Vitamin potentiating effect with

Statins should be avoided. If absolutely necessary, pravastatin could be used, starting at a low dose and with cautious adjustment according to clinical response. The patient s synthetic liver function should be monitored closely. In the event of the slightest deterioration of function, pravastatin should be stopped immediately. Colestyramine/colestipol should be safe to use but may cause a reduction in vitamin K absorption and increase the risk of a bleed. Constipation might induce encephalopathy. The fibrates should be avoided due to their potential effect on coagulopathy. Ezetimibe should be safe to use alone. Acipimox and niacin are gastric irritants and would be best avoided. 

Potential adverse effects with vitamin Bn replacement therapy are rare. Uncommon side effects include hyperuricemia and hypokalemia. Rebound thrombocytosis may precipitate thrombotic events. Another side effect of vitamin Bn therapy is sodium retention. This effect is more likely to occur in the patient with compromised cardiovascular status, because of an expansion in intravascular volume secondary to the sudden increase in the production of RBCs. Rare cases of anaphylaxis with parenteral administration of cobalamin have been reported. 

Signals such as a change in the body tocopherols composition at a high vitamin E consumption or a reduction of the necrotic effect induced by EPA in lymphoma cell, brought about by antioxidants (Heimli et al., 2001) suggest that antioxidants be applied with caution in view of their potential effect on the organism s pro- and antioxidative balance. 

We have stated earlier (Chapters 9 and 15) our view that the effectiveness of immunotherapy would be substantially advanced if the patients were at the same time ingesting high levels of ascorbate. The therapeutic use of vitamin C in fact might be considered to be mainly an example of immunotherapy, although this vitamin also exercises many functions in addition to that of potentiating the immune mechanisms. We see no reason for not using vitamin C together with immunotherapy. 

Although animal studies and small studies in humans have shown this strong association of vitamin K deficiency with vascular calcification, this has not been utilized as a standard therapy for vascular calcification. It is still unclear if vitamin K replenishment can affect the morbidity and mortality associated with vascular and valvular calcification in humans. Further studies are needed to determine the appropriate formulation of vitamin K (K1 vs. K2), dose, and duration of vitamin K therapy that would lead to beneficial effects in prevention of vascular calcification. Because of their very low toxicity and potentially beneficial effects on attenuation of arterial calcification, vitamin K supplementation can be considered in susceptible patients, such as patients with end-stage renal disease who are on hemodialysis. 

In work believed to be unpublished, Roberts and Schwarz following the same Selye granuloma pouch assay observed a potentiating effect of Vitamin E with selenium in the assay. The potentiation of the effect of selenite in the GPA was approximately four-fold when Vitamin E was administered (12.5 mg DL-alpha tocopherol) with selenite (Table I). Vitamin E alone was without measurable effect in reducing the exudate when given in concentrations of 0.8 mg to 12.5 mg per rat but was effective in reducing the exudate at dosages of 50 mg per rat. 

Carotenoids absorb visible light (Section 13 21) and dissipate its energy as heat thereby protecting the organism from any potentially harmful effects associated with sunlight induced photochemistry They are also indirectly involved m the chemistry of vision owing to the fact that p carotene is the biosynthetic precursor of vitamin A also known as retinol a key substance m the visual process... 

Along with increasing evidence of health benefits from consumption of vitamins at levels much higher than RE) A recommendations comes concern over potential toxicity. This topic has been reviewed (19). Like all chemical substances, a toxic level does exist for each vitarnin. Traditionally it has been assumed that all water-soluble vitamins are safe at any level of intake and all fat-soluble vitamins are toxic, especially at intakes more than 10 times the recommended allowances. These assumptions are now known to be incorrect. Very high doses of some water-soluble vitamins, especially niacin and vitamin B, are associated with adverse effects. In contrast, evidence indicates that some fat-soluble micronutrients, especially vitamin E, are safe at doses many times higher than recommended levels of intake. Chronic intakes above the RDA for vitamins A and D especially are to be avoided, however. 

In the Unites States, the daily intake of 3-carotene is around 2 mg/day Several epidemiological studies have reported that consumption of carotenoid-rich foods is associated with reduced risks of certain chronic diseases such as cancers, cardiovascular disease, and age-related macular degeneration. These preventive effects of carotenoids may be related to their major function as vitamin A precursors and/or their actions as antioxidants, modulators of the immune response, and inducers of gap-junction communications. Not all carotenoids exert similar protective effects against specific diseases. By reason of the potential use of carotenoids as natural food colorants and/or for their health-promoting effects, research has focused on better understanding how they are absorbed by and metabolized in the human body. 

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