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  • - WELCOME BACK TO THE SIXTH IN OUR SERIES ON VITAMINS

  • AND IN THIS SECTION I'M GOING TO BE

  • COVERING ALL OF THE B VITAMINS.

  • SO THIS SECTION IS GOING TO BE A LITTLE BIT LONGER,

  • AND REMEMBER THESE ARE WATER SOLUBLE VITAMINS.

  • WE JUST COVERED VITAMIN C

  • WHICH IS ALSO A WATER SOLUBLE VITAMIN.

  • "A," D, E AND K ARE OUR FAT SOLUBLE VITAMINS.

  • THE REASON I'M GOING TO TALK ABOUT ALL THE B VITAMINS

  • TOGETHER IS THEY WORK TOGETHER AND THEY'RE IN GENERAL PART

  • OF COENZYMES AND INVOLVED IN ENERGY METABOLISM

  • AND THAT'S WHY WE THINK OF,

  • OF COURSE WHEN YOU GO IN YOU SEE SUPPLEMENTATIONS OR SUPPLEMENTS,

  • YOU SEE A COMPLEX B OR B VITAMIN COMPLEX

  • BECAUSE THE B VITAMINS REALLY DO WORK TOGETHER.

  • THAT'S HOW I'D LIKE YOU TO THINK THEM.

  • THERE ARE A COUPLE B VITAMINS THAT I'M GOING TO

  • HIGHLIGHT AND POINT OUT FOR YOU IN PARTICULAR,

  • BECAUSE SOME ARE INVOLVED IN NEW CELL SYNTHESIS,

  • WHICH IS KIND OF AN IMPORTANT SEPARATE

  • ACTION OF THESE B VITAMINS.

  • WHEN I SAID THAT THEY ARE PART OF COENZYMES,

  • YOU MIGHT BE THINKING WELL, WHAT ARE THE COENZYMES?

  • LET'S START WITH AN ENZYME.

  • AN ENZYME IS ESSENTIALLY IT'S A PROTEIN,

  • BUT IT'S GOING TO HELP SPEED A REACTION,

  • WE THINK OF IT AS A CATALYST.

  • AND IF WE TOOK THESE TWO COMPOUNDS HERE,

  • AND THEY'RE SEPARATE, INDIVIDUAL COMPOUNDS,

  • BUT THE ENZYME IS GOING TO CONVERT

  • THEM INTO A SINGLE COMPOUND.

  • AND THIS COMPOUND MIGHT HAVE A

  • UNIQUE FUNCTION THAT'S NECESSARY.

  • THE ENZYME CAN'T DO THIS WITHOUT THE COENZYME.

  • AND THESE B VITAMINS ARE PART, ARE NECESSARY FOR THESE

  • COENZYMES TO WORK OR THEY WILL FUNCTION AS THE COENZYME.

  • AND IN GENERAL THAT'S HOW I WANT

  • YOU TO THINK ABOUT THESE B VITAMINS.

  • IT'S WORKING TOGETHER AS BEING COENZYMES

  • AND INVOLVED IN ENERGY METABOLISM.

  • NOW WHAT'S ENERGY METABOLISM?

  • YOU'RE THINKING WELL WHAT DOES THAT MEAN?

  • WE TAKE IN FOOD AND BREAK IT DOWN AND ABSORB IT,

  • AND THEN WE TAKE THOSE NUTRIENTS,

  • THE MACRO NUTRIENTS ONE OF OUR

  • THREE NUTRIENTS WE GET AS ENERGY.

  • THAT PROTEIN AND CARBOHYDRATE,

  • THOSE ARE BROKEN DOWN TO RELEASE ENERGY,

  • TO GIVE OUR BODY ENERGY,

  • TO MOVE YOUR HAND, MOVE YOUR MOUTH,

  • BLINK YOUR EYES, HAVE YOUR HEART BEAT.

  • THERE ARE OBVIOUSLY,

  • NUMEROUS FUNCTIONS IN OUR BODY THAT NEED CONTINUOUS ENERGY,

  • AND THAT'S WHERE OUR MACRO NUTRIENTS COME INTO PLAY.

  • THE MICRO NUTRIENTS THE B VITAMINS,

  • THEY DON'T ACTUALLY GIVE US ENERGY.

  • AND YOU'LL BE ASKED THAT ON YOUR EXAM,

  • DO B VITAMINS GIVE YOU ENERGY?

  • THEY DON'T, WE DON'T BREAK THEM DOWN TO RELEASE ENERGY.

  • BUT THEY'RE INVOLVED IN THAT PROCESS OF

  • BREAKING DOWN THOSE CARBOHYDRATES TO RELEASE

  • ENERGY OR THE FATTY ACIDS TO RELEASE ENERGY.

  • THE B VITAMINS ARE INVOLVED IN THAT PROCESS AND

  • NECESSARY FOR IT BECAUSE THEY ACT AS THE COENZYMES.

  • SO WE'RE GOING TO START WITH VITAMIN B1 WHICH IS THIAMIN.

  • NOW WHY IS IT B1, BECAUSE IT WAS DISCOVERED FIRST.

  • AND WE'LL GO THROUGH AND SEE ALL THE DIFFERENT TYPES OF VITAMIN,

  • B VITAMINS, AND IT WAS IN THE ORDER THAT THEY WERE DISCOVERED.

  • SO THIAMINE FUNCTIONS IN ENERGY METABOLISM IN THAT

  • ASSISTS IN METABOLISM OF CARBOHYDRATES,

  • AMINO ACIDS WHICH ARE THE BUILDING

  • BLOCKS FOR PROTEINS AND FATTY ACIDS.

  • NOW WHAT IF YOU DON'T GET ENOUGH THIAMIN?

  • WELL, THAT CAUSES A CONDITION CALLED BERIBERI,

  • AND THERE ARE ACTUALLY NUMEROUS

  • CASES OF BERIBERI BUT IN GENERAL,

  • CONFINEMENT IS SO IMPORTANT FOR BOTH THE NERVES AND

  • THE BRAIN BECAUSE THEY REQUIRE A LOT OF ENERGY.

  • YOUR, THESE SYMPTOMS THAT ARE SEEN

  • INVOLVE BOTH THE NERVES AND THE BRAIN.

  • SO LOSS OF SENSATION IN THE HANDS AND THE FEET,

  • OR WEAKNESS, EVEN ADVANCING PARALYSIS.

  • AND AS YOU CAN SEE HERE,

  • THIS GENTLEMAN IS REQUIRING CRUTCHES TO GET BY,

  • AND IS UNABLE TO LIFT HIS FEET UP WE DON'T SEE THIS

  • MUCH IN THE UNITED STATES, BECAUSE OF THIAMINE.

  • IT'S WIDESPREAD IN FOOD AND SO IT'S REALLY EASY

  • TO OBTAIN ENOUGH TO PREVENT DEFICIENCY.

  • SO LENTILS, BROWN RICE, WHEAT GERM, SPINACH,

  • AND THEN SOME OF THE MEAT SOURCES,

  • ANIMAL SOURCES ARE PORK.

  • IT IS FORTIFIED IN A LOT OF FOODS WHICH

  • IS ANOTHER REASON WE DON'T SEE DEFICIENCY.

  • BUT AGAIN ANY FOOD THAT'S GOING TO BE FORTIFIED

  • IS A PROCESSED GRAIN, AND I'M NOT RECOMMENDING

  • THAT YOU INCREASE YOUR INTAKE OF PROCESSED GRAINS.

  • I'D LIKE YOU TO STICK WITH WHOLE FOOD SOURCES OF,

  • FOR ALL YOUR NUTRIENTS.

  • VITAMIN B2, THIS IS RIBOFLAVIN.

  • RIBOFLAVIN ALSO INVOLVED AN ENERGY

  • METABOLISM DEFICIENCY WILL, IT'S VERY GENERALIZED JUST

  • BECAUSE IT'S INVOLVED IN THE ENERGY METABOLISM FOR ALL CELLS.

  • SO YOU SEE THE MOUTH CRACKS AND RASHES,

  • A RED TONGUE CALLED A MAGENTA TONGUE.

  • AGAIN WE DON'T SEE THIS THAT OFTEN.

  • RIBOFLAVIN NATURALLY OCCURS IN MILK, YOGURT,

  • AND THEN WE ALSO FIND IT IN GRAINS, SO IT'S IN,

  • WE DON'T SEE A LOT OF RIBOFLAVIN DEFICIENCY.

  • I DO WANT TO SPECIFICALLY POINT OUT ABOUT

  • RIBOFLAVIN THAT IT IS DESTROYED BY UV LIGHT.

  • AND BECAUSE ONE OF THE MAIN SOURCES THAT WE OBTAIN OUR

  • RIBOFLAVIN IS FROM MILK, WE DON'T WANT,

  • IF THAT'S EXPOSED TO LIGHT, IT'S GOING TO BE DESTROYED.

  • BUT HAVE YOU EVER NOTICED THAT ALL OF THE MILK COMES

  • IN THESE OPAQUE CARTONS OR THESE CARDBOARD CARTONS?

  • WELL, THIS IS SO THE UV LIGHT WON'T DESTROY RIBOFLAVIN.

  • LIKE WE'RE SEEING KIND OF A

  • RESURGENCE OF THIS GLASS CONTAINER.

  • BUT IT USUALLY HAS TO BE A UV PROTECTED GLASS IN

  • ORDER FOR THEM TO SELL IT, SO AS NOT TO DESTROY RIBOFLAVIN.

  • VITAMIN B3 IS NIACIN.

  • NIACIN ALSO INVOLVED IN ENERGY METABOLISM

  • AND DEFICIENCY RESULTS IN WHAT'S CALLED PELLAGRA.

  • WE CALL IT THE FOUR DS BECAUSE NIACIN DEFICIENCY

  • WILL EFFECT SKIN STRUCTURES AND THE DIGESTIVE TRACT.

  • SO THERE'S DIARRHEA,

  • DERMATITIS WHICH IS YOU CAN SEE HERE,

  • THIS SKIN CONDITION, DERMATITIS,

  • DEMENTIA AND EVEN DEATH WHICH CAN

  • BE ASSOCIATED WITH NIACIN DEFICIENCY.

  • I DO WANT TO POINT OUT THAT NIACIN IS ALSO

  • USED FOR CONTROLLING BLOOD LIPIDS,

  • AND WHEN YOU THINK ABOUT SOMEONE HAVING A HIGH CHOLESTEROL

  • THEN MAYBE THEIR LDL IS HIGH AND THEIR HDL IS LOW,

  • WELL NIACIN HAS HAS IN THE PAST, BEEN USED FOR THAT.

  • BUT I DO WANT TO POINT OUT THAT NEW RESEARCH HAS SHOWN THAT

  • IT'S NOT AS EFFECTIVE AS SOME OF THE OTHER DRUGS,

  • SO IT'S NOT BEING USED AS OFTEN.

  • WE CAN HAVE TOO MUCH NIACIN OR YOU'RE TAKING

  • NIACIN IN A PILL FORM, SO IN A SUPPLEMENT FORM,

  • PARTICULARLY TO CONTROL BLOOD LIPIDS,

  • ONE OF THE MAIN PROBLEMS THAT IS SEEN AS

  • WHAT'S CALLED A NIACIN FLUSH.

  • 'CAUSE NIACIN WILL ACTUALLY OPEN UP THE BLOOD VESSELS

  • AND THE FACE BECOMES REALLY RED OR FLUSHED,

  • AND IF SOMEONE IS TAKING NIACIN,

  • THEY REALLY SHOULDN'T DRINK ALCOHOL WITH IT.

  • IF YOU'VE EVER SEEN ANYONE DO THAT, AND I HAVE,

  • YOU'LL NOTICE THESE BIG WELTS THAT FORM ON THE

  • CHIN AND THE FACE AND IT'S, PEOPLE USUALLY MAKE THAT

  • MISTAKE ONE TIME BECAUSE IT'S SO UNCOMFORTABLE.

  • SO FOOD SOURCES, NIACIN NOTICE HOW

  • THE MAIN FOOD SOURCES OF NIACIN ARE ANIMAL FOODS.

  • SO WE HAVE THE CHICKEN AND PORK AND BEEF AND TUNA.

  • ALTHOUGH YOU WILL FIND IT IN SOME PLANT FOODS.

  • POTATOES IS ONE EXAMPLE.

  • PYRIDOXINE, WHICH IS VITAMIN B6, IS ACTUALLY

  • ALTHOUGH IT DOES HAVE SOME ROLE IN ENERGY METABOLISM,

  • IT ACTUALLY HAS A DIVERSE RANGE OF FUNCTIONS,

  • IT'S INVOLVED IN OVER A HUNDRED DIFFERENT REACTIONS,

  • MAINLY AS A COENZYME AND SOME OF THE MAIN FUNCTIONS ARE

  • AN AMINO ACID CONVERSION, RELEASING STORED GLUCOSE,

  • IMMUNE FUNCTION AND EVEN BRAIN DEVELOPMENT,

  • BUT THAT'S JUST, JUST A SMALL, A SMALL PART OF THE LIFT.

  • I WANT YOU TO KNOW THAT I DON'T, I'M NOT HOLDING YOU

  • ACCOUNTABLE FOR KNOWING ALL THE FUNCTIONS OF B6,

  • JUST KNOW THAT IT'S VERY DIVERSE AND IS

  • INVOLVED IN MANY REACTIONS IN THE BODY.

  • NOW BECAUSE IT'S INVOLVED IN SO MANY REACTIONS IN THE BODY,

  • THE DEFICIENCY WILL RESULT IN THESE VERY

  • GENERAL SYMPTOMS OF WEAKNESS, AND FATIGUE, AND DEPRESSION.

  • YOU CAN GET AN ANEMIA, IRRITABILITY,

  • INSOMNIA, SO VERY GENERAL SYMPTOMS.

  • VITAMIN B6 TOXICITY IS NOT COMMON FROM FOOD.

  • IT CAN OCCUR WITH SUPPLEMENTATION, THOUGH.

  • IF YOU GO TO THE STORE AND START LOOKING AT

  • SOME OF THOSE COMPLEX B VITAMINS AND SUPER B,

  • WHAT YOU'RE GOING TO FIND IS A, SOME OF THOSE

  • HAVE 1,000, 2,000, 5,000 THE TIMES THE RECOMMENDED

  • DIETARY ALLOWANCE AND YOU REALLY DO HAVE TO BE CAREFUL

  • BECAUSE THERE HAVE BEEN REPORTED VITAMIN B6 TOXICITY.

  • SO WHERE DOES B6 COME IN?

  • YOU'RE GOING TO SEE THE SAME THING,

  • THESE ANIMAL SOURCES SUCH AS TURKEY AND PORK, BEEF LIVER,

  • AND YOU KNOW MOST PEOPLE DON'T EAT BEEF LIVER THESE DAYS.

  • BUT SOME PLANT SOURCES AS WELL SUCH AS BANANAS AND SPINACH.

  • VITAMIN B9, SO THIS IS FOLATE.

  • AND FOLATE AND THIS IS WHY I WANT YOU TO KNOW

  • SPECIFICALLY AND IT'S INVOLVED IN NEW CELL SYNTHESIS.

  • SYNTHESIS IS DNA AND OF AMINO ACIDS WHICH

  • IS REALLY IMPORTANT BECAUSE THERE'S THIS

  • FOLATE DEFICIENCY DURING AN EARLY PART OF PREGNANCY,

  • THEN SOMETHING CALLED A NEURO TUBE DEFECT,

  • MOST COMMON FORM OF A NEURO TUBE

  • DEFECT IS SPINA BIFIDA, WILL DEVELOP.

  • AND THAT'S BECAUSE THE NEURO TUBE WE THINK THIS IS JUST OUR,

  • YOU KNOW OUR SPINAL CODE HERE, THE VERTEBRAE.

  • THE NEURO TUBE DEVELOPS WITHIN THOSE FIRST FEW

  • WEEKS OF LIFE AND IF YOU THINK ABOUT IT,

  • MOST WOMEN DON'T KNOW THEY'RE PREGNANT

  • THOSE FIRST FEW WEEKS IT'S AFTERWARDS,

  • AND THAT'S WHEN THE MAIN DEVELOPMENT OCCURS.

  • IF THERE'S NOT ENOUGH FOLATE,

  • THEN WHAT'S CALLED SPINA BIFIDA THAT THIS NEURO TUBE TO PROTECT

  • THE SPINAL CORD DOESN'T DEVELOP AND IT ENDS UP POUCHING OUT.

  • THIS IS A SPINAL CORD COMING OUT OF THE BACK.

  • AND I CAN TELL YOU I SEE AND TREAT SOME PATIENTS

  • WITH SPINA BIFIDA AND IT'S A REAL RANGE OF SYMPTOMS FROM

  • BEING IN A WHEELCHAIR WHEN THEY'RE OLDER WHERE THEY

  • CAN'T WALK TO JUST USING A CANE AND HAVING DIFFICULTY

  • WITH WALKING SO WEAKNESS AS OPPOSED TO PARALYSIS.

  • BUT IT'S A PREVENTABLE CONDITION.

  • FORTIFICATION OF FOLATE OF OUR GRAIN

  • PRODUCTS STARTED IN ABOUT THE MID 1990S,

  • AND THIS GRAPH REPRESENTS THE INCIDENTS OF NEURO

  • TUBE DEFECTS AND YOU CAN SEE WITH THE RISING

  • INCIDENTS OF FORTIFICATION STARTED SOON AFTER THAT.

  • THERE WAS A DECREASE IN INCIDENT.

  • AND THE IDEA IS THAT YOU NEED TO FORTIFY WITH

  • FOLATE BECAUSE PEOPLE ARE BECOMING PREGNANT

  • WITHOUT KNOWING IT AND ONCE THEY FIND OUT,

  • TAKING THE FOLATE ISN'T GOING TO HELP,

  • SO IF YOU ARE IN YOUR CHILDBEARING YEARS,

  • YOU ACTUALLY MIGHT FIND THAT YOUR OB MIGHT ACTUALLY RECOMMEND

  • THAT YOU USE A SUPPLEMENT WITH FOLATE JUST TO MAKE SURE,

  • ALTHOUGH YOU CAN GET ALL THE FOLATE YOU NEED FROM FOOD.

  • SO WHERE ARE THOSE FOODS SOURCES?

  • WELL, WE TEND TO THINK OF FOLATE, FOLIAGE,

  • FOLIAGE, SO SPINACH AND DARK LEAFY GREENS.

  • BUT AGAIN WE'RE GOING TO SEE LENTILS,

  • AND ASPARAGUS, AVOCADO,

  • AND AGAIN YOU CAN SEE THE BEEF LIVER CONTINUES TO POP UP,

  • NOT THAT MANY PEOPLE ARE EATING BEEF LIVER THESE DAYS.

  • AND AGAIN, LIKE OUR LEGUMES,

  • THE LENTILS AND BEANS, PINTO BEANS.

  • WE'RE GOING TO FINISH UP WITH VITAMIN B12.

  • AND VITAMIN B12 ALSO HAS KIND OF A DISTINCTIVE FUNCTION AND

  • THAT'S MAINTAINING NERVE SHEATHS, PROTECTING NERVES,

  • IT'S VERY IMPORTANT IN HEMOGLOBIN SYNTHESIS,

  • AND HEMOGLOBIN REMEMBER THAT'S WHAT CARRIES OXYGEN

  • IN THE BLOOD STREAM THAT'S PART OF OUR RED BLOOD CELLS.

  • SO WHEN THERE'S A DEFICIENCY OF B12,

  • WE'RE GOING TO SEE AN ANEMIA.

  • NOW MOST PEOPLE THINK OF ANEMIA AS AN IRON DEFICIENCY ANEMIA.

  • BUT THIS IS SEPARATE, IT'S NOT ASSOCIATED WITH IRON.

  • THIS IS A B12 DEFICIENCY BECAUSE B12

  • IS NECESSARY FOR THE FORMATION OF HEMOGLOBIN.

  • SO YOU HAVE DEVELOPED THAT PERNICIOUS ANEMIA,

  • SO IT'S A DIFFERENT TYPE OF ANEMIA.

  • THE B12 DEFICIENCY WILL ALSO RESULT IN PROBLEMS

  • WITH THE NERVES AND THAT'S GOING TO BE A NUMBNESS,

  • TINGLING, PARESTHESIA, WEIRD SENSATIONS.

  • IT'S GOING TO BE IN THE HANDS AND THE FEET,

  • AND ACTUALLY I SEE THIS AS A PODIATRIST,