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DNT final

final topics

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