What are the types of vitamins? How to supplement "eating" vitamins? "Medicinal" vitamins? What are the precautions and misunderstandings? Let's take it slowly.
Vitamins, divided into several types?
Vitamins are a group of organic compounds, which can be divided into two categories: fat-soluble vitamins and water-soluble vitamins according to their different solubility properties:
· There are 4 types of fat-soluble vitamins, including vitamin A, vitamin D, vitamin E and vitamin K.
· Water-soluble vitamins include vitamin C, vitamin B1, vitamin B2, vitamin B6, vitamin B12 and other 9 kinds.
Each vitamin has its own characteristics, and supplementation with these vitamins should be individualized.
What is the manifestation of vitamin deficiency?
Because different vitamins have different functions, the clinical manifestations of various types of vitamin deficiencies are different, as detailed in Table 1. Once the following symptoms occur, the possibility of vitamin deficiency should be considered, and the diagnosis should be made in a timely manner to improve the relevant examinations and confirm the diagnosis.
Table 1 Signs due to vitamin deficiency
The average person can obtain vitamins that meet the normal metabolic needs of the human body through a reasonable and balanced diet, and no additional supplementation is required. However, for some special groups, such as parenteral nutritionists, critically ill patients, burn patients, liver disease patients, inflammatory bowel disease patients, newborns and children, pregnant women and lactating women, etc., there will be clinical manifestations of vitamin deficiency.
Table 2 Vitamin daily supplements:
(Note: It should be consumed after meals to be more completely absorbed by the human body)
"Medicinal" vitamins, how to open correctly?
For patients with vitamin deficiency who have already developed associated symptoms, "medicinal" vitamins are required in addition to dietary supplementation.
Different vitamins have their own characteristics, how to correctly open the "medicinal" vitamins, appropriate supplementation, to avoid "overcorrection", you need to understand the characteristics of various types of vitamins and medicinal precautions. Let's talk about them one by one.
vitamin A
Vitamin A supplementation is generally taken orally, and vitamin A injections are only used in acute conditions caused by vitamin A deficiency (e.g., night blindness).
It is important to note that long-term high-dose application (more than 1 million units at a time for adults and more than 300,000 units for children) can lead to too much vitamin A and even acute or chronic poisoning.
In addition, long-term use of vitamin A in the elderly may cause vitamin A overdose due to delayed retinal clearance, so the use of vitamin A in elderly patients should be particularly careful.
Vitamin B1
Vitamin B1, also known as thiamine, is also known as thiamine due to the "sulfur" and "ammonia" in the molecule. Vitamin B1 deficiency can cause a special class of diseases - beriberi, so vitamin B1 is also known as anti-beriberi factor.
It should be noted that vitamin B1 can not be combined with tannin-containing traditional Chinese medicines and foods, tannin can be combined with vitamin B1, resulting in its excretion; vitamin B1 is more stable under acidic conditions, and is unstable in neutral and alkaline conditions, so it should be avoided in combination with alkaline drugs such as sodium bicarbonate and sodium citrate, so as not to lead to changes in the nature of the drug.
Vitamin B2
Vitamin B2, also known as riboflavin, is mainly used to prevent and treat symptoms caused by vitamin B2 deficiency (see Table 1 for details). It should be noted that the vitamin B2 drug trait is yellow or orange yellow, so the urine can be yellow after the application of vitamin B2, but it does not affect the continued use of the drug.
Vitamin B2 comes in tablets and injections. When taking vitamin B2 tablets, it should be noted that drinking alcohol (ethanol) can affect the absorption of vitamin B2 in the intestine; when taking phenothiazine, tricyclic antidepressants, probenecid and other drugs, the dosage of vitamin B2 needs to be increased; vitamin B2 should not be combined with metoclopramide.
The use of vitamin B2 injection should be noted: the drug is easy to deteriorate in light, so it should be used away from light; vitamin B2 injection contains formaldehyde, so intramuscular injection is contraindicated in preschool children.
Vitamin B6
Vitamin B6, also known as pyridoxal, pyridoxine, is mainly used for the treatment of vitamin B6 deficiency, infant convulsions, anemia caused by hemoglobin deficiency, nausea and vomiting caused by some anti-tumor drugs, and can also be used to prevent peripheral neuritis, insomnia, restlessness and so on caused by drugs such as isoniazid.
Vitamin B6 should be taken in accordance with the recommended dose, not in excess, long-term, overdose can lead to severe peripheral neuritis, neurosensory abnormalities, gait instability and numbness in the hands and feet.
In addition, the application of vitamin B6 should also pay attention to the interaction between drugs:
· Vitamin B6 affects the efficacy of levodopa in the treatment of Parkinson's disease, but has no effect on the efficacy of carbidopa.
· Chloramphenicol, cycloserine, ethioniazidazine, hydrazine hydrochloride, immunosuppressants (such as adrenocorticoids, cyclophosphamide, cyclosporine, penicillamine, etc.) can antagonize vitamin B6 or increase the excretion of vitamin B6 through the kidneys, which can cause anemia or peripheral neuritis.
Vitamin B12
It is mainly used for adjuvant treatment of neurological diseases such as megaloblastic anemia and subacute combined degeneration. The following points should be noted in the application of vitamin B12:
· Vitamin B12 should be used in patients with hyperuricemia, which can cause elevated blood uric acid and even induce gout attacks due to accelerated nucleic acid degradation;
· With vitamin B12, potassium should be reviewed within 48 hours of the start of the drug to warn of severe hypokalemia.
· Vitamin B12 should be avoided in combination with chloramphenicol to avoid reducing its prohetopoietic function.
· Aminoglycoside antibiotics, p-aminosalicylic acid, phenobarbital, phenytoin, primidone and colchicine can reduce the absorption of vitamin B12 from the intestine.
· Cholestamine binds to vitamin B12, reducing its absorption. Therefore, vitamin B12 concentrations should be measured when conditions permit.
vitamin C
Among the various vitamins, vitamin C is the most well-known, vitamin C has been called a natural antioxidant, and fruits and vegetables in the diet are rich in vitamin C. Medicinal vitamin C includes dosage forms such as vitamin C tablets, vitamin C effervescent tablets, and vitamin C for injection.
Although vitamin C is good, but it is not the more the better, nor do you want to supplement to make up, the application of vitamin C preparation has the following precautions:
· Long-term application of a large amount of vitamin C can increase the concentration of oxalate, urate and cysteine in the urine, which is easy to cause urinary stones.
· Patients with long-term use of a large amount of vitamin C (2-3g per day) should not stop the drug without authorization, be vigilant against scurvy after stopping the drug, and should gradually reduce the dose and stop the drug.
· Intravenous vitamin C should be given slowly, and rapid injection can cause dizziness and syncope.
In addition, due to the reductive nature of vitamin C, attention should also be paid to the interference of a large number of vitamin C applications on the test results, including:
· False positives may appear in fecal occult blood;
· Interfere with the results of the automatic analysis of serum lactate dehydrogenase and serum transaminases;
· Decrease in serum bilirubin levels;
· Decreased urine pH;
· Urine glucose (copper sulfate method) and glucose (oxidase method) can be false positives.
vitamin d
Vitamin D is mainly used for the prevention and treatment of rickets, osteoporosis, chronic kidney disease and other diseases. Drugs clinically used to supplement vitamin D mainly include the following categories:
· The first group is a common vitamin, divided into two forms, vitamin D2, also known as ergocalciferol, mainly derived from plants and fungi; vitamin D3, also known as cholecalciferol, mainly derived from animals.
· The second category is vitamin D analogues, including calcined glycol, calcitriol, alphacalciferol, palipritol, calcipotriene and the like.
· The third category is a compound preparation containing ordinary vitamin D, such as vitamin AD pills, cod liver oil pills, etc. Vitamin D supplementation should be particularly vigilant against vitamin D poisoning caused by overdose.
Typical vitamin D poisoning usually presents with hypercalcemia and its associated symptoms, such as polydipsia, polyuria, vomiting, decreased appetite, and kidney stones, which should be recognized with care.
vitamin E
Medicinal vitamin E is mainly used for adjuvant treatment of cardiac and cerebrovascular diseases, miscarriage and infertility. The following points should be noted when applying:
· Vitamin E is a fat-soluble vitamin, so drugs that reduce or affect fat absorption (such as cholestyramine, neomycin, and sucralfate) can interfere with their absorption and should not be taken together;
· Oral contraceptives can accelerate vitamin E metabolism, leading to vitamin E deficiency;
· When estrogen and vitamin E are used together, if the dosage is large and the course of treatment is long, thrombophlebitis can be induced;
· Vitamin E should be avoided in combination with dicoumarins and their derivatives to prevent the development of hypothrombin prosaemia.
vitamin k
Vitamin K is mainly involved in the synthesis of coagulation factors II., VII., IX., X., so it is also called coagulation vitamins, vitamin K has K1, K2, K3 and K4 and other forms. Among them, K1 and K2 are naturally occurring and belong to fat-soluble vitamins, while K3 and K4 are water-soluble vitamins that are synthesized by artificial.
The most commonly used clinically is vitamin K1 injection. The recommended use of vitamin K1 injection is muscle or deep subcutaneous injection, for intravenous injection in severe patients, the administration should be slow (the rate of administration should not exceed 1mg/min), intravenous injection too fast (more than 5mg/min) can cause facial flushing, sweating, bronchospasm, tachycardia, hypotension and other manifestations, and even rapid injection of death. Intramuscular injection may cause local redness and pain. Neonatals should be wary of hyperbilirubinemia, jaundice, and hemolytic anemia when applying vitamin K1.
Vitamins should not be neglected for their role and lack of timely and appropriate supplementation, nor should they be overdose, leading to other adverse reactions. In addition, the diet structure can be rationalized and diversified, and it is not possible to eat a single diet.
This article is compiled by Health Headlines from:
Vitamins, Baidu Baidu
"Guidelines for the use of various vitamins - recommended collections! ), China Network Medical Channel