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Vitamin and herbals

Vitamin and herbals. Vitamin A. Forms part of the visual pigments of the retina daily adult recommended doses range from 4000 international units (IU) for women to 5000 IU for men

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Vitamin and herbals

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  1. Vitamin and herbals

  2. Vitamin A • Forms part of the visual pigments of the retina • daily adult recommended doses range from 4000 international units (IU) for women to 5000 IU for men • Hypervitaminosis A: blurred vision, appetite loss, abnormal skin pigmentation, loss of hair, dry skin, pruritus, long-bone pain, and an increased incidence of bone fractures • Treatment: discontinuation

  3. Vitamin D • calciferol (vitamin D3 ) and ergocalciferol (vitamin D2 ). • 1,25-dihydroxycholecalciferol, the physiologically active form • Elevates plasma calcium and phoshorus levels • daily adult requirement of vitamin D is approximately 400 IU, and therapeutic doses sometimes exceed 5000 IU • Toxicity due to hypercalcemia • Tx: discontinuation, bisphosphates

  4. Vitamin E • competitive inhibitor of vitamin K–dependent processes • People ingesting large amounts of vitamin E who are taking anticoagulants should be observed closely for bleeding tendencies • neonates are more sensitive to the effects of vitamin E

  5. Vitamin K • Required for production of coagulation factors II, VII, IX, and X • Megadoses of menadione (vitamin K3) can be toxic • hemolytic anemia, kernicterus, and hemoglobinuria in premature infants • renal tubular degeneration, liver damage, hypoprothrombinemia, and petechial hemorrhages in adults

  6. Vitamin B2 (riboflavin): deficiency results in cracked lips, reddened tongue, and eczema of the face and genitals • Niacin releases histamine and can cause “niacin flush”. Also nausea, diarrhea, skin dryness.

  7. Vitamin B6 • deficiency • infants may lead to growth retardation, weight loss, hyperirritability, convulsions, and anemia • depression, convulsions, seborrheic dermatitis, and cheilosis • Excess (greater than 5 g/day) • unstable gait and numbness of the feet • Causes intestinal inactivation of levodopa

  8. Vitamin B12 • Deficiency causes pernicious anemia • paresthesias of the hands and feet, and decreased position and vibratory senses. • No toxicity

  9. Folate: required for DNA synthesis • Recommended dose is 400 mcg/day • Vitamin C • Formation of collagen • Excess amounts can cause gout, nephrolithiasis and renal failure

  10. Herbals • There is evidence to support the use of • ginkgo for dementia and intermittent claudication • St. John's wort for mild to moderate depression • kava for short-term treatment of anxiety • saw palmetto for short-term treatment of prostatism

  11. References • Tintinalli, Ch. 199

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