Vitamin serum

ARJMANDI B H, KHALIL D A and HOLLIS B w (2002), Soy protein its effects on intestinal calcium transport, serum vitamin D and insulin-like growth factor-1 in ovariectomized rats. Calcif Tissue Int 70(6), 483-7. 

Iribarren, C. et al.. Association of serum vitamin levels, LDL susceptibility to oxidation, and autoantibodies against MDA-LDL with carotid atherosclerosis a case-control %Vady, Arterioscler. Thromb. Vase. Biol, 17, 1171, 1997. 

Situnayake et al., 1991). No correlation between disease activity and serum vitamin E concentrations was found, but it was su ested that such patients might suffer a reduced antioxidant capacity. However, it is conceivable that a decreased serum antioxidant status is a primary event in the evolution of RA. Recent studies (Heliovaara etal., 1994) have demonstrated that lowered levels of vitamin E, /3-carotene and selenium (required for glutathione peroxidase) together may be a risk fector for subsequent development of RA. 

Fat-soluble vitamin supplementation is usually required in pancreatic insufficiency. Specially-formulated products for CF patients (ADEKs and Vitamax ) are usually sufficient to attain normal serum vitamin levels at a dose of 1 tablet daily for younger children and 2 tablets daily for teenagers and adults. Additional supplementation may be needed in uncontrolled malabsorption or for replacement of severe vitamin deficiency.5,15 Appetite stimulants such as cyproheptadine may be an option for promoting nutrition and weight gain, but efficacy has not been established. 

CF patients with low bone mineral density and low serum vitamin D levels may improve bone health through supplemental vitamin D analogs beyond those found in standard CF vitamins. The optimal dose and analog have not been determined. For ergocalciferol, a minimum of 400 IU and 800 IU... 

Monitor efficacy of vitamin supplementation through yearly serum vitamin levels. Obtain levels more frequently if an identified deficiency is being treated. 

The water-soluble and fat-soluble vitamins in the parenteral multivitamin mix are essential cofactors for numerous biochemical reactions and metabolic processes. Parenteral multivitamins are added daily to the PN. Patients with chronic renal failure are at risk for vitamin A accumulation and potential toxicity. Serum vitamin A concentrations should be measured in patients with renal failure when vitamin A accumulation is a concern. Previously, vitamin K was administered either daily or once weekly because intravenous multivitamin formulations did not contain vitamin K. However, manufacturers have reformulated their parenteral multivitamin products to provide 150 meg of vitamin K in accordance with FDA recommendations. There is a parenteral multivitamin formulation available without vitamin K (e.g., for patients who require warfarin therapy), but standard compounding of PN formulations should include a parenteral multivitamin that contains vitamin K unless otherwise clinically indicated. 

Koo WWR, Succop PA, Bomschcin RL, et al. 1991. Serum vitamin D metabolites and bone mineralization in young children with chronic low to moderate lead exposure. Pediatrics 87 680-687. 

Radu, RA, Han, Y, Bui, TV, Nusinowitz, S, Bok, D, Lichter, J, Widder, K, Travis, GH, and Mata, NL, 2005. Reductions in serum vitamin A arrest accumulation of toxic retinal fluorophores A potential therapy for treatment of lipofuscin-based retinal diseases. Invest Ophthalmol Vis Sci 46, 4393 4401. 

Cameron C, Lodes MW and Gershan WM. 2007. Facial nerve palsy associated with serum vitamin A level in an infant with cystic fibrosis. J Cyst Fibros 6 241-243. 

The so-called normal range of blood and serum vitamin levels is always derived from observations on healthy young subjects. How about a comparison with healthy old subjects, whose percentage in the population is steadily increasing Much may be learned about the cause of the decrease of physiological function and of the increased susceptibility to organic disease in old age, if the role of vitamins as parameter of these alterations were investigated with a view to preventive theory. 

More recently, Mustafa studied succinate-dependent mitochondrial oxygen consumption in rats fed either a diet containing vitamin E at approximately the normal American dietaiy intake or one with 6 times as much vitamin E. A statistically significant increase in oxygen consumption was observed in rats that received the diet lower in vitamin E when exposed to ozone at either 0.1 to 0.2 ppm for 7 days. In rats on the diet higher in vitamin E, ozone at 0.2 ppm for 7 days also produced a significant increase, but ozone at 0.1 ppm was without effect. Unfortunately, serum vitamin E concentrations jvere not obtained. 

Minor chromosomal abnormalities Inhibition of intracellular hydrolytic enzymes of alveolar macrophages increased fraction of polymorphonuclear leukocytes Alterations in blood, including red-cell membrane and enzyme changes and increased serum vitamin E and lipid peroxides Decreased lung DNA synthesis Decreased electric response of specific areas of brain with evoked-response technique... 

Alterations in blood, induding Man red-cell membrane and enzyme diaiiges and increased serum vitamin E and lipid peroxides... 

Vitamin Bf2 levels A decrease of previously normal serum vitamin B-12 levels has been observed in patients receiving metformin. 

Gallagher, J. C., Riggs, B. L., Eisman, J., Hamstra, A., Arnaud, S. B., and DeLuca, H. E. (1979). Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients. /. Clin. Invest. 64, 729-736. 

Kinyamu, H. K., Gallagher, J. C., Balhorn, K. E., Petranick, K. M., and Rafferty, K. A. (1997). Serum vitamin D metabolites and calcium absorption in normal young and elderly free-living women and women living in nursing homes. Am. ]. Clin. Nutr. 65, 790-797. 

The most common toxic effects of metformin are gastrointestinal (anorexia, nausea, vomiting, abdominal discomfort, and diarrhea), which occur in up to 20% of patients. They are dose-related, tend to occur at the onset of therapy, and are often transient. However, metformin may have to be discontinued in 3-5% of patients because of persistent diarrhea. Absorption of vitamin B12 appears to be reduced during long-term metformin therapy, and annual screening of serum vitamin B12 levels and red blood cell parameters has been encouraged by the manufacturer to determine the need for vitamin B12 injections. In the absence of hypoxia or renal or hepatic insufficiency, lactic acidosis is less common with metformin therapy than with phenformin therapy. 

Hematologic reactions (asymptomatic subnormal serum vitamin B,2 levels)... 

Vitamin B12 deficiency has been seen in healthy oral contraceptive users in whom serum vitamin B12 binding proteins were not altered. 

A 63-year-old man with type 2 diabetes, who had taken metformin for at least 5 years, had a low serum vitamin Bi2 concentration (110 pg/ml reference range 200-230) and a normal serum folate (90). There were no autoantibodies. A Schilling test showed malabsorption of vitamin Bi2. Metformin was withdrawn and 2 months later a Schilling test showed no malabsorption. 

Oral vitamin E, 300 mg and 600 mg daily for 2 weeks, administered to type II and IV hyperlipoproteinaemia patients increased the serum vitamin E concentration 2- fold and suppressed the normally elevated plasma lipid peroxide... 

Serum vitamin B12 levels decrease with age, and serum methylmalonic acid concentrations increase with age. These findings reflect a decline in vitamin B12 status in elderly people. 

Some mechanisms contributing to bone mineral homeostasis. Calcium and phosphorus concentrations in the serum are controlled principally by two hormones, l,25(OH)2D3(D) and parathyroid hormone (PTH), through their action on absorption from the gut and from bone and on excretion in the urine. Both hormones increase input of calcium and phosphorus from bone into the serum vitamin D also increases absorption from the gut. Vitamin D decreases urinary excretion of both calcium and phosphorus, while PTH reduces calcium but increases phosphorus excretion. Calcitonin (CT) is a less critical hormone for calcium homeostasis, but in pharmacologic concentrations CT can reduce serum calcium and phosphorus by inhibiting bone resorption and stimulating their renal excretion. Feedback effects are not shown. 

Dog (NS) 13-14 d 1x/d (GO) Hepatic 0.2 (impaired liver functions as indicated by decreased serum vitamin A levels increased prothrombin time and BSP retention increased urinary excretion of administered choline) Sigal et al. 1954... 

Numerous observational studies have found that vitamin C may decrease LDL cholesterol and elevate HDL (50). Some studies found an inverse association between serum vitamin C concentration and coagulation factor or coagulation activation markers (51). 

Although exposure to nitrous oxide is associated with an acute vitamin B12 deficiency due to oxidation of the vitamin, the serum vitamin B12 concentration remains normal even when measured using a biological system with E. gracilis as the test organism (A6). The organism is apparently able to use both reduced and oxidized forms of the vitamin. 

Vitamin B12 depletion could be expected in chronic alcoholics since their diet is often low in animal protein, and, although many alcoholic beverages are the result of bacterial fermentation, they have nevertheless been found to be essentially free of vitamin B12 (L9). Reduced levels of serum vitamin B12 have been reported in alcoholics by some workers (H16.L9) while others have found the concentration to be normal or elevated (Dll). Because of the liver damage often associated with alcoholism, serum levels of the vitamin may be normal or elevated even though liver stores of the vitamin are reduced (RIO, S15). An elevated level of serum vitamin B12 binding protein may also serve to increase the vitamin B12 level. The interpretation of serum vitamin B12 levels in alcoholics is of very limited importance since a clinically significant deficiency of the vitamin very rarely occurs. 

The gastritis and chronic pancreatitis associated with chronic alcoholism may result in a reduction of the amount of vitamin B12 absorbed but this has not been found to result in a clinical deficiency (M4). Alcohol can also cause damage to the ileum. Lindenbaum and Lieber gave alcohol to human volunteers for periods of 13—37 days and found that absorption of the vitamin was impaired in six of eight volunteers and this was not corrected by the addition of intrinsic factor or pancreatin (L10,L11). Biopsy of the ileum showed ultra-structural evidence of mitochondrial damage (Rll). It has been shown previously that folate deficiency may result in a reduction in the serum vitamin B12 level (H16) and the low serum vitamin B12 levels found in some alcoholics is probably secondary to folate depletion, which is common in this condition (L12). How folate is able to influence the serum vitamin B12 level is not clear. 

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