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Month: March 2014

Vitamin’s Physical State And Solubility are Two Different Things.

March 29, 2014 6:11 pm

One of the most common misconceptions regarding vitamins is that its physical shape and state (liquid versus solid) defines its solubility.  Water-soluble vitamins may be found in dry powder form (solid) or may be a form of liquid.  Fat-soluble vitamins may also be found in both solid and liquid form.  It is important to appreciate that one cannot assume that if a fat soluble vitamin is in liquid form in a gel cap it will be absorbed.  What makes a fat-soluble vitamin absorbable is not its liquid, physical state, but rather it’s molecular structure, which makes it possible to be absorbed.  When purchasing vitamins that are fat-soluble, labels such as “dry”, “water-soluble” are indications that it is water-soluble more important than its shape, size or the nature of the vitamin itself.
A liquid form of vitamin A and D may be less soluble than a dry powder form.  This is because it dry powder form may be chemically structured so that it is soluble in water versus a liquid form that is not.  An analogy will be the mixing of olive oil (liquid) with vinegar (liquid).  Olive oil will stay separated because it is not water-soluble even though it’s a liquid state.

Vitamins And Minerals

March 29, 2014 5:26 pm

Vitamins -Minerals
Function
Source
Problems with deficiency 
B1 (Thiamine)
Carbohydrate conversion, breaks down fats and protein, digestion, nervous system, skin, hair, eyes, mouth, liver, immune system
Pork, organ meats, whole grain and enriched cereals, brown rice, wheat germ, bran, brewer’s yeast, blackstrap molasses
Heart, age-related cognitive decline, Alzheimer’s, fatigue
B2 (Riboflavin)
Metabolism, carbohydrate conversion, breaks down fat and protein, digestion, nervous system, skin, hair, eyes, mouth, liver, antioxidant
Brewer’s yeast, almonds, organ meats, whole grains, wheat germ, mushrooms, soy, dairy, eggs, green vegetables
Anemia, decreased free radical protection, cataracts, poor thyroid function, B6 deficiency, fatigue, elevated homocysteine
B3 (Niacin)
Energy, digestion, nervous system, skin, hair, eyes, liver, eliminates toxins, sex/stress hormones, improves circulation
Beets, brewer’s yeast, meat, poultry, organ meats, fish, seeds, and nuts
Cracking, scaling skin, digestive problems, confusion, anxiety, fatigue
B5 (Pantothenate)
RBC production, sex and stress-related hormones, immune function, healthy digestion, helps use other vitamins
Meat, vegetables, whole grains, legumes, lentils, egg yolks, milk, sweet potatoes, seeds, nuts, wheat germ, salmon
Stress tolerance, wound healing, skin problems, fatigue
B6 (Pyridoxine)
Enzyme protein metabolism, RBC production, reduces homocysteine, nerve and muscle cells, DNA and RNA, B12 absorption, immune function
Poultry, tuna, salmon, shrimp, beef liver, lentils, soybeans, seeds, nuts, avocados, bananas, carrots, brown rice, bran, wheat germ, whole grain flour
Depression, sleep and skin problems, elevated homocysteine, increased heart disease risk
B12 (Cobalamin)
Healthy nerve cells, DNA/RNA, RBC production, iron function
Fish, meat, poultry, eggs, milk and milk products
Anemia, fatigue, constipation, loss of appetite, weight, numbness and tingling in the hands ad feet, depression, dementia, poor memory, oral soreness
Biotin
Carbs, fat, and amino acid metabolism (the building blocks of protein)
Salmon, meats, vegetables, grains, legumes, lentils, egg yolks, milk, sweet potatoes, seeds, nuts, wheat germ
Depression, nervous system, premature graying, hair, skin
Folate
Mental health, infant DNA/RNA, adolescence and pregnancy, with B12 to regulate RBC production, iron function, reduce homocysteine
Supplementation, fortified grains, tomato juice, green vegetables, black-eyed peas, lentils, beans
Anemia, immune function, fatigue, insomnia, hair, high homocysteine, heart disease
Eyes, immune function, skin, essential cell growth and development
Milk, eggs, liver, fortified cereals, orange or green vegetables and fruits
Night blindness, immune function, zinc deficiency, fat malabsorption
Calcium and phosphorus levels, calcium absorption, bone mineralization
Sunlight, milk, egg yolk, liver, fish
Osteoporosis, calcium absorption, thyroid
Vitamin E
Antioxidant, regulates oxidation reactions, stabilizes cell membrane, immune function, protects against cardiovascular disease, cataracts, macular degeneration
Wheat germ, liver, eggs, nuts, seeds, cold pressed vegetable oils, dark leafy greens, sweet potatoes, avocado, asparagus
Skin, hair, rupturing of red blood cells, anemia, bruising, PMS< hot flashes, eczema, psoriasis, cataracts, wound healing, muscle weakness, sterility
Calcium
Bones, teeth, helps heart, nerves, muscles, body systems work properly, needs other nutrients to function
Dairy, wheat/soy flour, molasses, brewer’s yeast, Brazil nuts, broccoli, cabbage, dark leafy greens, hazelnuts, oysters, sardines, canned salmon
Osteoporosis, osteomalacia, osteoarthritis, muscle cramps, irritability, acute anxiety, colon cancer risk
Chromium
Assists insulin function, increased fertility, carbohydrate/fat metabolism, essential for fetal growth/development
Supplementation, brewer’s yeast, whole grains, seafood, green beans, broccoli, prunes, nuts, potatoes, meat
Metabolic syndrome, insulin resistance decreased fertility
Magnesium
300 biochemical reactions, muscle/nerve function, heart rhythm, immune system, strong bones, regulates calcium, copper, zinc, potassium, vitamin D
Green vegetables, beans & peas, nuts and seeds, whole unprocessed grain
Appetite, nausea, vomiting, fatigue, numbness, tingling, cramps, seizures, personality changes, heart rhythm, heart spasms
Selenium
Antioxidant, works with vitamin E, immune function, prostaglandin production
Brewer’s yeast, wheat germ, liver, butter, cold water fish, shellfish, garlic, whole grains, sunflower seeds, Brazil nuts
Destruction to heart/pancreas, sore muscles, fragility of red blood cells, immune system
Zinc
Supports enzymes, immune system, wound healing, taste/smell, DNA synthesis, normal growth & development during pregnancy, childhood adolescence
Oysters, red meat, poultry, beans, nuts, seafood, whole grains, fortified breakfast cereals, and dairy
Growth retardation, hair loss, diarrhea, impotence, eye & skin lesions, loss of appetite, taste, weight loss, wound healing, mental lethargy
COQ10
Powerful antioxidant, stops oxidation of LDL cholesterol, energy production, important to heart, liver, and kidneys
Oily fish, organ meats, and whole grains
Congestive heart failure, high blood pressure, angina, mitral valve prolapsed, fatigue, gingivitis, immune system stroke, cardiac arrhythmias
Carnitine
Energy, heart function, oxidize amino acids for energy, metabolize ketones
Red meat, dairy, fish, poultry, (fermented soybeans), wheat, asparagus, avocados, peanut butter
Elevated cholesterol, liver function, muscle weakness, reduced energy, impaired glucose control
N-Acetyl Cystein (NAC) & Glutathione
Glutathione production, lowers homocysteine, lipoprotein, heal lungs, inflammation, decrease muscle fatigue, liver detoxification, immune function
Meats, ricotta, cottage cheese, yogurt, wheat germ, granola, and oat flakes
Free radical overload, elevated homocysteine, cancer risk, cataracts, macular degeneration, immune function, toxin elimination
Alpha Lipoic Acid
Energy, blood flow to nerves, glutathione levels in brain, insulin sensitivity, effectiveness of vitamins C, E, antioxidants
Supplementation, spinach, broccoli, beef, brewer’s yeast, some organ meats
Diabetic neuropathy, reduced muscle mass, atherosclerosis, Alzheimer’s, failure to thrive, brain atrophy, high lactic acid

What does elevated Alkaline Phosphatase level mean?

March 18, 2014 2:17 am

Alkaline phosphatase (ALP) is on enzyme that is produced mostly by the liver and bones.  There are other organs in an adult that produce alkaline phosphatase including the kidneys and the small bowel. Placental of a pregnant female also produces some alkaline phosphatase. The amount of alkaline phosphatase produced by the liver is more than the combined level of alkaline phosphatase by all other sources in an adult.

There are laboratory studies that can distinguish between 2 primary sources of the ALP.  The two “isoenzymes” are bone ALP and liver ALP.

The presence of an elevated level alkaline phosphatase is significant in post weight loss surgical patients because of its relationship to calcium and vitamin D absorption.  When a patient has inadequate calcium and vitamin D absorption (or intake) this will result in elevation of the parathyroid hormone (PTH).   Elevated level of parathyroid hormone will the cause, increased bone breakdown, increased absorption of calcium from the GI tract, increased resorption of the calcium from the kidneys.  All of these measures are to normalize the level of the calcium in the blood.  One of the byproducts of bone breakdown is alkaline phosphatase. 
When the patient has an elevated ALP consideration should be given to liver sources including biliary obstruction.  In post duodenal switch operation this can only be studied by a magnetic resonance cholangiopancreatography (MRCP.)  Patients with a duodenal switch operation cannot have an endoscopic retrograde cholangiopancreatography (ERCP.) Needless to say broader range of liver function tests should also be evaluated.

Parathyroid hormone level, vitamin D 25-OH level and calcium level will also be needed in order to evaluate the possible cause off calcium malabsorption as the underlying reason for elevated alkaline phosphatase by the mechanism described above.  A typical patient may have an elevated parathyroid level, low calcium and low vitamin D level.