Role Sources Deficiency Excess

Hepcidin inhibits
release of intracellular Heme iron- Manifestations Hemochromato
Most of the daily iron into plasma (binds to Flesh sources may present prior due to dysregulatio
ferroportin and induces its
iron required is internalization and degradation) (Meat, fish, to or along with iron sensing by t
poultry)
recycled via anemia: fatigue, liver: free iron
reticuloendothelial Iron overload cold intolerance, circulates; RO
system Hepcidin = developmental species generat
Non-heme end organ
absorption delays)
Stored complexed Iron not released iron- Plant accumulation of
Iron to ferritin; exported
by ferroportin;
sources;
vitamins &
Deficiency first results in
microcytosis and then Bantu overloa
Anemia microcytic anemia
oxidization for supplements (genetic predisposi
Hepcidin =
transport requires
absorption Reduce absorption: Enhance absorpti
Cu co-factor; Transported by
Iron released DCT1 or DMT1 & Polyphenols (tannic), sugars, acids, me
HFR transferrin oxalate (grains, fruit,
receptors at into plasma requires ethanol
solubilization from veg), phylates (legume),
membrane Also: Increased Vitamin C ma
oxidized 3+ form minerals (Ca, Zn, Mg,
enzyme activity
for absorption Ni)
enhance absorpt
(Dcytb and DMT1)

Water-Soluble Vitamins
1. Collagen
synthesis Synthesized
Scurvy:
2. Carnitine by plants GI intoleranc
weakness, swollen
synthesis from glucose (diarrhea, bloat
Supplemental use gums, bone
3. Neurotransmitter and fructose;
for decubitus bowing, bleeding
Vitamin metabolism Widely
ulcers may 4. Antioxidant into joints,
C distributed in Increased risk
enhance wound function infection,
anything that oxalate
healing (e- donor) depression,
is fresh and nephrolithias
5. Regeneration hysteria; prevented
rapidly (kidney stone
of reduced by 10 mg/day
growing
vitamin E
Thiaminases Lactic acidosis,
(Fish) and neurologic &
cardiac syndromes
antithiamines
(teas, betel nuts) 1. Energy Whole &
interfere with Enriched Dry Beriberi:
metabolism Distal peripheral neuropathy
thiamine in food and grains/
Thiamine 2. NADPH Wet Beriberi: No UL = No
GI tract cereals;
synthesis Cardiomegaly
Toxicity (body po
B1)
(
Increased 3. Nerve vegetables;
Wernicke- 30 days of RDA
Function legumes;
Erythrocyte Korsakoff
(synthesis of Ach, Meat, fish,
transketolase glutamate) Syndrome:
poultry; Dairy Early (Opthalmoplegia;
activity- most Ataxia; Confusion)
accurate assay of Late (amnesia;
confabulation; loss of
deficiency initiative)
 Whole grains, Pellagra 4 Ds:
1. Energy
Meat, fish, Dermatitis; Flushing
metabolism
Yeast, Some diarrhea; GI intoleran
2. Cellular
Niacin Bioavailability in
functions and
nuts, Eggs, dementia; death Hepatoxicity
grains requires Milk
(B3) alkali to release
protein
modification Risk factors:
Glucose
niacin Tryptophan: Maize, meat, molasses intolerance
3. Glutamate diet; Disorders of Hyperuricem
Precursor of
synthesis tryptophan absorption
and gout
niacin (Hartnups) or
synthesis metabolism (carcinoid
tumors)

Groups at high risk:

Folate and vitamin B12 1. Nucleotide Ethanol abuse;
metabolism intersect in synthesis Malabsorptive disorders;
Folate Status:
the conversion of Drugs interfering with folate
2. Methylation Absorption of folic
Serum folat
methyl THF to THF, a acid in:
of compounds
reaction that also an indicator
Folate converts homocysteine 3. Essential co-
Supplements
is~100%
Myelomeningocoele
(spina bifida) recent intake
to methionine factor for the Fortified foods is
(B9) rate-limiting
> 85%
Macrocytic anemia
RBC folate
Naturally-occurring
Homocysteine food is ~60% longer term
reaction in
increases with Megaloblastosis of indicator
DNA
deficiency GI epithelium:
synthesis diarrhea and malabsorption

Persons > 51 years:

most of B12 RDA Animal foods Brain problems,
should be Cofactor in the (plants do not
ataxia, diarrhea,
conversion of: synthesize B12)
consumed in the and peripheral
Vitamin
crystalline form, Is bound to neuropathy
B12 (due to increasing
prevalence of atrophic
gastritis)
1. Homocysteine
to methionine
protein & must
be liberated for At risk: vegans; conditions No UL/ no toxic
resulting in diminished
absorption gastric acid secretion and/or
Deficiency is 2. Methylmalonyl (requires intrinsic factor
indicated by: CoA to gastric acid
Accumulation of succinyl CoA and/or intrinsic Megaloblastic anemia:
methylmalonic acid factor) due to folate trapping
(MMA)

Fat-Soluble Vitamins
 Cleavage of Raw foods Decreased night Headache, liv
Carotenoids to 1. Vision have the lowest vision, dry eyes, damage, hair lo
retinol is inhibited 2. Bone growth bioavailability blindness due to bone/ muscle p
by adequate vit A 3. Reproduction Cooking increased epithelia
Vitamin stores 4. Cell division and
helps liberate in eyes; increased Risk for excess
differentiation
A 5. Regulation of the risk for measles Supplements; po
bear liver;
Circulates in the blood
bound to retinol binding immune system Animal (eggs, Renal disease
protein which is 6. Carotenoids (3 meat, dairy) Risk for deficiency:
removed & degraded in are provitamin A) Beta-carotene Liver disease; poor Carotenoids do not l
kidneys (leafy vegs, fruits)
diet; malabsorption vitamin A toxicit
Rickets; Hypercalce
Best assessed by 1. Absorption of osteomalacia; bone Elevated ser
25-OH vit D and calcium and loss; osteoporosis [Ca]: nause
PTH phosphate vommiting
from intestine Elevated PTH Mental stat
Vitamin Obesity is 2. Reabsorption Dietary and deficiency
changes;
of calcium in Arrhythmi
D inversely
the kidney
UV sources Nephrolithia
associated with Risk for deficiency:
circulating 25-OH 3. Bone & Limited sun exposure;
Risk for exce
vitamin D muscle health greater skin melanin
content; Liver/renal supplement u
concentration 4. Possibly increases (not from UV-
insulin sensitivity disease; fat synthesis inhibit
malabsorption; Obese adequate store
Neuropathy
Myopathy Excess is due
Limited food Retinopathy
1. Antioxidant sources supplement us
RBC hemolysis Bleeding ris
(reduced by (basis of RDA)
Vitamin vitamin C) Is absorbed May interfere w
vitamin K cyc
E 2. Immune with micelles Risk factors
function and Premature low birth
weight infants; Fat Supplemental dos
3. DNA repair transported to malabsorption; 400 IU not routin
liver Rare genetic disorders recommended
(eg. -tocopherol transfer
protein defects)

Warfarin inhibits Bleeding &

the vitamin K 1. Biochemical coagulopathy;
cycle by acting on function is embryopathy
the enzymes required carboxylation (warfarin use in
Vitamin Green leafy pregnancy)
for regeneration of of glutamic
vegetables &
K active vitamin K, acid
oil Risk factors:
thus reduces 2. Clotting/ Malabsorption;
coagulation and blood Liver disease;
prolongs time to coagulation Alcoholism; Babies
clotting are born deficient