Vitamin E Interactions with Drugs

Vitamin E supplements have the potential to interact with several types of medications.

Anticoagulant and antiplatelets drugs

Vitamin E can inhibit platelet aggregation and antagonize vitamin K-dependent clotting factors. As a result, taking large doses with anticoagulant or antiplatelet medications, such as warfarin, can increase the risk of bleeding, especially in conjunction with low vitamin K intake. The amounts of supplemental vitamin E needed to produce clinically significant effects are unknown but probably exceed 400 IU/day.

Simvastatin and niacin

Some people take vitamin E supplements with other antioxidants, such as vitamin C, selenium, and beta-carotene. This collection of antioxidant ingredients blunted the rise in high-density lipoprotein (HDL) cholesterol levels, especially levels of HDL2, the most cardioprotective HDL component, among people treated with a combination of simvastatin and niacin.

Chemotherapy and radiotherapy

Oncologists generally advise against the use of antioxidant supplements during cancer chemotherapy or radiotherapy because they might reduce the effectiveness of these therapies by inhibiting cellular oxidative damage in cancerous cells. Although a systematic review of randomized controlled trials has called this concern into question, further research is needed to evaluate the potential risks and benefits of concurrent antioxidant supplementation with conventional therapies for cancer.

General Signs of Deficiency of Vitamin E

1.  Gastrointestinal diseases

2.  Dry hair or loss of hair

3.  Muscular weakness

4.  Slow tissue healing

5.  Leg cramps

09. Vitamin E Improves Physical Endurance and Muscle Strength

Vitamin E can be used to improve your physical endurance. It can increase your energy and reduce the level of oxidative stress on your muscles after you exercised. Vitamin E can also improve your muscle strength. Vitamin E eliminates fatigue by promoting blood circulation; it can also strengthen your capillary walls and nourish your cells.

8. Vitamin E Improves Effects of Medical Treatments

Vitamin E is sometimes used to lessen the harmful effects of medical treatments such as radiation and dialysis. This is because it is a powerful antioxidant that fights off free radicals in the body. It is also used to reduce unwanted side effects of drugs that may cause hair loss of lung damage.

7. Vitamin E helps People with Alzheimer’s Disease

Vitamin E may slow down the worsening of memory loss and functional decline in people with moderately severe Alzheimer’s disease. It may also delay the loss of independence and the need for a caregiver or assistance. Vitamin E, taken with Vitamin C, can also decrease the risk of developing several forms of dementia.

6. Vitamin E Improves Vision

Vitamin E may help decrease the risk of age-related macular degeneration, which is a common cause of blindness. Keep in mind, in order for vitamin E to be effective for vision, it must also be consumed with adequate intakes of vitamin C, beta carotene, and zinc. It has also been found that taking high doses of vitamin E and vitamin A daily seems to improve healing and vision in people undergoing laser eye surgery.

5. Vitamin E balances Hormones

Vitamin E can help to play a crucial role in balancing your endocrine and nervous system, naturally working to help keep your hormones balanced. Symptoms of a hormonal imbalance may include PMS, weight gain, allergies, urinary tract infections, changes in the skin, anxiety, and fatigue. By keeping your hormones in balance, you will find it easier to maintain a healthy weight, you will keep a regular menstrual cycle, and you will find yourself feeling more energetic.

4. Vitamin E Thickens Hair

Because Vitamin E is a powerful antioxidant, it helps to decrease environmental damage to your hair. It can also promote circulation to the scalp. Vitamin E oil can retain the natural moisture in your skin, which will help your scalp from becoming dry and flakey. This oil will also make your hair look healthier and fresher. You can apply a few drops of vitamin E oil on your hair, especially if it is looking dry and dull.

3. Vitamin E Repairs Damaged Skin

Vitamin E helps to strengthen the capillary walls in your skin and to improve moisture and elasticity, acting as a natural anti aging nutrient within your body. Studies have shown that Vitamin E  helps to reduce inflammation both within your body and on your skin, helping to maintain healthy, youthful skin. These antioxidant properties are also helpful when you are exposed to cigarette smoke or ultraviolet rays from sunlight, protecting against skin cancer.Taking vitamin E with vitamin C fights skin inflammation after exposure to UV radiation and can also be useful in decreasing signs of acne and eczema. Vitamin E also helps the healing process in the skin. It is absorbed by the epidermis layer of the skin and can be used to treat sunburn, which is one of the leading causes of skin cancer among other factors. Because it speeds up cell regeneration, it can be used to treat scars, acne, and wrinkles; this makes your skin look healthier and younger.

2. Vitamin E Fights Free Radicals

Free radicals fight and break down the healthy cells in your body and this can lead to heart disease and cancer. These molecules form naturally in your body and they can cause severe damage when they accelerate or oxidize. Vitamin E is a powerful antioxidant that has the power to reduce free radical damage, fight inflammation, and therefore to help to naturally slow aging in your cells and fight off health issues like heart disease. Studies have shown that Vitamin E can significantly increase immunity, therefore helping to prevent both common illnesses and serious conditions from forming.

Functions of Vitamin E

1. Vitamin E help to balances Cholesterol

Cholesterol is a naturally occurring substance made by the liver and required by the body for the proper function of your cells, nerves, and hormones. When cholesterol levels are in their natural state, they are balanced, normal and healthy. When it oxidizes, it becomes dangerous. Studies have shown that Vitamin E serves as a protective antioxidant that fights cholesterol oxidation. This is because vitamin E can fight free radical damage in the body, which leads to cholesterol oxidation.

Diet rich in Vitamin E

Numerous foods provide vitamin E. Nuts, seeds, and vegetable oils are among the best sources of alpha-tocopherol, and significant amounts are available in green leafy vegetables and fortified cereals. Most vitamin E in diets is in the form of gamma-tocopherol from soybean, canola, corn, and other vegetable oils and food products.

VITAMIN E

Vitamin E is found naturally in some foods, added to others, and available as a dietary supplement. “Vitamin E” is the collective name for a group of fat-soluble compounds with distinctive antioxidant activities.

Naturally occurring vitamin E exists in eight chemical forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) that have varying levels of biological activity. Alpha- (or α-) tocopherol is the only form that is recognized to meet human requirements.

Serum concentrations of vitamin E (alpha-tocopherol) depend on the liver, which takes up the nutrient after the various forms are absorbed from the small intestine. The liver preferentially resecretes only alpha-tocopherol via the hepatic alpha-tocopherol transfer protein; the liver metabolizes and excretes the other vitamin E forms. As a result, blood and cellular concentrations of other forms of vitamin E are lower than those of alpha-tocopherol.

VITAMIN K

Vitamin K is a fat-soluble vitamin, so your body stores it in fat tissue and the liver. It is best known for its role in helping blood clot, or coagulate, properly. The "K" comes from its German name, Koagulations vitamin. Vitamin K also plays an important role in bone health.

It is rare to have a vitamin K deficiency. That’s because in addition to being found in leafy green foods, the bacteria in your intestines can make vitamin K. Sometimes taking antibiotics can kill the bacteria and lead to a mild deficiency, mostly in people with low levels to begin with. Vitamin K deficiency can lead to excessive bleeding, which may begin as oozing from the gums or nose.

Types of Vitamine K

K1 (phylloquinone) – Chloroplasts in plants

K2 (menaquinone) – Bacterial synthesis

K3 ( menadione) - Synthetic, water soluble form

Functions of Vitamin K

1.  Clotting factors are synthesized in the liver as inactive precursors - vitamin K converts them to their active forms

– Conversion of prothrombin to thrombin

– Formation of fibrinogen to fibrin, leading to clot formation

2.  Stimulates bone formation and decreases bone resorption.

Deficiency of Vitamin K

1.  Fat absorption is impaired (e.g., cystic fibrosis, Crohn’s disease).

2.  Long-term or high-dose administration of antibiotics (they kill the bacteria in large intestine)

3.  Newborn babies with sterile GI tract; single vitamin K dose given to prevent hemorrhage

4.  Prolonged clotting time– Generalized hemorrhages

Precautions during taken vitamin K

At recommended doses, vitamin K has few side effects.

1.  Vitamin K crosses the placenta and is also found in breast milk.

2.  People with a rare metabolic condition called Glucose-6-phosphate dehydrogenase (G6PD) deficiency should avoid vitamin K.

3.  People who take warfarin should not take vitamin K.

4.  During dialysis for kidney diseases can have harmful effects from too much vitamin K.

Drug interactions of Vitamin K

Antibiotics -- Antibiotics, especially cephalosporins, reduce the absorption of vitamin K in the body. It lower levels of vitamin K because these drugs kill not only harmful bacteria but also the bacteria that make vitamin K.

1.    Cefamandole

2.    Cefoperazone

3.    Cefmetazole

4.    Cefotetan

Phenytoin -- Taking anticonvulsants (phenytoin) during pregnancy or while breastfeeding may lower vitamin K in newborns.

Warfarin -- Vitamin K blocks the effects of the blood-thinning medication warfarin, so that it doesn’t work. You should not take vitamin K, or eat foods containing high amounts of vitamin K, while you are taking warfarin.

Orlistat and Olestra -- Orlistat, a medication used for weight loss, and olestra, a substance added to some foods, lowers the amount of fat you body can absorb. Because vitamin K is a fat-soluble vitamin, these medications may also lower levels of vitamin K.

Cholesterol-lowering Drugs -- Bile acid sequestrants, used to reduce cholesterol, reduce how much fat your body absorbs and may also reduce absorption of fat-soluble vitamins.

Minerals & its defieciency

Mineral deficiency is a condition where the concentration of a mineral element that is essential for the body becomes very low and leads to impairment of function directly related to the mineral.

Minerals are inorganic substances that are found in soil and rocks. They are essential nutrients that the body needs to survive and carry out daily functions and processes. You receive minerals by eating plants that absorb them from the earth and by eating meat from animals, which graze on plants. Minerals keep you healthy and have key roles in several body functions. You require these important nutrients from your daily diet.

Minerals help in Bone and Teeth Health

Your skeleton provides motility, protection and support for the body. It also stores minerals and other nutrients. Though they appear hard and unyielding, your bones are actually constantly being reabsorbed and reformed by your body. Several minerals make up the lattice architecture of your bones. Calcium is the most abundant mineral in your body and is found in your bones and blood. Along with the minerals phosphorus and magnesium, calcium gives your bones strength and density. This mineral also builds and maintains strong, healthy teeth. BBC Health reports that a calcium deficiency due to poor nutrition or illness can lead to osteoporosis, a condition in which the bones become brittle and less dense, increasing the risk of fractures. Kids Health notes that foods that are rich in calcium include milk and other dairy products, green, leafy vegetables and canned fish with bones.

Minerals help in Energy Production

You require oxygen to produce energy that is necessary for every bodily function and process. Red blood cells -- or erythrocytes -- carry oxygen to each of your infinite cells, where it is used to generate energy. Red blood cells contain a heme or iron component that binds to oxygen so that it can be transported. The University of Maryland Medical Center notes that without the iron molecules, oxygen could not be attached to the blood cells and the body would not be able to produce the energy necessary for life. Iron is an essential mineral, and failing to get enough from your diet can lead to a condition called anemia, which causes weakness and fatigue. This mineral is primarily found in the blood, and it is also stored in your liver, spleen, bone marrow and muscles.

Minerals help in Nerve and Muscle Function

Potassium is found in bananas, dates, tomatoes, green leafy vegetables, citrus fruits and legumes such as peas and lentils. According to KidsHealth, this nutrient is important to keep muscles and the nervous system functioning normally. Potassium helps to maintain the correct water balance in the cells of your nerves and muscles. Without this essential mineral, your nerves could not generate an impulse to signal your body to move, and the muscles in your heart, organs and body would not be able to contract and flex.

Minerals help in Immune Health

Some minerals such as calcium are needed in large quantities, while others such as zinc are only needed in trace amounts. Zinc is an essential mineral that is important for keeping your immune system strong and helps your body fight infections, heal wounds and repair cells. KidsHealth notes that eating meat and legumes such as beans, peas and lentils will give you sufficient amounts of zinc. According to BBC Health, the mineral selenium is also needed in small amounts for immune health. A deficiency of selenium has been linked to an increased risk of heart disease and even some types of cancers.

Important Minerals:

Zinc
 
Zinc is an important trace element that is required for optimal immune function, growth and repair, hormone production, wound healing, and acts as an antioxidant. 

Zinc is an essential mineral that is naturally present in some foods, added to others, and available as a dietary supplement. Zinc is also found in many cold lozenges and some over-the-counter drugs sold as cold remedies.

Zinc is involved in numerous aspects of cellular metabolism. It is required for the catalytic activity of approximately 100 enzymes and it plays a role in immune function, protein synthesis, wound healing, DNA synthesis, and cell division. Zinc also supports normal growth and development during pregnancy, childhood, and adolescence and is required for proper sense of taste and smell. A daily intake of zinc is required to maintain a steady state because the body has no specialized zinc storage system.

diet rich in Zinc:

Oysters, Meat (lamb, pork, beef, chicken), Lobsters, Pumpkin seeds, Yogurt, Chickpeas, Cashews.

Deficiency Symptoms:

Impaired neurological function, Impaired immunity, Growth retardation, Food allergy, Diarrhea, Gastrointestinal problems (abdominal pain, diarrhea, anorexia, glossitis), Skin problems (alopecia, dermatitis, acne, stomatitis), Hormone imbalances.

Diagnosis: 

Zinc deficiency can be diagnosed by conducting a blood test, which measures its level in the serum or plasma. The test is important because zinc is not stored in the body and can fluctuate with time, so it must be measured directly as and when required. 

Treatment:

Zinc deficiency can be treated by multivitamin supplements in which the element may be present as gluconate, acetate or sulfate. 

Sodium
Sodium is a mineral that your body must have in order to function properly. The primary source of dietary sodium is sodium chloride, or salt, more than three-quarters of which comes from processed foods. Although sodium is vital to a number of routine body functions, too much can have adverse effects, particularly for people who are sensitive to sodium. Excessive sodium can cause hypertension, which in turn can lead to other health problems.

Nerve, Muscle Function

Sodium is a mineral that carries an electrical charge, known as an electrolyte. Electrolytes facilitate muscle contraction and nerve cell transmission. Ions of sodium, potassium and chloride trigger muscle contractions and nerve impulses when they shift places across cell membranes. As explained by nutrition professors Michelle McGuire and Kathy Beerman, authors of “NUTR,” a nerve cell at rest has positively charged potassium ions inside the cell and is surrounded outside the cell by positively charged sodium ions and negatively charged chloride ions. When stimulated, potassium ions rush out of the cell as sodium ions rush in, creating an electrical signal or nerve impulse. A similar scenario occurs during the contraction of muscles.

Fluid Balance

Sodium also works in concert with potassium to maintain normal water balance in the body. Each of the minerals chemically attracts water to itself, thus assuring that optimal levels of hydration are maintained both inside human cells and outside the cells, in the extracellular spaces that surround them. In healthy people, Brown writes, the body has a built-in mechanism to guard against the effects of occasional excess levels of sodium, but continued intake of high amounts of sodium can eventually override this safety valve and lead to hypertension.

Blood Volume

Closely related to sodium’s role in the maintenance of normal fluid levels is the part it plays in controlling your body’s blood volume and thus blood pressure. Your body constantly monitors sodium concentrations and blood volume, according to the Merck Manual Home Health Handbook. If either blood volume or sodium levels get too high, your body stimulates your kidneys to excrete excess sodium, returning blood volume to normal levels.

Food rich in Sodium:

Table salt, Salted snacks (nuts, chips, popcorn), Meat (bacon, ham) / fish / poultry (smoked, cured, salted, canned), Sauces / salad dressings (soy sauce), Milk, Cheese (Roquefort), Pickles, Beet, Celery

Deficiency Symptoms:

Sodium deficiency leads to lowering of the level of sodium in the blood (hyponatremia), which occurs in certain disease conditions like kidney failure and in some types of cancer. The main symptoms of sodium deficiency are given below:

·Fatigue and lethargy

·Confusion

·Muscle cramps / spasms

·Headache

·Nausea and vomiting

·Dizziness

·Seizure and coma (in severe cases)

Diagnosis:
Sodium deficiency can be suspected if the patient presents with prolonged vomiting or profuse sweating. However, a definitive diagnosis can only be made based upon a blood test that measures the level of sodium ions (Na⁺) in the serum.

Treatment:
Treatment usually involves adjustment in diet and lifestyle. In severe cases of hyponatremia, fluids and electrolytes need to be administered intravenously.

Medications may also be needed to treat the underlying cause of hyponatremia as well as to manage the symptoms.

Selenium
Selenium is a trace element and is required in small amounts for maintenance of health. As an essential component of enzymes, it acts as an antioxidant and catalyzes the production of active thyroid hormones.

It is also required in the maintenance of optimal immune functions.

Food  rich in selenium:

Brazil nuts, Red meat, Liver, Chicken, Eggs, Fish (cod, tuna, shellfish, sardines, halibut), Mushrooms, Sunflower seeds, Wheat germ, Bread, fortified.

Deficiency Symptoms:

Memory lapses / sluggish memory and difficulty concentrating, Lowered immunity (increased susceptibility to infections), Hair fall, Discoloration of skin and nails, Tiredness and fatigue, Infertility / recurrent miscarriage, Poor wound healing

Treatment:

Selenium deficiency can be corrected by selenium supplementation, which is available in combination as multivitamin / multimineral formulations, or by itself in the form of selenomethionine or as sodium selenite or sodium selenate. Importantly, the bio-availability of selenomethionine is much higher (~90%) than the selenite or selenate forms.

Potassium

Potassium is a very significant body mineral, important to both cellular and electrical function. It is one of the main blood minerals called "electrolytes" (the others are sodium and chloride), which means it carries a tiny electrical charge (potential). Potassium is the primary positive ion (cation) found within the cells, where 98 percent of the 120 grams of potassium contained in the body is found. The blood serum contains about 4-5 mg. (per 100 ml.) of the total potassium; the red blood cells contain 420 mg., which is why a red-blood-cell level is a better indication of an individual's potassium status than the commonly used serum level.

Magnesium helps maintain the potassium in the cells, but the sodium and potassium balance is as finely tuned as those of calcium and phosphorus or calcium and magnesium. Research has found that a high-sodium diet with low potassium intake influences vascular volume and tends to elevate the blood pressure. Then doctors may prescribe diuretics that can cause even more potassium loss, aggravating the underlying problems. The appropriate course is to shift to natural, potassium foods and away from high-salt foods, lose weight if needed, and follow an exercise program to improve cardiovascular tone and physical stamina.

Potassium is well absorbed from the small intestine, with about 90 percent absorption, but is one of the most soluble minerals, so it is easily lost in cooking and processing foods. Most excess potassium is eliminated in the urine; some is eliminated in the sweat. When we perspire a great deal, we should replace our fluids with orange juice or vegetable juice containing potassium rather than just taking salt tablets. The kidneys are the chief regulators of our body potassium, keeping the blood levels steady even with wide variation in intake. The adrenal hormone aldosterone stimulates elimination of potassium by the kidneys. Alcohol, coffee (and caffeine drinks), sugar, and diuretic drugs, however, cause potassium losses and can contribute to lowering the blood potassium. This mineral is also lost with vomiting and diarrhea.

food rich in Potassium:

Red meat and chicken, Fish (salmon, cod, flounder, sardines), Fruits (bananas, citrus juice, avocados, apples, raisins, apricots), Leafy greens (spinach, parsley, lettuce, broccoli), Peas and lima beans, Tomatoes, Potatoes, Whole grains and wheat germ, Seeds and nuts

Deficiency Symptoms:

Hypertension and Congestive heart failure, Nausea and vomiting, Tingling and numbness, Abdominal cramps and bloating, Constipation, Cardiac arrhythmia, Muscle cramps, fatigue and weakness, Depression and other mood changes.

Diagnosis: 

Abnormalities in potassium levels can be determined by a blood test. This can detect both potassium deficiency (hypokalemia) and potassium elevation (hyperkalemia). This test is especially used to monitor kidney failure patients undergoing hemodialysis.

Treatment:

Potassium supplementation is recommended only under medical supervision. Children, especially should not be given potassium supplementation until prescribed by a medical practitioner. Generally, these supplements are available as potassium salts of acetate, gluconate, bicarbonate, citrate, and chloride. 

Phosphorous
Phosphorus is an essential mineral primarily used for growth and repair of body cells and tissues. According to the University of Maryland Medical Center, all body cells contain phosphorus, with 85 percent found in bones and teeth. There, together with calcium, phosphorus provides structure and strength. Phosphorus is also required for a variety of biochemical processes including energy production and pH regulation.

Energy Production

Phosphorus is commonly found in the body as phosphate. Phosphates play an important role in energy production as components of ATP, or adenosine triphosphate. ATP is readily used to fuel your body's many functions. Structurally, ATP consists of adenosine, an organic compound, and three phosphate molecules. When bonding between one phosphate and adenosine is severed, energy is released which then fires cellular activity. According to the authors of "Nutrition," energy released from ATP is used quickly, so your body contains only a small amount at any one time.

Protein Synthesis

Phosphorus is a component of deoxyribonucleic acid, or DNA, and ribonucleic acid, or RNA, long molecules which carry genetic information used to make proteins. Synthesis begins in the cell nucleus, where a portion of DNA serves as a template for RNA manufacture. RNA then carries specific coding instructions for building needed body proteins to the ribosomes, where proteins are assembled from amino acids. Without sufficient phosphorus, body protein manufacture is impaired, which eventually affects overall health.

Secondary Functions

Phosphorus also acts as a buffer, neutralizing acids to maintain normal pH in the blood. Many enzymes and hormones also contain phosphorus as a structural component. Hemoglobin, the important oxygen-carrying protein in the bloodstream, also depends upon phosphorus contained in its structure for proper function.

Diet rich in phosphorus:

Meat, Tuna fish,Lobster, Milk, Cheese, Yogurt, Cereals (rice, wheat germ, maize), Pulses, legumes and vegetables (broccoli, peas, potatoes), Nuts (almond, cashew nuts, pistachio, walnuts), Oil seeds (mustard seed, sunflower seed)

Deficiency Symptoms:

Excessive fatigue / weakness, Loss of appetite, Irritability, Numb / burning / tingling sensation in extremities, Diffuse bone pain, Joint pain / swelling / stiffness, Susceptibility to dental cavities, Brittle hair and nails

Treatment: Phosphorus can be treated by taking adequate amounts (recommended daily allowance of 1200 mg for adults, both male and female, and 800 mg for children) in the form of supplements and multivitamins.

Manganese

Manganese is a micronutrient that is a component of several enzyme complexes and helps in various metabolic functions. It is required for the metabolism of carbohydrates, amino acids, and cholesterol, and in the formation of bones, connective tissues, sex hormones and clotting factors. It also helps to maintain normal brain function and blood sugar levels. It facilitates calcium absorption and wound healing. It also has an antioxidant function.

Manganese is a trace mineral that is present in tiny amounts in the body. It is found mostly in bones, the liver, kidneys, and pancreas. Manganese helps the body form connective tissue, bones, blood clotting factors, and sex hormones. It also plays a role in fat and carbohydrate metabolism, calcium absorption, and blood sugar regulation. Manganese is also necessary for normal brain and nerve function.

Manganese is a component of the antioxidant enzyme superoxide dismutase (SOD), which helps fight free radicals. Free radicals occur naturally in the body but can damage cell membranes and DNA. They may play a role in aging, as well as the development of a number of health conditions, including heart disease and cancer. Antioxidants, such as SOD, can help neutralize free radicals and reduce or even help prevent some of the damage they cause.

Low levels of manganese in the body can contribute to infertility, bone malformation, weakness, and seizures. It is fairly easy to get enough manganese in your diet -- this nutrient is found in whole grains, nuts, and seeds -- but some experts estimate that as many as 37% of Americans do not get the recommended dietary intake (RDI) of manganese in their diet. The American diet tends to contain more refined grains than whole grains, and refined grains only provide half the amount of manganese as whole grains.

food rich in manganese:

Pecan nuts, Brown rice, cooked, Spinach, cooked, Raisin bran cereal, Green tea, Oatmeal cereal, Whole wheat bread, Pineapple

Deficiency Symptoms:

Impaired growth, Impaired reproductive function, Impaired glucose tolerance, Skeletal abnormalities, Altered carbohydrate and lipid metabolism.

Diagnosis:

manganese defieciency can be detected by testing the blood or serum. The analysis is carried out using an automated equipment such as an inductively coupled plasma-mass spectrometer. 

Treatment:

Treatment relies upon oral multivitamin / mineral supplementation.