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470 Vitamins

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Vitamin A
- retinoids, beta-carotene
- Dim light vision, regulation of gene expression, immune cell differentiation
- Sources: liver, dairy, green/orange/yellow veggies
- Bile salts help absorb
- Transport in chylomicra via lymph
- Binds RBP
- Prophylactic vaccine in developing countries
- Oral contraceptives increase RBP synthesis






Vitamin E
- Antioxidant, inhibits platelet aggregation, vasodilation
- mobilized slowly from adipocytes
- deficiency: erythrocyte instability (hemolytic anemia in preemies)
- Used for CV disease, intermittent claudication
- Exacerbate K deficiency, anticoagulants



Vitamin D
- maintain blood Ca++, phosphate; differentiation; immunity
- fortification, few natural sources
- calcitriol joins VDR, binds RXR, binds VDRE
- deficiency: rickets, osetomalacia




Hormone replacement
- Increased risk of breast & uterine cancer and CV disease
Raloxifene
- Agonist & antagonist effects depending on location
- Less activity at ERs in breast -- less BC risk
Bisphosphonates
- Etidronate & alendronate
- Antiresorptive
- Inhibit osteoclast recruitment/differentiation by blocking H2 pump
- N-containing inhibit prenylation
- Intermittent





Teriparatide
- Synthetic PTH
- Intermittent
- Anabolic therapy
- Increased resorption but also increases absorption, decreases secretion


Vitamin K
- Clotting factor
- Deficiency: increased prothrombin time
- Limited storage

Vitamin C
- ascorbic acid
- detoxifying, decreased free radicals, more immunity
- saturable active transport
- used in TB, peptic ulcer, tyrosinemia
- Rebound effects with large doses
- Inhibit anticoagulants




Riboflavin
- B2
- FAD, FMN component
- Destroyed by light
- Antioxidant, B vitamin metabolism
- Bright yellow urine



Vitamin B6
- Many enzymes, including RBC formation & function, niacin formation, nucleic acid synthesis
- glycosylated form from plants -- less available
- Prevent neuritis, morning sickness, sickle cell anemia, asthma, carpal tunnel

Pantothenic acid
- B5
- acetyl-coA component
- intestinal bacteria

Biotin
- enzyme co-factor
- deficiency w/ prolonged biotin-free IV feeding, lots of raw egg whites
B12
- cobalamin (Co-containing)
- methionine synthetase cofactor -- hemoglobin synthesis, folate regulation
- Stomach acid frees B12 from food to bind intrinsic factor (IF)
- Deficiency: due to pernicious anemia, causes megaloblastic anemia


Folate
- Nucleotide synthesis, DNA & homocysteine methylation
- Leafy greens, mushrooms, liver
- Cleaved before absorption (active transport in intestine)
- Deficiency: megaloblastic anemia, caused by malabsorption
- prevent neural tube defects



Iron absorption
- iron turnover, diet

Megaloblastic/pernicious anemia
- blocked DNA synthesis
- causes: auto-Abs, bowel disease, pancreatitis, drug interactions, poor diet, surgical resection
- given parenterally
- Nerve demyelination -- B12 deficiency only


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