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CNM Naturopathic Nutrition 1 > Vitamins > Flashcards

Vitamins Flashcards

(105 cards)

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1
Q

List 5 key functions of vitamins

A

Supporting the immune system
Regulating gene expression
Supporting neurological activity
Facilitating ATP production
Manufacturing of blood cells
Regulating hormones

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2
Q

True or false - the body cannot produce vitamins

A

Mostly true with the exception of vitamin D

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3
Q

What are the 2 types of vitamins?
List the vitamins found in each category and how they’re absorbed.

A

Fat-soluble - A, D, E, K
Absorbed with fats in the small intestine into the lymphatic capillaries and then into the blood.

Water-soluble - B vitamins and vitamin C
Absorbed in the small intestines and directly into the blood.

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4
Q

What is the range between efficacy and toxicity for the two vitamin categories?

A

Fat-soluable - tighter range thank water soluable.

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5
Q

What are the 5 stages of vitamin insufficiency to deficiency?

A
  1. Preliminary reduction of stores
  2. Reduction in enzyme activity
  3. Physiological impairment
  4. Classical deficiency symptoms.
  5. Terminal tissue pathology.
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6
Q

What are vitaminers?

A

Varying active forms of a vitamin

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7
Q

What are the 3 vitamers of Vitamin A

A

Retinol
Retinal
Retinoic acid

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8
Q

What are the 2 forms of vitamin A?
Are they active or need converting?

A
  1. Pro-vitamin A
    Found in non-animal foods.
    Carotenes (or caratenoids) are examples.
    Need converting in the small intestine
  2. Pre-formed vitamin A
    From animal foods.
    Already in active form
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9
Q

Give 3 examples each of the 2 forms of vitamin A

A

Pro-vitamin A = Dark green, yellow / orange vegetables and fruit.
Eg Carrots, squash, mango, spinach, sweet potato, apricots, paprika.

Pre-formed vitamin A =
liver, egg yolk, mackerel, salmon

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10
Q

How should you prepare fruit/veg to optimise absorption of vitamin A?

A

Vit A is fat-soluble, so ensure adequate healthy fats in the diet - e.g. drizzle olive oil or eat with avocado.

Bioavailbiilty it also increase through cooking such as lightly steaming.

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11
Q

What pathologies can reduce carotene conversion in the body?

A

Hyperlipidaemia
Liver disorder
Diabetes
Hypothyroidism

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12
Q

What are the risks of a high intake of animal foods high in vitamin A?

A

70-90% of dietary retinol is absorbed so high intake can lead to vitamin A toxicity.

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13
Q

What’s the tolerable upper limit of vitamin A supplementation?

A

Adults max 3000 mcg preformed A

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14
Q

List 4 main areas in the body / health that vitamin A supports?

A

Vision and eye health
Immunity
Gene expression and cell differentiation
Reproduction

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15
Q

List 5 signs or symptoms of vitamin A deficiency

A

Vision impairment (starts with night vision)
Hyperkeratosis of skin (“goose flesh”)
Reduced skin integrity
Poor bone growth
Poor sense of taste and smell
Lowered immunity

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16
Q

Describe 4 factors that can affect vitamin A absorption in an individual.

A

Pathologies such as diabetes, thyroid and liver disease lower carotene conversion.

Alcoholism accelerates the breakdown of liver-stored retinol.

Poor gut health and conditions that affect fat absorption

Zinc deficiency and/or protein malnutrition as they’re both responsible for Retinol Binding Pritein to movevitamin A from liver stores to tissues in the body.

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17
Q

List 4 signs/symptoms of Vitamin A toxicity

A

Birth defects
Bonefractures
Liver disease
Hyperlipidaemia
Amenorrhoea
Dry,red, scaling skin.

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18
Q

What are the 2 dietary sources of vitamin D?

A

D2 from plants - specifically mushrooms
D3 from animals - found in cod liver oil, oily fish, and organic egg yolks

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19
Q

Briefly describe the activation pathway for vitamin D in the body

A

Provitamin D is from sun exposure. Vitamin D2 & D3 is from the consumption of food.

Both converted into Calcidiol in the liver.
Then converted into Calcitriol (the active form of Vit D) in the kidneys

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20
Q

What serum levels of vitamin D are considered…:
- Deficient
- Sufficient (by medical professionals)
- Optimal

A

Deficient = below 25 nmol/L
Sufficient = over 50 nmol / L
Optimal = 75 - 125 nmol/L

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21
Q

How long can vitamin D be stored in the body for?

A

4 months in the liver

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22
Q

What supplementary doses of vitamin D should be prescribed?

A

2000UI daily in the winter for ongoing maintenance.

4000UI daily if low

Significant deficiency may require up to 50,000 IU weekly for 2-3 months.

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23
Q

What is the key function of vitamin D?

A

To maintain serum calcium and phosphorus homeostasis. This balance impacts many body processes, including heart and nervous system functioning.

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24
Q

Briefly outline some of the functions vitamin D plays in the body (5)

A

Bone health - bone density (along with K2)

Immune health - regulation of T-helper cells, and reducing inflammatory cytokines

GIT Health - regulates mucosal inflammation

Anti-cancer - enhances anti-tumour activity

Insulin - transcription and cellular sensitivity.

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25
How do vitamin A and D interact?
Balance is essential for proper gene transcription. DNA transcription includes vitamin A & D receptors.
26
What signs and symptoms can develop from vitamin D deficiency?
Rickets and osteomalacia - demineralisation of bones Osteoporosis - brittle bones Severe asthma in children Poor immunity Menstrual irregularities Non-specific musculo-skeletal pain
27
Name 4 causes of vitamin D deficiency
Inadequate UVB sun exposure and overuse of sunscreens. Dietary factors such as excessive animal protein or calcium intake can lower vit D serum levels. Lack of dietary fats and/or magnesium (co factor for vit D synthesis) Impaired liver function Elderly Kidney disease Poor intestinal absorption.
28
Discuss toxicity levels for Vitamin D
Cannot occur through sun exposure. Supplementation of 50,000 IU per day for an extended period can cause toxicity. Serum levels above 375 nmol/L = toxicity Symptoms due to vitamin D related hypercalcemia: nausea, diarrhoea, vomiting, weakness, hypertension, constipation
29
There are several compounds within the Vitamin E family. Which one is the only form recognised for human nutrition?
a-tocopherol
30
What are the effects of freezing and heating vitamin E foods?
Freezing destroys up to 80% of the vitamin E Heating destroys around 30%
31
List 4 foods high in vitamin E
(Fresh, raw food sources are best) Sunflower seeds Almonds Pine nuts Olive oil Avocado Sweet potato Spinach
32
Why should you avoid synthetically produced vitamin E?
Less active and derived from petroleum oil
33
Briefly outline the 5 main functions vitamin E plays in the body
Antioxidant - protects against oxidation. Works closely with vitamin C Immunity - increasing phagocytes activity Anti-coagulant Endocrine - improves insulin action and modulates oestrogen receptors Skin repair
34
How can vitamin E deficiency present?
Serious deficiency is rare unless significantly impaired absorption. Red blood cell destruction (through oxidation) Easy bruising and slow healing Nerve damage
35
What is the K referring to in vitamin K
Koagulation (german spelling) - Coagulation / blood clotting
36
Where will you find the 3 forms of vitamin K?
K1 - green leafy vegetables K2 - fermented foods K3 - toxic, synthetic form
37
Name 2 key foods high in vitamin K
Natto (fermented soy beans) Dark green leafy vegetables (Fat soluble so best eaten with some dietary fats)
38
Outline the 2 main functions vitamin K has in the body
Blood clotting - required for the formation of 4 out of 13 clotting factors. Bone mineralisation - working with vitamin D
39
What are some of the causes for vitamin K deficiency?
Liver disease Warfarin Antibiotics Fat malabsorption
40
What are the signs and symptoms of vitamin K deficiency?
Excessive bleeding Bruising Bone fractures Soft tissue calcification
41
What are the maternal considerations with vitamin K?
Low amounts of vitamin K transferred from placenta to foetus. Vitamin K injection is offered at birth to newborns but this contains undesirable preservatives in it. Opt for delayed cord clamping and consuming vitamin K rich foods before due date.
42
What's the real name for vitamin B1?
Thiamine
43
What does vitamin B1 depend on for its activation?
Magnesium
44
How long can B1 be stored in the body for?
Approximately 1 month
45
What cooking methods affect B1?
It's very easily reduced by processing including chopping, canning, additives, boiling, freezing and cooking. Fresh, raw sources are best.
46
List 5 foods containing B1
Yeast extract Peas Oranges Nuts Pulses Sunflower seeds Whole grains Meat and fish
47
Outline the 2 main functions B1 plays in the body.
Energy (ATP) production - crucial for carb metabolism. And needed for formation of Acetyl-CoA Nervous system - creates neurotransmitters such as GABA
48
What can impair the absorption of vitamin B1?
Alcohol Tea (tannins) Coffee Oral contraceptive pill Stress Antacids
49
What can a deficiency in B1 lead to?
Beriberi is the primary disease. Rare in the west. Alcoholics can develop cerebral beriberi.
50
What symptoms can develop with B1 deficiency?
Depression Irritability Fatigue Memory loss Muscle weakness and cramps GIT disturbance.
51
Can B1 be toxic?
Very rare as water soluble so excreted easily. Only really from high supplementation (i.e. 5g daily)
52
What's the real name for B2?
Riboflavin
53
List 5 foods high in B2
Yeast extract Spinach Wild salmon Mushrooms Almonds Quinoa Lentils Kidney beans Organic eggs Meat
54
Outline the 3 main functions B2 plays in the body
Energy (ATP) production - metabolism of carbs, fats and proteins Liver detoxification - via CYP450 enzymes Iron metabolism
55
What can impair the bioavailability of B2 in the body?
Copper Zinc Caffeine Chocolate
56
What dose might you prescribe for B2 supplementation?
90-400 mg per day
57
What are the signs and symptoms of poor intake of B2?
Sores in the corner of the mouth Red, dry tongue Scaly dermatitis Fatigue Poor concentration Depression
58
What's the real name for B3?
Niacin
59
What amino acid can B3 be synthesised from within the body?
Tryptophan
60
What are the two compounds of B3? And their active forms?
Nicotinic acid & Nicotinamide Into NAD & NADP which are energy-carrying modules.
61
List 5 foods high in vitamin B3
Mushrooms Green leafy vegetables Yeast extract Sunflower seeds Salmon Sardines Peanuts Avocado Meat and poultry
62
Outline the 3 main functions B3 plays in the body
Energy (ATP) production - NAD & NADP Cardiovascular - lowers secretion of LDL & vasodilates Insulin response
63
What are the signs and symptoms of severe and mild deficiencies?
Severe deficiency (called Pellegra) = the 4 D's Diarrhoea, dermatitis, dementia, then death Mild deficiency - Unrelenting fatigue, vomiting, depression, indigestion, red tongue
64
Discuss toxicity with B3
Adverse effects from high levels: Hypertension Hyperuricaemia Flush Hypothyroidism Do not mega dose Supplementation can also worsen gout
65
What's the real name for B5?
Pantothenic (meaning found everywhere)
66
B5 is found in a lot of foods. Name 5 sources that are particularly rich in it.
Shitake mushrooms Avocados Nuts Seeds Fish and meat
67
B5 plays a huge role across the body. Outline the 4 main functions.
ATP Production - metabolism of carbs and proteins. Required for Acetyl CoA Fat metabolism - synthesis and degradation of fatty acids Stress hormones - cofactor Anti-histamine properties
68
What can cause B5 deficiency? And what are the signs/symptoms?
Deficiency is rare. Depletion from high alcohol use, prolonged stress, and surgery. Symptoms = burning sensation in feet, fatigue, abdominal distress
69
What's the real name for vitamin B6?
Pyridoxine
70
List 5 food sources of vitamin B6
Whole grains Green vegetables Sunflower seeds Pistachios Walnuts Bananas Lentils Avocados Meat & fish
71
Outline 4 key functions B6 plays in the body
Neurotransmitter production (GABA, serotonin, dopamine, noradrenaline) Red blood cell formation - heam production Methylation which lowers homocysteine Energy production - amino acid metabolism
72
What can increase the demand of B6 in the body?
Alcohol dependence Long periods of high stress Pregnancy (particularly the 3rd trimester)
73
What are the symptoms of B6 deficiency?
(Deficiency is rare) Skin lesions and dermatitis Tongue inflammation Recurrent mouth ulcers Hormonal imbalances Anaemia Depression
74
What drug interactions are there for B6?
Lots of drugs deplete B6: Parkinsons medication Anticoagulants Antibiotics Alcohol Chemotherapy Oral contraceptive pill
75
What levels of supplementation can lead to toxicity of B6?
Long-term supplementation of 100-200 mg/day
76
What is the name used for B7 & B8?
Biotin
77
What specific food prevents biotin absorption and why?
Raw egg whites contain a protein called avidin, which joins with biotin making it unabsorbable.
78
List 5 foods high in biotin
Egg yolks Yeast Whole grains Cauliflower Sweet potator Nuts Meat Oily fish Liver
79
Outline the 2 main functions biotin plays in the body
Gene regulation, particularly rapidly regenerating tissues (skin, hair nails) Blood sugar regulation
80
What are the symptoms of biotin deficiency?
Dermatitis Dry scaly flaky skin Smooth pale tongue Hair thinking and loss Depigmentation
81
What is the active form of B9 (folate)?
THF - tetrahydrofolate
82
List 5 foods high in folate
Leafy greens Asparagus Avocado Brussels sprouts Legumes Citrus fruit (especially oranges) Liver
83
What occurs in the body to affect the bioavailability of B9?
Absorption requires adequate pancreatic enzymes. After absorption, a methyl group (-CH3) is added to folate to then be delivered to body cells. A B12 enzyme is required to remove the methyl group. Without it, folate becomes trapped inside the cells, unable to perform its functions.
84
What adverse effects can occur from B9 supplementation?
Folic acid (the synthesised version of folate) is 1.7x more available than dietary folate. It is less regulated and so absorption is uncontrolled. Can cause nausea
85
Outline 3 main functions of B9 in the body.
Cardiovascular health through the methylation of homocysteines. Formation of red blood cells Embryo health - development of neural tube
86
What are the key signs and symptoms of B9 deficiency?
Affects rapidly dividing cells - Skin and digestive issues Megoblastic anaemia
87
What factors are related to B9 deficiency?
Alcoholism Oral contraceptive pill Diuretics Aspirin GIT disorders Diets low in green veg Old age
88
What dose of B9 supplementation is recommended both pre and post conception?
600 mcg / day
89
What safety considerations are there with B9 supplementation?
Folic acid supplements mask the megaloblastic anaemia of B12 deficiency. Folic acid have the most drug interactions of all vitamins - check rigorously.
90
What is the real name for B12?
Cobalamin
91
How is vitamin B12 synthesised?
It's synthesised by bacteria. B12 is found in animal-based foods originates from their ingestion of bacterial-contaminated feed.
92
List 3 vegan B12 food sources and animal sources.
Vegan: Nutritional yeast Nori and kombu sea vegetables Shitake and Lion's mane mushrooms Animal: Meat Liver Milk Cottage and feta cheese Organic eggs Fish
93
Outline 4 key functions B12 plays in the body.
Nervous system - myelin production and neurotransmitter production Red blood cell production Methylation - homocysteine cycle Energy production from fats and proteins.
94
List some causes of B12 deficiency
Lack of dietary B12 intake Stomach problems (lack of intrinsic factor) Low pancreatic enzymes High alcohol
95
What is pernicious anaemia?
Most common cause of B12 deficiency from malabsorption due to inadequate intrinsic factor. It's associated with an immune attach on parietal cells in the stomach.
96
What signs and symptoms can be found with B12 deficiency?
Megaloblastic anaemia - fatigue, breathlessness, pallor Neurological abnormalities - tingling, numbness, loss of balance
97
What serum levels should you find when testing someone's B12 levels?
Normal range is big - 110 nh/L to 900 ng/L Can show signs of deficiency though when in normal range.
98
What is vitamin C also referred to as?
Ascorbic acid
99
List 5 food sources high in vitamin C
All fresh, raw fruit and vegetables but particularly: Red peppers Kiwi fruit Papaya Currants Berries Citrus fruit Crucifers Mangos Tomatoes
100
What can affect the absorption of vitamin C?
High blood glucose (as transported into cells by glucose transporters) Smoking Stress Fever/viral illness Alchohol Heavy metals
101
Outline 5 key features vitamin C plays in the body
Antioxidant and immune boosting - protecting against free radicals and recycles other antioxidants. Cholesterol lowering Enhances iron absorption by 65% Synthesises steroid hormones Cofactor in collagen synthesis Cofactor in serotonin production Energy production - transports long-chain fatty acids
102
What are the 2 most notable signs of vitamin C deficiency?
Bleeding gums around the teeth Pinpoint haemorrhages
103
How will subclinical deficiency in Vitamin C present?
Susceptible to infections Poor wound healing Fatigue Skin and gum degeneration
104
What dosages should you consider when prescribing vitamin C supplements?
500 mg/day normally Higher dose for cancer support 250mg - 1000mg can reduce colds by 50% Avoid high doses in 3rd trimester of pregnancy as baby becomes accustomed to it.
105
Can vitamin C become toxic?
No, as it is excreted easily. Too much can cause diarrhoea.

CNM Naturopathic Nutrition 1 (8 decks)

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