A

D E K B1 B2 Niacin
RDAs: Men: 900ug Ages 1-70: Both: 15mg Men: 120ug Men: 1.2mg Men: Men:16mg
Women: 700ug 15ug Women: 90ug Women: 1.3mg Women:14mg
70+: 20ug 1.1mg Women:
1.1mg
Sources: Liver, Sweet Sunlight Wheat germ, Leafy greens, Pork, peas, Liver, milk, Liver, tuna,
Potatoes, Salmon, soy milk, broccoli, fish, lentils yogurt, salmon, nut
carrots, sardines, sunflower eggs, liver spinach butters, lentils
spinach tuna, seeds, almonds
fortified
grains
Assess Less than Hemolysis test Phylloquinone Transkeltolase Erythrocyte Urine
ment: 20ug/dL in on blood in plasma activity in RBC glutathione
serum reductase NAD
Less than Prothrombin activity concentrations
5mg/L serum blood clotting in the blood
conc. time Urine



Deficien Night Rickets Those with fat Impaired blood Beriberi (wet Cheilosis Pellagra (4 Ds)
cies: blindness, dry Osteoporosis malabsorption clotting, dry)
scaly skin, bruising, Glossitis Hartnup
frequent in Hemolytic bleeding Wernicke’s disorder
children of anemia Disease Anemia - impaired
developing antibiotics absorption of
countries Maple syrup Stomatitis tryptophan
disease
Interacti Zinc is required Calcium and Selenium & Too much A & Vitamin B6 Riboflavin
ons: for RBP & phosphorus vitamin C E can interfere
transthyretin homeostasis with K Iron
synthesis Polyunsaturate absorption
Also vitamin d fatty acids
K
Transpo Lymph system Blood Major: Via RBC as TPP Albumin in Blood
rt: & blood chylomicrons chylomicrons blood
and LDL
Minor: Flavin in
Lipoproteins plasma
Storage: Liver & adipose Blood, Adipose tissue Liver 50% in Liver, kidney, Mostly
muscle, skeletal heart, brain excreted
adipose muscle

Liver, heart,
kidney, brain

 C Calcium Phosphorus Magnesium Potassium Chloride Iron
RDAs: Men:90mg 11- All adults: Men:420mg All Adults: All adults: Men:8mg
Women:75mg 18yrs:1300mg 700mg Women:320mg 4700mg 2300mg Women:18mg
Smokers:+35mg 19-50:1000mg 8mg post-
50+:1200mg meno
27 –pregnant
9 - lactation
Sources: Red peppers, Milk, cheese, Meat, Coffee, tea, Fruits, Table salt Red meat,
broccoli, Chinese cabbage, poultry, barley, oats, veggies, milk, seafood,
strawberries white beans fish, eggs, beans, nuts, yogurt, nuts, legumes, dark
milk, nets, seeds, spinach seeds greens, nuts
legumes
Assessment: Urine Bone mineral Serum Difficult Plasma/serum Serum Biomarkers
density conc. because only conc. conc.
- DEXA 1% in fluids
- CT Scan Urine
Deficiencies: Scurvy Stunted growth Renal Those with Result from 7g per 100mL
disease Chron’s loss of fluids blood
Osteoporosis patients, disease, & electrolytes
too many diabetes, or
antacids renal disease
are at risk
Interactions: Iron and copper Regulated active Vitamin D is Vitamin D is an Na+ Vitamin C is an
transport by an enhancer needed enhancer
vitamin D enhancer for
Other cations absorption
Other inhibit
cations can
inhibit
Transport: Unbound in Blood Blood Blood Blood Glucose Ferric is
blood transport attaches to
system transferrin
protein in
blood


Storage: No means of Bones Bones 60% in bones ICF ECF Liver, bone
storage 25% in soft marrow, spleen
tissues

Zinc Copper Iodine B12

RDAs: Men:11mg All adults: 900ug All adults: 150ug All Adults: 2.4ug
Women:8mg
Sources: Red meat, seafood, Meats, shellfish, nuts, Iodized salt Meat, meat products
poultry, legumes, dairy seeds, legumes, dark
chocolate Foods grown in iodine
rich soil
Assessment: Serum/plasma Serum Urine Serum conc.
Plasma
Metallothionein conc. Blood Thyroid size
Serum ceruloplasmin
Hair sample conc. Serum TSH
Deficiencies: Aging population, Malabsorption due to Goiters or cretinism can Pernicious anemia –
vegetarians, alcoholics Chron’s disease or be a result enlarges RBC due to
celiac disease lack of IF
Those with sickle cell
anemia, or trauma
Interactions: Needed for retinol Needed for Iron Impaired selenium
conversion in vitamin A absorption absorption affects
thyroid hormone
metabolism

Iron and A can cause
worse effects
Transport: Blood bound to albumin Blood bound to Free iodide in blood In blood bound to
or alpha-2 marcoglobulin albumin or alpha-2 cobalamins
marcoglobulin

Storage: All organs, tissue, body All organs, tissue, body Thyroid Gland Liver for long periods
fluids fluids

Deficiency Details:
Vitamin C:
Vitamin D:
- Those at risk are populations that don’t get enough
- Those at risk are breastfed infants, dark fruits and vegetables (possibly those with conditions
skinned individuals, older adults, limited
that make for very limited food preferences)
sunlight exposure, fat malabsorption, those - Scurvy:
who use a lot of sunscreen o Abnormal bone growth
- Rickets: o Bleeding gums due to collagen malformation
o Insufficient bone mineralization in o Hemorrhages under skin
children o 4 H’s
o Can cause seizures and growth
retardation Calcium:
o Malformed legs
- most commonly due to poor intake
o Rachitic rosary
- children – stunted growth
o Spine curvature
- adults – osteoporosis
o Deformed chest and pelvis
- Osteoporosis:
B1 Thiamin: o Leading cause: drop in estrogen in women
during menopause
- Beriberi § Drop in testosterone in men
o Symptoms include anorexia, cardio § Women over 50 and men over 70 at
issues, apathy, confusion, memory loss most risk
o Dry Beriberi: o Thinning of bone tissue and loss of bone
§ Adults mineral density
§ Muscle weakness, peripheral o 1 in 5 American women as osteoporosis
neuropathy o corticosteroid medications can increase risk
o Wet Beriberi: o need at least 1200mg calcium daily, plenty of
§ Heart involvement protein, and weight bearing exercises
§ Lung involvement - Milk-Alkali Syndrome:
§ Edema o Caused by overconsumption of milk
o Acute Beriberi: § Also by taking antacids over long
§ Infants periods of time
§ Anorexia, vomiting, lactic o Results in hypercalcemia and shifts the
acidosis body’s acid/base balance
§ Altered HR o Can lead to calcification and renal failure
- Wernicke’s Disease
o Associated with alcoholism B12:
o Ophthalmalgia – paralysis of eye muscles
- Pernicious anemia:
o Involuntary eye movement
o Lack of Intrinsic Factor due to inability to
o Ataxia, memory loss, confusion
absorb
- Maple Syrup Disease
o Enlarged RBC
o Results from genetic mutations in
o Can cause neurological issues
branch-chain keto acid dehydrogenase

complex
o Urine smells sweet

Iron:

- 7g/100mL of blood = microcytic anemia o in children – poor cognitive development

- poor intake and high iron losses o Adults – reduced work capacity
- Symptoms à o All – increase risk of infection, impair
temp. reg.
Digestion & Absorption Mechanisms + Functions:

Vitamin A:

1. Carotenoids & retinyl esters are combined with proteins in order to by hydrolyzed into free carotenoids and free
retinol (digestion)
2. These free forms are combined with fatty acids and bile and thin incorporated into a micelle in order to cross
the brush border membrane into the intestinal cell
3. From this point Vitamin A takes 3 forms inside the cell
a. Beta-carotene:
i. Splits into 2 retinal à 1 of which forms retinoic acid and travels to the liver through blood
ii. The second binds with CRBPII ad creates CRBPII-retinol
b. Retinol:
i. Also combines with CRBPII to form CRBPII-retinol
1. This then combines with fatty acids and LRAT to form CRBPII-retinyl-palmitate
2. Then it enters the chylomicron and is exported into lymph
c. Carotenoids:
i. Combine with phospholipids and other fats and enter the chylomicron
ii. Then enter the lymph as well

Functions of Vitamin A:

- Gene transcription
o RXR and RAR work together as a “lock and key” mechanism to activate transcription
- Vision
o Opsin & Cis-retinal + light à opsin & trans-retinal
o Opsin and trans-retinal break apart
o Trans turns back into cis and reattaches to opsin again
- Antioxidant
o Singlet molecular oxygen is inactivated
- Prevent Heart Disease
o Prevent oxidation of LDLs
Vitamin D:

- Does NOT require digestion

- Absorbed from micelle via passive diffusion with help from fat and bile salts
- Absorbed in jejunum
- Incorporated into chylomicron and transported into lymphatic system

Functions of Vitamin D:

- Calcium Homeostasis:

1. Blood is low on Ca++
2. Parathyroid gland sends PTH into the blood
3. PTH stimulates the conversion of 25-OH D à 1,25-(OH)2 D (aka calcitriol)
4. Calcitriol stimulates kidneys to increase Ca++ reabsorption
5. Calcitriol stimulates Ca++ absorption in the lumen of the intestines
6. PTH and calcitriol also travels to the bones and stimulates a release of calcium stores
from them
7. Blood Ca++ levels increase

Vitamin E:

- Tocopherols do NOT require digestion

- Tocotrienols require digestion by pancreatic and intestinal esterase
- Absorption via passive diffusion in jejunum
- Best absorbed with fats
- Transported in chylomicrons and lipoproteins

Functions of Vitamin E:

- Antioxidant – destroys singlet molecular oxygen

o Works with vitamin C
- Heart Disease – may inhibit oxidation of LDLs and prevent blood clots

Vitamin K:

- No digestion
- Phylloquinones are absorbed in duodenum
- Menaquinones are absorbed via passive diffusion in ileum and colon
- Transported in chylomicrons and LDL
- Metabolized in the liver – also stored in the liver
- Rapid turnover (1.5 days)

Vitamin K Functions:

- Blood Clotting:

Vitamin C:

- No digestion
- Ascorbic Acids:
o Facilitative diffusion
o Na-dependent transporters
o SVCT1 and SVCT2 cotransporters
o Ileum
- Dehydroascorbic Acid (oxidized form):
o Glucose transporters (GLUT 1 & 3)
o Stomach and small intestine
o Higher doses = less absorption
- Transported unbound in the blood
- Stored primarily in the liver but no TRUE means of storage in the body

Functions of Vitamin C:

- Production of Neurotransmitters
- Electron donation (antioxidant)
- Collagen synthesis:

1. While iron is being converted from Fe2+ à Fe3+, ascorbate is being oxidized à dehydroascorbate during
collagen formation

Iron:

- Heme iron
o Hydrolyzed from hemoglobin & myoglobin in the stomach and small intestine
- Non Heme iron
o Must be hydrolyzed in GI tract
o Fe3+ à Fe2+
o Less available for absorption

1. Iron is digested by HCL in stomach
2. Heme iron enters intestinal cell via HCP1 channel protein
a. Once inside the cell, heme iron is catabolized into Fe2+ and heme protoporphyrin via oxygenase
3. Non Heme iron can be bound by inhibitors and excreted or absorbed via DMT1 channel protein once it is
reduced
4. Fe2+ inside the cell can do 1 of 3 things:
a. Be oxidized and stored bound to ferritin
b. Be used functionally by the cell
c. Be oxidized and exported into the blood bound to transferrin

Cellular Iron Uptake:

1. Fe3+ is bound to transferrin

2. It attaches to transferrin receptors

on the cell membrane

3. the attached complex enters the

cell via endocytosis

4. It forms an endosome inside the

cell cytosol

5. The pH in the endosome drops

and stimulates the release of Fe3+

6. Fe3+ is reduced by steap3

7. Fe2+ is transported out of the

endosome by DMT1

8. Once released the iron may be

used by the cell, exported, or stored
as ferritin

Zinc:

- Hydrolyzed from amino acids in the stomach and small intestine 1. Enters the cell via ZIP4
channel protein

2. via ZnT7 zinc enters the trans-

Golgi-network and is stored as
metallothionein

3. via ZnT1 zinc is exported into

the blood bound to albumin or
alpha-macroglobulin

Paracellular Diffusion is possible

during levels of high intake

Sodium:

- Mostly absorbed in small intestine and proximal colon

- Absorption:
o Na+/glucose cotransporter
o Electroneutral Na+/Cl- cotransport exchange

Functions of Sodium:

- Osmotic pressure maintenance

- Nerve impulse transmission
- Muscle contraction
- Increase sodium = increased Ca++ excretion

Vitamin B12:
1. B12 is released from food with help from
the acidic environment of the stomach

2. B12 binds to R proteins in saliva and gastric

juices

3. The R protein complex travels from the

stomach to the duodenum

4. The duodenum is alkaline and allows for the

digestion of R protein. This releases B12.

5. B12 then forms a complex with intrinsic

factor (IF)

6. Once in the ileum, B12 + IF complex binds to

a specific receptor and is absorbed via
endocytosis

Functions of B12:

- Homocysteine à methionine
- L-methylalonyl CoA à succinyl CoA