MD140 Vitamins & Minerals Lecture Notes (7 Feb 2024) PDF

MD140 Vitamins & Minerals th 7 Feb 2024 Today Vitamins and minerals 1. General introduction (Folder 1) 2. Vitamins (Folder 2) 2.1 General introduction to Vitamins 2.2 Fat soluble vitamins: A, D, E & K 2.3 Water soluble Vitamins : B family & C - Overview 3. Minerals (Folder 3) 3.1 General introductio...

MD140 Vitamins & Minerals th 7 Feb 2024 Today Vitamins and minerals 1. General introduction (Folder 1) 2. Vitamins (Folder 2) 2.1 General introduction to Vitamins 2.2 Fat soluble vitamins: A, D, E & K 2.3 Water soluble Vitamins : B family & C - Overview 3. Minerals (Folder 3) 3.1 General introduction 3.2 Major minerals 3.3 Trace and ultra-trace minerals yesterday Q13 What applies to Vitamin K? 1. plays an essential role in preventing thrombosis. 2. increases the coagulation time in newborn infants with hemorrhagic disease. 3. is present in high concentration in cow or breast milk. 4. is synthesized by intestinal bacteria. 5. is a water-soluble vitamin. Vevox Q13 What applies to Vitamin K? 1. plays an essential role in preventing thrombosis. It stimulates coagulation 2. increases the coagulation time in new-born infants with hemorrhagic disease. it increases coagulation, so DECREASES coagulation time 3. is present in high concentration in cow or breast milk. 4. is synthesized by intestinal bacteria 5. is a water-soluble vitamin. Human milk only contains 1/5 of daily requirement of newborn Vitamin K deficiency bleeding (VKDB) See Parent information sheet from Cavan Hospital 1mg Vit K Intramuscular injection to newborn as recommended National Institute for Health and Clinical Excellence. (2006) Routine postnatal care of women and their babies. NICE: London. https://www.hse.ie/eng/services/list/3/acutehospitals/hospitals/cavanmonaghan/vitamin-k.pdf Case study A 42-year-old woman presents with tiredness and lethargy. She has tingling in her hands and feet. Blood work shows a macrocytic anemia, along with elevated homocysteine levels. What deficiency can explain these symptoms? 1. 2. 3. 4. 5. Thiamine - Vitamin B1 Niacin - Vitamin B3 Folate – Vitamin B9 Cobalamine – Vitamin B12 Ascorbic Acid – Vitamin C Vevox Case study A 42-year-old woman presents with tiredness and lethargy. She has tingling in her hands and feet. Blood work shows a macrocytic anemia, along with elevated homocysteine levels. What deficiency can explain these symptoms? 1. 2. 3. 4. 5. Thiamine - Vitamin B1 Niacin - Vitamin B3 Folate – Vitamin B9 Cobalamine – Vitamin B12 Ascorbic Acid – Vitamin C Case study answer Deficiency in B9 and B12 Elevated homocysteine level: B12 is needed for folate cycle involved in this pathway Macrocytic/ megalocytic anemia: Due to defect in Nucleic acid synthesis (lack of Purines and pyrimidine) Neurological symptoms (tingling in her hands and feet): specific for B12, abnormal Fatty acid synthesis (nervous system cell mb) Question: Does Folic Acid supplementation prevent cleft palate? Cleft lip or cleft palate: craniofacial malformations due to perturbation of the growth, approach and fusion of the frontonasal and maxillary facial tissues Either due to genetic syndrome or complex multifactorial genetics & environmental cause Lip & Palate close between week 4 and week 8 of embryonic dvpt 47% risk reduction with periconceptional intake of folic acid supplements - van Rooij et al, 2004 References Martinelli et al. Non-syndromic Cleft Palate: An Overview on Human Genetic and Environmental Risk Factors. Frontierss In Cells & developmental biology 2020. https://www.frontiersin.org/articles/10.3389 /fcell.2020.592271/full van Rooij et al, Periconceptional folate intake by supplement and food reduces the risk of nonsyndromic cleft lip with or without cleft palate. Preventive medicine. 2004 https://www.sciencedirect.com/science/artic le/pii/S0091743504001215 2.3 Water soluble Vitamins Videos 231, 232 Energy Releasing B vitamins & Vit C A. Hematopoietic Folic Acid (B9) Vit B12 B. Energy Releasing Vit B1: Thiamin Vit B2: Riboflavin Vit B3: Niacin Vit B7: Biotin Vit B5: Panthotenic Acid C. Other 231 – Vitamin B energy releasing complex Vitamins Vit B6 family: Pyridoxine, Pyridoxal, Pyridoxamine Summary table of Energy Releasing B vitamins & Vit C Name Vit B1 Thiamin Function Co-enzyme for several multienzyme complexes Disease due to deficiency Wernicke’s encephalopathy Beriberi Symptoms Vit B2 Riboflavin (FAD/FMN) Component of flavin coenzymes : electron carriers glossitis/magenta tongue Vit B3 Niacin (NAD/NDAP) Vit B7 Biotin Vit B5 Panthotenic acid Vit B6 Vit C Nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). Electron carrier reactions. Glossitis Pellagra Mental confusion, ataxia (inability to fine-control of motor function), ophtalmoplegia (loss of eye co-ordination) Lesions of the margin of the lips (cheilosis) and corners of the mouth (angular stomatitis) Inflammation of the tongue Inflammatory skin condition that causes flaky, white to yellowish scales to form on oily areas such as the scalp or inside the ear Lower metabolic rate Inflammation of the tongue Dermatitis progressed in Sun burn like lesions in area exposed to sunlight, Diarhea and Dementia Food sources Meat, Oatmeal, breakfast cereals, wheat and fortified white flour, milk, eggs, vegetables Offal, eggs, milk, cheese, yeast extracts, dark green leafy vegetables (eg broccoli, asparagus, spinach) Meat, Grains, vegetables Co-enzyme involved in carboxylation in lipogenesis, gluconeogenesis, catabolism of AA rare Dermatitis, glossitis, loss of appetite and nausea Widely available in food and intestinal flora supply Component of Co-enzyme A No deficiency characterised and no RDA established n/a Rare as stored in muscles n/a Meat, fish, and poultry, potatoes, vegetables, and fruits Weakening of connective tissue: loose teeth, bleeding gums Delayed healing of wounds due to limited formation of collagen-rich scar tissue Bruising and haemorrhaging as the vascular system weaken Susceptibility to infection Incomplete iron absorption Citrus, soft fruits, tomatoes and pepper Co-enzyme required for transamination reactions Antioxidant Cofactor for a number of hydroxylation reactions scurvy Synthetised by intestinal flora widely available (egg, liver and yeast) Case study: A malnourished patient presents the following symptoms: fatigue, depression, irritability, appetite loss, headaches, numbness, confusion, soreness of tongue and mouth and dermatitis, looking like severe sunburn. Which vitamin is likely to be deficient? 1. 2. 3. 4. 5. Thiamine - Vitamin B1 Niacin - Vitamin B3 Folate – Vitamin B9 Cobalamine – Vitamin B12 Ascorbic Acid – Vitamin C Vevox Case study: A malnourished patient presents the following symptoms: fatigue, depression, irritability, appetite loss, headaches, numbness, confusion, soreness of tongue and mouth and dermatitis, looking like severe sunburn. Which vitamin is likely to be deficient? 1. 2. 3. 4. 5. Thiamine - Vitamin B1 Niacin - Vitamin B3 Folate – Vitamin B9 Cobalamine – Vitamin B12 Ascorbic Acid – Vitamin C Vitamin B3 – Niacin 1. Active form: nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP). Electron carrier reactions. 2. Deficiency: Diet or disease preventing absorption Glossitis Pellagra: 3Ds Dermatitis progressed in Sun burn like lesions in area exposed to sunlight, Diarrhea and Dementia MD140 Minerals Video lectures on Bb Inorganic elements Macro minerals needed >100 mg/day Ca, Cl, Mg, P, K, Na Micro minerals/Trace minerals Needed 1 to 100 mg/day Cr, Cu, F, Fe, Mn, Zn What Are Minerals? Ultra Trace microminerals 2000ug/L or >200ng/mL (ref interval 14-200ugL; 14-200ng/mL) and fasting transferrin saturation of 93% (2000ug/L or >200ng/mL (ref interval 14-200ugL; 14-200ng/mL) and fasting transferrin saturation of 93% (