Lactation niacin

Lactation Niacin is actively excreted in breast milk. 

The RDA for adult males is 16 mg/day and for adult females 14 mg/day. As usual, children require less and pregnant or lactating women a bit more. Niacin is not hard to come by in your diet good sources include eiuiched and whole-grain bread and bread products, fortified cereals, meat, fish, and poultry. 

Ezetimibe/Simvastatin (Vytorin) [Antilipemic/HMG CoA Reductose Inhibitor] Uses H rp cholest olemia Action X Absorption of cholesterol phytost ol w/ HMG-CoA reductase inhibitor Dose 10/10-10/80 mg/d PO w/ cyclosporine or danazol 10/10 mg/d max w/ amio-darone or verapamil 10/20 mg/d max -1- w/ sev e renal insuff Caution [X, -] w/ CYP3A4 inhibitors (Table VI-8), gemfibrozil, niacin >lg/d, danazol, amiodarone, verapamil Contra PRG/lactation livCT Dz, t LFTs Disp Tabs SE HA, GI upset, myalgia, myopathy (muscle pain, weakness, or tendOTiess w/ CK 10 x ULN, rhab-domyolysis), Hep, Infxn Interactions t Risk of myopathy W7 clarithromycin, erythromycin, itraconazole, ketoconazole EMS None OD Sxs unknown symptomatic and supportive... 

Reductase inhibitors are useful alone or with resins, niacin, or ezetimibe in reducing levels of LDL. Women with hyperlipidemia who are pregnant, lactating, or likely to become pregnant should not be given these agents. Use in children is restricted to selected patients with familial hypercholesterolemia or familial combined hyperlipidemia. 

Milk contains about 0.1 mg niacin per 100 g and thus is not a rich source of the preformed vitamin. Tryptophan contributes roughly 0.7 mg NE per 100 g milk. In milk, niacin exists primarily as nicotinamide and its concentration does not appear to be affected greatly by breed of cow, feed, season or stage of lactation. Pasteurized goats (0.3 mg niacin and 0.7 mg NE from tryptophan per 100 g) and raw sheep s (0.4 mg niacin and 1.3 mg NE from tryptophan per 100 g) milk are somewhat richer than cows milk. Niacin levels in human milk are 0.2 mg niacin and 0.5 mg NE from tryptophan per 100 g. The concentration of niacin in most dairy products is low (Appendix 6A) but is compensated somewhat by tryptophan released on hydrolysis of the proteins. 

Vitamin E, while not necessary for health, seems to be required for the reproduction and lactation of animals. Niacin, a member of the B group of vitamins, is necessary for the prevention of the deficiency disease pellagra. Pantothenic acid, inositol, />-aminobenzoic acid, and biotin are substances involved in the process of normtl growth. Vitamin K is a vitamin that prevents bleeding, by assisting in the process of dotting of the blood. 

Niacin is a nutritional supplement used during periods of deficiency known as pellagra and for the treatment of dyslipidemia. Niacin needs may increase during chronic illness such as diabetes mellitus, malignancy, metabolic diseases, hyperthyroidism, infections, chronic fever, alcoholism, and during pregnancy and lactation. 

The enzyme lactate dehydrogenase, which catalyzes the transfer of electrons from lactate to NAD, illustrates these principles (Fig. 8.14). The coenzyme nicotinamide adenine dinucleotide (NAD ) is synthesized from the vitamin niacin (which forms the nicotinamide ring), and from ATP (which contributes an AMP). The ADP portion of the molecule binds tightly to the enzyme and causes conformational... 

Bs niacin Be pyridoxine Eggs, meat, Ever, beans, peas, enriched bread and cereals Lean meat, leafy green vegetables, whole-grain cereals, yeast, bananas Male 15-19 mg/day Female 13-15 mg/day Pregnancy 18 mg/day Lactating 20 mg/day... 

Enzymes with niacin coenzymes in human metabolism (examples of 200 enzymes ). L-Lactate dehydrogenase (EC 1.1.1.27) alcohol dehydrogenase (EC l.l.l.l) glyceraldehyde-phosphate dehydrogenase (EC 1.2.1.12) NADPH-cytochrome-P-450-reductase (EC 1.6.2.4). 

There are numerous sources of niacin that are essential and these include poultry, fish (tuna, salmon), meat (beef), yeast, legumes, milk and fortified eereals. In addition, niacin is naturally occurring in tiny amounts and the human body can make nicotinic acid from the metabolism of dietary tryptophan (Vosper 2009). The body requires tryptophan for two main reasons (i) for the synthesis of niacin and (ii) to raise serotonin levels, which is essential for the regulation of sleep, appetite and mood. The vast majority of proteins contain about 1 % of tryptophan and it is suggested that approximately 100 g of protein intake a day will be sufficient to ensure optimum levels of niacin in the body. The recommended dose of niacin is higher when there is an increase in physiological states such as pregnancy and lactation. Importantly, the Committee of Medical Aspects of Food Policy (COMA) in the UK stated that the Reference Nutrient Intake (RNI) for niacin was 17 mg/day and 13 mg/day. 

With a recommended increase of 500 Calories (kcal) to support lactation, an additional intake of 3.3 niacin equivalents would be indicated hence, a total additional intake of 5 niacin equivalents per day is recommended during lactation. 

The average content of niacin in human breast milk is 8 mg (65.6 pmol) per 1000 kcal (4200 kJ), and this is the basis for the recommendations (and dietary reference values) for infants up to 6 months. In the UK, the Reference Nutrient Intake niacin increment during pregnancy is nil, and during lactation it is 2 mg per day. 

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