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list 1 food item that naturally contains vitamin D
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what is the daily dose that is associated with vitamin D toxicity?
>10,000 IU/day
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What forms does Vit D take within the body?
- Cholecalciferol - made by the body
- Calcidiol -storage form
- Calcitriol - biologically active form
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Vitamin D and Ca relationship in human body
- increase Ca absorption from intestines
- Increase bone mineralization and maintains Ca balance in the body
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Recomended daily intake range of Vit. D per IOM in adults
400-4000
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Promate lactation but CI during lactation
chasteberry
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Fenugreek shouldn't be taken by pregnant women because it may induce
uterine contractions
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black cohosh use should be limited to less than
6 months
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phytoestrogens should be avoided in patients with
- hormone-dependent conditions
- bleeding disorders
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marketed for menopause symptom relief can cause photodermatitis
dong quai
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marketed for premenstrual symptom relief is associated with increased seizure risk
evening primrose oil
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marketed for menopause symptom relief associated with liver toxicity
black cohosh
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marketed for premenstrual symptom relief interacts with dopaminergic agents
chasteberry
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2 side effects of St. John's Worth
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Regulation status of St. John's Wort: USA, France, Germany
- France: banned
- German: rx
- USA: supplement
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3 drug interactions with St. John's Worth that can have serious consquences
- HIV meds
- Birth control
- Warfarin
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Marketed for memory that can increase risk for seizures
Gingko: can lead to seizures/decrease seizure threshold
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how dose light affect melatonin secretion in the human body?
light inhibits melatonin secretion
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FDA "dear provider" letter regarding Kava Kava
- CI in parkinson's because it's a dopamine antagonist
- can also cause severe liver damage
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long term and/or heavy use of kava
scaly, yellow skin
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what type of cinnamon and at what doses have been studied to see benefit for diabetes?
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Food allergies that have cross reactivity to bitter melon
members of gourd/melon family
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why might bitter melon cause GI issues?
seeds and outer rind contain a toxic lectin that inhibits protein synthesis in the intestinal wall
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favism and what can prevent it
- favism: onset of hemolytic anemia and other symptoms including headache, fever, tomach pain, and coma
- individuals with glucose-6-phosphate dehydrogenase deficiency are at an increased risk after ingesting bitter melon seeds
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deplete chromium
corticosteroids
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NSAIDS vs. chromium
cause retention and increased absorption of chromium
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Prickly Pear Cactus can cause GI effects imilar to what?
bulk laxatives
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Bitter orange is chemically similar to what dietary supplement that was pulled off the market
ephedra
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what se can pts experience with carb-blocker products?
GI, diarrhea, flatulence
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What dietary supplement was recalled by teh FDA in May 2009 and why was it recalled?
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HCG FDA indications
- induces ovulation and pregnancy
- hypogonadism
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target dose of glucosamine for use of osteoarthritis
1500 mg daily
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case reports support an increased risk of what with glucosamine
rare effect of increased INR associated with use of warfarin
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topical glucosamine help with arthritis pain?
no, only oral glucosamine has been shown tho help with arthritis pain
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Activon is similar to what other OTC products?
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what natural product is associated with permanent loss of smell?
topical zinc
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ginseng effect on blood pressure
- low doses: increases blood pressure
- high doses: decreases blood pressure
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SE with high doses of vitamin C
- dental erosion
- esophageal ulcers
- intestinal bezoars
- renal insufficiency
- nephropathy, kidney stones
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SE with high doses of Vitamin A
- CNS
- Dermatologic
- GI
- Hematologic
- Hepatomegaly
- visual distrubance
- tinnitus
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Cause QT interval prolongation in high doses or in sensitive patients
Ginseng
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Ginseng Abuse Syndrome
ingesting 3-15 g/day of ginseng for up to 2 years may be associated with a syndrome of diarrhea, hypertension, nervousness, dermatologic eruptions, and insomnia
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Vitamin A: DRI (19-50 yo and 14-18 yo)
- M: 900 mg/day
- F: 700 mg/day
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Vitamin C: DRI (19-50 yo)
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Vitamin C: DRI (14-18 yo)
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Vitamin A: TUIL (19-50 yo)
3000 mcg
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Vitamin A: TUIL (14-18 yo)
2,800 mcg
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Vitamin C: TUIL (19-50 yo)
2,000 mg
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Vitamin C: TUIL (14-18 yo)
1,800 mg
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Zinc: TUIL (19-50 yo)
40 mg
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Zinc: TUIL (14-18 yo)
34 mg
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