Vitamins Table PDF

**Vitamin** **Precursor to** **RDA/AI: /UL:** **Clinical name of deficiency** **Symptoms** **Best dietary source** **Example enzyme** **Increased requirement** **Notes** **Water Soluble: most B are absorbed in SI-jejunum : B12 in terminal Ileum** Vit B1 (Thiamine) Coenzyme Thiamine pyroph...

**Vitamin** **Precursor to** **RDA/AI: /UL:** **Clinical name of deficiency** **Symptoms** **Best dietary source** **Example enzyme** **Increased requirement** **Notes** **Water Soluble: most B are absorbed in SI-jejunum : B12 in terminal Ileum** Vit B1 (Thiamine) Coenzyme Thiamine pyrophosphate 1.1-1.2 mg (No UL) Beri-Beri: dry,wet,cerebral ( Wernicke and Korsakoff), Gastrointestinal Dry: Peripheral neuropathy Wet (cardiac): rapid heart rate, enlarged heart, edema, difficulty breathing, CHF Cerebral: May lead to Wernicke encephalopathy: Abnormal eye movements, stance and gait abnormalities, abnormalities in mental function and Korsakoff psychosis- confabulation, memory loss and gait abnormalities Gastrointestinal : lactic acidosis from PDH inhibition associated with nausea, vomiting, severe abdominal pain whole grains, pork, legumes, seeds, nuts transketolase, PDH, α-KGDH Biological half life 10-20 days, deficiency signs develop rapidly during depletion. Thiaminases in food can worsen deficiency heavy alcohol intake is main cause of thiamine deficiency- causes megaloblastic anemia **TREAT WITH BOLUS OF THIAMINE BEFORE GIVING GLUCOSE, THEN ORAL THIAMINE SUPPLEMENTATION as follow** Vit B2 Riboflavin redox coenzymes FAD, FMN 1.1-1.3 mg (no UL) Ariboflavinosis (rare) Sore throat, **cracked lips, red lips, inflamed tongue, seborrheic dermatitis,** Normochromatic, normocytic anemia, **corneal vascularization,** dermatitis, glossitis, cheilosis, anemia, erythroid, hypoplasia dairy products, eggs, meat/fish, green vegetables succinate dehydrogenase, MCAD, MTHFR pregnancy (prevent preeclampsia), migraine yellow color, fluorescent, destroyed by light exposure. need for metabolize carbs, fats and protein Vit B3 -- Niacin to coenzymes NADH/NADPH (\> 400 enzymes) 14-16 mg; UL 35 mg (skin flushing) Pellagra Can cause INH therapy (tuberculosis), Hartnup disease, carcinoid syndrome Excess use: facial flushing Black tongue disease GI: diarrhea, vomiting, abdominal pain Neurologic: headache, apathy, fatigue, depression, disorientation and memory loss **3Ds: diarrhea, dermatitis, dementia/delirium** **4^th^ D is Dead** Hartnup disease: absence of AA transport in PT (loss tryptophan in urine Carcinoid syndrome: caused by GI tumors that secretes serotonin: diarrhea flushing, cardiac valve disease: alter trp metabolism meat, whole grains, legumes, seeds lactate dehydrogenase, malate dehydrogenase Pharmacological use for [nicotinic acid]: lipid lowering, HDL raising Niacin is synthesized by tryptophan which needs B6 multiple vitamers- nicotinic acid, nicotinamide, nicotinamide riboside; medications (e.g. isoniazid) can interfere with niacin synthesis NAD plays a redox role and a nonredox role. Non redox; act as a substrate for NAD+-dependent histone deacetylases (sirtuins) and the poly(ADP-ribose)polymerases (PARPs). NAD+ is also the substrate for ADP-ribosylation by both human sirtuins and bacterial toxins such as the cholera toxin. Populations at risk: dialysis patient, cancer patients, chronic alcoholics, HIV patients, homeless, anorexia nervosa patients, consumers of diets high in corn and low in animal proteins, patients treated with isoniazid Vit B5- Pantothenic Acid Coenzyme A and 4'-phosphopantetheine arm of acyl-carrier protein and similar proteins AI 5 mg (no UL set) none, rarely seen in humans. In animals, B5 deficiencies are known to cause adrenal failure and "burning feet syndrome" wide distribution in foods all coenzyme A utilizing enzymes Same transporter as biotin and lipoic acid some gut bacteria may synthesize pantothenic acid Vit B6- plant Pyridoxine/animal:pyridoxal, pyridoxamine coenzyme pyridoxal phosphate: need for Aminotransferase reaction, neurotransmitter synthesis, Homecyctine to cystathionine ( ctstathionine synthase need it, histadine to histamine ( histidine decarboxylase need it), glycogen phosphorylase need B6, need trp to niacin conversion, synthesis of gamma aminolaevulinic acid ALA ( sideroblastic anemia) RDA 1.3 mg; UL 100 mg (LPI recommends 2 mg) De facto B6 deficiency by using Isoniazid ( inhibitor of B6 action)- need to supplement with B6. Deficiency is rare- Long term supplementation with very high dose ( \ 50 yrs take 100-400 ug/day of supplemental vitamin B12) pernicious anemia (intrinsic factor def) Deficiency- due to malabsorption due to atrophic gastric or weak acid stomach Deficiency: Leads to nerve damage ( peripheral neuropathy), Megaloblastic anemia, Inflammation of tongue ( atrophic glossitis) Eventually severe nerve damage and dementia steamed clams and mussels, animal products Deficiency is treated with IM injections or nasl spray; mild deficiency can be treated with high dose oral B12. methionine synthase, methylmalonyl-CoA mutase vegans, GI surgery Stored in liver, total body stores \>2500 ug, daily turnover slow B12 is light sensitive Vit C- Ascorbic acid- oxidize form transported via GLUT1 and GLUT3; reduced form: transported by SVCT1 and SVCT2 Reduced form acts directly as redox coenzyme and antioxidant RDA 75-90 mg; UL 2000 mg (minor GI issues) Scurvy No ascorbate -- weak collagen (use Vit C serum if you want to keep your youth) Deficiency: serous concentration of less that 11.4uM. Excessive intake -- increase oxalate levels Crokscrew hairs, perifollicular hemorrhage, gingival bleeding. poor wound healing loose teeth, joint pain, altered bone formation, listessenss, general malaise, periungual hemorrhage- bleeding under or around nails Excessive intake - GI problems , headaches, insomnia citrus fruits, strawberries, peppers, broccoli prolyl hydroxylase, dopamine beta-hydroxylase malnutrition, malabsorption, kidney disease, and smokers 80% tissue saturation at 200 mg (LPI recommendation: 400 mg) Neurons have 10mM of ascorbate (highest) Heat destroys ascorbate. Choline ( not a vitamin) not a coenzyme or vitamin, but is a vitamin-like essential nutrient AI 425-550 mg; UL 3,500 mg Deficiency: vegans may be in risk HIGH DOSES Impaired VLDL secretion and accumulation of fat in the liver (steatosis), leads to liver damage (NAFLD). Young infants may suffer growth retardation and suboptimal cognitive development High doses: FISHY ODOR, VOMITING, SALIVATION, INCREASED SWEATING, and MILD hypotension eggs, meat, cruciferous vegetables, peanuts, dairy products acetylcholine, phosphatidylcholine, sphingomyelin, betaine (oxidized choline). pregnancy essential for optimal brain development and influences cognitive function in later life. However, it is absent from most prenatal vitamins and \>90% of expectant mothers consume less than the RDA. Vit c facilitates uptake of Dietary (nonheme) iron by reducing ferric to ferrous iron **Lipid Soluble** Vit A -- Retinol Beta-carotene precursor to retinol, which is then precursor to retinal (vision cofactor) and retinoic acid (hormone) RDA 700-900 retinol activity equivalents (RAE); UL 3000 RAE 1 IU of retinol is equivalent to 0.3 RAE Night blindness deficiency toxicity (hypervitaminosis A) Night blindness: impaired dark adaptation, thickening of conjunctiva (bitot spots), xerophthalmia ( dry eyes) , eventually corneal ulcers, scarring and blindness, also prone to infectious disease, follicular hyperkeratosis Retinol: liver and fish oils beta-carotene: orange and green vegetables, such as sweet potato and spinach a child eating less than a bottle of children flavored vitamins can have life-threatening toxicity. Vit D- Cholecalciferol precursor to calcitriol, the most active form of Vit D RDA 600-800 IU; UL 4000 IU (LPI recommends 2000 IU) rickets (children)/osteomalacia (adults) poor bone, teeth, and cartilage formation Marked genu varum, decrease bone opacity, poor bone mineralization , beaded ribs, rachitic rosary fatty fish and fish liver oils renal 25-hydroxyvitamin D3-1α-hydroxylase enzyme (CYP27B1) autoimmune disorders, elderly made from cholesterol Vit E- Tocopherols RDA 15 mg; UL 1,000 mg (possible bleeding) Deficiency- Human deficiency result from genetic abnormalities in a tocopherol transfer protein (a TTP) or in lipoprotein synthesis -- also associate with a characteristic syndrome, ataxia with vitamin E deficiency, AVED Failure to placentation, neuromuscular impairments, hemolytic anemia, retinopathy, reduced immunity, and enhanced inflammation. vegetable oils, nuts and seeds, and green/leafy vegetables Eight structural forms of vitamin E but body prefers alpha-tocopherol Primary function is as a lipid-soluble antioxidant to protect membrane lipids and lipoprotein particles, esp LDL, from ROS Oxygen use in preterm infants -- eye problems due to oxidative stress lessened by vit E. Vit K- Phylloquinones- need for blood clotting, skeletal formation and prevention of soft tissue and vascular calcification for gamma-glutamylcarboxylase (GGCX) AI 90-120 ug (no UL) Deficiency- causes : Biliary tract disease interfering with enterohepatic circulation, leading decreased absorption of vit Antibiotic intakes , poor nutritional status : malabsorption, chronic disease or poor oral intake un patients who are acutely ill green leafy vegetables, animal livers, fermented foods Reduced GGCX activity may contribute to bone mineralization defects and abnormal soft tissue calcification synthesized by human intestinal microbiota, stored in very small amounts that are rapidly depleted **Minerals** Iodine Use in Thyroid hormone RDA 150 ug Iodine deficiency ID: common cause of preventable brain damage in the world Hypothyroidism goiter Graves disease: autoimmune disorder stimulating growth of thyroid gland and excess secretion of T3 and T4 ( hyperthyroidism ) Hashimoto thyroiditis - autoimmune disorder where antibodies against thyroid peroxidase or thyroglobulin cause thyroid failure (primary hypothyroidism) ; labs: Elevated TSH, low T4, low T3 Thyroid autoantibodies Learning disabilities, developmental abnormalities (myelination of CNS before and shortly after birth ) ID: leads to low T3 production, which leads to high TSH, which promotes glandular tissue growth to form a goiter Graves disease; Consistent with thyrotoxicosis: fatigue; warm, moist skin; palpitations; dyspnea on exertion; heat intolerance; weight loss; restlessness, irritability, anxiety Hashimoto T: Fatigue; constipation; cold, dry skin; weight gain; cold intolerance; depression, dementia; hair loss; thickened, brittle nails; slow speech Iodized salt Treat Graves with : correcting high thyroid hormone levels with antithyroid medications or radioactive iodine (most common) or surgery, followed by thyroid hormone replacement Magnesium RAD 320-420; 350mg UL Can have deficiency loss of appetite, nausea, vomiting, fatigue, weakness, tingling, muscle contractions, cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms. Too much: diarrhea, nausea, abdominal cramping green leafy vegetables, legumes, beans, seeds and nuts Very abundant element in both solid compound and dissolved form. Always in divalent form and interacts with polyphosphates, eg Mg-ATP. Risk of deficiency from GI, renal, and endocrine disorders Adult humans have 22-26 g Mg, 60% in skeleton, 39% intracellular, and 1% extracellular (\~1 mM). Mg commonly used to treat pre-eclampsia and restless leg syndrome. Manganese Not a precursor but need it for activities of glutamine synthetase in astrocytes, arginase, and Mn-SOD. RDA 1.8-2.3 mg; UL 11 mg Can have deficiency skeletal deformation and inhibits production of collagen in wound healing. Manganese overexposure in factories is associated with manganism, a rare neurological disorder. Manganese has several oxidation states but the most stable is +2 Manganese important in macronutrient metabolism, bone formation and free radical defense systems. Mn+2 can compete with Mg+2 and is also very similar to Ca+2 and Zn+2. High intake of other minerals can inhibit Mn intake. Zinc RDA 8-11 mg; UL 40 mg Deficiency Acrodermatitis enteropathy (AE) is a disorder of zinc absorption caused by mutations in the SLC39A4 gene. Too much: (nausea, vomiting) Deficiency: growth retardation, loss of appetite, impaired immune function AE: The lack of zinc can cause skin inflammation with a rash (pustular dermatitis) around the mouth and/or anus; diarrhea; and abnormal nails (nail dystrophy). Irritability and emotional disturbances can also occur. Oral zinc therapy is indicated. is high in animal products (red meats, shellfish). Zinc is a component of many proteins. It is particularly important in immune health and wound healing. Dietary zinc deficiency is common in the developing world where main food source is grains or legumes. Phytic acid (IP6), high in seeds and nuts, impairs absorption of iron and zinc. High intake of zinc can compete with copper for absorption, and will induce metallothionine in intestinal cells. Zinc supplementation is used to treat Wilson's disease and age-related macular degeneration. Molybdenum Molybdenum is a part of molybdopterin, a redox cofactor synthesized from GTP and required for function of xanthine oxidase, sulfite oxidase, aldehyde oxidase and mitochondrial amidoxime reducing component (mARC). These metabolize sulfur-containing amino acids, purines, and xenobiotics. RDA 45 mcg; UL 2,000 mcg Genetic defects in formation of molybdopterin impairs sulfite metabolism and causes sulfite buildup leading to encephalopathy and seizures; usually fatal within days of birth legumes (black eyed peas), liver Molybdenum found in two valence forms, +4 and +6. Only Group V transition metal known to be essential. Can treat Wilson's disease with tetrathiomolybdate (Coprexa)- complexes with copper and facilitates elimination Selenium Involve in reproduction, thyroid hormone metabolism, DNA synthesis, and protection from oxidative damage/stress and infection RDA 55 mcg; UL 400 Deficiency Too much increase susceptibility to some illnesses, male infertility, exacerbate iodine deficiency (deiodinase) too much : neuropathy Brazil nuts (very high, can overdose), green vegetables, mushrooms, fish glutathione peroxidase and two dozen other selenoproteins Selenium exists in two forms: inorganic (selenate and selenite) and organic (selenomethionine and selenocysteine) RDA: Recommended dietary allowance AI: Adequate intake UL: Tolerable upper intake level