Vitamins and Minerals

Vitamins and

Minerals The role and the sources of vitamins and minerals.

When do you need vitamin & mineral supplements

DBMI & Dr. I. Xhura July 2017 London, UK

Vitamins and Minerals, Copyright Š 2014-2017 DBMI All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles or reviews.

DBMI - previously known as Doctor Besi Medical Information - is based in London, United Kingdom. Cover photo credit: www.ibdrelief.com For information contact: http://doctorbesimedicalinformation.blogspot.co.uk

What are vitamins and minerals? The former are organic compounds and the later are inorganic compounds. Found naturally in food – in small amounts – they are essential for several physiological functions of our bodies. Vitamins are separated into: 

fat soluble vitamins (A, D, E & K) dissolve in fat



water soluble (C, B-complex vitamins) dissolve in water

Why vitamins and minerals are important? Vitamin deficiencies can cause or make worse, an array of health problems. These nutrients are involved in our bodies cell producing and cell repair mechanisms, muscle function, metabolism, reproduction etc.

Where do I find vitamins and minerals? By combining different food groups, all vitamins and minerals will be in a varied & balanced diet, With the exception of vitamin D, that is found on few foods, you need sunlight exposure in order for your skin to produce it.

Do I need vitamin and minerals supplements? In general you do not need to take supplements. They are usually given by your doctor or dietician in cases when you need a healthier diet. There are also times when your requirements will change (pregnant women, women over 50 & men over 70) and you might need a higher daily amount of vitamins and minerals.

According to WHO “Several nutrients, including water, are essential for growth, reproduction and good health. Macronutrients are consumed in relatively large quantities and include proteins, carbohydrates, and fats and fatty acids. Micronutrients – vitamins and minerals – are consumed in relatively smaller quantities, but are essential to body processes”

“Vit & minerals are nutrients your body needs in small amounts to

work properly & stay healthy. Most people should get all the nutrients they need by having a varied & balanced diet, although few people may need to take extra supplements.” nhs.co.uk

Vitamin A Also known as beta carotene, carotenoid, retinoic acid, retinol, retinyl palmitate It is available over the counter as one of the above formulations or combined with other vitamins and minerals.

The role of vitamin A. Retinol is part of the chemical mechanism in our retinas that allows us to see. It is essential to the normal growth and development of bones and teeth in children, also helps keep our skin and inner linings of digestive and respiratory organs healthy.

Sources of vitamin A. Liver, cod liver oil, eggs, dairy products, oranges, yellow fruit and vegetables and lettuce are all good dietary sources of vitamin A. When do you need vitamin A supplements? Problems that include diabetes and hyperthyroidism, use of some statins (drugs that lower cholesterol levels) and gallbladder diseases; are all causes of vitamin A deficiency. Night blindness (reduced ability to see in the dark), is one of the first signs; as well as dry skin, loss of appetite and diarrhea. Increased susceptibility to infections, dry eyes, poor teeth and feeble bones are signs of extreme deficiency. *** Vitamin B1, Thiamine. It is available over the counter as vitamin B1, also as a combination with other vitamins and minerals.

The role of vitamin B. It is essential for the normal functioning of many enzymes, which in turn are needed for most of the chemical reactions in the human body. Such examples are the metabolism of alcohol, fatty acids and carbohydrates. Thiamin is important for a healthy heart, nervous system and strong muscles.

Sources of vitamin B1. All unprocessed foods, especially in wholemeal bread, brown rice, liver, kidney, meat, fish, beans & most vegetables.

VITAMINS & MINERALS

When do you need vitamin B1 supplements? Thyroid disease (hyperthyroidism), intense physical activity, trauma and psychological stress are situations when, guided by a physician, thiamine is needed as a supplement.

Fatigue, irritability, loss of appetite & sleep disturbances are signs of thiamine deficiency. Depression, memory loss, cramps and cardiac insufficiency result from severe deficiency. Wernicke's syndrome develops in alcoholics and drug addicts who are malnourished. *** Vitamin B2 Also known as riboflavin, vitamin G It is available over the counter, also combined with other vitamins and minerals The role of vitamin B2. Riboflavin has a vital role in activating various enzymes in the human body. It is involved in the metabolism of carbohydrates, fats and proteins. It is also essential to the production of hormones by the adrenal gland.

Sources of vitamin B2. Liver, milk, cheese, eggs and vegetables and beans are good sources of vitamin B2.

When do you need vitamin B2 supplements? Low-calorie diets, use of estrogen-based contraceptives, chronic diarrhea, long-term psychological stress, long-term use of antipsychotic drugs and antidepressants may cause deficiency and therefore bring the need to supplement. Itching and burning of the mouth, especially the angles of the lips, the eyes and in the genital area are all signs of deficiency.

7

DBMI

Vitamin B3, Niacin Also known as nicotinamide, niacinamide, nicotinic acid It is available over the counter, also combined with other vitamins and minerals. High doses of nicotinamide are available only as prescribed by a physician.

The role of vitamin B3. Niacin plays an important role in the activity of many enzymes. It is an integral part of the chain of reactions that turn glucose into energy for our body and it is necessary for the synthesis of essential fatty acids. It contributes to maintain our nervous system, skin and digestive tract healthy. It influences the production of sexual hormones (estrogen, progesterone and testosterone) Sources of vitamin B3. Liver, meat, chicken, fish, beans and nuts are the best sources of niacin.

When do you need vitamin B3 supplements?. Liver disease, alcoholism and malabsorption (small bowel disease) are conditions that bring up the need to supplement on vitamin B3. High doses of vitamin B3 also help treating hyperlipidemia (high blood cholesterol and/or triglycerides). *** Vitamin B5, Panthotenic acid. Also known as calcium panthotenate, panthenol, panthotenol. It is available over the counter, also combined with other vitamins and minerals The role of vitamin B5. Vitamin B5 has as important role in the activity of many enzymes. Namely, it is vital to the production of essential fatty acids, steroid hormones, carbohydrate metabolism and to the normal functioning of the nervous system.

8

VITAMINS & MINERALS

Sources of vitamin B5. Liver, kidneys, heart, fish and egg yolk are the best sources of vitamin B5. It is also found in most vegetables.

When do you need vitamin B5 supplements?? Alcoholism is a condition which, as with most b-vitamins, brings up the need to supplement on vitamin B5. Psychological stress, chronic and debilitating diseases, and trauma; are all conditions when supplementing is recommended. *** Vitamin B6, Pyridoxine. Known as pyridoxin hydrochloride it is available over the counter, also combined with other vitamins and minerals.

The role of vitamin B6. Pyridoxine is essential to haemopoiesis (the productions of red blood cells) and to the metabolism of carbohydrates, proteins and fatty acids. It is important to a healthy skin, digestive tract & nervous system, also in creation of antibodies, balancing blood sugar levels & proving energy from foods.

Sources of vitamin B6. Liver, chicken, fish, whole grain foods and eggs are good sources of vitamin B6. It is also found in avocados, bananas and potatoes.

When do you need vitamin B6 supplements? Small bowel diseases (that cause malabsorption), alcoholism, depression, the use of drugs such as isoniazide, penicillamine are condition that warrant supplementin on pyridoxine.

It is also recommended for women on estrogen-based oral contraceptives. ***

9

DBMI

Vitamin B12, Cobalamin. Also cyancobalamine, hydroxycobalamine

known

as

cobalamine,

It is available over the counter in various formulations.

Hydroxycobalamin is available only as injection through medical supervision The role of vitamin B12. Cobalamin is vital to the synthesis of DNA, hence necessary for cellular replication. This function is especially important to red blood cells, that have are substituted continuously.

It is also necessary to maintain a healthy nervous system.

Sources of vitamin B12. They are naturally found on animal products, meat, fish, eggs and milk products.

When do you need vitamin B12 supplements?? Malabsorption (caused by pernicious anemia, coeliac disease, steatorrhoea etc.) is the most common cause of vitamin B12 deficiency. A vegan diet will also eventually cause deficiency. Another cause of deficiency are intestinal parasites. Anemia (called macrocytic anemia), memory loss and depression are manifestations of deficiency. *** Vitamin D, Calciferol Also known as alphacacidol, calcifediol, calcitriol, cholecalciferol, ergocalciferol, Vitamin D2, Vitamin D3.

It is available over the counter in various formulations, also in combination with other vitamins and minerals. Injections are only available under medical supervision.

The role of Vitamin D. Vitamin D has an important role in maintaining calcium and phosphorus homeostasis (balance) in the human body.

It helps our guts absorb calcium and it is vital to the health of bones and teeth.

10

VITAMINS & MINERALS

Vitamin D supplements have been shown to speed weight loss in overweight/obese people.

Sources of Vitamin D. Margarine, fish oil, liver, milk and egg yolk, are all rich in vitamin D. Sunlight exposure coverts chemicals in our skin into vitamin D. It is a source of vitamin D for many people.

When do you need vitamin D supplements? A diet that is poor on vitamin D and little sunlight exposure can cause deficiency. Those who have dark skin, and those who work on night shifts are at higher risk. Premature babies, pregnant women (it is recommended during pregnancy) and the elderly benefit from supplementing.It is given under medical supervision as treatment needed in many conditions such as: malabsorption, kideny disease, liver disease, hypoparathyroidism, bone disease or long term use of certain medications. *** Vitamin E, Tocopherol. Also known as alpha-tocopherol acetate. It is available over the counter, also in combination with other vitamins and minerals. It is often added to skin creams and ointments. Alpha tocopherol is its most powerful form.

The role of Vitamin E. Vitamin E is a powerful anti-oxidant, vital to slow down ageing and maintain cells healthy (especially red blood cell production).

Research indicates that vitamin E has a protective role against cancer and coronary heart disease. It protects lungs and other tissues against pollutants that enter the body.

Sources of Vitamin E. It is found in green vegetables and leafs, and whole grain foods.

11

DBMI

When do you need vitamin E supplements? It is necessary to supplement when there is liver disease, malabsoption, premature births or when one eats a lot of fried food using vegetable oils.

Deficiency leads to red blood cell destruction (hemolysis) and consequently anemia from which symptoms as fatigue, pale skin, breathlessness and palpitations arise. *** Vitamin H, Biotin Also known as Coenzyme R. It is available over the counter, also in combination with other vitamins and minerals.

The role of Vitamin H. Biotin is essential to carbohydrate and fatty acid metabolism. This means it is necessary for their synthesis and conversion to energy.

Sources of Vitamin H. The best sources for biotin are: liver, nuts, beans, egg yolk and peas. Gut bacteria produce part of the quantity of biotin the body needs, underlining the importance of a healthy bacterial gut flora.

When do you need vitamin H supplements? Long term use of antibiotics (especially sulfonamides) can destroy biotin-producing bacteria in the gut.

The same is true for the consumption of egg whites only, which contains a protein called avidin that prevents the absorption of biotin.

Also, vitamin H has been fond to help with synthesis of a functional gene product and DNA replication.

12

VITAMINS & MINERALS

Vitamin K, Menadione Also known as Vitamin K1, Vitamin K2, Vitamin K3, menadione, phytomenadione It is available over the counter in various formulations, also in combination with other vitamins and minerals. Injections and tablets are available only through a medical prescription.

The role of Vitamin K. Vitamin K is necessary for blood clotting. Its role is expressed in the liver where it makes possible the activation of chemicals that are essential to the clot formation process.

Sources of Vitamin K. The best sources of vitamin K are green vegetables, fruits, nuts, cow milk and yogurt.

When do you need vitamin B2 supplements? Supplements are always taken under medical supervision. Liver diseases, malabsorption, long term use of sulfonamides & diarrhea can cause deficiency, therefore need supplementing. With deficiency there is delayed blood clotting which leads to bleeding from the guts, gums and delayed healing. *** Vitamin M, Folic Acid Also known as foliacine, sodium folate, folates. It is available over the counter in various formulations, also in combination with other vitamins and minerals.

The role of folic acid. Necessary to make possible the production of nucleotides, which in turn are part of the DNA, therefore essential to cellular replication & growth. Its role is more marked in cells with high turnover rate (continuous replication & substitution) such as red blood cells. It plays an important role in the healthy development of the nervous system.

Sources of folic acid. Green vegetables and liver are rich in folates.

Egg yolk and nuts are also good sources of folic acid.

13

DBMI

When do you need folic acid supplements? Premature babies, babies fed with goat milk, patients on dialysis, those who suffer from psoriasis, chronic alcoholism or liver diseases all need to supplement on folic acid. Non-steroidal anti-inflammatory drugs, estrogen based contraceptives, steroids & sulfonamides deprive the body of folic acid, therefore supplementing is needed in these cases. Symptoms of deficiency include fatigue, vertigo, diarrhea, hair loss and anemia.

14

VITAMINS & MINERALS

MINERALS

Copper (Cu) Also known as amino acidic copper chelate, copper chloride, copper chloride dihydrate, copper gluconate, copper sulfate.

It is available over the counter as copper chelate and copper sulfate.

Copper chloride injections are available only under medical supervision.

The role of copper. Copper is an essential component of many enzymes. It is necessary for the synthesis of collagen and elastine (protein that is part of ligaments, blood vessels and lungs). Copper also serves as a pigment for skin and hair, and helps the body utilize vitamin C. It is needed for the activity of the central nervous system.

Sources of copper. Liver, mussel, nuts, mushrooms, dry beans and corn are good sources of copper.

15

DBMI

When do you need copper supplements? A healthy diet provides the necessary quantity of copper needed. However, malnourished children may need to supplement. *** Calcium (Ca) Also known as amino acidic calcium chelate, calcium carbonate, calcium chloride, calcium citrate, calcium gluconate, calcium gluceptate, calcium lactate.

It as available over the counter in oral routes. Calcium injections are given only under medical supervision.

The role of calcium. Calcium is the most abundant and distributed mineral in the human body. It makes up about 90% of the solid mass of bones and teeth. Calcium is essential for the maintainance of the health bones and teeth, for blood clotting, nerve impulse transmission and muscle contraction. Almost any activity at a cellular level happens with the mediation of calcium.

Sources of calcium. Milk and dairy products, green vegetables, peas, beans and nuts are all good sources of calcium.

When do you need calcium supplements? If a person does not consume enough milk and dairy products each day, the need for calcium supplements may arise. Mothers who breastfeed their babies need more calcium than the average person each day. If they do not take adequate quantities, their bones will get weaker, with a greater risk for osteoporosis later. Calcium supplements are of help to all women.

Prolonged deficiency causes weakening of the bones. Extreme deficiency causes low blood levels of calcium, a life threatening condition.

16

VITAMINS & MINERALS

*** Chromium (Cr) Also known as amino acidic chromium chelate, GTF – glucose tolerance factor. Chromium supplements are available over the counter The role of chromium. Chromium has a vital role in the activity of a few enzymes. It is essential to the action of insulin, making possible the utilization of glucose by the cell.

Sources of chromium. Chromium is found in small quantities in different foods like meat, dairy and whole grain meals.

When do you need chromium supplements? Chromium deficiency is very rare. It is seen in malnourished children. People with diabetes may benefit from supplementing since chromium promotes the action of insulin to move sugar from blood into the cell. Deficiency can cause raised blood sugar levels and facilitate atherosclerosis. *** Fluorine (F) Also known as calcium fluoride, sodium fluoride, sodium monofluorophosphate It is available over the counter in various products, like mouthwash, toothpaste. Calcium fluoride is its natural form.

The role of fluorine. Fluorine prevents tooth decay and contributes to bone health. Its effect is important in children during the development of teeth. It is believed that it makes teeth more resistant to the acidic environment created by food in the mouth.

Sources of fluorine. Fluorine is added to potable water in many areas, therefore making it available to everyone. Tea and sea fish are also good sources of fluorine.

17

DBMI

When do you need fluorine supplements? When fluorine quantity in drinkable water is not adequate, children may be given supplements in the form of oral drops, to help with the development of healthy teeth. The role of fluorine in the prevention of osteoporosis is still under scientific investigation.

Iodine (I) Also known as calcium iodide, sodium iodide It is available over the counter as tablets, also in combination with other vitamins and minerals, in the form of skin creams and ointmens. Small quantities are added to cooking salt to prevent deficiency.

The role of iodine. Iodine is necessary for the synthesis of thyroid hormones, therefore the normal functioning of the thyroid gland.

These hormones play an extensive role in the regulation of metabolism and are essential for normal growth in children.

Sources of iodine. Seafood is the best source of iodine. Cooking salt is also enriched in iodine (iodized), because of the importance of adequate intake throughout life.

When do you need iodine supplements? Iodine supplements are rarely necessary, only given through a medical prescription. Eating too much cabbage or nuts can promote iodine deficiency which affects the normal functioning of the thyroid gland.

Iodine deficiency leads to hypothyroidism which causes lethargy, weight gain, swelling of the face and constipation. Babies born to iodine deficient mothers are lethargic and suffer developmental delay. *** 18

VITAMINS & MINERALS

Iron (Fe) Also known as ferrous fumarate, ferrous gluconate, ferrous sulfate, polysaccharide-iron complex.

It is available over the counter, also as in the form of injections through a medical prescription.

The role of iron. Iron plays an important role in the formation of red blood cells because it is part of the core of hemoglobin, the oxygen carrying component of the red blood cell. It is also part of myoglobin, the molecule that deposits oxygen in the muscle to be used during exercise. It also part of enzymes that convert carbohydrates into energy.

Sources of iron. Liver is the best source of iron. Meat, eggs, fish, chicken, green vegetables, nuts, dry beans and whole grain foods are also good sources of iron. Vitamin C containing foods increase the absorption of iron.

When do you need iron supplements? Iron supplements are given to pregnant women and up to 3 months after childbirth to replenish iron stores in the body. Premature babies may also be given supplements. Supplements are necessary for people on a vegetarian diet and those with chronic blood loss (eg., those with a peptic ulcer).

Iron deficiency leads to anemia (called iron deficiency anemia) with symptoms such as: fatigue, breathlessness a& palpitations. Increased susceptibility infections, apathy and irritability may be present. *** Potassium (K) Also known as potassium acetate, potassium chloride, potassium citrate, potassium gluconate. It is available over the counter in small doses as a part of multivitamin supplements. It is prescribed in high doses to supplement potassium loss, for example due to diuretics use.

19

DBMI

The role of potassium. Potassium and sodium act together to maintain water balance in the body, to conduct nerve impulses, to make possible muscle contraction and a normal functioning of the heart. Potassium is necessary for the process of storage of carbohydrates and for their breakdown in order to be converted to energy.

Sources of potassium. Green leafy vegetables, tomatoes, oranges, potatoes and bananas are great sources of potassium. Meats low in fat, beans, chocolate, coffee and milk are also rich in potassium. Food processing may decrease potassium content.

When do you need potassium supplements? Consumption of alcohol in large quantities, eating salty food, diabetes, and some kidney disorders may lead to potassium deficiency. The most common cause though remains the long-term use of diuretics. Prolonged steroid therapy can also lead to potassium deficiency. Supplements are also used in cases with laxative abuse, chronic diarrhea and vomiting.

Muscle pain, fatigue, vertigo, arrhythmia (abnormal heart rhythm), and confusion are signs of deficiency. *** Magnesium (Mg) Also known as amino acidic magnesium chelate, magnesium gluconate, magnesium hydroxide, magnesium oxide, magnesium sulfate.

It is available over the counter in various combinations with vitamins and minerals. Magnesium is often a component of antacids and laxatives that are available over the counter.

The role of magnesium. Magnesium is essential for the formation of bones and teeth, for muscle contraction and nerve impulse conduction.

20

VITAMINS & MINERALS

It activates enzymes that are necessary to convert carbohydrates and fats into energy. It also plays a role in the regulation of body temperature.

Sources of magnesium. Grains, nuts, soy bean, cheese, seafood and green leafy vegetables are good sources of magnesium.

When do you need magnesium supplements? Magnesium supplements are only taken with advice from a physician. It is prescribed in cases of malabsorption, diarrhea and vomiting, and long term diuretic use.

Estrogen based contraceptives can lower blood levels of magnesium.

Anxiety, tremor, confusion, palpitations, irritability, depression and disorientation are signs of deficiency. Extreme deficiency can cause overstimulation of the nervous system and muscle cramps.

Magnesium deficiency can contribute to coronary heart disease and to the formation of kidney stones. *** Sodium (Na) Also known as sodium bicarbonate, sodium chloride, sodium lactate and sodium phosphate.

It is widely distributed through cooking salt. Sodium bicarbonate is often a component of antacids that are available over the counter.

Sodium lactate is only given intravenously under medical supervision. Sodium phosphate is prescribed as a laxative.

The role of sodium. Sodium and potassium act together to maintain water balance in the body, to conduct nerve impulses, to make possible muscle contraction and a normal functioning of the heart.

Sources of sodium. Sodium is found in almost all food as a natural component. The main sources are cooking salt, processed foods, cheese, bread, corn, meat and fish.

21

DBMI

When do you need sodium supplements? Sodium supplements are prescribed in cases with prolonged diarrhea and vomiting, which has caused dehydration, especially to children. In tropical areas, people on a low sodium diet may be given supplements to prevent muscle cramps & treat heatstroke. Vertigo, muscle cramps, palpitations, low blood pressure, confusion & loss of consciousness are signs of deficiency. *** Selenium (Se) Also known as selenic acid, selenium sulfate, sodium selenite.

It is available over the counter in the form of tablets or capsules, combined with vitamin E, also in combination with other vitamins and minerals. Selenium sulfide is the active component of antidandruff shampoos.

The role of selenium. Selenium and vitamin E work together to preserve the elasticity of tissues, thus slowing the aging process. It also improves oxygen delivery to heart muscle. Selenium is necessary for the synthesis of prostaglandins, which protect the body from high blood pressure, prevent abnormal clot formation inside the arteries, which in turn can lead to heart attacks and stroke. Prostaglandins are also essential during childbirth.

Sources of selenium. Meat, fish, whole grain foods and dairy are good dietary sources of selenium. Its concentration in vegetables depends on the land where they are cultivated.

When do you need selenium supplements? Most diets contain the necessary quantity of selenium that the body needs. Deficiency can lead to premature ageing and decreased athletic performance. ***

22

VITAMINS & MINERALS

23

DBMI

Zinc (Zn) Also known as zinc acetate, zinc chloride and zinc oxide.

It is available over the counter in various formulations in combination with other vitamins and minerals. Zinc chloride is given intravenously under medical supervision.

Zinc is also part of ointments and other preparations that are used to treat skin disorders, dandruff, hemorrhoids and fungal infections.

The role of zinc. Zinc has a vital role in the functioning of over 100 enzymes. It is essential for the production of proteins and nucleic acids.

It also affects the function of insulin, in order to make possible the utilization of carbohydrates as a source for energy. It is necessary for normal growth and development.

Sources of zinc. Zinc is found in many types of food. It is absorbed more easily from animal foods. Meat and seafood are the best sources of zinc. Whole grain foods are also good sources.

When do you need zinc supplements? Zinc supplements are rarely needed. When given, they are prescribed for malnourished children, people with sickle cell anemia, those with massive burns & in case of malabsorption (such as cystic fibrosis), alcohol abuse & liver disease.

Deficiency can lead to loss of appetite & taste disorders. In children it can affect normal growth & development, and delay sexual maturity. ***

24

Albanian to English translation by Dr. I. Xhura. Materials are presented in abridged version from DBMI’s e-book: Urgjencat, Drogat, Vitaminat dhe Mineralet - Dr. Besi [Emergency Situations, Drugs & Abusive Substances, Vitamins & Minerals.] Published on Jun 21, 2015.

Photo & link of the book in its original format, as it appears in ISSUU https://issuu.com/doctorbesimedicalinformation/docs/urgjenca__drogat_e_substancat_abuzu

My thanks and gratitude go to a small team of people; Dr. I. Xhura for translating my materials from Albanian into English Sh. Tota & A. Gjidoda for their review of grammar & punctuation