immune deficiency

A vitamin is a natural substance that is required by the human body in order for it to grow and develop. Vitamins provide a source of energy that is used for metabolism in the body as well as promote health by the prevention of certain illnesses. Vitamins are made up of chemical elements that must be obtained from food. It is essential, therefore, that the human diet contains a blend of foods that will provide vitamins in order to maintain a healthy status.

Vitamins are categorized as two different kinds: fat soluble, which are stored in body tissues, and water soluble. The water soluble vitamins are also known as the B-complex vitamins as well as vitamin C. These water soluble vitamins are not able to be stored within the body and are excreted after a short period of time. Therefore, in order to maintain adequate levels of water soluble vitamins, they must be replenished daily in the diet. Eating a diet of certain foods that contain B-complex vitamins as well as vitamin C will promote adequate nutrition and will provide the benefits of health and protection against many diseases.

Use in Nutrition

When a person eats food that contains water soluble vitamins, it passes through the stomach and into the small intestine where the vitamins are absorbed and distributed throughout the body through the blood stream. The exception to this is vitamin B12, which requires the presence of intrinsic factor, a substance produced in the stomach that allows for absorption in the small intestine.

Without intrinsic factor, the body cannot absorb vitamin B12. After absorption, water soluble vitamins are only of use in the body for their necessary tissues and, if too much is available, the body will excrete the excess. Water soluble vitamins eventually are excreted either through the urine or feces, requiring replacement vitamins daily.

Types of Water Soluble Vitamins

Vitamin B1 (thiamine)

Vitamin B1 is also referred to as thiamine and was one of the first B-complex vitamins discovered for its nutritional properties. Thiamine is found in many foods, particularly in grains such as whole wheat and oatmeal; fruits and vegetables, such as asparagus and oranges; and seeds, such as flaxseed and sunflower seeds.

Many grains, in particular those found in white bread, are required to have thiamine added as part of an enrichment process in order to replace any that may have been lost. The recommended daily allowance of thiamine is 1.4 milligrams, although taking in more than this amount has not been shown to have adverse effects.

Thiamine Deficiency

Because thiamine is frequently found in many foods, a deficiency of this type of vitamin is typically associated with other illness that results in a person being unable to acquire the needed amounts of the vitamin. Situations such as gastrointestinal illnesses that may inhibit the absorption of thiamine may lead to a deficient state.

Alcoholism can also result in a thiamine deficiency, as the affected person may have insufficient nutrition and vitamin intake. Alcoholism, when severe, can impair the body’s ability to absorb thiamine from the gastrointestinal tract as well as impairing liver function.

There are two main diseases associated with a deficiency of Vitamin B1. The first is beriberi, which is classified as being either wet or dry. Wet beriberi may affect the cardiovascular system by causing symptoms of rapid heart rate, swelling in the extremities, and shortness of breath. The symptoms of wet beriberi can be similar to those of congestive heart failure.

Dry beriberi affects the neurological system and symptoms include confusion, numbness and tingling of extremities, paralysis, difficulty with motor coordination and walking, pain, and involuntary eye movements. Treatment is aimed at replacing the thiamine deficiency, which provides rapid relief of symptoms. Severe damage may be irreversible, even with proper vitamin supplementation.

Wernicke’s encephalopathy (also referred to as Wernicke-Korsakoff syndrome or alcoholic encephalopathy) is a condition of thiamine deficiency that eventually causes damage to the brain, resulting in neurological symptoms. It is associated with alcoholism due to the number of patients seen with the illness as a result of heavy drinking.

Symptoms include difficulty with walking and motor coordination, memory loss, hallucinations, and involuntary eye movements. The condition is treated by giving thiamine, which will reduce symptoms but may not reverse neurological damage, such as memory loss.

Vitamin B2 (riboflavin)

Vitamin B2 is also called riboflavin and is available in many foods. Many people choose to take a vitamin supplement to increase the amount of B-complex vitamins they are receiving daily in order to promote health. The recommended daily allowance of Vitamin B2 is 1.1 to 1.3 milligrams.

Riboflavin has been shown to reduce cataracts and migraine headaches in some patients, as well as help with symptoms of anemia. Riboflavin is an antioxidant and works as a protector within the body, destroying free radicals that work to slow growth and development or that may cause cancer. Riboflavin is found in whole grains and yeast; vegetables, such as broccoli and spinach; and dairy products, such as milk, yogurt, and eggs.

Riboflavin Deficiency

Riboflavin deficiency results in a condition called ariboflavinosis, which most commonly occurs with those that have a diet lacking in sufficient nutrients. Ariboflavinosis typically occurs in conjunction with other vitamin deficiencies, so for the person lacking riboflavin, there may be other vitamin insufficiencies as well. Ariboflavinosis can also occur in persons suffering from alcoholism, as alcohol can be destructive to the gastrointestinal tract, preventing its ability to absorb the vitamin.

Symptoms of ariboflavinosis are red and cracked lips; cracking at the corners of the mouth; sensitivity to light; itchy, watery eyes; ulcers in the mouth; and dermatitis. Treatment of the condition includes increasing the amount of Vitamin B2 in the diet, or in severe cases, riboflavin supplements in vitamin form.

Niacin (Vitamin B3)

Vitamin B3 is typically called by the name niacin. Niacin is found in many foods and a deficiency is uncommon, except in extreme cases of malnutrition or alcoholism. Niacin is added to many cereals and breads as a fortifier to add amounts to the diet. The recommended daily allowance of niacin is 14 to 16 milligrams daily. Niacin works to help the body’s circulatory system and can improve cholesterol levels. It has been used to treat high levels of triglycerides and LDL cholesterol.

It is also beneficial in reducing atherosclerosis, which is the buildup of fatty tissue within the blood vessels. Niacin is found in meats such as chicken, beef, or fish; dairy products, such as milk and eggs; vegetables, such as broccoli, carrots, and asparagus; as well as mushrooms and yeast.

Niacin Deficiency

Lack of niacin in the diet is unusual in developed countries where diets are fortified and complete. A niacin deficiency causes a condition called pellagra, a disease that if left untreated, will result in death. Symptoms of pellagra include difficulty walking and problems with motor coordination; diarrhea; inflammation of the skin; hair loss; a red, swollen tongue; skin lesions; weakness; and cognitive changes. Treatment is available through measured doses of niacin to control toxicity.

Vitamin B6 (Pyridoxine)

Vitamin B6 is one of the B-complex vitamins that is frequently found in foods, although deficiencies in this vitamin have been seen in the elderly or in children with unbalanced diets. Vitamin B6 is also called by its lesser known name, pyridoxine. The recommended daily allowance of vitamin B6 is 1.3 to 1.7 milligrams, depending on age.

Vitamin B6 is responsible for building up some of the neurotransmitters in the brain that contribute to elevated mood and decreased depression. For this reason, it has been used in the treatment of some mood disorders as a supplement. Vitamin B6 also is helpful in reducing cardiovascular disease in the body and maintaining good heart health.

Finally, it is an essential component of the absorption of Vitamin B12 by the body and the two vitamins work closely together for health maintenance. Vitamin B6 is found in many foods, including poultry and fish, such as chicken, turkey, and shrimp; grains, such as whole wheat and wheat germ; vegetables, such as carrots and spinach; and dairy, such as milk and eggs.

Vitamin B6 Deficiency

A deficiency of vitamin B6 is rare, but can be seen in patients with medical conditions, such as those undergoing dialysis. Vitamin B6 deficiency used to be seen more commonly as a pediatric illness, referring to the lack of the vitamin received by infants eating certain types of formula. The condition is rare today with the fortification of most infant formulas in the United States.

Symptoms of vitamin B6 deficiency include red, chapped lips; skin rash; inflammation of the tongue, with mouth ulceration; and conjunctivitis. A mild form of the illness may result in symptoms of depression, related to the vitamin’s effect on serotonin in the body, a neurotransmitter that stabilizes the mood.

Folic Acid (Vitamin B9)

Folic acid is probably best known for its essential supplementation needed for women that are pregnant. Folic acid assists the body in the development and growth of tissues and body systems, particularly during infancy and childhood. It also facilitates the growth of a fetus during pregnancy and can lessen the risk of certain birth defects that may form during gestation. Folic acid provides stability for mood function and cognitive abilities and contributes to overall mental health.

The recommended daily allowance of folic acid is 400 micrograms per day, with an increase to 600 micrograms per day recommended for women that are pregnant or that are planning to become pregnant.

Folic acid is found in a variety of foods, particularly in vegetables, such as spinach, asparagus, Brussels sprouts, and beans; orange juice; milk; and whole grains. Most breads and cereals are fortified with this vitamin to provide added supplementation for the diet.

Folic Acid Deficiency

A deficiency in folic acid can occur in those with an unbalanced diet, or persons suffering from a medical disorder that disrupts absorption of vitamins within the gastrointestinal system. Folic acid deficiency is characterized by a sore tongue and inflammation of the gums; diarrhea; loss of appetite; and depression.

Women that are deficient in folic acid during pregnancy have a greater risk of having a baby with a neural tube defect, which includes the areas of the brain and spinal cord. Types of neural tube defects include spina bifida, meningocele, and cleft lip and palate. Supplementation of folic acid is particularly important for the woman considering pregnancy, as the structures of the brain and spinal cord develop in the early weeks of gestation, possibly before a woman may know she is pregnant.

Vitamin B12 (Cobalamin)

Vitamin B12 is important in the regulation of nerve centers within the body: those that are responsible for connection between the brain and motor coordination, as well as stabilization of mood. Vitamin B12 is also responsible for adjusting the body’s immune cells, which can keep a person healthy.

It works alongside folic acid to control the creation of red blood cells, providing needed oxygen to all parts of the body. Vitamin B12 is absorbed in the stomach by stomach acid, and it is found in foods that come from animals, namely beef; poultry; fish; eggs; and milk. Its recommended daily allowance is 2.4 micrograms.

Vitamin B12 Deficiency

A deficiency in vitamin B12 can occur with those that eat unbalanced diets, people with a medical illness that causes malabsorption of vitamins, and those that do not eat meat or dairy products. Since stomach acid is needed for the absorption of vitamin B12, the elderly are also at increased risk of deficiency, as stomach acid reduces in amounts as the body ages.

Symptoms of vitamin B12 deficiency include shortness of breath; numbness and tingling of the extremities; fatigue; and diarrhea. Symptoms of mild vitamin B12 deficiency may go unnoticed for a period of time until severe. Untreated, severe vitamin B12 deficiency can cause cognitive changes and damage to the neurological system.

Pernicious anemia is a condition characterized by the body’s inability to absorb vitamin B12. Persons with this illness must take regular supplements of the vitamin, usually in the form of injection daily, in order to retain an adequate amount in the body for proper functioning and to avoid permanent damage.

Biotin (Vitamin B7)

Biotin has also been referred to as Vitamin H, and is a necessary component for strength in finger and toenails, skin, and hair. This vitamin is also needed for development during pregnancy, making it an essential vitamin required for proper growth of a fetus. Biotin can be found in several foods in small concentrations.

It is commonly found in eggs (cooked); nuts, such as walnuts, peanuts, and almonds; legumes and beans; mushrooms; and bananas. The recommended daily allowance of biotin is 30 micrograms daily for adults.

Biotin Deficiency

A deficiency in biotin is uncommon, as the necessary amounts needed for health are considered low in comparison with many of the other water soluble vitamins. Biotin may be produced by some intestinal flora found in the body in situations where a deficiency may occur.

Nevertheless, there are some circumstances that cause biotin deficiency in certain populations. Persons that eat egg whites over a long period of time can develop a deficiency in the vitamin.

Biotin is available in cooked eggs as part of the yolk, but when raw, egg whites have a substance called avidin that does not allow the body to absorb biotin. People that take certain antibiotics or anticonvulsants may be at risk for developing biotin deficiency, as these medications may inhibit the body from absorbing the vitamin.

Symptoms of biotin deficiency include changes in the texture of hair and hair loss; dry, rashy skin; fungal infections; depression; numbness and tingling of the extremities; and cognitive changes. The condition is treated with biotin supplementation.

Pantothenic Acid (Vitamin B5)

Vitamin B5, also called pantothenic acid is extremely common as a vitamin in many sources of food. It is needed for control of cholesterol and triglycerides in the body, to reduce the occurrence of atherosclerosis in the blood vessels. Pantothenic acid has also been known to help the body manage stress and it has been shown to be of some benefit for those suffering from the effects of rheumatoid arthritis.

It is found in a large number of foods, although some processing methods may reduce the amount of the vitamin. Vitamin B5 is found in meats, such as chicken, beef, and duck; beans and legumes; vegetables, such as corn, broccoli, avocado, and sweet potatoes; nuts and seeds, such as peanuts and sunflower seeds; whole grains; yeast; and milk. The recommended daily allowance for pantothenic acid is five milligrams.

Pantothenic Acid Deficiency

Symptoms of pantothenic acid deficiency are very rare and usually occur within populations that are extremely malnourished. Symptoms include depression and fatigue; abdominal pain; vomiting; and irritability. The condition is treated with an adequate diet or supplementation when necessary.

Vitamin C (Ascorbic Acid)

Also known as ascorbic acid, vitamin C is a necessary element in many functions of the body. Vitamin C is responsible for the production of collagen in the body, a substance that is the foundation of ligaments and tendons; skin; and blood vessels. It also helps the body during the healing process, so that wounds and injuries heal more quickly.

Vitamin C is found in many foods, and is well-known as a substance in a variety of citrus fruits. Lemons, limes, grapefruit, and oranges are all sources of the vitamin. It is also found in vegetables, such as peppers, tomatoes, squash, cabbage, broccoli, and spinach; and other fruits, such as pineapple, blueberries, cranberries, strawberries, raspberries, and kiwi. The recommended daily allowance of vitamin C is 75 to 90 milligrams.
Vitamin C Deficiency

Mild vitamin C deficiency can be common among children, the elderly, and those that do not consume adequate amounts of fruits and vegetables. Cigarette smokers are also at increased risk of vitamin C deficiency as the ingredients of cigarette smoke reduce the amount of the vitamin within the body. Symptoms of mild vitamin C deficiency include dry skin, nosebleeds, bruising easily, and brittle hair.

Severe deficiency of vitamin C causes a condition known as scurvy, which is rarely seen in developed countries today. Historically, scurvy was often seen in sailors that travelled for weeks by boat without fresh fruits and vegetables in their diets.

The disease was eventually treated by stocking limes as a part of the food sources on each voyage, thereby reducing the amounts of the illness among that population. The disease can be very severe and will lead to death if left untreated. Symptoms of scurvy include all of the listed signs of mild vitamin C deficiency. In addition, bleeding and soft gums; loss of teeth; pallor; bleeding; slow wound healing; depression; and paralysis are all associated with the disease.

Sources:
1. University of Maryland Medical Center: Vitamin B1 (thiamine)
2. Colorado State University: Water Soluble Vitamins
3. Healthwise: Vitamin B3
4. Linus Pauling Institute: Vitamin B6
5. University of Maryland Medical Center: Vitamin H (biotin)
6.Ohio State University: Folate
7. University of Michigan Health System: Vitamin B12
8. Linus Pauling Institute: Pantothenic Acid
9. Ohio State University: Vitamin C

Vitamin D is a fat-soluble organic nutrient divided into five analogues, the two most important of which are D2 and D3. Vitamin D mentioned without the subscript usually means D2, D3, or a combination of both. Some analogues of vitamin D are produced by the skin of all vertebrates as a result to the exposure of sunlight or other forms of ultraviolet B radiation. Vitamin D is also found in a variety of popular foods, and many countries fortify their milk with it. It is also available in pill or capsule form as a dietary supplement.

Vitamin D is absorbed into the bloodstream where the liver converts it into calcidiol, a type of prohormone. Calcidol, in turn, is then converted into calcitriol in the kidneys and by the immune system in the blood. Calcitriol is a form of vitamin D that is physiologically active and works as a hormone that regulates phosphate and calcium levels and is also responsible for bone health and bone growth. People who suffer from deficiency in vitamin D can develop fragile and malformed bones. They are also more prone to contracting rickets and osteoporosis.

Forms of Vitamin D

Since vitamin D was first discovered in 1932, five natural analogues, called vitamers, have been found to exist and four synthetic analogues have been synthetically created. As a group, vitamin D analogues are chemically classified as secosteroids, which are steroids with one broken bond.

Natural Analogues of Vitamin D

• Vitamin D1 is a molecular compound of ergocalciferol (D2) with lumisterol in a 1:1 ratio.
• Vitamin D2 (ergocalciferol) was the first to be discovered in 1932. This form is produced by invertebrates, some plants, and fungi. Biological production of D2 is stimulated by ultraviolet light. Scientists are unsure how the vitamin works in invertebrates, but it is thought to act as a natural sunscreen.
• Vitamin D3 (cholecalciferol) is the form created in the skin by the reaction of 7-dehydrocholesterol with ultraviolet B radiation, present in sunlight with a UV index of 3 or more. When enough of the vitamin is created, excess amounts spontaneously degrade.
• Vitamin D4 is an analogue scientifically known as 22-dihydroergocalciferol.
• Vitamin D5 (sitocalciferol) is another analogue created from 7-dehydrositosterol.

Synthetic Analogues of Vitamin D

Calcipotriol is derived from calcitriol and is used as a treatment for psoriasis. It was first discovered during trials involving the use of vitamin D for treating osteoporosis. It is applied as a cream or ointment to the skin or scalp with very few side effects noted. Rarely, the use of calcipotriol causes hypercalcemia.

Dihydrotachysterol (DHT) is a synthetic form of vitamin D that many consider superior to natural D2 and D3. It becomes active by the liver without needing to go through hydroxylation in the kidneys. DHT has a two-hour onset time and is more efficient in the mineralization of bone salts.

Paricalcitol is also derived from calcitriol. It is used to treat and prevent secondary hyperparathyroidism that is caused by kidney failure. Paricalcitol is manufactured and marketed by the drug company Abbott under the brand name Zemplar. Zemplar is administered intravenously and is associated with several side effects, including weakness, nausea, vomiting, constipation, and decreased libido.

Tacalcitol is a derivative of vitamin D3. It is known to hinder keratinocytes in the skin and is used primarily as a treatment for psoriasis. It is most commonly sold under the brand names Curatoderm or Bonalfa.

Sources of Vitamin D

Sunlight

For most vertebrates, including humans, the primary source of vitamin D is that produced by their own skin. 7-dehydrocholesterol is produced in mass quantities by the skin of most every vertebrate, one exception being the naked mole rat. As ultraviolet B light (290 “ 315 nm wavelength)from the sun or other sources makes contact with the 7-dehydrocholesterol, it undergoes a photochemical reaction that converts it to cholecalciferol. In animals such as birds and furry mammals where their skin is blocked from the sunlight, 7-dehydrocholesterol is secreted into the feathers or fur in an oil, where it converts through sunlight and is eaten by the animals during oral grooming. The cholecalciferol then moves through the bloodstream where it is converted into calcitriol, the form that is usable biologically.

In areas north of 42 degrees north latitude, there is not enough UVB light for vitamin D to be synthesized in humans from November to February. For this reason, people living in northern latitudes (southern latitudes in the southern hemisphere) often run vitamin D deficient in the winter months. For those living north of the 34 degree north latitude, that period is extended to 6 months. From the 34 degree north latitude to the 34 degree south latitude, sufficient UVB rays reach the Earth for year-round synthesis. Some physicians recommend 30 minutes of sunlight exposure twice per week for adequate vitamin D production. Care must still be taken to limit exposure because of the dangers of skin cancer. There are some factors that limit UVB transmission from the sun to the skin:

UVB light does not penetrate glass windows. Sunscreen over SPF 8 totally inhibits vitamin D production, but experts say most people accidentally leave some areas of skin uncovered by sunscreen. A small patch left uncovered still produces active levels of vitamin D. Cloud cover reduces UVB rays by 50 percent. Shade blocks UVB rays by 60 percent.

Food

Vitamin D is rare in natural foods. The largest amounts are found in fish, such as tuna, mackerel, and salmon. The highest concentrations are in the oils of the fish liver. Smaller amounts of vitamin D3 can be found in egg yolks, cheese, and beef liver. Vitamin D2 is found is found in edible mushrooms that have been exposed to sunlight or UV light. Here is the vitamin D content of some common foods: (Recommended daily value is 400 IU)

• Cod liver oil (1 Tbsp) “ 1360 IU
• Salmon, cooked (3 oz) “ 794 IU
• Mackerel (3 oz)“ 388 IU
• Tuna (3 oz)“ 154 IU
• Sardines, canned (1 sardine) “ 23 IU
• Beef Liver (3.5 oz) “ 46 IU
• Chicken Egg (large) “ 25 IU
• Cheese, Swiss (1 oz) “ 6 IU

In the U.S. and other developed countries, most dietary vitamin D comes from artificially fortified foods. In the early 20th century, rickets was a major health problem. Since vitamin D combats rickets, the U.S. government began to artificially introduce vitamin D into milk. Results among the general population were almost immediate, and the program has continued to this day. Other countries have since followed suit. Other foods can also be fortified with vitamin D, including breakfast cereal, orange juice, margarine, and yogurt. Unlike milk, which is almost all fortified, other products may or may not be fortified. Mushrooms have recently begun to be fortified semi-naturally by exposing them to controlled UV light emissions greater than they would be exposed to naturally.

• Mushrooms, enhanced (3 oz) “ 400 IU
• Milk, fortified (1 cup) “ 115 “ 124 IU
• Orange Juice, fortified (1 cup) “ 100 IU
• Yogurt, fortified (6 oz) “ 80 IU
• Margarine, fortified (1 Tbsp) “ 60 IU
• Breakfast cereal (1 cup) “ 40 IU

Dietary Supplements

Dietary supplements are available as vitamin D2 or D3. D2 supplements are made by exposing yeast to UV radiation. This causes the yeast to naturally produce the vitamin. D3 supplements are made by exposing lanolin containing 7-dehydrocholesterol to UVB radiation. Although both work equally well as a treatment for rickets, some question has been recently been raised as to how they are metabolized. In tests, vitamin D3 shows to be as much as 3 times as effective as vitamin D2. Some people, such as vegetarians and vegans, are opposed to the D3 supplements, however, because they are sourced from animals.

Health Effects of Vitamin D

Although the exact serum concentrations of vitamin D for optimal health have not been established, researchers estimate the level is somewhere between 16 and 48 ng/ml and varies by age with older people requiring higher levels. Recently, however, one group of researchers have claimed support for their statements that the true optimum serum levels are 16 to 48 ng/ml, and supplementation of 400 IU per day only increase serum levels by 2.8 to 4.8 ng/ml. Therefore, they are recommending a daily value of 1,700 IU/day. Having sufficiently levels of vitamin D plays an important role in health and can prevent or treat several conditions.

Immune System

Although studies are still continuing, vitamin D shows an increase in ability of natural killer (NK) cells to fight infections. It also shows an increase in macrophage activity. Increased bodily production of cathelicidin, a natural antimicrobial agent, is also linked to sufficient levels of vitamin D. Some researchers have suggested that the immune system response to vitamin D can reduce the risk of fetuses to develop multiple sclerosis, but these claims are refuted by other researchers.

Cardiovascular System

A National Health and Nutrition Examination Survey once showed a link between low levels of vitamin D and peripheral artery disease. In addition, a study done in the U.K. showed that those who work outdoors in the summer had lower cholesterol. Others have claimed vitamin D deficiency is linked to high blood pressure. All of these claims were later shown to be untrue during systemic reviews.

Cardiovascular studies with vitamin D continue and some recent findings have suggested benefits that are associated to particular ethnicities. In these studies, sufficient vitamin D levels in people of African descent may reduce the risk of cardiovascular disease, while no such correlation exists in people of European or Caucasian descent. Another study shows that Indians, despite receiving plenty of sunshine, may still suffer from vitamin D deficiency.

Osteoporosis

Osteoporosis, which causes loss of bone density and increased risk of fractures, is usually associated with calcium deficiency, but studies show that vitamin D deficiency also plays a role in the development of the condition. Sufficient levels of vitamin D increase the body’s absorption of calcium and long-term deficiencies can manifest in osteoporosis. Vitamin D supplementation is recommended for seniors, individuals with limited mobility, and postmenopausal women to help prevent osteoporosis.

Since most research of vitamin D and osteoporosis include calcium intake, the exact effects of vitamin D alone are impossible to determine at the present. Studies always recommend the two be taken together, and the final conclusion is that 700 -800 IU/day of vitamin D3 and 500 -1,200 mg/day of calcium reduces the bone loss and decreases incidents of falls and fractures for people between the ages of 62 and 85 years.

Cancer

Both human and animal studies suggest that sufficient vitamin D levels play an important role in the prevention of some forms of cancer, including breast cancer, prostate cancer, and colon cancer. So far, the presence of vitamin D shows the most promise in those with colon cancer, while the other forms of cancer have highly variable test results. Other studies of vitamin D and cancer show either no effect or even a negative effect. One study in Finland on smokers showed that the subjects in the top 20% of vitamin D serum levels are three times more likely to develop pancreatic cancer. The general consensus is that much more research is needed to determine the exact effects of vitamin D on cancerous cells.

Mortality

An independent group of researchers using the data from the National Health and Nutrition Examination Survey concluded that high levels of vitamin D indicate statistically lower rates of mortality among the general population. The research began with detecting vitamin D levels over a 6 year period, ending in 1994. The subjects, however, were continued to be tracked for mortality until 2000. By using the leukocyte telomere length (LTL) to predict the development of diseases and health conditions related to aging, it was determined that those with optimal levels of vitamin D would live longer.

Other Health Conditions

Vitamin D analogues may be effective in treating a variety of other diseases and health conditions:

• Low blood phosphate levels
• Psoriasis
• Low calcium
• Rickets
• Rheumatoid arthritis
• Hyperparathyroidism
• Tooth decay

One group of researchers and concerned citizens known as the Vitamin D Council is claiming vitamin D deficiency is the source of a range of disorders, including autism, depression, and other forms of mental illness. While initial research shows some correlation, studies on these conditions have only just begun.

Side Effects and Health Risks of Vitamin D

Vitamin D supplementation has been linked to several minor side effects:

• Nausea
• Vomiting
• Loss of appetite
• Constipation
• Weakness

Other side effects have been linked to vitamin D’s ability to increase absorption of calcium:

• Confusion
• Mental abnormality
• Heart arrhythmia
• Kidney stones

Vitamin D has shown to interact with some medications. Corticosteroids, which are used to treat inflammation, impair vitamin D absorption. This can contribute to osteoporosis and a doctor should be consulted regarding vitamin D intake. Orlistat, a weight-loss drug, and cholestyramine, a drug to reduce cholesterol, also reduce vitamin D absorption. Phenobarbital and phenytoin, both used to treat epilepsy, increase metabolism of vitamin D into inactive substances.

Vitamin D has also been shown to increase calcium levels in people suffering from lymphoma, sarcoidosis, and histoplasmosis. This can lead to kidney stones. Vitamin D may also contribute to more severe symptoms in people with atherosclerosis.

Fat soluble vitamins are stored in the body’s fatty tissue and liver. These vitamins are used over a period of time unlike water soluble vitamins that need to be replenished daily. Individuals with an inability to digest fats, as in intestinal disorders or persons with reduced consumption because of low fat diets, may have deficiencies in fat soluble vitamins, which include A, D, E and K. Excesses occur in the body as fat soluble vitamins are not as readily eliminated.

A healthy well-balanced diet containing foods from all four food groups is the way to ensure the body is obtaining adequate amounts of these vitamins.

Vitamin A

Vitamin A consists of retinols and carotenes (alpha, beta and gamma), which are converted in the body after consuming animal and plant products. The vitamin in carotene form is transformed into retinol while in storage, or into the active form retinal, and back again as needed. Vitamin A conversion takes place in the intestine. Healthy sources of vitamin A include:

• Animal fats
• Butter, buttermilk or margarine
• Cod liver oil or oily fish
• Egg yolks
• Green leafy vegetables
• Liver
• Yellow/orange fruits and vegetables

Purpose

Vitamin A is essential for fighting infection, maintaining healthy body tissues, and contributes to bone and teeth development. In reproduction, vitamin A in retinal form, binds to the nucleus of cells and assists with beginning and ending gene transcription, making it essential in neonatal development and ongoing growth and repair. Vitamin A, in the form of retinal, binds to the rods and cones of the eye, permitting light adaptation and the ability to see color.

Vitamin A as retinoic acid is a successful acne treatment as it shrinks sebaceous glands and inhibits secretions. In the form of isotretinoin, vitamin A decreases the number of skin bacteria and the bacterial nutrient sebum.

Recommended Daily Dosages:

• Infants require 1,300 to 1,650 IU daily depending on age.
• Children require 1,000 to 2.000 IU daily depending on age.
• Women require 2,300 IU of vitamin A daily.
• Men require 3,000 IU of vitamin A daily.

Deficiencies

Getting less than the minimal daily requirements is a concern for children in third world countries. Another form of deficiency occurs in persons who eat low fat diets, conditions that prevent fat absorption, or those subjected to chronic oxidants like cigarette smoke.

Inadequate amounts of vitamin A cause a preventable form of blindness as keratin deposits and builds up on the cornea, causing erosion and destruction. Deficiencies of this vitamin lead to impaired growth and development, inability to fight infection, malfunction of the gastric, urinary, and respiratory systems due to impaired tissue development, night blindness and dry, thickened and peeling skin.

Toxicity

Excessive vitamin A intake results in anorexia, bone and joint pain, changes in mental state, drying and peeling skin and lips, yellow/orange discolored skin, hair loss, vomiting and weakness. Taking vitamin A in amounts exceeding the daily requirement, results in birth defects in unborn children.

Tips: Though vitamin A is not destroyed by cooking, freezing foods could result in a 10-20% loss.

Vitamin D

Whether absorbed and synthesized by the skin or ingested, vitamin D is absorbed by the liver through the blood and transformed into calcidiol. Once converted, vitamin D is transported to the kidneys and the immune system through the blood. In the kidneys, vitamin D is transformed again and recirculated in the blood where it binds to receptor sites throughout the body. The skin only synthesizes the necessary amount of the vitamin, after which it is no longer manufactured, so overdoses cannot occur in this manner.

The vitamin D group contains D2 (calciferol), D3 (7-dehydrocholesterol), D4 (22-dihydroergoasterol) and D5 (dehydrositosterol). Healthy sources of vitamin D include:

• Butter fat
• Cod liver oil, salmon, and oily fish
• Egg yolks
• Foods that have been irradiated
• Fortified milk and foods
• Sunlight

Purpose

In the blood, vitamin D regulates calcium and phosphorus, thus contributing to bone and teeth formation.

Vitamin D also aids in white blood cell production and determination. The vitamin increases infection fighting white cell activity and contributes to the chemical white cells excrete in combating bacteria, fungus and viruses. Some research studies suggest that increasing daily intake to 1000 IU daily has a dramatic effect in preventing cancer.

Because of vitamin D’s wide range of abilities, persons found to have low levels overall had higher mortality rates and premature aging due to body malfunction.

Recommended Daily Dosages

Infants to adults require 200 IU of vitamin D daily. Elderly adults require 400 IU daily.

Deficiencies

Persons getting less than the minimal daily requirements experience irritability, weakness, malabsorption of calcium and phosphorus causing poorly developed or deformed bones and teeth in a condition known as rickets. Adults may experience osteomalacia, where bones thin, become fragile and are accompanied by muscle weakness.

Toxicity

Ingesting excessive amounts of vitamin D results in abnormal kidney function, anorexia, anxiety, excessive urination and thirst, excessive blood calcium levels, nausea, vomiting and weakness.

Tips

15 minutes of exposure to sunlight daily allows the skin to synthesize enough vitamin D for 24 hours. However, vitaimin D deficiencies are still noted in third world countries where there is an abundance of sunshine. Individuals are advised to consume meats or fortified milk and foods to ensure an adequate intake.

Vitamin E

The vitamin E group consists of tocopherols and tocotrienols and each has four forms, alpha, beta, delta and gamma. The human body requires alpha-tocopherols. Vitamin E is absorbed by the liver from the intestine and recirculates it through the bloodstream. Healthy sources of vitamin E include:

• Asparagus
• Avocado
• Eggs
• Leafy green vegetables
• Milk
• Nuts
• Rice
• Seeds
• Vegetable oils
• Wheat germ
• Whole grain foods

Tocotrienols are specifically found in barley and other grains, nuts, saw palmetto, wheat germ and vegetable oils.

Purpose

Vitamin E is essential for maintaining healthy cell membranes as it is believed to act as an antioxidant which minimizes aging effects and disease processes brought about by free radicals on the body. Free radicals are molecules with an unpaired electron. These combine with oxygen to cause damaging effects commonly associated with cardiovascular disease and cancer.

Tocotrienols have been researched and show promise in protecting brain cells against damage, inhibiting cancer and decreasing blood cholesterol. The unsaturated chain increases absorption into fatty tissue making it more effective as a protectant.

Vitamin E in the lining of blood vessel walls helps minimize build up of harmful plagues and blood clots. In addition, early research suggests that vitamin E may play a part in preventing age related macular degeneration in the elderly.

Recommended Daily Dosage

• Infants require 6.75 to 10 IU of vitamin E daily.
• Children require 9 to 10 IU of vitamin E daily.
• Adults require 22 IU of vitamin E daily.

Deficiencies

Inadequate amounts of vitamin E result in edema, muscle weakness and neurological deficits related to poor nerve conduction. Anemia occurs as a result of red blood cell damage.

Toxicity

Excessive doses cause breast enlargement, blurred vision, headaches, flu-like symptoms, hemorrhagic strokes and prolonged bleeding times. Administering the vitamin to low birth weight infants may result in colitis and sepsis. Pregnant women are advised against taking vitamin E supplements as they cause congenital heart defects in unborn children.

Vitamin K

The vitamin K group consists of K1 (phyloloquinone) and K2 (menaquinone). Synthetic forms of the vitamin include K3 (menadione) found in pet foods (but banned in OTC use), K4 and K5, which inhibits fungal growth. K2 is naturally manufactured by the bacteria in the large intestine. Vitamin K requires bile salts and fats to be properly absorbed. Healthy food sources include:

• Avocados
• Dairy products
• Eggs
• Green leafy vegetables
• Kiwi fruit
• Meats

Purpose

The vitamin allows the liver to synthesize clotting factors ( II, VII, IX and X), which are vital in preventing bleeding abnormalities. Vitamin K is used as an antidote for coumadin and hemorrhagic rat poisons.

Topically, the vitamin is prescribed to diminish post surgical bruising, broken capillaries, rosacea and dark under eye circles. As infants are not born with the intestinal bacteria necessary to form vitamin K, an injectible form is administered.

There is a correlation between vitamin D and K in the development of healthy teeth and bones. Ongoing research suggests that vitamin K reduces liver and prostate cancers.

Recommended Daily Dosage

• Newborns receive 0.5 to 1.0 mg injections of vitamin K at birth.
• Infants require 10 to 20 mcg of vitamin K daily.
• Children require 15 to 100 mcg of vitamin K daily, depending on age.
• Women require 90 mcg of vitamin K daily.
• Men require 120 mcg of vitamin K daily.

Deficiencies

Inadequate amounts of vitamin K result in prolonged bleeding times or hemorrhagic conditions. Individuals with intestinal disease are unable to manufacture vitamin K and are in need of supplementation. Prolonged use of large doses of antibiotics annihilate the bacteria necessary to produce vitamin K.

Toxicity

Vitamin K3 has been banned from OTC supplements as ingestion results in allergic reactions, anemia and destruction of liver cells.

Tips

1 tablespoon of parsley contains 153% of the FDA’s recommended daily allowances of vitamin K.

Resources

WebMd.Com
Cdc.Gov
National Institute of Health

Vitamin B5, or pantothenic acid, is an unstable viscous oil that is sensitive to acids, bases, and heat. It is biologically active in the forms of coenzyme A (CoA) and acyl carrier protein. It is an essential nutrient that’s crucial to a number of life-sustaining reactions in the human body. One of the B vitamins, pantothenic acid, or B5 is found in virtually every food source. In fact, the name pantothenic acid is derived from the Greek word pantos which means “from everywhere.”

Vitamin B5 goes by a number of different names, which can make it difficult to clearly identify if the nutrient is present in a particular food, medicine, or cosmetic preparation. Generally, if any of the following ingredients are listed, the nutrient is present:

• Vitamin B5
• VitaminB-5
• B Complex Vitamin
• Coenzyme A
• Pantothenic Acid
• Calcii Pantothenas
• Calcium D-Pantothenate
• Calcium Pantothenate
• D-Calcium Pantothenate
• D-Panthenol,
• D-Pantothenic Acid
• D-Panthenol
• D-Pantothenyl Alcohol
• Panthenol
• Pantothenate
• Pantothenic Acid
• Pantothenol
• Pantothenylol,
• Dexpanthenol
• Dexpanthenolum
• Calcii pantothenas
• C9H17NO5
• D (+)- N -(2,4-dihydroxy-3, 3-dimethylbutyryl)-beta-alanine
• D(+)-pantothenic acid

It can be most often found in commercial supplements as D-pantothenate (D-calcium pantothenate). Dexpanthenol is considered a provitamin form of the nutrient and is the alcohol of pantothenic acid. Dexpanthenol is used in various cosmetic products and is available in topical treatments to promote wound healing.

B5 in the Body

B5, or pantothenic acid is necessary for the human body’s chemical reactions that generate energy from food. In addition to serving an important role in releasing energy from foods, B5 in the form of CoA is also important for the synthesis of foods into fatty acids and cholesterol, as well as the creation of sphingosine. This fat-like molecule plays an important role in delivering chemical messages inside the body’s cells. Finally, B5, in its CoA form, is needed for the liver to safely metabolize several drugs and toxins.

Because pantothenic acid is in the form of Coenzyme A in most food sources, the body has to convert it into free pantothenic acid so that it can be absorbed by the intestinal cells. This conversion takes place within the lumen of the intestine where CoA is hydrolyzed A through a series of enzymatic reactions to produce pantothenic acid which is then absorbed by passive diffusion into the intestinal cells by a sodium-dependent transport system.

Dietary Needs

The Institute of Medicine at the National Academy of Sciences set adequate intake guidelines for B5 in 1998. According to those guidelines, recommended average daily intakes of pantothenic acid should range from 5 to 6 mg. per day in adults.

It is noteworthy that the human body’s need for the nutrient increases with age as indicated below:

Age Required mg/day

• 0-6 months 1.7
• 7-12 months 1.8
• 1-3 years 2
• 4-8 years 3
• 9-13 years 4
• 14-18 years 5
• 19+ 5

In addition, women who are pregnant should get 6 mg. each day. Women who are breast-feeding should ensure a daily intake of 7 mg. daily. Except in the case of extreme malnutrition, most people get adequate amounts of B5 or panthothenic acid through a healthy, balanced diet.

The symptoms of vitamin B5 deficiency are much like other B vitamin deficiencies. Because of low Coenzyme A levels there is low energy production, which can in turn causes fatigue, irritability and general apathy. In addition a deficiency in panththenic acid may also result in increased insulin sensitivity, or hypoglycemia.

Pantothenic acid sources

Approximately 85 percent of pantothenic acid found in food sources is present in the form of coenzyme A. There are several food sources that are rich in vitamin B5 including kidney, liver, avocado, yogurt, and sunflower seeds. Other foods such as fish and shellfish, chicken, milk, sweet potato, mushrooms, legumes, avocado and sweet potatoes are also excellent sources of the nutrient.

Although whole grains are also a good source of pantothenic acid; up to 75 percent of the nutrient can be lost in processing since it is largely found in the outer components of raw grains. Likewise, because it is a water-soluble nutrient, up to 50 percent of pantothenic acid in food is lost in processing and cooking.

The following provides a quick look at some of the richest sources of pantothenic acid:

• Food Serving Size B5 (mg)
• Calf’s Liver (braised) 4 oz. 2.59
• Sunflower Seeds (raw) ¼ C. 2.43
• Avocado 1 whole 1.99
• Low-fat Yogurt 8 oz. 1.35
• Yellow Corn (cooked) 1 Cup 1.44
• Chicken (cooked) 3 oz. 0.98
• Milk 8 oz. 0.83
• Winter Squash (baked) 1 Cup 0.72
• Mushrooms ½ C. chopped 0.52

In addition to occurring naturally in many foods, B5 is frequently found in combination with the other B vitamins in commercially available B Complex formulas, which also include thiamin (B1), riboflavin (B2), Niacin (B3), Pyridoxine (B6), cyanocobalamin (B12), and folic acid.

Finally, researchers have found that the bacteria that normally colonize the colon, or large intestine, are capable of manufacturing their own pantothenic acid.

Unfortunately, scientists are not yet certain if humans have the capability to absorb the pantothenic acid that is produced by their own intestinal bacteria. Even so, a specialized process for the uptake of pantothenic acid has been identified within cultured cells taken from the colon’s lining. This suggests that humans may indeed be able to absorb the pantothenic acid produced by their intestinal bacteria.

B5/pantothenic Acid in Use

The therapeutic and medicinal uses for pantothenic acid are numerous and varied, including treatment of acne, adrenal gland stimulation, allergies, Alzheimer’s disease, the prevention of anxiety, asthma, autism, carpel tunnel syndrome, celiac disease, chronic fatigue syndrome, colitis, dandruff, depression, diaper rash, eczema, gray hair, head ache, hypoglycemia, hypotension, enhancement of immune function, prevention of infection, insomnia, lupus, multiple sclerosis, muscle cramps, muscular dystrophy, obesity, Parkinson’s disease, pink eye, PMS, poison ivy, respiratory disorders, shingles, skin disorders, vertigo, and many others maladies.

Nonetheless, there isn’t sufficient scientific evidence available to determine just how effective the nutrient is as a treatment for most of these claims. Because the nutrient is so widely prevalent, many studies have been done and continue to be done to determine effective uses. A few of the uses that have shown positive results include:

Wound healing—When tested on animals, the application of a pantothenol ointment to the skin and ingestion of oral pantothenic acid has proven to accelerate the closure of skin wounds and to strengthen the resulting scar tissue. Most of the tests with these encouraging results have been conducted on animals and there is not enough data to be conclusive that the same benefits are applicable to humans.

High cholesterol—A pantothenic acid derivative known as pantethine has reportedly shown a cholesterol-lowering effect. While the results of the controlled tests have been promising in the studies that have been conducted, it’s important to keep in mind that pantethine is not a dietary supplement. Rather, the body derives it from pantothenic acid. For this reason, using it to self-treat high cholesterol is not recommended without the guidance of a qualified healthcare provider.

Acne—A study from 1995, published by Dr. Lit-Hung Leung, provided evidence that high doses of B5 decreased pore size and helped to resolve acne. The study was conducted on Asian adults who received anywhere from 10 to 20 grams of pantothenic acid daily. This high dose is equivalent of up to 100,000 times the recommended daily amount; 80 percent of the daily dose was orally ingested, while 20 percent was applied topically.

ADHD—Confliciting evidence exists as to whether or not pantothenic acid in concert with large doses of other vitamins is effective for the treatment of ADHD or Attention deficit-hyperactivity disorder.

Toxicity and Interactions

Generally, pantothenic acid is not known to be a toxic substance for humans. Moderate doses of pantothenic acid do not appear to cause side effects in any notable way. However, if an allergy exists, B5 or pantothenic acid supplements should not be added to the diet.

On the other hand, while the recommended daily allowance does not appear to cause any problems, large doses of pantothenic acid taken orally have been known to cause diarrhea. In addition, when using dexpanthenol topically, skin irritation has been an often-cited reaction. This is particularly notable because dexpanthenol is a common ingredient in a number of cosmetic products.

There has been some anecdotal findings of increased bleeding time with dexpanthenol causing a concern for a risk of bleeding when the supplement is combined with other substances that also indicate a risk for bleeding. In fact, there have been a number of cases of bleeding reported when the despanthenol was used in conjunction with Ginkgo biloba, as well as a few cases when combine with garlic and saw palmetto. For people who suffer from hemophilia, there is certainly increased risk when taking dexpanthenol.

Finally, women taking oral contraceptives containing estrogen and progestin, may need to increase their daily intake of B5 because of an increased need for the nutrient when estrogen and progestin are being taken.

Sources:

National Institute of Health

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-vitaminb5.html

WebMD

http://www.webmd.com/vitamins-supplements/ingredientmono-853-PANTOTHENIC+ACID+VITAMIN+B5.aspx?activeIngredientId=853&activeIngredientName=PANTOTHENIC+ACID+%28VITAMIN+B5%29&source=3

Oregon State University, Linus Pauling Institute, Micronutrient Information Center

http://lpi.oregonstate.edu/infocenter/vitamins/pa/

The George Mateljan Foundation for the World’s Healthiest Foods

http://www.whfoods.com/genpage.php?tname=nutrient&dbid=87

Wikipedia

http://en.wikipedia.org/wiki/Vitamin_B5

http://en.wikipedia.org/wiki/Pantothenic_acid

Drugs.com

http://www.drugs.com/npp/pantothenic-acid.html

Vitamin & Herb University

http://www.vitaminherbuniversity.com/topic.asp?categoryid=1&topicid=1013

Sitocalciferol or Vitamin D5 is one of six different forms of vitamin D, which are numbered from D2 to D7. All six of these forms are based upon calcitrol, and will be converted into calcitrol by the body when they are consumed. They differ in their origin, however, with vitamin D2 and D3 being naturally available. Vitamin D5 is a synthetically produced form of the vitamin.

Vitamin D is a fat-soluble chemical. It is only found naturally in a few types of food, but in some countries including the US, vitamin D is added to other foods such as milk. Stores of vitamin D can be built up in the body. Having too much or too little vitamin D in the body can be harmful.

Maintaining the optimum levels of this vitamin is very important in order to stay healthy. Vitamin D has a particularly strong effect on the bones. If the body does not get enough vitamin D then the bones can become weak and can grow abnormally. If the level of vitamin D in the body become too high, and reaches toxic concentrations, then the bones can be weakened.

Common Forms

The most common forms of vitamin D are D2 and D3. Vitamin D2 is produced by plants and can therefore be obtained from food. Vitamin D3 is produced in the body. When the skin is exposed to the ultraviolet B or UVB rays in sunlight, the synthesis of vitamin D3 in stimulated in the skin. People can also obtain both D2 and D3 from foods that have been artificially fortified with vitamin D.

Vitamin D5 is an artificially produced analog of vitamin D3. An analog is a chemical that shares some structural properties with another chemical, but which can behave differently from it. Vitamin D5 is structurally similar to vitamin D3, and both can be used by the body in similar ways. The D5 form is less toxic than the D3 analog, however, which makes vitamin D5 a better option for medicinal uses of vitamin D.

The 1α-Hydroxyvitamin D5 form of the vitamin was designed and produced by a team of scientists at the University of Illinois, Chicago and has since been studied in a number of experiments to test its safety and efficacy as a treatment for various cancers, particularly cancers of the breast, prostate and colon.

Chemistry

Vitamin D is a prohormone rather than being a true vitamin. When it is consumed, the body metabolizes it into a number of chemicals that are hormones. Hormones are chemical signals that are used by the body to control various functions.

Vitamin D5 is an analog of vitamin D3. They have very similar structures, but vitamin D5 has been slightly modified. Just a few of the atoms have been changed. Many different analogs of vitamin D3 were designed by scientists searching for a less toxic version of the vitamin that could be used for medicinal purposes without causing problems with toxicity.

Over 1500 of these analogs were produced. The available forms of vitamin D are now classified into six primary forms, named D2, D3, D4, D5, D6 and D7. Each form has a slightly different molecular structure, although they are all still basically the same molecule, and have similar functions in the body. The least toxic of these forms is vitamin D5, which has now undergone a number of experiments to test its efficacy and safety for the prevention and treatment of cancer.

Function

Vitamin D is essential for the maintenance of adequate levels of phosphorus and calcium in the blood. Vitamin D helps the body to absorb calcium from the intestine. Both phosphorous and calcium are required for the development and maintenance of strong bones. Vitamin D may also be able to help to protect the body against high blood pressure, cancer, osteoperosis and certain autoimmune diseases, although the scientific evidence for these functions is less clear-cut that that which shows the importance of vitamin D for the skeleton.

The vitamin D which is obtained from food or which is produced in the skin following stimulation by the sunlight is an inactive chemical. It must be converted through two hydroxylation reactions into its active forms in order to be used. The first reaction occurs in the liver, where the vitamin D is converted into calcidol. Next, the second reaction, which takes place in the kidneys, converts this calcidol into calcitrol.

The most active metabolite of vitamin D is calcitrol. Conversion of vitamin D into calcitrol is regulated according to how much calcium and phosphorus is in the blood, the concentration of calcitrol that is already present in the body, and by the parathyroid hormone. This regulation ensures that the calcitrol levels are maintained at the correct level, as long as there is enough vitamin D available from which to produce more calcitrol when it is needed.

Important Function

The most important function of vitamin D in the body is in the maintenance of calcium and phosphorus levels, and so for ensuring there is proper bone growth and development. There are also some other important functions played by this vitamin in the body. It is involved in the working of the immune system, neuromuscular function, and in reducing inflammation. Vitamin D also plays a role, along with other chemicals, in the modulation of a number of genes that regulate cell division, growth, differentiation and death.

Since most of the vitamin D that is consumed in food, fortified foods and supplements, are in the form of vitamin D2 and D3, these are the most important forms for humans. Vitamin D5, however, may have some important uses, particularly in medicine. Vitamin D5 can also perform similar functions to other versions of the vitamin, when it is consumed.

Deficiency

Vitamin D deficiencies are one of the more common vitamin deficiencies, since the levels of this chemical in food are so low. The chances of suffering a deficiency in vitamin D are related not only to a poor diet, and therefore to poverty, but to certain lifestyle choices and to the climate and latitude at which people live. This is because people do not only obtain vitamin D ready made from their food, but can synthesize it themselves. This synthesis relies on sunlight in order to work, however, therefore exposure to the sun is an important guard against vitamin D deficiencies.

The most well known effect of a deficiency in vitamin D is rickets, which is a condition in which skeletal abnormalities and deformities develop in children. Adults who are not obtaining enough vitamin D can also suffer from weaknesses in their bones, and their muscles may also become weakened. This condition is called osteomalacia. Without a sufficient intake of vitamin D, there will not be enough calcium or phosphate in the blood to ensure that bone mineralization and development occurs properly. This will lead to the bones becoming too thin, weak and brittle. They can also become misshapen and deformed.

Risk Factors

Certain groups of people are at a higher risk of developing a vitamin D deficiency than others. People who are elderly or obese are at an increased risk of vitamin D deficiency, as are infants who have been fed exclusively on breast milk, which contains only low levels of vitamin D, and anyone who has experienced very limited exposure to the sun. Some diseases can also increase the risk of a vitamin D deficiency. These are conditions that affect the absorption of fats, such as cystic fibrosis, or disorders that affect the digestive system, such as Crohn’s disease and inflammatory bowel disease.

A vitamin D deficiency can be treated by increasing the uptake of vitamin D through dietary supplements, or, if possible, increasing exposure to sunlight.

Toxicity

An excess of vitamin D in the body can be toxic, but D5 is the least toxic form of this vitamin. It is therefore the most suitable for medicinal uses, since it is less likely to cause adverse side effects than the other types of vitamin D. If vitamin D, in any form, does build up to toxic levels, however, it can be very harmful.

Vitamin D toxicity can result in a condition called hypocalcaemia that can lead to bone loss. In the most serious cases of hypocalcaemia, the damage can be very serious and may even lead to life threatening side effects. The earliest symptoms of toxicity may include nausea and vomiting. Anorexia, which presents as a loss of weight and appetite may also occur. This can be followed by excess thirst and urination, fatigue, weakness, headache, a metallic taste, dry mouth, tinnitus or ringing ears, vertigo and unsteadiness. The functioning of the kidneys can be impaired, and calcium may be deposited in them and around the organs of the rest of the body. This deposition is known as metastatic calcification.

Hypercalcaemia is treated by stopping further intake of calcium or vitamin D, and gradually reducing the calcium levels in the body. This must be done under medical supervision, in order to ensure that the calcium levels can be monitored. In some cases, it may also be necessary for the condition to be treated with corticosteroids and acidification of the urine.

Medicinal Uses

Research into the potential of vitamin D for the prevention and treatment of cancer was stimulated by epidemiological studies that showed people who had high levels of vitamin D in their diet, or who had high levels of sunlight-induced formation of vitamin D in their skins, were less likely to develop cancer. An epidemiological study is one that looks at what is happening in real populations of people rather than setting up an experiment or testing a particular treatment.

In studies that were conducted in vitro, that is in isolated cells in a laboratory, Vitamin D3 was found to be effective at preventing cancer. However, there was the problem of toxicity.

The doses that were high enough to reduce the chances of a cell developing cancer were also so high that they would be toxic to patients. This meant that vitamin D3 treatment for the prevention of cancer was not possible. In order to be effective, vitamin D3 treatment would require doses that were hundreds of times greater than those that are normal in the body.

The use of vitamin D as a treatment was limited by the toxic effects that it can have when it is present at high concentrations in the body. In order to test the efficacy of vitamin D against cancer, and to have a prospect of using it as a safe treatment if it was found to be effective, it was first necessary to find a safer alternative form of vitamin D, one which would not have the same toxic effects as vitamins D2 and D3.

Studies of Usage

Vitamin D5 was developed as a possible safe analog of the vitamin for medical use. It is a low calcemic analog of vitamin D. D5 is, in fact, the least toxic form of this vitamin and therefore the safest for medicinal use. A number of studies have been carried out to examine the possible therapeutic uses of the D5 form of vitamin D. Despite the research that has been conducted, vitamin D5 is not yet being used by doctors. Further research is necessary before it can be determined whether vitamin D5 is a suitable treatment.

It is the differences between vitamin D5 and the more common forms of the vitamin, D2 and D3 that make D5 a suitable candidate for clinical trials. The reactions which these different forms undergo in the body have different consequences that make D2 and D3 unsuitable for therapeutic use against cancer. The products of the reactions that take place when vitamins D2 and D3 enter the body are hypercalcemic.

Raising Levels of Calcium

This means that they are very effective at raising the levels of calcium in the blood serum, and D2 and D3 are therefore not a suitable medication for cancer prevention or treatment. They are very effective at playing their role in maintaining the appropriate levels of calcium in the body, as long as they are only present in low concentrations. Vitamin D5, however, can exist in the body at much higher concentrations without causing any problems with toxicity.

Studies have been carried out that have looked at both the therapeutic and preventative potentials of vitamin D5. Trials have been conducted in animals to determine whether vitamin D5 can affect the growth of cancer cells, or prevent animals from developing cancers.

D5 has been found to be effective in both of these types of animal-based study. Work has also been begun which will lead to studies of vitamin D5 in humans. The initial studies have been carried out to determine the doses that should be used in future clinical trials in order to avoid toxicity and adverse reactions. These studies investigated the toxicity of vitamin D5 in animals.

Cancer

The scientific evidence points towards an influence of vitamin D on the risk of developing cancer. It appears to be particularly effective in the prevention of colon cancer, and to have some effect in the prevention of breast and prostate cancer. Results from studies of other types of cancer have been more variable and inconclusive. There is as yet no definitive scientific proof that vitamin D can be effective as a treatment against cancer, or that a high vitamin D intake can help to reduce the risks of developing cancer. Further research is required in order to determine the efficacy of vitamin D against cancer.

Sources

Vitamin D2 and D3 are the most common forms of vitamin D in nature. Vitamin D is still a rare vitamin, even in these forms, and it is only found at low levels in food. The vitamin D that is found in plants is in the form of vitamin D2, while some vitamin D3 can be obtained from certain animal-based products.

The best sources of vitamin D are fish and fish liver oil. Cheese, egg yolks and beef liver also contain some vitamin D3. All of these food sources contain the vitamin in its D3 form.

Vitamin D2 can be obtained at fairly high levels from some mushrooms. The amount of vitamin D2 that is available in mushrooms can be increased by growing them under an ultraviolet light.

Other Ways to Get Vitamin D

Vitamin D does not have to be obtained from food. It can also be manufactured in the skin, and this is the method through which most people obtain a sufficient amount of vitamin D to remain healthy. Anyone who does not get enough exposure to sunlight, either through remaining indoors or living in a part of the world that does not receive enough sunshine, is at risk of a vitamin D deficiency.

For example, the region that is north of the line of 42 degrees of latitude will not be receiving enough sunlight during the winter months, between November and February to produce adequate amounts of vitamin D during these months.

Exposure

The amount of sun exposure that is necessary is fairly low. Although there is no consensus on the amount of time that needs to be spent in the sun to ensure sufficient production of vitamin D, it is probably enough in most climates to spend between 5 and 30 minutes out of doors between the hours of 10 am and 3 pm, with the face, legs, arms or back exposed to the light, twice a week. Excessive exposure to the sun should be avoided, since it can lead to sunburn and an increased risk of skin cancer.

A vitamin D deficiency can be avoided or treated by increasing the amount of vitamin D that is consumed in food, increasing exposure to sunlight, or by taking vitamin D supplements. A traditional treatment for a deficiency of vitamin D was to take cod liver oil, since this is a rich source of vitamin D3.

Supplements

Vitamin D5 is not a naturally occurring form of vitamin D. It can be artificially produced, however, and it was designed as a safer form of the vitamin for medicinal use. Vitamin D5 or sitocalciferol is manufactured from the chemical 7-Dehydrositosterol.

Both the D2 and D3 forms of the vitamin are available in dietary supplements and as fortified foods, although D3 is the most commonly used form. Vitamin D2 and D3 supplements are available in different forms including tablets and injections. Different strengths are available to treat severe deficiencies and to provide an additional source of vitamin D for long term supplementation in people who are at risk of developing a deficiency.

Food Products

In addition to naturally occurring vitamin D, some food products are artificially enriched with vitamin D in order to ensure that people are getting enough of this scarce vitamin in their diets. Food that has been fortified with vitamin D is available in the US and in numerous other countries. Most milk that is sold in the US has been fortified with vitamin D.

A cup of fortified milk contains 100 IU (International Units) of vitamin D per cup. This is equivalent to 50% of the adequate daily intake of vitamin D for people who are between 14 and 50 years of age. Other dairy products such as cheese or ice cream are not usually fortified.

Other products that may be fortified with vitamin D in the US are breakfast cereals, cereal flours, margarine, orange juice and yogurt. The amount of vitamin D that can be added to a food product is legally restricted in order to prevent anyone suffering from toxic levels of the vitamin.

Most people do not need to take vitamin D supplements, but those who are at an elevated risk of a vitamin D deficiency may benefit from a dietary supplement of the vitamin. People who are elderly, and women who are pregnant or breastfeeding, should consider taking vitamin D supplements.

A dose of 10 micrograms per day is recommended by the UK Food Standards Agency. People who are in one of the other risk groups may also benefit from vitamin D supplementation.

Sources

Mayo clinic: Vitamin D

The Merck Manuals: Vitamin D

National institute of health, office of dietary supplements: Dietary Supplement Fact Sheet, Vitamin D

Food standards agency: Vitamin D

Patient UK: Vitamin D Deficiency

IITRI: Vitamin D5 Ready for Clinical Trials in Breast Cancer

University of Illinois at Chicago medical center, this week, April 5 1999: US Defense Department OKs UIC Vitamin D5 study

International journal of cancer 108: 6: 922-929, 2003: Punj, Graves and Mehta, Cancer Diagnosis and Therapy

Journal of the national cancer institute, 89:3:211-218, 1997: Mehta, Moriarty, Mehta, Penmasta, Lazzaro, Constantinous and Guo, Prevention of Preneoplastic Mammary Lesion Development by a Novel Vitamin D Analogue, 1 alpha-Hydroxyvitamin D5

Journal of steroid biochemistry and molecular biology, 97: 1-2:129-136, 2005: Murillo and Rajendra, Chemoprevention of chemically-induced mammary and colon carcinogenesis by 1alpha-hydroxyvitamin D5

United States PAtent number 6900191: 1 alpha-hydroxyvitamin D5, its synthesis and use in cancer prevention

Overview

Tocofersolan is a synthetic form of vitamin E that is also water soluble. Natural forms of Vitamin E are fat soluble instead of water soluble. Chemically, tocofersolan, is a polyethylene glycol. The product is derived from an alpha-tocopehrol. The synthetic form of vitamin E, Tocofersolan, is available for people who cannot absorb fats as result of a particular disease. Some of these diseases include cholestatic liver and short bowel syndrome. Individuals who possess a healthy, normal diet typically do not need a vitamin E supplement. However, in some instances the supplement is necessary.

This form of vitamin E supplement was introduced in July of 2009 under the name, Vedrop. The 50 milligram per milliliter solution was introduced to alleviate vitamin E deficiency in infants who suffer from malabsorption. Alternatively, it was also for patients suffering from congenital or chronic cholestasis. Most of these conditions originate from birth. Some conditions begin in adolescence when the teenager is between 16 and 18 years old. Age groups may vary depending upon the region.

When physicians refer to vitamin E, they are describing a family of eight antioxidants. There are four tocopherols and four tocotrienols that comprise the family. Each of the groups contains an alpha, beta, gamma, and delta version of the antioxidant. Alpha-tocopherol is the most common form of vitamin E found in the body and thus, is the most widely researched discussed. When smoke or pollutants enter the body and form free radicals, alpha-tocopherals are the primary antioxidant that intercepts the free radicals to avoid damage in the body.

Problems in Nervous System

Vitamin E deficiencies can cause problems in the nervous system. These problems manifests as numbness, loss of balance, and tingling. Vitamin E is an antioxidant that protects the body’s cells from damage. Because tocofersolan is an antioxidant, this water soluble version of vitamin E is often found in cosmetics or pharmaceuticals.

Alpha-tocopherol protects the cellular membrane from oxidation. The antioxidant accomplishes this goal through a “lipid peroxidation chain reaction.” This process removes damaging free radicals and prevents further oxidation that may damage the cells. After this process is complete, antioxidants, retinol, ascorbate, or ubiquinol, may transform the alpha-tocopheroxyl radicals back into their oxidized state.

Scientists have not proven why vitamin E is vitally important in a person’s diets. Some speculate that its importance is related to its healing antioxidant properties. Some research also suggests that vitamin E functions as a signaling molecule as opposed to playing a role in antioxidant metabolism. However, this has not been proven conclusively.

Different Forms

Vitamin E comes in several different forms. Each form has the same basic function with a few unique qualities. Gamma-tocopherol is an example of a nucleophile that interacts with “electrophilic mutagens” in the body. Most research conducted is related to alpha-tocopherols. Much of the research relates to the heart disease and the efficacy of vitamin E in preventing heart disease. The studies are not conclusive.

According to a 2007 study, none of the research could conclusively prove the effects of vitamin E. Additionally, tocopherols are studied more than tocotrienols in relation to vitamin E. Although, this is one of the lesser known versions of vitamin E, more research is being conducted in order to prove the efficacy of this form in the daily diet.

Experts are suggesting however, that the main role of tocotrienols is to protect the neurons from damage and to reduce cholesterol. This version of vitamin E is also thought to protect against strokes and brain damage that is associated with strokes. More studies must be conducted to prove these findings conclusively.

Recommended Daily Allowances (RDA)

Physicians instruct individuals to take no more than 400 units of vitamin E per day to avoid unpleasant side effects. The Recommended Daily Allowances are determined by Dietary Reference Intakes (DRIs) and the Food and Nutrition Board (FNB). The Recommended Daily Allowances provided below refer to alpha-tocopherol and not to gamma and delta-tocopherol. For reference purposes: 1 milligram of alpha-tocopherol is equal to 2.22 IU and 1 IU of alpha-tocopherol is equal to 0.45 milligrams of the synthetic form of vitamin E. The Recommended Daily Allowances are listed below:

Birth to 6 months

Males and Females: 4 mg or 6 IU

7 to 12 months

Males and Females: 5 mg or 7.5 IU

1 to 3 years

Males and Females: 6 mg or 9 IU

4 to 8 years

Males and Females: 7 mg or 10.4 IU

9 to 13 years

Males and Females: 11 mg or 16.4 IU

14 years and older

Males and Females: 15 mg and 22.4 IU

Pregnant Females: 15 mg and 22.4 IU

Lactation: 19 mg and 28.4 IU

Take vitamin E as instructed by your physician or as instructed on the label. Most forms of vitamin E are ingested orally. However, there are topical forms of vitamin E as well. If your experience tingling or numbing in the feet, then you may have a serious medical problem and you should seek the advisement of a physician.

Sources of Tocofersolan

Although, tocofersolan refers to water soluble synthetic forms of vitamin E, food sources that contain vitamin E sources are listed below for the sake of knowledge. The foods listed below have very high levels of vitamin E:

• Asparagus
• Avocado
• Egg
• Milk
• Nuts (Almonds, Hazelnuts)
• Seeds
• Spinach
• Wheat Germ
• Whole Grain Foods
• Unheated Vegetable Oils

Other sources include:

• Sunflower seeds: 1 ounce contains 7.4 mg of vitamin E which equates to 40 percent of the Daily Value (DV) of vitamin E.
• Wheat germ oil: 1 tablespoon contains 20.3 mg of vitamin E which equates to 100 percent of the Daily Value (DV) of vitamin E.
• Sunflower oil: 1 ounce contains 6 mg of vitamin E which equates to 30 percent of the Daily Value (DV) of vitamin E.
• Safflower oil: 1 tablespoon contains 4.6 mg of vitamin E which equates to 25 percent of the Daily Value (DV) of vitamin E.
• Hazelnuts: 1 ounce contains 4.3 mg of vitamin E which equates to 22 percent of the Daily Value (DV) of vitamin E.
• Peanut Butter: 2 tablespoons contains 2.9 mg of vitamin E which equates to 15 percent of the Daily Value (DV) of vitamin E.
• Spinach: 0.5 cup contains 1.9 mg of vitamin E which equates to 10 percent of the Daily Value (DV) of vitamin E.
• Broccoli: 0.5 ounce contains 1.2 mg of vitamin E which equates to 6 percent of the Daily Value (DV) of vitamin E.
• Kiwi: 1 medium kiwi contains 1.1 mg of vitamin E which equates to 6 percent of the Daily Value (DV) of vitamin E.
• Tomato: 1 medium contains 0.8 mg of vitamin E which equates to 4 percent of the Daily Value (DV) of vitamin E.
• Mango: 0.5 cup contains 0.9 mg of vitamin E which equates to 5 percent of the Daily Value (DV) of vitamin E.

Health Benefits

Vitamin E may prove to be effective in treating or preventing any of the following health conditions:

• Cystic Fibrosis
• Thalassemia
• Sickle Cell Anemia
• Disease of the Retina of the Eye in Premature Infants
• Blockage of Normal Bile Flow
• Hemorrhage into a Part of the Brain of a Newborn Infant
• Abnormal Development of Bronchopulmonary Tissue in Newborn
• Anemia in Low Birthweight Infants
• Abetalipoproteinemia

Other studies have shown that selenium taken with vitamin E may reduce the risk of prostate cancer. Experts speculate that the disease may be reduced by as much as 30 percent. Other studies have shown that Vitamin E did not prevent prostate cancer. Thirty-five thousand men participated in the study. The studies are inconclusive and further research must be conducted to prove these findings.

Ailments from Vitamin E (tocofersolan) Deficiencies

Vitamin E deficiencies are rare. Symptoms rarely manifest in people who have not obtained vitamin E from their diets. Premature infants may suffer from a deficiency in vitamin E. These deficiencies may promote infections of the retina and other parts of the body.

Those individuals who possess absorption problems related to fat are more likely to develop a deficiency in vitamin E than those who can absorb fat through food. People who possess fat-malabsorption problems have difficulties because the digestive tract requires fat to absorb natural fat-soluble vitamin E. Tocofersolan was developed in order aid people with fat absorption disorders. Tocofersolan should be used in the same manner that vitamin E would be used in the body.

People who have symptoms of deficiency may experience:

• Peripheral neuropathy
• Ataxia
• Skeletal Myopathy
• Retinopathy
• Immune Response Impairment

Crohn’s disease, Cystic fibrosis, and other Liver Conditions

People with Crohn’s disease, cystic fibrosis, or who have problems with their livers secreting bile may require a water soluble form of vitamin E, tocofersolan. People with bile problems may experience chronic diarrhea or stools that contain grease.

Abetalipoproteinemia

People with abetalipoproteinemia also have a problem absorbing fat from natural foods. These individuals may also require a water soluble supplement. Most of these patients require as much as 100 mg per day of this substance. This rare disorder is a result of a genetic inheritance and cannot be prevented. Abetalipoproteinemia causes muscle weakness, poor nerve impulse transmissions, and retinal degradation. In some instances, the retinal degradation may lead to blindness.

Ataxia

Ataxia is another rare disorder that is the result of a defective gene. This particular disorder is a result of the absence of the transfer protein, alpha-tocopherol. People with this disease lose their ability to walk or develop nerve damage.

Negative effects of Vitamin E

Congenital heart defects

Some studies have found that vitamin E was recommended for pregnant mothers. However, one study conducted in the Netherlands suggested that high quantities of vitamin E supplements during pregnancy may contribute to congenital heart defects. The National Health Service in the United Kingdom suggests that pregnant women should not take supplemental vitamin E tablets. More studies should be conducted in order to determine the efficacy of this particular supplement.

Vitamin E, strokes and heart attacks

While studies have shown in that vitamin E may have some benefits for stroke victims, new studies indicate that vitamin E supplements may actually increase the risk of a stroke. A Finnish group of scientists found this to be true in their particular study. The study was published by The Alpha-Tocopherol Beta-Carotene Cancer Prevention Study Group. In a 2005 study conducted by the Journal of American Medical Association, vitamin E supplements were shown to increase the risk of heart failure. Nearly 7000 people participated in this particular trial. The findings are inconclusive and more studies should be conducted to prove this conclusively.

Another study published in the Stroke Journal in 2005 showed that tocotrienol administered to hypertensive rats did protect against strokes. This form of vitamin E was administered orally to the rats. The supplement also showed improvements in neurodegeneration. Tocopherols were also studied. However, this particular form of vitamin E was only found effective at higher concentrates.

Additional Study Conclusions

Other studies conducted by Wayne State University and Ohio State University Medical Center showed that tocotrienol offered health benefits to various organs in the body. Previous studies concluded that tocotrienols did not travel effectively as a synthetic supplement in the blood stream. This is because the transfer protein is less attracted to tocotrienols than tocopherols. This study was also conducted in 2005. People with fat malabsorption problems will be more likely to benefit from tocofersolan, which is water based. However, this synthetic form focuses primarily on the alpha-tocopherol aspect of vitamin E.

By contrast, in a small study of men who had previously undergone coronary artery bypass surgery, the studies found that these men saw a reduction in the instances of atherosclerosis. Physicians measured this by using an angiography. These men consumed 100 IU per day of alpha-tocopherol to achieve these results. While the vitamin did alleviate some of the symptoms associated with heart disease, vitamin E alone did not reduce the number of total deaths from heart disease. However, the vitamin did reduce the number of non-fatal heart attacks by 77 percent. This trial took place in Great Britain.

Vitamin E and Cancer

Studies are being conducted to prove the efficacy of vitamin E in various types of cancers. Experts speculate that many cancers result from damage caused by free radicals. Vitamin E is an antioxidant that assists in the protection against cancer causing free radicals. Nitrosamines are also known carcinogens that are formed in the stomach. Vitamin E may also fight or block these carcinogens. Trials, associated with vitamin E and cancer, have not provided any conclusive results to positively and concretely solidify these results. Most of the studies involved human subjects.

Breast cancer studies have also been conducted. One such study involved over 83,000 women to study the effects of vitamin E for 14 years. This study showed that vitamin E reduced the chance of breast cancer by 43 percent in those patients who consumed the highest amount of vitamin E. Women with the family history of breast cancer enjoyed the greatest benefits. Women with no family history only experienced a 16 percent reduction in the risk for breast cancer.

Tocotrienols have been cited in research studies as possessing cancer eliminating effects. Most of these studies were conducted in conjunction with breast cancer. University of Louisiana at Monroe demonstrated that statins and tocotrienols were effective in treating breast cancer in women. This form of vitamin E killed cancer cells while avoiding myotoxicity. Gamma-tocotrienol has been proven to be most effective in killing cancer cells. This phenomenon of killing cancer cells was not only proven effective in breast cancer, but also prostate cancer and other melanomas.

Peyronie’s Disease

Some urologists may prescribe vitamin E for Peyronie’s disease. This disease describes the treatment for males who possess abnormal curvature in their penises due to inflammation. While the studies are not conclusive, scientists are constantly researching to determine the benefits of vitamin in this disease.

Neuromuscular Problems

Vitamin E deficiencies have been known to contribute to neurological problems. Some of the neuromuscular problems include spincerbellar ataxia and myopathies. Anemia may also result from vitamin E deficiencies due to red blood cell damage caused by oxidation.

Cognitive Decline

Excessive exposure of nerves to free radicals may result in damage over time. This damage may contribute to memory loss and other neurodegenerative diseases. Alzheimer’s disease is one such disease that may evolve as a result of free radical damage.

Experts suggest that consumption of a vitamin E supplement, such as tocofersolan may provide protection against the disease. Research studies involving over 300 Alzheimer’s patients found less deterioration over time. Each patient was administered 2000 IU per day. Less of these patients needed institutionalizing due to memory problems. However, these patients did experience more falls due to balance problems.

Another study involved patients between 65 and 102 year of age who were given vitamin E. Over a 3 year time period, these patients experienced less cognitive decline than similar patients who were not receiving vitamin E. Some groups did not show any improvements after being administered 2000 IU per day. Therefore, more studies should be conducted to determine the efficacy of vitamin E supplements in patients who may be healthy or suffering from Alzheimer’s disease.

Precautions when Taking Tocofersolan

Before beginning a tocofersolan regimen, consult with a physician. Inform the physician of all known allergies and other health problems. The physician will recommend a dosage to meet the patient’s particular needs. Patients who are suffering from the following conditions should exercise extra caution before starting a vitamin E regimen:

• Blood Clotting/Bleeding Problems
• Stomach Ulcers
• Hemophilia
• Low Platelets
• Stroke
• Liver Disease

Patients, who may undergo surgery, should consult with the surgeon prior to the procedure. The doctor may recommend that patients cease their vitamin E regimen until the surgery is complete. Also, discuss any potential risks of consuming vitamin E during pregnancy with your physician. This will avoid any unpredictable side effects that may be associated.

Drug Interactions

Before beginning a vitamin E regimen, inform the physician of any medications you are taking. The physician will make informed recommendations regarding dosage and other interactions that may occur. Some common drug interactions may include the following:

• Amprenavir
• Antiplatet Drugs, such as aspirin, clopidogrel, and ticlopidine
• Blood Thinners, such as warfarin
• Herbal Products, such as garlic or gingko
• Cyclosporine
• Fat-soluble supplements, such as vitamin A, vitamin D, vitamin E, vitamin K, and coenzyme Q
• Iron supplements
• Selenium
• Vitamin C
• Beta-Carotene

The list of all possible interactions is not exhaustive. Keep both the physician and pharmacist informed of each medication to avoid unpleasant side effects. Make note of other products containing vitamin E. This will aid in avoiding over consumption of vitamin E and causing adverse effects.

Vitamin E may also interact with Simvastin or Zocor and Niacin. The two used in conjunction with one another appear to lower high density lipoproteint (HDL) cholesterol levels. Oncologists cite risks of using any antioxidant supplement, including vitamin E, tocofersolan, with chemotherapy or radiotherapy. Oncologists suspect that the antioxidant may decrease the effectiveness of the treatment. The effectiveness may be lowered if the cellular oxidative damage is inhibited in cancer cells. Further studies are being conducted to evaluate the benefits of vitamin E supplements in cancer therapy.

Allergies and Side Effects

Individuals who consume vitamin E in the recommended doses typically do not experience side effects. Those who take vitamin E in high doses over a long period of time may begin to experience side effects. A large dose would consist of a dose over 400 units per day. Side effects may include the following:

• Nausea
• Diarrhea
• Stomach Cramps
• Tiredness
• Blurred Vision
• Headache
• Rash
• Itching
• Swelling of face, tongue or throat
• Dizziness
• Wheezing
• Trouble Breathing

Miscellaneous

Individuals who miss a dose of vitamin E should take the dose on the next scheduled time. Store vitamin E in an airtight container. Keep the product away from heat, light, and moisture. To dispose of the product do not flush the product down the drain. Inquire to find out the proper disposal of the product.

Vitamin E is a broad-term that commonly refers to a group of eight fat-soluble compounds with antioxidant activity. Vitamin E works in the body by preventing oxidation and damage to cells caused by free radicals. When free radicals react with oxygen the body naturally produces reactive oxygen species that damage cells.

Not only is vitamin E a powerful antioxidant, it also protects essential fatty acids and Vitamins A and K. Vitamin E was discovered in the 1920s and synthesized for the first time several years later. Although vitamin E is an antioxidant it seems deeply connected with regeneration and the health of cells. Vitamin E is broken into two groups, tocopherols, which are more common, and tocotrienols, which were discovered later and are different from tocopherols in their isometric construction.

Vitamin E is naturally present in vegetables, fruits, seeds, grains, and nuts. Due to the fat-soluble nature of vitamin E, foods rich in these vitamins are often have a high fat content, like avocados or wheat germ. Vitamin E includes four tocopherols and four tocotrienols both with four sub-classifications Alpha, Beta, Gamma, and Delta.

The body uses vitamin E by absorbing it in the small intestines. The liver then processes the vitamin E and selectively secretes only alpha tocopherol, using a special protein. Since alpha tocopherol is the only form of vitamin E retained in the body and present in blood it has been studied more than any other.

List of E vitamins

Tocopherols

• Tocopherol (Alpha tocopherol)
• Tocopherol (Beta tocopherol)
• Tocopherol (Gamma tocopherol)
• Tocopherol (Delta tocopherol)

Tocotrienols

• Tocotrienol (Alpha tocotrienol)
• Tocotrienol (Beta tocotrienol)
• Tocotrienol (Gamma tocotrienol)
• Tocotrienol (Delta tocotrienol)

Functions and Health Benefits

In vitro cell studies have shown vitamin E prevents blood from adhering to artery walls, dilates blood vessels, and prevents platelets from sticking and forming clots.

• Vitamin E helps the body to use vitamin K more effectively.
• Red blood cells are formed with the help of vitamin E.
• Vitamin E in involved in the function of a healthy immune system.
• Although less than 1% of vitamin E studies are on tocotrienols, there is evidence they may specialize in protecting nerve cells and neurons.

Deficiency

Symptoms of vitamin E deficiency can include anemia, muscle weakness, loss of muscle mass, loss of muscle tone, problems transmitting nerve impulses, issues with stability and balance, degeneration of the retina, problems seeing, and difficulty controlling eye movement.

Vitamin E deficiency is very rare in healthy adults with an average caloric intake. People with serious medical conditions that effect fat absorption are most likely to suffer from a vitamin E deficiency. Medical conditions that affect fat-absorption in the intestines include Crohns disease, cystic fibrosis, problems with the pancreas, chronic diarrhea, and greasy stools.

There are also severe very rare medical conditions that prevent-fat absorption, including a genetic condition called abetalipoproteinemia, which requires massive doses of Vitamin E for ever pound of body weight and AVED Ataxia and Vitamin E Deficiency is genetic condition where the protein in the liver that secretes vitamin E is totally absent. People with these rare conditions need to take vitamin E supplements to prevent the symptoms of deficiency from occurring.

Premature babies with a very low birth weights are at an increased risk for vitamin E deficiencies, adding a vitamin E supplement could help eye health but may increase the risk for infections. Talk with your healthcare provider about the risks and benefits of a vitamin supplements for newborns. The Recommended Dietary Allowance for children under six months of age is 4 milligrams or 6 international units.

Dietary Sources

Vitamin E is naturally found in eggs, fish, dark leafy greens, bright orange vegetables, seeds, nuts, and grains. Fruits and vegetables rich in fat also contain vitamin E. In the US fortified cereals are supplemented with vitamin E, mainly in the form gamma tocopherol. In vitro and animal studies have recently indicated gamma tocopherol may be a potent anti-inflammatory and antioxidant. Population studies are currently being conducted on the effective of gamma tocopherol on cardiovascular disease and cancer risk.

• Proteins, fats, and oils
• Eggs
• Fish
• Crustaceans
• Sardines
• Herring
• Margarine
• Vegetable oil
• Canola oil
• Peanut oil
• Corn oil

Fruits and Vegetables

• Green and orange fruits and vegetables are particularly high in vitamin E.
• Mango
• Papaya
• Oranges/orange juice
• Tomato
• Sweet potato
• Sweet Red Peppers
• Carrots
• Apricots
• Peaches
• Raspberries
• Blackberries
• Asparagus
• Spinach
• Avocado
• Turnip Greens
• Dandelion Greens
• Collards

Seeds, Nuts, and oils

• Roasted sunflower seeds are extremely high in vitamin E.
• Almonds
• Brazil Nuts
• Peanuts
• Peanut butter
• Wheat bran contains 100% of the daily vitamin E requirement in one tablespoon.
  • 0 to 6 months: 4 mg/day
  • 7 to 12 months: 5 mg/day
  • Children
  • 1 to 3 years: 6 mg/day
  • 4 to 8 years: 7 mg/day
  • 9 to 13 years: 11 mg/day
  • Adolescents and Adults
  • 14 and older: 15 mg/day
  • Antidepressants
  • Antipsychotics
  • Blood pressure medications that use beta-blockers
  • Cancer and chemotherapy drugs
  • Statin drugs for high cholesterol, including Zocor, Lipitor, and Crestor
  • Bile acid sequestrants used to treat high cholesterol.
  • Vitamin E may counteract the side effect of the HIV/AIDS medication AZT.
  • The weight loss medication Alli prevents vitamin E from being absorbed.

Health benefits and Effectiveness

Due to correlations between certain medical conditions and low Vitamin E blood serum levels alpha tocopherol has been studied for its effectiveness of everything from cancer to Alzheimers and sun sensitivity. Unfortunately, vitamin E has not proven to be consistently effective in preventing these health conditions in long term population studies, lasting four to eight years.

Heart Disease

Population studies have shown patients with lower risk of heart disease were found to have higher levels of vitamin E. Leading scientists hypothesize that vitamin E was responsible for the correlation; studies have not been so conclusive. One of the largest studies on vitamin E and heart health the Heart Outcomes Prevention Evaluation (HOPE) trial showed that daily consumption of 400 IU of vitamin E did not lower the risk of heart disease-related deaths in men and women who were at a high risk.

Likewise, the Physicians’ Health Study II tracked more than 14,000 male doctors at a low risk for heart disease and proved that consuming 400 IU of vitamin E every other day for eight years did not reduce the risk of cardiovascular attacks.

One study with positive results showed that postmenopausal women who consumed foods rich in vitamin E lowered their risk for stroke-related deaths. However, the same study showed that vitamin E supplements were not an effective preventative strategy.

Congenital Heart Defects

According to studies in the Netherlands and the National Health Service in the UK, mothers with high vitamin E diets and those who consumed vitamin E supplements, while pregnant and before conception, have a nine-fold increased for delivering a child with congenital heart defects (CHD.)

The data in this study was limited because mothers were questioned about their diet when children were already 16 months old, so its not a good indication of the diet before or during pregnancy.

Officials in the UK warn against taking vitamin E supplements during pregnancy, saying consumption equal to 75% of the daily allowance could be too much vitamin E, leading to an increase rick for congenital heart defects in newborns.

Cancer

Although there have been studies showing a deceased risk for prostate cancer in patients with high vitamin E levels, this has not been backed up in large population studies. Despite a study on vitamin E showing a 30% reduction in prostate cancer, a clinical trial SELECT (Selenium Vitamin E Cancer Prevention Trial) carried out on 35,000 men for four years was subsequently cancelled after an independent panel showed no reduction in prostate cancer risk with vitamin E alone or a combination of selenium and vitamin E.

Another large population study on 29,000 male smokers showed lower prostate cancer risk and fewer deaths in patients who took 50 mg of vitamin E daily. One large eight-year study of men who took 400 mg of vitamin E every other day showed no reduction in overall cancer risk. Vitamin E in the form alpha tocopherol has not been proven to reduce breast cancer risk, or prevent lung or pancreatic cancer. Additionally, taking vitamin E supplements after diagnosis with cancer doesnt improve treatment, in fact, antioxidants may interfere with chemotherapy drugs. Talk to your medical provider before taking any vitamin E supplements if you are undergoing chemotherapy.

Vitamin E has also been studied on colorectal cancer, but hasnt been proven to reduce risk in women or diabetics. However, there is evidence that vitamin E in combination with vitamin A and vitamin C may protect people with benign tumors, considered a precursor to colon cancer.

Alzheimers Disease

Scientists have linked oxidation with the incidence of Alzheimers, unfortunately vitamin E has not proven to be consistently effective in slowing the onset of Alzheimers symptoms.

Once study, comparing vitamin E to placebo, showed these patients developed Alzheimers at the same rate, while another study on 340 patients, comparing vitamin E to placebo and a pharmaceutical Alzheimers medication selegiline showed that patients given 2,000 IU of vitamin E slowed the onset of the disease by 200 days, compared to placebo, but selegiline was more effective.

Eye Health

Vitamin E has been proven to play a critical role in eye health. A combination 400 IU of vitamin E, 80 mg of zinc, 15 mg beta-carotene, and 500 mg vitamin C benefits patients with advanced macular degeneration–the leading cause of blindness in people over 55. People with advanced macular degeneration had the greatest benefit from this treatment. Further research is needed to see if this treatment works to prevent AMD and if it is effective on less advanced cases.

A combination of vitamin E and vitamin C is also proven to help uveitis, an inflammatory condition affecting uvea a layer of the eye between the white part and the retina. Patients with uveitis who took vitamin E supplements had consistently clearer vision that those on placebo.

Recommended Daily Intake

The following is a recommended daily intake of vitamin E based on age, according to The Food and Nutrition Board at the Institute of Medicine. The recommended value depends on age, sex, and other medical factors. Always talk to your doctor before taking a vitamin E supplement.

Infants

Considerations

In 2004 the American Heart Association warned that high doses of vitamin E may be harmful, taking more than 400 IU of vitamin E per day may increase the risk of death. Small doses of vitamin E, like those found in multivitamins, have not been proven to be harmful.

Due to the complex nature of the immune system and antioxidant defense system supplements of vitamin E may not have the same effect as vitamin E found naturally in foods. Vitamin E in foods naturally contains many forms of tocopherols and tocotrienols. For best results eat a well balanced diet including all of the food groups.

Vitamin E supplements are available in soft gels, tablets, capsules, and topical oils. Vitamin E is naturally fat-soluble, meaning it is most commonly an oil, however, special water-soluble forms of vitamin E are available, these especially important to people who cant absorb fat.

Vitamin E is available in natural and synthetic forms. Natural vitamin E is sold as d-alpha-tocopherol and the synthetic form is always labeled dl-alpha-tocopherol.

Applying Vitamin E oil is one of the most popular home remedies for lessening the appearance of stretch marks, scars, and burns. Despite its popularity vitamin E is not proven effective at improving the appearance, size, or thickness if scars. Not only was vitamin E not effective but about one third of people in the study developed contact dermatitis from the topical application. Always test vitamin E oil on the inside on your arm before using.

Drug Interactions

Always check with your doctor before taking a vitamin E supplement, vitamin E reacts with many popular prescriptions. Do not take vitamin E if you are on any blood thinning medications, like aspirin, Warfarin and Coumadin, as it can increase the risk for bleeding.

Sources:

• Healing Daily, Vitamin E Healing Daily.
• Natural Standard Patient Monograph, Vitamin E MayoClinic.com.
• National Institutes of Health, Vitamin E Office of Dietary Supplements NIH.
• University of Maryland Medical Center, Vitamin E UMM.edu.
• U.S. Library of Medicine and National Institutes of Health, Vitamin E MedlinePlus.
• Dr. George Obikoya, Free Radicals and Vitamin E The Vitamins and Nutrition Center.
• Dietrich M, Traber MG, Jacques PF, Cross CE, Hu Y, Block G., Gamma Tocopherol PubMed.gov.
• USDA, USDA National Nutrient Database USDA.gov.
• National Health Service, Babies at risk from Vitamin E NHS Choices.
• Anahad O’Connor, The Claim: Vitamin E helps Remove Scars New York Times.

Vitamin D4 (Also known as: 22,23-Dihydroergocalciferol (Vitamin D2 without the 22,23 double bond)

Vitamin D4 is an ineffective form of Vitamin D. It forms dihydrotachysterol, or Dht (not to be confused with DHT, the hormone treatment).

Vitamin D4 is a form of the D Vitamin group, categorized as fat-soluble secosteroids. The two most commonly used forms of vitamin D for humans are D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D is found in food and produced by the body after exposure to sunlight (or ultraviolet B light), in the form of D3; it can also be taken in pill form as a supplement.

Vitamin D Group

While categorized as vitamins, the vitamin D group actually circulates the body as a hormone after being synthesized in the kidneys. Technically, despite the name, vitamin D is not a “vitamin” at all and targets close to 10% of the human genome within the body (200 genes). Vitamin D is ingested via supplement or diet, or produced naturally by the skin’s exposure to the sun and ultraviolet B rays.

After being carried from the bloodstream to the liver, vitamin D converts into prohormone calcidiol, and then into the biologically active form of vitamin D, calcitriol. Calcitrol is known to have properties that help boost the immune system, and locally acts as a cytokine. At this point, the vitamin is being circulated as a hormone. The calcitrol in the bloodstream helps to regulate phosphate and calcium, and promotes healthy bone growth.

Deficiency in the D vitamins can lead to brittle bones, poorly formed bones, or weak bones, especially in children who suffer the deficiency during formative years. Rickets, osteomalacia and osteoporosis are diseases known to afflict individuals who are deficient in vitamin D.

Forms of Vitamin D

There are five known forms of Vitamin D: D1 (ergocalciferol with lumisterol), D2 (ergocalciferol with ergosterol), D3 (cholecalciferol), D4 (22-dihydroergocalciferol), and D5 (sitocalciferol). Both D2 and D3 were discovered in the 1930s.

All the forms of Vitamin D chemically contain steroids in which one of the bonds in the steroid rings is broken, called secosteroids. Most of the differences between forms result from slight changes in chemical structure; the only difference between D2 and D3 is that of a single versus double bond in the side chains.

For nutrition purposes and medical use in human beings, the forms of Vitamin D in D2 and D3 are the most widely used, with D3 gaining a critical perception as the more potent of the two in recent years. Vitamin D4 is an active metabolite of Vitamin D2.

Production

Vitamin D3 can be produced by humans in their skin photochemically from 7-dehydrocholesterol, which is produced in large quantities by vertebrates. Sunlight is necessary for vertebrates to produce vitamin D3; some studies have shown deficiencies in animals whose habitat has little light, such as mole rats. (The study also showed, however, that the mole rat was less susceptible to aging and maintained healthy vascular function).

Some animals without direct skin exposure to the sun, such as birds, Vitamin D3 is produced by the skin’s natural oils and secreted onto the fur or feathers.

It should be noted that vitamin D2, though available, is not naturally produced by vertebrates. While plants, fungus, and invertebrates produce D2 after exposure to ultraviolet light, little is known about the biological reason behind it.

Sources

The three sources of Vitamin D are skin production via exposure to sunlight, through dietary foods, and via supplement.

The best source of Vitamin D is safe, regular exposure to sunlight. Doctors recommend exposing the face and hands to direct sunlight at 10 minutes at a time at least once a day to boost Vitamin D production. Through regular sun exposure (10-15 minutes a day), humans can make their own Vitamin D in the form of D3. People should use caution, however, as sunscreen blocks the production of Vitamin D (since the skin does not get direct exposure to ultraviolet B light).

Sun exposure can cause skin care and other issues, so moderation is key. Exposure to sunlight for 20-30 minutes is estimated to result int he production of approximately 10,000 IU of vitamin D, although this will vary based on location, heritage, and other factors. Sunlight is the easiest method to acquire vitamin D; by contrast, a person would have to drink roughly 25 glasses of 8oz milk to get the same 10,000 IU of vitamin D.

Producing Vitamin D4

The ability for a person to produce vitamin D depends greatly on age, height, weight, geographic location, and genetic background. Those with darker skin will need much longer exposure to generate the same amount of the vitamin; for reasons still largely unknown, persons with darker skin have more difficulty making vitamin D.

For this reason, a supplement via diet or oral pill may be helpful. Those living in regions that experience limited sunlight throughout the year may also need to take an alternate approach. It can be difficult for people to produce enough Vitamin D, but it is a fat soluble vitamin, and caution should be taken not to overdose.

Availability

Many cereals, margarine, bread, pastries, milk are fortified with Vitamin D, especially in the United States and Canada. Natural sources of Vitamin D can also be found in oily fish (such as catfish, salmon, tuna, mackerel), eggs, mushrooms, and cod liver oil.

Supplements of Vitamin D are readily available, although individuals should consult with a medical provider to select the correct dosage and type that best suits their needs.

Active metabolites may be required for those with kidney or liver problems; these more active derivatives of Vitamin D are more easily absorbed into the body.

Uses

The vitamin D group is often used to promote healthy bone growth, healthy teeth, prevent osteoporosis and other degenerative bone diseases, prevention of rickets, and lately as a possible prevention for cancer.

Recent studies have also shown potential for vitamin D as a potential treatment for high blood pressure, fibromyalgia, multiple sclerosis, diabetes mellitus, and rheumatoid arthritis. Vitamin D stimulates bone growth and helps to establish a healthy mineral metabolism. The use of vitamin D for the treatment of cardiovascular disease has also grown in popularity within the past few decades.

Vitamin D4 is often used for the treatment of postoperative tetany in its chronic, latent, and acute forms. Tetany is a condition which involves the involuntary contraction of muscles due to complications with the body’s ability to absorb calcium, which vitamin D facilitates. Consequently, it is also used to treat idiopathic tetany and hypoparathyroidism.

Recent Studies

Recent studies have shown promise for vitamin D as a treatment for cancer due to the ability of vitamin D, when in the form of an active metabolite, to stimulate the growth of white blood cells, the building blocks of the body’s immune system. In 2006, a study found a correlation between cancer and patient’s vitamin D levels.

The study suggested adding an additional 1,000 IU of vitamin D per day could significantly reduce the risk of cancer in individuals, particularly breast cancer, colon cancer, and ovarian cancer. However, a conflicting study conducted by the National Cancer Institute found no link between a cancer patient’s mortality rate and their intake of vitamin D. Ongoing research is being performed to better determine what, if any, use vitamin D can have for cancer treatment.

There have also been conflicting studies on the link between vitamin D and mortality.

Pharmacology and Mechanism of Action

Vitamin D4, or dihydroergocalciferol, effectively synthesizes in the kidneys after passing into the bloodstream and then the liver. It is a more active metabolite of the more mainstream versions of vitamin D. Due to the increased metabolic activity, D4 is often effective in elevating serum calcium due to its ability to stimulate the calcium absorption of the intestines. D4 can also help mobilize bone calcium and functioning renal tissue if parathyroid hormone is absent.

For this reason, D4 in the form of dihydrotachysterol, a synthetic analogue of viamin D, has been a form of treatment for hypocalcemia (a condition where the blood lacks calcium) and hypoparathyroidism (which results from a deficiency of parathyroid hormone in the body). Dihydrotachysterol is converted to an active metabolite in the liver in the form of 25-hydroxydihydrotachysterol.

After the 25-hydroxydihydrotachysterol is hydroxylated, it binds to the receptor (which has DNA binding and hormone binding domains) of the vitamin D. This results in an suppression of synthesis for type I collagen as well as an expression of osteocalcin; both are due to the bound form of the receptor of vitamin D serving as a transcription controller for bone matrix proteins.

Subsequently, this helps to stimulate the calcium absorption as described above. Interestingly, several research studies have shown that many (if not all) cells in the body are equipped with vitamin D receptors.

Potential Overdose and Toxicity

Categorized as fat soluble, Vitamin D is stored in the body, so excess is not flushed out in urine as with water soluble vitamins. As a result, individuals should be very careful to supplement the correct amount of vitamin D into their diets. Hypercalcima, an excess of calcium, can occur when there is an excess of vitamin D in the body. Hypercalcima due to vitamin D can cause kidney pain and kidney stones and result in an over-calcification of bones, heart, soft tissues, and kidneys.

The nomenclature for an excess of vitamin used by the medical community is hypervitaminosis D. The recommended intake of vitamin D daily is 400IU; for an overdose to occur, significantly more vitamin D would have to be ingested.

Overdoses have been recorded at 77,000 IU per day, with 10,000 being the maximum recommended dose. Symptoms of hypervitaminosis include fatigue, dehydration, vomiting, decreased appetite, and irritability. Toxicity is not likely unless specific other medical conditions are present; it is not common.

http://science.jrank.org/pages/44204/vitamin-D.html

http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/otherendo/vitamind.html

http://ods.od.nih.gov/factsheets/vitamind.asp