Midterm 1 Flashcards

1
Q

What nutrients reduce HOMOCYSTEINE?

A

B6
B9
B12

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2
Q

Why is it desirable to REDUCE homocysteine?

A

DECREASES the risk of HEART DISEASE

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3
Q

L. ACIDOPHILUS and BIFIDUS bacterium are supplemented when?

A

Patient on antibiotics.

Antibiotics destroys some of the NEEDED normal gut flora.

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4
Q

What does “Drinking in moderation” mean?

A

1-2 drinks per day

12-24 oz beer
1-2 oz hard liquor
8-12 oz wine

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5
Q

List examples of “special diets”

A
High fiber
Low fat
Liquid diet
Vegetarian
Diabetic
Low Sodium
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6
Q

Vegan Diet

A

Plants ONLY

<1% of Population

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7
Q

Lacto Diet

A

Dairy + Plants

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8
Q

Ovo Diet

A

Eggs + Plants

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9
Q

Pesco Diet

A

Fish + Plants

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10
Q

Ave Diet

A

FOWL ONLY

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11
Q

Of the types of “diets” (Vegan, etc.), what are the two most common? Most rare?

A

MC: Lacto, Ovo

Rare: Ave

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12
Q

What does “Lite” mean?

A

Less than the normal product

  • sodium
  • sugar
  • color
  • kcals
  • fat
  • eTOH
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13
Q

What is the most common symptom when the CO-FACTORS for Kreb Cycle are missing?

A

Fatigue

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14
Q

What is the MAXIMUM OTC dosage for FOLIC ACID? Why?

A

Max OTC Dose = 400 mcg

Because it MIGHT mask the signs of PERNICIOUS ANEMIA

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15
Q

Examples of HEAT STABLE ANTI-THIAMINES

heat resistant

A

Flavinoids (citrus fruit)
Tannus (tea/coffee/wine)
Sodium Nitrate (preservatives)

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16
Q

Examples of HEAT LABILE ANTI-THIAMINES

easily destroyed by heat

A

Thiaminases

  • Fresh water fish
  • Shellfish
  • Bacterial/fungi

(Eating primarily raw fish +/- beri-beri)

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17
Q

Examples of ANTI-THIAMINE drugs

A

Oxythiamin
Pyrithiamin

(Leads to weight loss, anorexia, neuro dmg)

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18
Q

Example of ANTI-BIOTINS

A

Avidin in raw egg whites

Avidin is destroyed by heating. Eat a cooked egg, it doesn’t deplete B7

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19
Q

Benefits of ALLICIN. Where is it found?

A

Kills bacteria
Lowers cholesterol
Lowers BP

Found in GARLIC + ONIONS
*Only works when combined with B1

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20
Q

Vitamins & Minerals depleted by ALCOHOL consumption

A
B1
B2
B3
B6
B9
B12

Vit C

Calcium
Zinc

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21
Q

Vitamins & Minerals depleted by BIRTH CONTROL PILLS

A

Vit A

B2
B6
B9

Vit C

Copper
Iron
Zinc

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22
Q

Vit ___ protects against TYLENOL side effects.

A

Vit E

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23
Q

Vit ___ protects against ASPIRIN + COUMADIN side effects.

A

Vit K

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24
Q

What are the hazards of FLOURIDE FORTIFICATION?

A
Teeth Mottling (brown spots on teeth)
Bone deformities

(Calcium out of bone to soft tissue, Osteoporosis fractures, +/- allergies, +/- increase cancer risk)

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25
What binds up ZINC? (Decreases absorption, enhances secretion) **Check this.
``` PHYTATES Unleavened bread Cadmium Ca++ Cu ``` Fiber Iron Heavy metals Coffee/tea/cocoa
26
What binds up IRON?
PHYTATES- Phytic acid (Grains) Red wine Grapes Milk Apple Juice +/- be a problem in kids (Antacids, tannic, phytates-from whole grain, phosvitin- egg yolks, XS minerals, chelating agents- EDTA) *EDTA = common preservative
27
Who's at RISK for Vitamin B DEFICIENCIES? (Commonly seen by chiros)
Alcoholics (B1, B2) Vegetarians (B12) Bitches on birth control (B2, B6, B9) Old people Diabetics Hypothyroidism Antibiotic users
28
Scurvy ssx
Pirates!!!! ``` Fatigue Anorexia Easy bruising Swollen/bleeding gums Anemia Loose teeth XS wavy hair ``` Def. Vit C
29
Dry Beri-Beri ssx
``` PNS - neurological Neuropathies Anorexia Weakness Foot/ankle drop - calf muscle pain ``` *B1 def
30
Wet Beri-Beri ssx
(Same as DRY ber-beri PLUS..) Cardiac enlargement Pitting edema *B1 def
31
Hemochromatosis
Sun tanned look Cirrhosis Diabetes (d/t decreased glucose tolerance) *XS Iron
32
Ariboflavinosis
``` Dermatitis (around nose, mouth) Cheilosis Eye infections Stomatitis Geographic Tongue ``` B2 Def.
33
Wilson's Disease
Kayser-Fleisher ring of Cornea UE Tremors Copper in piss *XS Copper
34
Rickets
``` Bowed legs Knocked knees Rachitic Rosara - bumps on ribs Spine/Pelvis Deficiency *End stage = Convulsions ``` *Vit D def.
35
Osteomalacia
Uncalcified bone matrix DUE TO: * collagen formation * muscle weakness * bone pain * fractures *Vit D def.
36
Wernicke-Korsakoff Syndrome
All beri-beri ssx PLUS ``` Confusion Confabulation (inventing stories) Psychosis Memory loss Nystagmus CN 6 Paralysis (Cross eyed) ``` *B1 def.
37
Pellagra
Rough skin esp. exposed area Casal's Collar (rough skin around neck) ``` Weakness Anorexia (3 Ds) Diarrhea Dermatitis Dementia ``` *B3 def.
38
Hart Nups Dx " heart.
Lots of TRYPTOPHAN in piss Can't transport or absorb AAs *B3 def.
39
Pernicious Anemia
``` Acholorhyria 2* to HYPOthyroidism Syncope Headaches Sore/red tongue Hallucinations ``` *B12 def.
40
Blood test to identify EARLY IRON DEFICIENCY ANEMIA
Serum Ferritin Depletion Test | Most SENSITIVE lab test
41
How to get adequate Vit D without the risk of toxicity
Sun everyday (some say 15 minutes)
42
Who's at the MOST RISK for Vit D TOXICITY? **Check this.
People supplementing XS Vit D??
43
Nutrients needed for MUSCLE RELAXATION (reduction of spasms)
Magnesium Potassium Calcium
44
Nutrients made by GUT FLORA
B7 B12 Vit K
45
Long term antibiotic use +/- lead to destruction of good gut flora...they should be given ___ + ____ supplements to INCREASE proper gut flora.
L. Acidophilus | Bifido Bacterium
46
Define "divided dose"
Full dose divided equally | Taken throughout the day
47
Define "empty stomach"
Take 1-2 hours BEFORE or | 1-2 hours AFTER a meal
48
Define "taper off"
Gradual decrease in dosages to | ULTIMATELY NONE
49
Define "back up"
Take all B Vitamins in CONJUNCTION with SPECIFIC dose of B Vitamin
50
What are kids given to DECREASE the severity of MEASLES?
Vit A
51
Most TOXIC vitamins and minerals?
Vit D - Most toxic vitamin Flouride - Most toxic Mineral Vit A Vit B3 - Liver toxic Calcium - "Milk Alkali Syndrome" Selenium - really toxic
52
Calcium deficiency ddx
Type I Insomnia *trouble falling asleep Muscle cramps - NO exertion *MC legs, calves
53
Magnesium deficiency ddx
Type II Insomnia * fall asleep easily * wake frequently Muscle cramps WITH EXERTION Isolated Dia/Sys HTN XS sweat Inc risk S. Aureus Gestational HTN
54
Potassium deficiency ddx
Muscle cramps UPON exertion
55
"Milk Alkali Syndrome"
Calcium
56
Where's B1-12, Vit A&E absorbed?
Sm. Intestine
57
Where's Vit D absorbed?
Skin
58
Where's Vit K absorbed?
Sm. Intestine | Gut
59
Vit A is bound to __ to CROSS GUT LINING.
Fat | Bile salts
60
Vit D is bound to __ to CROSS GUT LINING.
Bile salts
61
Vit K is bound to __ to CROSS GUT LINING.
Bile salts Pancreatic juice *Made by gut flora
62
Vit C is bound to __ to CROSS GUT LINING.
SODIUM dependent transport system
63
B1 is bound to __ to CROSS GUT LINING.
SUCKER!!! IT'S NOT BOUND TO ANYTHING!!!
64
B2 is bound to __ to CROSS GUT LINING.
Protein
65
B3 is absorbed in what forms?
Amide (Nicotinamide) | Acid (Nicotinic Acid)
66
B5 (Pantothenic Acid) is bound to __ to CROSS GUT LINING.
SUCKER!!! IT'S NOT BOUND TO ANYTHING!!!
67
B6 is absorbed as ___
Aldehyde/Alcohol form | Pyridoxal phosphate
68
B7 is bound to __ to CROSS GUT LINING.
Amino residue
69
B9 requires ___ to CROSS GUT LINING
Enzyme in Brush Border Pancreatic secretions Stomach enzymes
70
B12 requires ___ to CROSS GUT LINING.
pH < 6 | Intrinsic Factor
71
5 reasons to be MINERAL/VITAMIN DEFICIENT.
INADEQUATE 1. Ingestion 2. Absorption 3. Utilization (across cell membrane) INCREASED 4. Excretion 5. Needs
72
Lacto-Ovo Diet
Dairy Eggs Plants
73
Inadequate ingestion examples
Poverty Bad health - can't go out, can't open food Mentally handicapped
74
Inadequate absorption examples
Lack * HCl * Co-Factors * Enzymes GIT Diseases Ca++ Channel problems Ulcers Antibiotics (Destroys good gut flora)
75
Inadequate utilization examples (issues reaching the end target)
``` Diseases (Diabetes) Drugs Throwing up Alcohol Def b vits (mood disorders) Lack co-factors/enzymes ```
76
Increased excretion examples
``` Diarrhea Sweat Vomit Bleeding (menses) Urinary ```
77
Increased Needs
``` Infants, kids, elderly Prego, lactating Athletes Post surgery Major wasting disease ```
78
5 Stages of Vitamin/Mineral deficiency
1. Preliminary 2. Biochemical 3. Physiological 4. Clinical 5. Anatomical
79
Stage 1 Vit/Min Deficiency
"Preliminary" Body storage gradually depleted NO ssx
80
Stage 2 Vit/Min Deficiency
"Biochemical" Decreased enzyme function
81
Stage 3 Vit/Min Deficiency
"Physiological" Non-specific ssx * memory loss * fatigue
82
Stage 4 Vit/Min Deficiency
"Clinical" Classic ssx * Beri-Beri * Scurvy * Pellagra * etc.
83
Stage 5 Vit/Min Deficiency
"Anatomical" Fatal if untreated.
84
"Real" food brewer's yeast
A complex of B Vitamins *Used for Kreb's Cycle as CO-FACTORS + nerve impulse conduction B1 B3 B7 Chromium, Selenium (support the nervous system, help maintain the muscles used for digestion, and keep skin, hair, eyes, mouth, and liver healthy)
85
Go look at some THERAPEUTIC USES OF vitamins and minerals.
:)
86
Hazards associated w/ XS IRON in the diet
"Hemosiderosis" Iron deposits into tissues Toxicity
87
What causes HEMOSIDEROSIS? | Iron deposits into tissues
Multiple blood transfusions | Red wine
88
HEMOSIDEROSIS can increase the risk for
Heart disease - Fe increases SERUM CHOLESTEROL LEVELS!!! Parkinson's Alzheimer's Spread of bacterial infections Colorectal cancer
89
Iron Toxicity can come from ingesting XS
``` Oysters Red meat Liver Dried fruit Red wine Green leafy veggies ```
90
How to ENHANCE IRON absorption
``` Adequate Hcl in stomach Vit C - Ascorbic Acid Fructose (fruits) Citric/Lactic Acid *Eating VEGGIES w/ RED MEAT enhances non-heme absorption ```
91
How to INHIBIT IRON absorption
Antacids Tannic Acid (tea, coffee) PHYTATES (whole grain) Phosvitin (egg yolks) XS competing minerals (Ca, P04, Cu, Zn, Mn) Chelating agents (EDTA- common preservative)
92
Where does HEME IRON come from, in general?
40% Animal tissues *Found to cause cancer
93
Where does NON-HEME IRON come from, in general?
60% Animal 100% Plant Iron ``` Dried fruit Green veggies Legumes Nuts Seeds ``` *LESS BIOAVAILABLE
94
Ferrous Sulfate
Cheap Iron in supplements. Nausea Constipation
95
Iron Oxide = Rust
Cheapest Iron | Causes side effects
96
Best form of CALCIUM to PREVENT OSTEOPOROSIS (bone) & what's the TRACE ELEMENT
Microcrystalline Hydroxyapetite Trace element = BORON
97
Best form of CALCIUM for MUSCLE FUNCTION
GLUCONATE - best for muscle spasms * Usually combined w/ CITRATE * Lactate is good at reducing m. spasms, too.
98
Common OXALATE containing FOODS
``` Beets Berries Black Tea Celery Cucumbers Grapefruit Parsley Asparagus Brussel Sprouts Beans Carrots Chard Kale Peppers Plums Peanuts Rhubarb Spinach Chocolate, cocoa Instant Coffee Sweet Potatoes ```
99
Dietary TREATMENT for URIC ACID stones
Decrease animal protein Decrease red wine Eat MORE fruits + veggies Avoid: * Canned fruit * Sports drinks * Lots of Vit C
100
Dietary TREATMENT for CALCIUM/OXALATE stones
Drink super mucho H2O (8 oz/hour MINIMUM) ...bad diets, bigger bodies need more Eat a HIGH FIBER DIET Eat MORE CITRUS fruits + veggies Eat less meat *POTASSIUM CITRATE Reduce * Ca/Oxalates * XS animal protein * Sodium * Sugar * Coffee, soda * XS Vit D
101
What are the DEFICIENCY AND TOXICITY SSX for ALL vitamins & minerals?
Diarrhea | Nausea
102
Who gets MILK ALKALI syndrome? | *XS Calcium
This is SECONDARY to HYPERCALCEMIA. * hyperparathyroidism * bone diseases * Vit D poisoning Ingesting XS * milk * antacids (Ca Carbonate) - wants to prevent osteoporosis * baking soda (Na Carbonate)
103
Vitamins & Minerals that PREVENT ANEMIA
Vit ACE B 6, 12 ``` Iron Folate Copper Zn Phosphorous ```
104
Vitamins & Minerals needed for BONE INTEGRITY
Vit AD ``` Calcium Phosphorous Flouride Zinc Magnesium ```
105
Vit/Min that ENHANCE NERVE TRANSMISSION/FUNCTION
``` B1 B5 B6 B9 - Choline/Purine synthesis B12 - Myelin Sheaths ``` ``` Potassium Phosphorous Magnesium Vit C Calcium ```
106
What INCREASES CALCIUM absorption?
``` Vit D - Sunlight Inc. pH Lactose Estrogen Acidic Stomach Exercise Prego ```
107
What DECREASES CALCIUM absorption?
``` Oxalates Fiber (phytate) Alcohol Dec Vit D XS Coffee XS Sodium XS Competitive Minerals XS PTH Liver/Kidney Disease Malabsorption Sedentary lifestyle Amenorrhea ```
108
PROTEIN's affect on CALCIUM status
DECREASES Ca++ Inc Protein = Dec Phosphate = Dec Calcium
109
Where is Ca++ stored for use, why?
Bone & Teeth *Buffers blood
110
Therapeutic for OSTEOPOROSIS
``` Vit D Vit E Ca Phosphate Shark Cartilage Cod Liver Oil ```
111
Therapeutic for HEALING of DISEASE/INJURY
B9
112
Therapeutic for WOUND HEALING
Zn
113
Therapeutic for LBP
Vit C (increases collagen synthesis) Garlic Bromeline Magnesium
114
Therapeutic for SUBDELTOID BURSITIS
B12
115
Therapeutic for CARPAL TUNNEL
B6
116
Therapeutic for TRAUMA
Dec inflammation = BIOFLAVINOIDS *take w/ Vit C Proteolytic Enzymes * Bromelin * Trypsin * Chymotrypsin
117
Therapeutic for PAIN
Tryptophan?
118
Therapeutic for FIBROMYALGIA
``` Vit E B9 Lythamin Carbonate Flaxseed oil Low purine diet ```
119
What is COUMADIN's affect on Vit K?
Stops blood from clotting
120
Top 3 killers of kids
Diarrhea Pneumonia Hemmorhage
121
What's the ONLY VITAMIN we "TAPER OFF"?
Vit C
122
Define "bowel tolerance"
Gradually increase amount until stool is SOFT, but not diarrhea
123
Define "megadose"
RDA x10
124
Where is Vit C mainly stored?
Adrenal Gland
125
What is the main function for Vit C?
Collagen synthesis. Enhances absorption of IRON * stimulates collaged for the repair of wounds * NOT for tissue growth
126
Random Vit C functions
Aids in formation/function of CARNITINE (shuttling FAs) Lowers histamine response Converts B9 into it's ACTIVE FORM
127
What is B9's active form?
Tetrahydrofolate
128
How long does it take SCURVY to develop?
2-4 months
129
Common THERAPEUTIC USES for Vit C
Tx cold + flu (take upon 1st sx) Improve cortisol levels (times of stress) *Asthma
130
What are FLAVINOIDS?
H2O Soluble PHYTOCHEMICAL It enhances Vit C utilization Acts as an anti-oxidant (In citrus, berries, leafy veggies)
131
Effects of ISOFLAVONES?
Decrease risk of cancer Decrease ssx of menopause (hot flashes) Decrease risk of heart disease
132
Juvenile Beri-Beri ssx
*Neurologic problems mostly Can't wear well Ptosis - droopy eyelid Nystagmus
133
What is the MAIN side effect of Vit B, and how do you solve it?
Nausea/Queasy Take w/ food Divided doses!!
134
What's the recommended dose of B1 for women on birth control?
B100 formula Daily B25, 4x/day
135
You would NOT want to store B2 (Riboflavin) in what kind of bottles?
Glass Clear Plastic *Because it's DESTROYED BY LIGHT
136
Main function of B2?
Co-Enzyme FAD, FMN ``` Dehydrogenase enzyme in FA oxidation ETC Kreb's AA Oxidases ```
137
What are EARLY/SUBMARGINAL ssx of for a B2 deficiency?
Photophobia w/ tearing, itching, burning eyes Loss of visual acuity Sore lips, mouth, tongue, scrotum, labia
138
THERAPEUTIC use of B2
Cataracts | Treatment of deficiency states
139
B3 is LOW in ___ & ___, but HIGH in ____.
``` Low = milk, eggs Hi = Tryptophan ```
140
What percentage of TRYPTOPHAN is converted to NIACIN?
90%
141
What are the 3 GLUCOSE TOLERANCE FACTORS? (GTF)
Chromium Niacin - helps insulin @ cell receptor Zinc (Helps blood sugar regulation)
142
Casal's Collar
Pellagra - B3 Def. | Dermatitis on neck.
143
Those on HIGH ___ diets are at risk for B__ deficiencies.
Hi Leucine B3 def. Leucine causes Tryptophan excretion. Tryptophan is converted to B3. Need TRYPTOPHAN to get NIACIN!!!
144
What B vitamin is needed to convert TRYPTOPHAN to NIACIN?
B6
145
B3 (Niacin) TOXICITY ssx
``` Acute: Flushed GI irritation (Nausea, Vomit) Headache Diarrhea ``` Chronic: Liver dmg, cirrhosis, jaundice, elevated AST, ALD
146
B5 is therapeutic for
``` Burns + skin lesions Fights against COPPER toxicity (Wilson's) Atherosclerosis Chronic stress Prednisone ```
147
2 Hours of sunlight exposure will DESTROY 70-100% of your B__.
B6
148
What main B vitamin helps produce energy from GLYCOGEN?
B6
149
Trans-Amination
B6
150
Who is at risk for a B6 deficiency?
Baby's on the teet Bitches on birth control Alcoholics
151
B6 Therapeutic uses
Decrease nausea/vomiting in prego Decrease PMS ssx Decrease risk of OXALATE KIDNEY STONES
152
B__ is one of the most POTENT vitamins.
B7 - Biotin
153
B__ is the most SENSITIVE vitamin to environmental damage.
B9 - Folic Acid
154
Which VITAMIN is essential in converting B9 to it's ACTIVE form "Tetrahydroflorate"?
Vit C - Ascorbic Acid
155
A diet HIGH in ___ will ENHANCE the uptake of FOLIC ACID
Carbs
156
What is the most common VITAMIN deficiency in the WORLD?
B9- Folic Acid
157
Who's at risk for a B9 deficiency?
``` Baby's on goat's milk Junk diet Alcoholics Teens Those with increased cell proliferation (chicken pox, cancer, prego, injuries) ```
158
B9 deficiency conditions
Megablastic anemia Glossitis Neural Tube Defects (Spina Bifida)
159
Do ANTACIDS cause B12 to increase or decrease?
Decrease
160
What is the most ABUNDANT MINERAL in the BODY?
Calcium
161
Calcium is an UNBOUND ION found in the blood as either ___ or ___.
Ionized | Albumin bound
162
XS Phosphorus may result in cases of
HYPOparathyroidism | Renal Insufficiency
163
Which MINERAL is needed for the PROPER utilization of Vit B, E, C?
Magnesium
164
Toxicity of POTASSIUM
Kidney Disease
165
People with XS IRON are at risk of
Parkinson's Alzheimer's Spread of BACTERIAL infections COLORECTAL cancer
166
What is the most common MINERAL deficiency in the WORLD?
Iron
167
What is the most common MINERAL deficiency in the US?
Magnesium
168
Classic IRON def. ANEMIA ssx
Nails * spoon-shaped * vertical ridges/splitting Mouth * glossitis * cheilosis * stomatitis Blue sclera Rosy-pink lips
169
What do you give someone who is at risk of IRON deficiency?
Serum Ferritin
170
Recommended dose for IRON def.
100-400 mg IRON GLYCINATE Daily w/ Vit A, C Between meals
171
Who is likely to get IRON POISONING ?
American Kids | *Accidental
172
ZINC enhances the ABSORPTION of Vit __
Vit D - Cholecalciferol
173
What DECREASES the ABSORPTION of zinc?
PHYTATES XS Cu, Fe, Ca, Cd Caffeine
174
Main functions of Zinc
Support absorption/utilization of B vitamins Supports dev/maintenance of GUY PARTS Helps with CALCIUM deposit in bones/teeth (carbonic anhydrase enzyme) Growth/wound healing - TOPICAL Regulates lipid metabolism
175
Therapeutic uses of ZINC
``` Wound healing Sickle Cell Anemia Nyctolopia RA Immune support Male infertility, low count MACULAR DEGENERATION (MC cause of blindness) KILLS H. PYLORI ```
176
Copper is transported in plasma as ___ with some BOUND to ___ in the RBC's.
CeruloPlasmin Bound to ALBUMIN
177
Which TRACE MINERAL helps with OXYGENATION/FORMATION of RBCs?
Copper
178
Which TRACE MINERAL converts FERRIC to FERROUS state?
Copper
179
Which TRACE MINERAL helps with PIGMENTING HAIR?
Copper *It's the co-factor for TYROSINE. Tyrosine -> Melanin pigmentation
180
Does WILSON'S Disease cause tremors?
Yes
181
Kayser-Fleisher ring
Wilson's Disease XS Copper