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August 23, 2014

A functional approach to vitamins

by Helene van den Berg

Vitamins do not yield energy when metabolized; many of them assist the enzymes that participate in the release of energy from carbohydrates, fats and proteins. Insufficiencies of a vitamin may lead to problems related to less obvious physiological dysfunction. This decreased functioning may not readily be attributed to a vitamin insufficiency – therefore a thorough patient history including diet and lifestyle will help identify this link. The importance of vitamin interactions have been recognized e.g. methylation interactions of vitamin B6, B12 and folic acid in the prevention of heart disease. The homocysteinemia resulting from insufficient supplies of these vitamins may lead to coronary artery disease, neurodegenerative disease or cancer.

Individual needs for vitamins vary, based on the genetic code for physiological activity and conditional needs for increased vitamin availability (depends on proper digestion and absorption). Classic signs associated with these “deficiency” diseases may be end-stage manifestations of sustained nutrient inadequacy. Clinicians should carefully monitor a patient’s vitamin insufficiency, before it is manifest as an overt disease. Insufficiencies normally exist in more than one nutrient.

There is a big difference between a lack of illness and the presence of wellness.

An average person gets 3.5 colds per year. A study has shown where people who took 410 mg of vitamin C a day had the lowest incidence of colds, which is ten times higher than the RDA for vitamin C. RDAs are set by panels of scientists to prevent classic nutrient deficiency diseases, but do not take into account an individuals circumstances or what is optimal. It is very difficult to meet the RDA levels – most people eating what they conceive as a well-balanced diet, fails to meet the RDA requirements.

For most people two-thirds of their average calorie intake, is from fat, sugar and refined flours (processed foods and snacks), which are “empty” calories, because they provide no nutrients and satisfy our appetite instantly. Refined wheat has 25 nutrients removed to turn it into white flour, yet only four (iron, B1, B2, B3) are replaced. On average 87% of the vital minerals zinc, chromium, manganese are lost. RDA levels are clearly not enough!

Water Soluble Vitamins

Thiamin (Vit B1)

  • Part of coenzyme TPP and used in energy metabolism.
  • Found in pork, whole-grain products, potato, watermelon, soy milk.
  • NOTE: easily destroyed by heat.
  • Deficiency will cause Beriberi (wet with edema, dry with muscle wasting).
  • Symptoms of a deficiency includes muscular weakness, anorexia and weight loss, neurological disturbances ( poor short term memory, confusion, irritability); heart enlargement and failure.

Riboflavin (vit B2)

  • Part of coenzyme FMN and FAD and used in energy metabolism
  • Found in Liver, milk products (yoghurt, cheese), mushrooms.
  • NOTE: easily destroyed by UV light, irradiation
  • Deciciency will cause ariboflavonosis
  • Symptoms of a deficiency includes inflammation of mouth, skin, eyelids (cracks and redness at corners of mouth; smooth, purplish red tongue.

Niacin (vit B3)

  • Part of coenzyme NAD and NADP, used in energy metabolism
  • Found in All protein-rich foods (meat, poultry, fish, milk, eggs)mushrooms, peanuts.
  • Deficiency will cause pellagra (dermatitis, dementia, diarrhea)
  • Symptoms of a deficiency includes diarrhea, abdominal pain, vomiting; swollen, smooth, bright red tongue; depression, fatigue, memory loss; skin darkens, flakes away and skin lesions

Pantothenic acid (vit B5)

  • Part of coenzyme A, used in energy metabolism.
  • Found in beef, poultry, whole grains, potatoes, tomatoes, broccoli,
  • NOTE: easily destroyed by food processing.
  • Deficiency will cause digestive, neurological disturbances.
  • Symptoms of deficiency includes vomiting, nausea, stomach cramps; depression, insomnia, fatigue, increased sensitivity to insulin; muscle cramps, numbness.

Pyridoxine (Vit B6)

  • Part of coenzyme PLP and PMP, used in amino acid and fatty acid metabolism; helps to make red blood cells; helps to convert tryptophan to niacin and serotonin
  • Found in protein-rich foods: Meat, fish , poultry, starchy vegetables, banana, watermelon, prune juice.
  • NOTE: easily destroyed by heat
  • Deficiency will cause anemia (small-cell-type) and scaly dermatitis.

Cobalamin (vit B12)

  • Part of coenzyme methylcobalamin, used in new cell synthesis, helps to maintain nerve cells, helps to break down some fatty acids and amino acids. Activates folate.
  • Found in foods derived from animals (meat, fish and poultry; milk, cheese and eggs).
  • NOTE: easily destroyed by microwave cooking
  • Deficiency will cause pernicious anemia
  • Symptoms of a deciency includes anemia (large-cell type), fatigue, nerve damage and paralysis; constipation; loss of appetite.

Biotin

  • Part of coenzyme used in energy metabolism, fat synthesis, glycogen synthesis and amino acid metabolism
  • Widespread in foods -Liver, egg yolks, fish, whole grains, also produced by GI bacteria.
  • Deficiency will cause depression, numb or tingling sensation in the arms and legs; hair loss; red, scaly skin rash around eyes, nose, mouth.

Folate/ folic acid

  • Part of coenzyme THF and DHF, used in DNA synthesis and important in new cell formation; breaks down homocysteine & protect against heart disease.
  • Found in leafy green vegetables, legumes (lentils, pinto beans), asparagus, seeds (sunflower ), tofu.
  • NOTE: easily destroyed by heat and oxygen.
  • Deciency will cause anemia (large-cell type); smooth, red tongue, mental confusion, fatigue; elevated homocysteine – blood clots, atherosclerotic lesions.

Choline

  • Needed for synthesis of the neurotransmitter acetylcholine and the phospholipid lecithin; lowers blood pressure.
  • Found in liver, milk, eggs, peanuts.
  • Deficiency can cause liver damage.

Ascorbic acid

  • Used in collagen synthesis (strengthens blood vessels, forms, scar tissue, provides matrix for bone growth); antioxidant, thyroxin synthesis; amino acid metabolism; strengthens resistance to infection; helps in absorption of iron.
  • Found in fruit and vegetables: citrus fruits, strawberries, kiwi fruit; broccoli and brussel sprouts; red bell pepper, tomato.
  • NOTE: easily destroyed by heat and oxygen.
  • Deficiency can cause scurvy.
  • Symptoms of deficiency includes anemia (small-cell type); pinpoint hemorrhages and blotchy bruises ; poor wound healing, frequent infections, bleeding gums, loosened teeth; joint pain; abnormal bone growth; depression.

Fat Soluble Vitamins

Vitamin A (retinol & beta-carotene)

  • Play a role in vision, maintenance of cornea, epithelial cells, mucous membranes, skin; bone and tooth growth; reproduction; immunity.
  • Retinol is found in liver, eggs, milk products.
  • Beta-carotene found in green leafy vegetables, broccoli, deep orange fruits (apricots) and vegetables(carrots, sweet potatoes, pumpkin).
  • Deficiency can cause night blindness/ permanent blindness, very dry skin; impaired immunity.

Vit D (calciferol)

  • Plays a role in calcium absorption, bone formation .
  • Found in UV light, dairy products, egg yolks, veal, beef, liver, fatty fish and their oils (salmon, sardines,cod).
  • Deficiency can cause rickets.
  • Symptoms of a deficiency includes osteomalacia/osteoporosis in adults Bowing of legs, deformity of ribs(knobs); delayed closing of fontanel – rapid enlargement of head; muscle spasms; soft, brittle, deformed bones.

Vit E (alpha-tocopherol)

  • Is an antioxidant ; protects polyunsaturated fatty acids and cell membrane from oxidation.
  • Found in green leafy vegetables, vegetable oils; nuts and seeds; whole grains; liver; egg yolks.
  • NOTE: easily destroyed by heat and oxygen.
  • A deficiency can cause erythrocyte hemolysis (red blood cell breakage); nerve damage.

Vit K (phylloquinone)

  • Plays a role in blood clotting
  • It is synthesed in the body by GI bacteria; It is also found in green leafy vegetables, liver and milk.
  • Deficiency can cause hemorrhaging (uncontrolled bleeding).

In Addition

Tetrahydrobiopterin (BH4)

  • this vitamin compound functions as a coenzyme in the synthesis of several neurotransmitters.
  • Patients with low levels of BH4 in their brains, suffer from depression.
  • BH4 is stimulated by folic acid, vit B12, ascorbic acid.

Folate and vitamin B12

  • stimulate BH4 formation.
  • Patients suffering from psychotic syndromes (depression) have low levels of serum folate and vitamin B12.

Folate is the most common nutrient deficiency in the world.

Patients with organic psychosis, depression, and schizophrenia, treated with folate, fare much better than control subjects not receiving folate. Patients with severe mania and psychosis, had complete remission upon B12 supplementation.

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