Vitamin B12

Neutrophils

NADPH oxidase

Calcium will go up, phosphorus will go down

Moans and groans (severe abdominal pain)

Obesity

Intracellular calcium is needed for all muscle contraction, while smooth muscle uses extracellular calcium for second messenger systems.

The atrium and thalamus are the only membranes that use calcium to depolarize.

Babies in utero need calcium for the release of neurotransmitters. If not, they may be born with mental retardation.

Magnesium is a cofactor for all kinases, which make and use negatively charged ATP. It also interacts with potassium in the early distal convoluted tubules of the kidneys.

Zinc deficiency may lead to dysgeusia and can affect the hair, skin, sperm, and taste buds.

The recommended INR range for patients taking Warfarin is 2 to 3 times the normal value.

Warfarin should be given for 3 months for a first-time venous clot with a known cause.

The most common cause of genetic spontaneous venous clot formation is Factor V Leiden Mutation.

Heparin is administered before Warfarin because it activates antithrombin III, providing immediate protection against clot formation while Warfarin takes time to block Factor VII.

The side effects of Heparin include bleeding, hyperlipidemia, and Heparin-induced thrombocytopenia (HIT).

Vitamin B12 is needed by two enzymes: Homocysteine methyltransferase and Methyl malonyl-CoA mutase. It is also used to recycle odd-numbered carbon fatty acids and to make tetrahydrofolate.

Symptoms of Vitamin B12 deficiency include megaloblastic anemia, hyper segmented neutrophils, and neuropathy, especially involving the dorsal column pathways and corticospinal tracts.

The most common cause of Vitamin B12 deficiency in the US is pernicious anemia, which is a type of gastritis.

Vitamin C is used for hydroxylation and is the main antioxidant in the GI system.

Symptoms of Vitamin C deficiency include scurvy and bleeding from hair follicles and gums.

Riboflavin is used in cofactors, like FAD, and is best sourced from milk.

Niacin deficiency can cause pellagra, which is characterized by diarrhea, dermatitis, dementia, and death.

Niacin is necessary for cofactors like NAD, NADH, NADP, and NADPH, and is needed by enzymes such as pyruvate dehydrogenase, alpha-ketoglutarate dehydrogenase, and branched chain amino acid dehydrogenase.

The most effective treatment for acute gout is colchicine, which blocks microtubules. Indomethacin is also commonly used.

Pyridoxine deficiency can cause neuropathy. Chronic neuropathy/pain can be managed with amitriptyline (a TCA) or gabapentin, depending on the presence of heart disease.

To help create energy (through all the pathways). If the vitamin, mineral or trace element is missing, it will lead to a low energy state.

Vitamin A is a cofactor for parathyroid hormone function. It stimulates osteoclastic activity (calcium increases, phosphorus decreases). Whenever PTH is involved, serum calcium and phosphorus will go in opposite directions. Calcium and the hormone always go in the same direction (except in pseudo). If the calcium and phosphorus go in the same direction, the problem is a vitamin D issue. It is also used for cerebrospinal fluid (CSF) production and epithelial cell maturation (anywhere), especially hair, skin, and eyes. Its most unique function is night vision. It also acts as a mild antioxidant.

Vitamin A is used for the maturity of cells in conditions such as measles (regeneration of epithelium of the lung), cancer (T15/17), infections that destroy cells, and burn patients.

Antioxidants eat up free radicals, which are made of oxygen and are high energy molecules. Free radicals can pierce the cell membrane, nuclear membrane, and DNA, causing cells to either die or mutate. If cells mutate, they may cause cancer. For example, cancer can occur after radiation therapy due to free radical production.

Virus