids and carbohydrates to convert them into energy. • Sources are beans, egg yolks, liver, nuts, and cauliflower.
Vitamin B7(cont’d) • Deficiency: lethargy, weakness or easily fatigued and hair loss; eczema, swelling of the tongue
Vitamin B9 • Folic acid • Essential for DNA synthesis and creation of cells with high growth turnover (bone marrow, white blood cells) • Found in: • Green vegetables, broccoli, avocado, beets, orange juice, liver
Vitamin B9(cont’d) • Deficiency: diarrhea, weight loss, weakness, sore mouth, irritability, behavior disorders • Drug interactions: • Phenytoin, estrogen, nitrofurantoin
Vitamin B12 • Cyanocobalamin • Obtained from dietary intake • Required for red blood cell and myelin sheath production, synthesis of nucleic acids • Deficiency: anemia, dementia, depression, hair loss, poor growth rate in children, loss appetite
Vitamin B12(cont’d) • Deficiency: • Red cell anemia seen in pernicious anemia (megaloblastic anemia) • Red cells abnormally form
Vitamin C • Ascorbic acid • Antioxidant • For formation of connective tissue found in bones, teeth, gums; aids in healing wounds
Vitamin C • Deficiency: • Scurvy; causes excessive bleeding in skin and gums; teeth become loose • Decrease in immune system’s ability to produce T cells • Found in citrus fruits and vegetables
Minerals • Minerals, as opposed to vitamins, are inorganic molecules found in a variety of substnaces. • Found in living and nonliving substances. • The body can NOT make minerals and electrolytes. • Mineral dissolved in water = electrolyte
Calcium • Needed for bone and tooth formation, muscle contraction and relaxation, blood clotting, nervous system transmission, insulin secretion • Calcium carbonate (tums) and os-cal good sources • Postmenopausal women need vitamin D for effective calcium absorption
Phosphorus • Needed for bone and tooth formation, energy • Helps in storage of fats and metabolism
Zinc • Essential component of DNA and RNA • Necessary for sexual development, wound healing, normal taste and smell
Zinc Excess • Side effects: nausea, vomiting, diarrhea, pulmonary edema, hypotension, tachycardia • Drug interactions: • Penacillamine (binds to metals), treat metal toxicity • Penacillamine binds to zinc and increases renal excretion
Iron • Ferrous sulfate, ferrous fumarate, ferrous gluconate • Transport oxygen in blood • In red blood cells, iron in hemoglobin binds to oxygen molecule, transports it throughout body (red color) • Stored in liver
Iron (cont’d) • Deficiency: anemia • Symptoms: hair loss, shortness of breath, lethargy, heart palpitations • Toxic effects of overdose: acidosis, liver and kidney impairment, coma • DDI: Do not mix antacids and iron supplements. • Liquid oral iron supplements can discolor tooth enamel (use of a straw can help prevent this). • Use of iron supplements can cause constipation.
Magnesium • Helps synthesize proteins, stimulates muscle contraction and nerve transmission, activates enzymes, aids in bone formation • Supplements found in combinations with other minerals (calcium) • Excess Mg can lead to diarrhea. • Slow Mag, MOM, Epsom salts