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DNT final
final topics
| Question | Answer |
|---|---|
| Iron Biochemistry | -Hemoglobin synthesis -Energy generation in ETC -Cofactor in synthesis of dopamine, NE, serotonin - |
| Iron Indications | Iron Deficiency Anemia Iron Deficiency w/o Anemia (fatiue, pallor, nail/hair loss, weakness, irritability, PICA) -Menorrhagia (less muscle tone) -Breath holding attacks in children |
| Iron Dosage | 60mg elemental form BID to correct deficiency =325mg ferrous sulfate -PO first, then IV, never IM Fe -black strap molasses has high absorption (vegetarian source) -heme/animal form better absorbed |
| Iron Testing | -Low to normal MCV (<95) -Ferritin <12= absent, 20-35= diminished -Low Serum Fe, transferrin sat., TIBC for anemia chronic dz |
| Iron Interactions | -Absorption of levothyroxine, ciprofloxacin, norfloxacin, captopril, penicillamine -Fe absorption inhibited by coffee, black/green tea, soy, Ca, phytate. Deficiency->Tricyclic antidepressant jitteriness -Reduce cough d/t ACE inhibitors 50mg/day |
| Iron Toxicity | Cause of diabetes, hepatic dz, atherosclerosis. Inc RA inflammation. -Serum ferritin and transferrin saturation >44% for hemochromatosis (Biopsy) |
| Selenium Biochemistry | Cofactor for glutathione peroxidase -Conversion of T4->T3 -Improve lymphocyte response |
| Selenium Indications | -Autoimmune thyroiditis/Hashimotos -GI Cancer prevention -Lymphedema (thins lymph) -Critical care (reduced mortality) |
| Selenium testing | Selenoprotein P Glutathione levels |
| Selenium Deficiency sxs | -fatigue, thyroid dysfunction, cardiomyopathy, immune dysfunction, and joint pain |
| Selenium Dosing | Food sources: brazil nuts, whole grains, yeast, fish Usual dosage: 100-250mcg/day |
| Se Interactions | Enhances antioxidant effects of vit. E -Increased antibody response to flu vaccine |
| Se Toxicity | -Brittle nails, hair loss, pruritic skin rashes, neurologic problems -Diabetes risk |
| Chromium Biochemistry | part of Glucose tolerance factor= Low-molecular weight chromium binding substance -> increases downstream signaling from insulin receptor |
| Cr Indications | -Diabetes mellitus (reduce blood glucose and HbA1c levels) 1000mcg/day -Dysthymic d/o, atypical depression sxs relieved -PCOS (improve glycemic control) -Weight lost (at lower dose) -Alzheimer's (memory improve) |
| Cr Dosage/Administration | Dosage: 200-1000 mcg/day Real brewer's yeast (not nutritional): potent source of preformed glucose-tolerance factor (9g/day) |
| Cr Interactions | -Prevent steroid induced diabetes -Diabetes meds -ARV for HIV (decrease insulin-resistance) |
| Cr Toxicity | -Mutagenicity? |
| Manganese Biochemistry | Synthesis of connective tissue Cofactor for one superoxide dismutase enzymes, blood glucose control -No major indications |
| Molybdenum Biochemistry | -Cofactor for sulfite oxidase (detoxifies sulfites) -Cofactor in xanthine oxidases and aldehyde oxidase |
| Molybdenum Indications | -Sulfite sensitivity -Aches and pains -Primary biliary cirrhosis(w/ tetrathiomolybdate-chelates Fe+Cu |
| Boron Biochemistry | Increases levels of estrogen (estradiol) |
| Boron Indications | Osteoporosis (inc. bone mineral density) |
| Boron Toxicity | Increase risk of hormone-dependent cancers (ie breast cancer) |
| Boron Dosage | Dosage 1-6mg/day Fruits/vegetables, nuts |
| Boron Interactions | Hormone replacement therapy (inc. hot flash incidence at 2.5 mg/day |
| Manganese potential indications | -Tardive dyskinesia -Osteoporosis |
| Manganese dosage | Dietary 1mg-8mg/day from whole grains, nuts, vegetables, tea Supplementation: 5-20mg/day |
| L-Tryptophan Biochemistry (5-Hydroxytryptophan) | Precursor to serotonin, picolinic acid and niacin. 5-HTP is precursor molecule in neurotransmitter synthesis (mood/behavior regulation and GI motitility) |
| Tryptophan Indications | -Depression (accelerate anti-depressant effect) -Insomnia (clear awakenings) -Sleep terrors/nightmares -PMS (relieve sxs; dysphoria, mood swings, tension, irritability) -Fibromyalgia (5HTP): |
| Tryptophan Dietary sources/Dosages | -Dairy, meat(tuna, shellfish, turkey), nuts/seeds, bananas, soy, -Sup: 500-4000mg/day on empty stomach w/ some carbs |
| Tryptophan Interactions | -SSRIs (serotonin excess?) -w/ Omeprazole for gastroduodenal ulcer accelerates healing |
| Tryptophan Toxicity | -Teratogenicity? -Peak X contaminant cause Eosinophilia-myalgia syndrome (EMS) |
| Serotonin syndrome | euphoria, drowsiness, sustained REM, overreaction of the reflexes, clumsiness, restlessness, feeling drunk and dizzy, sweating, intoxication, muscle twitching, rigidity, high body temperature, shivering, diarrhea, loss of consciousness and death |
| L-Lysine Biochemistry | Essential amino acid required to produce acteyl CoA and methionine. -Antagonizes arginine absorption and/or utilization |
| L-Lysine Indications | -Herpes simplex (prevention/treatment of outbreaks)1-3g/day |
| Arginine | "Semi-essential amino acid" produced in body from glutamic acid. -Precursor for nitric oxide |
| Arginine Indications | -Angina 3g TID x 6months(reduce sxs) -Congestive Heart Failure, HTN, -Erectile function -Preeclampsia (reduce incidence in high risk women) -Post-operative wound recovery (w/ glutamine, omega-3-fatty acids, probiotics)-improve immunity |
| Arginine Interactions | +Statin increases reduction of TGs |
| Arginine Toxicities | -Herpes simplex outbreaks -CI in those w/ recent MI |
| Tyrosine Biochemistry | Nonessential amino acid (from phenylalaline). Structure of almost all proteins in body. Production of dopamine, epiniephrine, norepinephrine, melanin, Cholecystokinin, thyroid hormones. |
| Tyrosine Indications | -Acute stress (reduced decline in preformance from sustained work/sleep deprivation) -Hypothyroidism |
| Tyrosine Interactions | -Oral contraceptives deplete it (depression related to this) -MAO inhibitors |
| Tyrosine Dosage/Dietary sources | >7g/day diet: fish, meat, dairy, eggs, nuts, wheat germ, oats |
| Taurine Biochemistry | Neurotransmitter w/ calming effect. Used to conjugate bile acids and has a positive inotropic effect (inc. contractility) |
| Taurine Indications | -Congestive heart failure (w/ carnitine+CoQ10 improves ejection fraction) -Fe Deficiency anemia: improve response -Diabetes (have deficiency of it) |
| Taurine Dietary sources/Dosage | Seafood and meat 1-4g/day |
Created by:
phdinh33
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