Quick Facts on Obesity

• The incidence of obesity is rising.  
• In 2004, approximately 23% of adult Canadians were
obese & 36% were overweight.
• Reducing weight by only 5-10% can reduce the risk of
cardiovascular (CV) disease, diabetes & comorbidites.
• There is debate as to whether Body Mass Index (BMI) is
the best risk predictor for obesity as it does not take into
account fat-free mass, or the abdominal fat shown to
contribute to CV risk.  A measurement of waist
circumference or the waist:hip ratio is a better predictor
of metabolically active visceral fat and disease risk.
• “1lb (0.45kg) = 3500 calories”.  Reducing energy intake
or increasing energy expenditure by 500 calories/day will
result in losing about 1lb (½ kg) in one week. 
• 1kg weight loss Ö ~1cm decrease in waist circumference
• Removal of adipose fat tissue via liposuction does not
achieve metabolic benefits of weight loss.

Weight Loss: Other Options.

• For patients with impaired glucose tolerance (IGT),
lifestyle changes decrease the risk of developing
diabetes; however lifestyle may be hard to
maintain. Drugs such as metformin and
acarbose may also be useful for IGT/weight loss.
{Rosiglitazone ↓ progression to diabetes, but ↑HF, edema & wt.}
• Metformin is useful for obese patients with Type
2 diabetes (providing no contraindication) for its
beneficial outcomes and weight loss potential.
• Drugs known to decrease morbidity & mortality in
patients with CV risk should be considered. (e.g.
ASA, antihypertensives and statins).
• Drugs that should not be used for weight loss:
o thyroid hormone: may cause bone loss & arrhythmias
o amphetamines (eg. Adderal)
• New Drug: Rimonibant (Not yet in Canada)
o A cannabinoid (CB1) receptor blocker with favourable
changes in weight (-6kg/1yr 20mg daily) and cardiometabolic
risk factors (↓waist circumference ↓TG; ↑HDL).  Side effects
(e.g. nausea, anxiety, depression), a high drop-out rate >45%
 and lack of clinical outcome trials warrant caution.

Weight Regain With Continued Therapy

• There generally appears to be a trend towards
partial weight regain despite continued therapy.
(e.g. orlistat, XENDOS trial - Figure 1).  This may
be due in part to the natural history of aging.

Are Weight Loss Drugs Safe?

• Since 1997, 6 weight loss drugs have been
removed from the market:
o Fenfluramine  & dexfenfluramine (heart
valve abnormalities, primary pulmonary HTN);
o phenylpropanolamine (strokes in females);
o phentermine, diethylpropion, & mazindol
 (discontinued by manufacturers;
concerns with abuse and adverse events CNS & CV).
• Sibutramine was temporarily suspended from the
market in Italy, citing tachycardia, hypertension,
arrhythmia & cardiac arrest.  An increase in
BP of 1-3mmHg & heart rate of 4-5 beats/min can
result from sibutramine use; however it is unclear
if any increase in cardiovascular risk is offset by
the reduction in body weight.
• Orlistat is minimally absorbed (<5%); however,
tolerability due to GI adverse events is an issue.
{Discontinuation GI, Lab ~2x  vs placebo 8% vs 4%.}
Absorption of fat soluble vitamins is decreased,
yet remains within range (but a daily multivitamin
is recommended).  The FDA USA is considering
approving a 60mg strength for OTC sale.
• Long term safety has not yet been established.
Adverse reaction reporting is encouraged.

Do Weight Loss Drugs Work?

• In the short term, weight loss drugs may provide a
modest reduction in body weight (<5kg at 1 year;
See Table 1).
 Whether long-term outcome
benefits will result is yet to be established.
• Sibutramine & Orlistat have been shown to reduce
and, to some extent, maintain weight loss.
{No additional benefit when agents combined.}
• Drug therapy alone is insufficient as trials also
included lifestyle modification co-interventions.
• Weight regain is common upon discontinuation.

Weight Loss Therapy Options.

Lifestyle & behavioural modifications:
• Lifestyle interventions are recommended for all
overweight patients.
  They should be continued
even if medication or surgery options are used.
E.g. ŠConsider membership at a suitable gym
e.g. Curves
ŠLimit computer & TV “screen-time” for kids
Drug therapy:
• The role of weight loss drugs is of some debate.
Limited long-term effectiveness and risks must be
weighed against the complications associated with
obesity such as diabetes and heart disease.  
• A 6 month trial of diet, exercise & behavioural
therapy is recommended prior to considering drug
therapy.
  Drug therapy may be considered in
select patients: obese patients (BMI ≥30kg/m) or
those with a BMI ≥27 kg/m + 1 risk factor
(diabetes, hypertension, hyperlipidemia, coronary
artery disease or sleep apnea).  Safety, efficacy
and overall costs should be considered.
Surgery (e.g. Roux-en-Y gastric bypass or duodenal switch):
• Surgery may be considered in select patients
{obesity class III (BMI≥40 kg/m) or obesity class II (BMI 35-
39.9 kg/m) + ≥1 severe obesity related medical complications}.
• Mortality rates (generally between 0.1%-1.1%) vary
with surgery type and experience of centre.

Weight Loss Management

• Obesity is a chronic condition requiring a
long-term management plan.  
• Goals should be individualized and include weight
loss, blood pressure, blood glucose, and lipids.
• Suggested initial goal: 5-10% weight loss in 6 mo.
• Lifestyle & behavioural modifications, such as
diet & exercise, are the cornerstone of therapy.  A
multidisciplinary approach is ideal.
• Assess patients for their risk of obesity-related
health risks, weight history, previous weight loss
attempts, and current medications that may cause
weight gain (e.g. antipsychotics, antidepressants,
diabetic medications, anticonvulsants & steroids).
• Whenever possible, consider choosing drugs with
lower potential to cause weight gain.  (See bottom
notes on Weight Loss Agents Comparison Chart.)

Weight Loss Drugs. Weighing modest long-term weight loss against safety and cost.

ŠObesity and it’s associated comorbidities is increasing.
ŠWeight loss drugs provide a modest reduction in body
weight (<5kg at 1 year); weight regain is common.
ŠImprovements in metabolic risk factors may be seen.
  {e.g. ↓ progression to diabetes with orlistat in those with IGT}
ŠLong-term efficacy, safety and outcome data is lacking.
ŠPrescription, herbal and OTC agents used for weight
loss are expensive.  The 2 drugs with official weight
loss indications, Sibutramine MERIDIA and Orlistat
XENICAL, cost >$120 per month.  (Neither are
currently covered by the SK formulary or NIHB.)
ŠConsider cardiovascular risk reduction strategies such
as lifestyle interventions and drugs such as ASA,
antihypertensives and statins if indicated.
ŠMinimizing weight gain may be a consideration when
choosing drugs within certain therapeutic classes.
_______________________________________________

IGT= impaired glucose tolerance;  OTC=over the counter products;
SK=Saskatchewan; NIHB=Indian Affairs

Natural ed remedies

Natural ed remedies

Herbal Treatments for Erectile Dysfunction

Erectile dysfunction (ED) is defined as 'the inability to achieve an erection sufficient for intercourse to the mutual satisfaction of both partners'.

There are many causes of erectile dysfunction but most important is the fact that this is an age-related phenomenon.

Other conditions such as diabetes, renal disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease and neurological diseases may be the reason of erectile dysfunction in approximately 70% cases. NIH also reported that between 35 and 50% of men with diabetes suffer from erectile dysfunction (ED). Furthermore, men taking medications such as antihypertensive drugs, antihistamines, antidepressants, tranquillizers, appetite suppressants and cimetidine will experience erectile dysfunction as a side effect. Psychological factors can also cause erectile dysfunction (ED).

Every Vitamin Page

All Vitamins and Pseudo-Vitamins

Vitamin A
Chemical Names- Retinol, Beta Carotene (pro-vitamin A)
Deficiency- Night blindness
RDA- 5,000 IU
Optimal intake- 2,000-5,000 IU
Good Sources- Liver, carrots, spinach
Discussion- Vitamin A is fat soluble, and can be toxic in large amounts. Beta-Carotene,
which the body converts into Vitamin A as needed, is an antioxidant, and non-toxic.
Synthetic Beta-Carotene (sold in supplement stores) is ineffective in preventing cancer in
humans, and seems to harm smokers. Consuming over the RDA of Vitamin A is
associated with a shorter lifespan.
Vitamin B1
Chemical Names- Thiamine
Deficiency- Beriberi
RDA- 1.5 mg
Optimal Intake- 5-15 mg
Good Sources- Brewer's yeast, peanuts, milk, rice
Discussion- Thiamine is relatively safe.
Vitamin B2
Chemical Names- Riboflavin
Deficiency- Lesions on mouth, lips, skin, etc.
RDA- 1.7 mg
Optimal Intake- 5-20 mg
Good Sources- Milk, cheese, leafy vegetables
Discussion- Riboflavin is a mild antioxidant. Its bright yellow color colors urine after it is
taken. Also known as Vitamin G
Vitamin B3
Chemical Names- Niacin, Niacinamide, Nicotinic Acid
Deficiency- Pellagra
RDA- 20 mg
Optimal Intake- 50-500 mg
Good Sources- Lean meat, whole wheat, brewer's yeast
Discussion- Niacin, but not Niacinamide, in high doses results in a "flush" reaction.
Niacinamide does not have anti-cholesterol properties, and will not raise HDL cholesterol
as Nicotinic Acid will. Also known as Vitamin PP for "pellagra-preventative"
Vitamin B4*
Chemical Names- Adenine
Deficiency- Muscular weakness (in rats and chicks)
Good Sources- Widespread in animal and plant tissues
Discussion- Adenine is a purine base of nucleic acids. Its status as a human vitamin is
doubtful.
Vitamin B5
Chemical Names- Pantothenic Acid, Panthenol, Pantethine, (Calcium) Pantothenate
Deficiency- Hypoglycemia, ulcers, skin disorders.
RDA- 10 mg
Optimal Intake- 15-500 mg
Good Sources- Meat, whole grains, leafy vegetables
Discussion- Studies with rats by Dr. Roger Williams showed that Pantothenic Acid may
be highly beneficial in fighting the effects of stress.
Vitamin B6
Chemical Names- Pyridoxine
Deficiency- Anemia, dermatitis, glossitis
RDA- 2 mg
Optimal Intake- 10-100 mg
Good Sources- Brewer's yeast, soy beans, wheat germ
Discussion- As a methylating agent, B6 has potential to reduce blood levels of
homocysteine, possibly reducing the risk of heart disease. Amounts in excess of 200
mg/day might lead to toxicity, expressed in nerve problems.
Vitamin B7*
Deficiency- Digestive disorders in pigeons.
Good Sources- Rice polish
Discussion- Also known as Vitamin I. See also Biotin which some have called "Vitamin
B7."
Vitamin B8*
Chemical Names- 5'-Adenylic Acid, Ergadenylic Acid, Adenosine Monophosphate
Deficiency- Decreases RNA, ADP, and ATP synthesis, inhibits breakdown of food into
energy, reduces hormone function.
Good Sources- Yeast
Discussion- This nucleotide is still listed as a "Nutrient" by the Merck Index. Many
sources now claim this substance is indeed an essential vitamin.
Vitamin B9*
Chemical Names- Mixture of multiple B Vitamins
Discussion- See Folic Acid. Some later researchers used Vitamin B9 to classify Folic
Acid
Vitamin B10*
Chemical Names- Pteroylmonoglutamic acid mixed with other B vitamins
Deficiency- Depressed growth and feathering in chicks.
Discussion- Also known as "The Feather Factor," Vitamin R and "Factor R."
Vitamin B11*
Chemical Names- Pteryl-hepta-glutamic acid (?)
Deficiency- Depressed growth and feathering in chicks
Discussion- Also called "The Growth Factor," Vitamin S and "Factor S."
Vitamin B12
Chemical Names- Cobalamin, Cyanocobalamin, Methylcobalamin
Deficiency- Pernicious Anemia
RDA- 6 mcg
Optimal Intake- 100-1,000 mcg
Good Sources- Animal products, cheese
Discussion- Like Folic Acid, B12 reduces homocysteine levels. B12 is present in animal
products, so vegans need to supplement. B12 vegetable "analogues" do not treat a B12
deficiency, and may exacerbate it. B12 needs "intrinsic factor" to be absorbed, and some
stomachs do not produce enough, hence the need for injections or sublingual absorption.
Vitamin B13*
Chemical Names- Orotic Acid, Pyrimidinecarboxylic Acid
Deficiency- Possibly Multiple Sclerosis
Good Sources- Whey, root vegetables
Discussion- Orotic Acid, a "mineral transporter," is commercially available in the form of
mineral orotates. Its vitamin status is unlikely. Aspartic Acid and Colamine Phosphate
(Calcium AEP) are "mineral transporters," and might have some claim as "B13."
Vitamin B14*
Deficiency- Anemia
Good Sources- Yeast, grains, legumes, organ meats, wine.
Discussion- Little is known about this; it might be similar to B10 and B11. Perhaps a
substance isolated from wine that prevents cancer.
Vitamin B15 *
Chemical Names- Pangamic Acid, Pangametin, Calcium Pangamate; Some B15 tablets
contain either Dimethylglycine, diisopropylamine dichloroacetate, or other chemicals
Optimal Intake- 50-150 mg
Good Sources- Yeast, apricot seeds, corn
Discussion- The chemical identity of Pangamic Acid is disputed. It is believed to be
Dimethylgycine (DMG) and Gluconic Acid, although mixtures vary. If DMG is
responsible for the benefits often attributed to Pangamic Acid, then Trimethylglycine
may be considered to have "B15" activity. Both DMG and TMG act as methylators,
reduce homocysteine in the blood, and are good for liver health. Vitamin status is
unlikely. “Discovered,” along with laetrile, by Ernst Krebs, Sr., MD and Ernst Krebs, Jr.
Vitamin B16*
Discussion- Perhaps studied in Russia, but vitamin status never fully developed.
Vitamin B17*
Chemical Names- Amygdalin, Prunasin (d-mandelonitrile glucoside), Dhurrin,
Linamarin, Lotaustralin, Sambunigrin (l-mandelonitrile glucoside), Prulaurasin (dlmandelonitrile
glucoside), Triglochinin, Linustatin, Neolinustatin, Laetrile, oratrile.
Deficiency- Possible increased incidence of cancer
Optimal Intake- 25-100 mg
Good Sources- Apricot seeds, buckwheat, millet, lima beans, flax
Discussion- Supposed anti-cancer substances, Vitamin B17 is a group of cyanide
producing sugars known as "cyanogenic glycosides" or "nitrilosides" that release cyanide
when acted upon by the enzyme beta-glucosidase (emulsion). Often taken in concentrated
form of amygdalin, one particular glycoside, but soon after mixed with water, the
chemical is subject to epimerization, so quality is poor when stored in water. Laetrile is a
patented formula that contains amygdalin, and is no longer available commercially.
Rodent research suggests anti-metastatic effect at high injectable doses. Is an unproven
therapy for cancer. Vitamin status unlikely.
Vitamin B22*
Discussion- Listed in Linda Clark's “Know Your Nutrition.” Otherwise, unknown. Aloe
Vera is a possible source.
Vitamin Bc- See Folic Acid
Vitamin Bh- See Inositol
Vitamin Bp- See Choline
Vitamin Bt*
Chemical Names- L-Carnitine, Acetyl L-Carnitine
Optimal Intake- 500 mg
Good Sources- Chicken, red meats, fish
Discussion- L-Carnitine is an amino acid, and not essential as a protein or vitamin. It has
been promoted as a treatment for heart disease. Its acetylated form has been promoted as
good for brain health.
Vitamin Bx- See PABA
Vitamin Bw- See Biotin
Folic Acid
Chemical Names- Folacin, Pteroylglutamic Acid, Folate, Folinic Acid
Deficiency- Nutritional macrocytic anemia
RDA- 400 mcg
Optimal Intake- 400-1,000 mcg
Good Sources- Green leafy vegetables, soy beans, oranges
Discussion- Folic Acid lowers blood levels of homocysteine, perhaps reducing heart
disease. Folic Acid is a key factor in the prevention of many birth defects. Consuming too
much may contribute to the development of colon cancer. Also known as Vitamin M
Biotin
Deficiency- Eczema, improper fat metabolism
RDA- 300 mcg
Optimal Intake- 300-10,000 mcg
Good Sources- Brewer's yeast, soy beans, egg yolk
Discussion- A Biotin deficiency is rare. Unless raw egg whites are eaten often (they
contain a substance that binds Biotin), we get ample Biotin. Recently high-dose Biotin
has been found to benefit Diabetes. Also known as Coenzyme R, Factor W, Factor S,
Factor H, Factor X, and Vitamin H
Choline*
Deficiency- Liver problems
AI (Adequate Intake)- 425 to 550 mg
Optimal Intake - 100-1000 mg
Good Sources- Brewer's yeast, lecithin, wheat germ
Discussion- Choline is not a vitamin, defined strictly, because it can be made by the
human body. However, Choline is considered an essential nutrient because it is often
needed in amounts greater than the body is able to synthesize. Choline does not have an
RDA, but the Institute of Medicine has established an "adequate intake" for it.
Inositol*
Deficiency- possibly Eczema
Optimal Intake- 100-1,000 mg
Good Sources- Brewer's yeast, grapefruits, lecithin, peanuts
Discussion- Inositol is present in many B-Complex formulas, and is probably best
thought of as a B-Complex "factor," appearing with the B vitamins in many foods and
supplements, rather than an actual vitamin. It is a component of Lecithin with Choline.
PABA*
Chemical Names- Para-Aminobenzoic Acid
Deficiency- Graying of hair, eczema in animals
Optimal Intake- 10-100 mg
Good Sources- Brewer's yeast, wheat germ, sunflower seeds
Discussion- PABA has been used topically as a sunscreen, although it is rarely used now.
Like Choline and Inositol, it still appears in B-Complex formulas, despite not actually
being essential for humans. It is an essential nutrient for some bacteria.
PQQ*
Chemical Names- Pyrroloquinoline Quinone
Deficiency- fertility issues in mice
Optimal intake- unknown
Good Sources- Natto, parsley, green tea, green peppers, papaya, and kiwi
Discussion- Some Japanese researchers at the Institute of Physical and Chemical
Research in Tokyo believe that PQQ (discovered in 1979) may actually be a vitamin,
within the B-Complex. If so, it is the first new vitamin to be discovered in over 55 years!
Vitamin C
Chemical Names- Ascorbic Acid, Ascorbyl Palmitate
Deficiency- Scurvy
RDA- 60 mg
Optimal Intake- 250-1,000 mg
Good Sources- Citrus fruits, strawberries, broccoli
Discussion- Vitamin C is an antioxidant, and it is claimed to have a positive effect against
cancer, infections, and other health disorders, including the prevention and treatment of
the common cold. It is generally non-toxic.
Vitamin D
Chemical Names- Ergocalciferol (D2), Calciferol, Cholecalciferol (D3)
Deficiency- Rickets
RDA- 400 IU
Optimal Intake- 800-4000(?) IU
Good Sources- Milk, fatty fish, sunlight
Discussion- Vitamin D, a hormone in its bioactive form, is essential for bone health, and
shows promise in the prevention of cancer, multiple sclerosis, and perhaps even autism.
Some experts suggest supplementation at over 1,000 IU/day in order to consume amounts
produced by regular adequate sun exposure, although taking more than the RDA has been
linked with an increased number of calcium deposits in the brain. Generally, doses up to
10,000 IU per day, for a limited period, are deemed safe. Vitamin D3 is thought to be
better utilized than D2.
Vitamin E
Chemical Names- α-tocopherol, α-tocopheryl
Deficiency- possibly infertility
RDA- 30 IU
Optimal Intake- 100-300 IU
Good Sources- Sunflower seeds, wheat germ
Discussion- Vitamin E is an antioxidant; α-tocopherol is a vitamin, although other
tocopherols, e.g. γ-tocopherol exist in nature, and might be beneficial. Consuming 400
IU/day has been linked to increased mortality. Supplements sold with "d-α-tocopherol"
contain the natural, more potent, form of vitamin E, while "dl-α-tocopherol," is synthetic.
Vitamin F*
Chemical Names- Linoleic Acid, Linolenic Acid, Arachadonic Acid
Deficiency- Similar to those associated with lack of fat in diet
RDA- None established
Good Sources- Vegetable oils
Discussion- Vitamin F is a term for the macronutrients known as Essential Fatty Acids.
They are essential, but not vitamins.
Vitamin G - See Vitamin B2
Vitamin H - See Biotin
Vitamin I*- See Vitamin B7
Vitamin J*
Chemical Names- Catechol, Flavin
Good Sources- Higher woody plants
Discussion- Catechol is a flavonoid. Vitamin J has also been applied to Choline
Vitamin K
Chemical Names- Menadione, Phytomenadione, Phylloquinone, Menaquinone
Deficiency- Hemorrhage
RDA- 80 mcg
Optimal Intake- 100-150 mcg
Good Sources- Green leafy vegetables, many cheeses
Discussion- Essential for blood clotting; is now recognized as a key factor in bone health.
Vitamin L1*
Chemical Names- Ortho-Aminobenzoic Acid, Anthranilic Acid
Good Sources- bovine liver
Deficiency- Lactation problems in animals. Anthranilic Acid is an amino acid.
Vitamin L2*
Chemical Names- Adenyl Thiomethylpentose
Good Sources- Yeast
Deficiency- Lactation problems in animals
Vitamin M- See Folic Acid
Vitamin N*
Chemical Names- Thioctic Acid, α-lipoic acid
Deficiency- Lack of growth in protozoa and bacteria.
Optimal Intake- 50-100 mg
Discussion- α-Lipoic Acid has been used to regulate blood sugar, and is a universal
antioxidant, i.e. the chemical is fat and water soluble. It is not a vitamin, strictly defined.
Vitamin P*
Chemical Names- Rutin, Hesperidin, Quercetin, Citrus Bioflavonoids
Deficiency- Capillary fragility
Optimal Intake- 100-1,000 mg
Good Sources- Citrus fruits, onions, vegetables
Discussion- While not vitamins, Bioflavonoids are beneficial nutrients. Often associated
with Vitamin C, many refer to Vitamin P as the "C-Complex." There are over 1000
chemicals that can be classified as Bioflavonoids. Quercetin may have anti-aging
properties because of its relationship to sirtuin in the body. Resveratrol (not a
bioflavonoid) has similar properties.
Vitamin PP - see Vitamin B3
Vitamin Q*
Deficiency- Inability of blood to clot in patients with telangiectasia
Good Sources- Soybeans, clover, alfalfa
Discussion- Named after Dr. Armand James Quick, who believed he had found a
substance in soybeans that could prevent bleeding in people with telangiectasia.
According to Quick, Vitamin Q is only essential in patients with that rare blood disorder.
Quick apparently references Vitamin Q in his book Bleeding, Drugs, Vitamins: Their
Impact on History. Occasionally, Co-Enzyme Q10 is called "Vitamin Q."
Vitamin R*
Discussion- Old name for Vitamin B10. Also on "The Simpsons" the vitamin in the
"malk" drink, the kids drank at lunch during a budget crisis!
Vitamin S*
Deficiency- Sterility
Good Sources- kelp
Discussion- I found one reference to this in a book a long time ago. Kelp is known for its
many nutrients, so it's likely that this substance is some other vitamin or mineral.
Vitamin B11 was also called Vitamin S for awhile. Some have proposed that Salicylic
Acid (Salicylates), a natural chemical related to aspirin, is Vitamin S. This is based on its
anti-inflammatory effects, which may have a role in preventing cancer and other diseases.
Vitamin T*
Chemical Names- Tegotin, Termitin, Torutilin
Deficiency- Anemia, lack of growth
Good Sources- Yeast, termites, fungi, sesame seeds
Discussion- Vitamin T is a name for two substances. The first is a group of growthpromoting
substances in termites, torula yeast and fungi. W. Goetsch, an Austrian, came
up with this designation, and sometimes this Vitamin T is called "Vitamin T Goetsch," or
"Vitamin T Complex." However, researchers Schiff and Hirschberger, in the 1930s, gave
the name "Vitamin T" to a fat soluble blood health factor they believed was present in
sesame seeds and egg yolks. Whatever this chemical is, it is different from "Vitamin T
Goetsch."
Vitamin U*
Chemical Names- Methylmethioninesulfonium Chloride, Cabagin-U, SMethylmethionine
Deficiency- Ulcers
Good Sources- Cabbage, alfalfa, green leafy vegetables, egg yolks
Discussion- Cabbage Juice often heals ulcers in a week or two, so Dr. Garnett Cheney of
Stanford, whose research backed up this assertion, proposed it was a vitamin. However,
while beneficial for treating ulcers, it is likely not a vitamin. It is possible that SMethylmethionine,
identified by Dr. Cheney, is not even the factor responsible for the
"vitamin U" activity of cabbage. Another possible factor responsible might be Allantoin
or possibly the amino acid Glutamine. Dr. Cheney believed that whatever factor was
responsible, it was destroyed by cooking.
Vitamin V*
Chemical Names- Nicotinamide Adenine Dinucleotide, NAD
Deficiency- Developmental problems in chicks
Discussion- Vitamin V was also used of PABA
Vitamin W*
Discussion- Possibly Biotin
Vitamin X*
Deficiency- Aging
Good Sources- Hydrocotyle Asiatica Minor (an herb)
Discussion- A proposed vitamin by certain researchers, I read about in Worldwide
Secrets For Staying Young by Paavo Airola. Ultimately "Vitamin X" is used to describe
any unknown vitamin, including PABA before it was isolated.
Vitamin Y*
Discussion- Perhaps Vitamin B6.
* (asterisk) – vitamin status unlikely

Vitamin K (Konakion)

Information for parents

This guide is to explain the reasons for National Women’s Hospital
recommending vitamin K injections for newborn infants.
Definitions
Vitamin K: Is essential for normal blood clotting. It is contained in
some foods and it is also produced in the gut by the action of
bacteria.
IM: Means an injection into muscle.
Classical HDN: Is classic haemorrhagic disease of the newborn,
which is bleeding in the first seven days of life. It is serious in
about 1 case in 10,000 births.
Late HDN: late haemorrhagic disease of the newborn which is
bleeding between one week and about six months of age. It
occurs in between 4-8 cases per 100,000 births. About half
the cases are serious.
Serious Bleeding: Means bleeding which causes significant brain
or other organ damage or death.

Who is at risk of bleeding?
All babies are deficient in Vitamin K and therefore at risk.
Breastfed babies have a greater risk than formula fed babies,
as breast milk has very low levels of Vitamin K, whereas
formula is much more rich in this Vitamin.
Babies whose mothers have been on some sort of medication
during pregnancy, such as anti-convulsants (Dilantin or
Phenobarbitone) or anti-tuberculosis drugs (for instance
Rifampicin).
Premature and sick babies.
Compiled by
Newborn Services
National Women’s Health
Auckland City Hospital
Updated November 2004

Why give vitamin K to Babies?
Vitamin K prevents haemorrhagic disease as shown.
* The research and some comments
One paper said that babies who had been given IM Vitamin K at
birth had twice the chance of developing childhood cancer
as babies given oral or no Vitamin K.
Since this study was published several major studies have looked
at the question again. All of the studies from North America,
Europe and Australia have shown no link at all between IM
Vitamin K and cancer.
The rate of childhood cancer has not increased in Great Britian,
the USA or Europe since IM Vitamin K was introduced.
Since some countries have swapped to oral Vitamin K , there
have been published reports of severe or fatal bleeding in
infants who have received Vitamin K orally.

What are the recommendations at National Women’s Hospital?
All babies need Vitamin K.
Intramuscular Vitamin K in a dose of 1mg is recommended.
It is possible to give babies Vitamin K orally. However we do not
recommend this as:
There may be doubt as to whether the dose has been
swallowed.
There is risk that the later dose may be forgotten!
If parents choose to give Vitamin K orally, the dose is 2mg given 3
times – at birth, at 5-7 days and at 6 weeks.

TYPES OF B12 INJECTIONS

Vitamin B12, or cobalamin, is absorbed from food in the stomach with the help of a protein known as intrinsic factor, according to the University of Maryland Medical Center, or UMMC. Patients who lack intrinsic factor cannot absorb vitamin B12 and require injections of the water-soluble vitamin to prevent a deficiency. It is administered as an intramuscular injection.

Deltoid
Vitamin B12 is injected in the deltoid muscle, which is a muscle in the upper arm, according to Drugs.com. The injection is made deep into this muscle at an angle of 90 degrees. The syringe should be pulled back slightly once the vitamin is injected to check for blood. Blood in the syringe is a sign that a vessel has been hit. If blood is present, the vitamin should not be administered and a different injection site should be used. Vitamin B12 injections should not be done continuously on the deltoid to prevent scar formation, which can interfere with its absorption.

Ventrogluteal
The ventroglutueal, or hip muscle, is a good spot for injecting vitamin B12 because there is little danger of hitting blood vessels and nerves, according to Drugs.com. Injections at the hip muscle are only suitable for adults and children over 7 months. Infants do not have well-developed ventrolgluteal muscles for injections at this site.

Vastus Lateralis
The vastus lateralis, or thigh muscle, is another injection site option, according to Drugs.com. The vastus lateralis is mainly used in children under 3 years old because there is little danger of hitting blood vessels and nerves, and the muscles are well developed.

SIGNS OF LOW B12

Vitamin B12, also called cobalamin, plays a role in regulating nervous system function, general cell metabolism, DNA synthesis and red blood cell production. The most severe form of vitamin B12 deficiency causes pernicious anemia, a blood disorder characterized by markedly reduced red blood cell counts, gastrointestinal problems and neurological disorders. This type of deficiency occurs only in people with an autoimmune disease that kills the cells in the stomach that secrete proteins necessary for B12 absorption. Milder forms of vitamin B12 deficiency are caused dietary insufficiency and stomach disorders that reduce gastric acid production and decrease B12 absorption. The Office of Dietary Supplements, or ODS, indicates that a doctor diagnoses a deficiency when your blood levels of B12 fall below 250 pg/mL.

Cognitive Problems

Vitamin B12 deficiency can contribute to neuron damage in the central nervous system, resulting in depression, memory impairment and dementia. An article in the "Journal of Neuropsychiatry and Clinical Neurosciences" reports that vitamin B12 deficiency has been linked to Alzheimer's disease and other cognitive impairments. The authors note that successful reversal of neurological abnormalities with vitamin B12 supplements depends on the duration and severity of the symptoms and that people with chronic dementia respond poorly.

Neuropathy

A deficiency in vitamin B12 can cause nerve degeneration, which leads to a condition called neuropathy. One of the primary functions of vitamin B12 is to serve as a cofactor, or helping molecule, in a biological reaction that produces the membranes that surround and protect your nerves. The signs of peripheral neuropathy are pain and tingling in the extremities, lack of coordination, sensory loss and weakness.

Gastrointestinal Disorders

If you have vitamin B12 deficiency, you may experience a loss of appetite and nonlocalized abdominal pain. These symptoms are likely caused by an underlying gastrointestinal disorder that is causing the malabsorption of vitamin B12.

Anemia

Anemia refers to a defect in red blood cell production. The symptoms of anemia are fatigue and weakness. A review in the journal "American Family Physician" reports that more than 70 percent of people with vitamin B12 deficiency have decreases in red blood cells. The ODS reports that excessive intake of folic acid can sometimes mask the effects of vitamin B12 deficiency on red blood cell formation but it does not correct any associated neurological damage that occurs in your body.

LOW B12 SYMPTOMS CAUSING DAMAGE

Numerous symptoms associated with low vitamin B12 can cause health problems or damage. According to the Linus Pauling Institute--a nutrition-related research institute at Oregon State University--vitamin B12 is an important water-soluble vitamin that participates in many important biological functions. Deficiencies in vitamin B12 may be caused by autoimmune conditions, malabsorption syndromes and certain lifestyle factors. Vitamin B12 deficiency can cause significant health problems and, in some cases, physical or mental damage.

Psychiatric Problems

Psychiatric problems associated with a vitamin B12 deficiency, or low vitamin B12, can damage your mental health and relationships with friends and family. According to the Mayo Clinic, vitamin B12 deficiency has been linked to numerous psychiatric disorders, including impaired memory, irritability, depression, dementia, psychosis and mood disturbances. Vitamin B12 deficiency-related psychiatric problems may manifest when vitamin B12 levels are just slightly lower than normal and significantly greater than the levels typically associated with anemia. If you are a strict vegetarian, elderly, pregnant, an alcoholic or possess certain medical conditions--including thyrotoxicosis, hemolytic anemia, cancer and liver or kidney disease--you may have a greater chance of developing vitamin B12 deficiency and psychiatric problems. The Mayo Clinic states that early detection and treatment of vitamin B12 deficiency can decrease your likelihood of developing psychiatric problems.

Vitamin B12 Deficiency Anemia

Vitamin B12 deficiency anemia is a symptom of low B12 that can damage your health. According to Medline Plus, vitamin B12 deficiency anemia is a decreased red blood cell count caused by a lack of vitamin B12. Anemia is a condition in which your body does not have an adequate amount of healthy red blood cells. Red blood cells transport oxygen to your tissues and organs. Vitamin B12 deficiency anemia may be caused by decreased consumption of foods containing vitamin B12 or an inability of your gut to absorb vitamin B12 from the foods you eat.

Common signs and symptoms associated with vitamin B12 deficiency include diarrhea or constipation, fatigue or lack of energy, decreased appetite, pale skin, difficulty concentrating, shortness of breath and swollen tongue. Medline Plus states that treatment for vitamin B12 deficiency anemia is usually effective for restoring your health and reducing damage to your body.

Neurological Problems

Neurological problems are common symptoms associated with low B12 that can cause damage to your body and health. The American Academy of Family Physicians, or AAFP, states that vitamin B12 plays an important role in neurological functions and the production of DNA. A vitamin B12 deficiency can result in a wide spectrum of neurological disorders that are often reversible by early diagnosis and treatment. However, in some cases, especially if you have had a vitamin B12 deficiency for a prolonged period, you may experience irreversible nerve damage. Common neurological signs and symptoms associated with vitamin B12 deficiency include abnormal sensations such as numbness and tingling in your extremities, or peripheral neuropathy, and demyelination--loss of the fatty substance insulating your nerves--of certain portions of your spinal cord.

What Are the Symptoms of Low Platelets Caused by a Lack of Vitamin B12?

The medical term for a low platelet count is thrombocytopenia. There are several disorders that can cause the condition, including vitamin B12 deficiency and folate deficiency. Signs and symptoms of thrombocytopenia can appear suddenly or over a longer period of time, according to the National Heart Lung and Blood Institute. Individuals who have mild disease may have no signs or symptoms so it becomes important to have routine blood testing.

Spontaneous Bleeding

Low platelet counts can also lead to blood in the urine, stool or bleeding from the gums and prolonged bleeding from cuts, according to MayoClinic.com. Women may experience unusually heavy menstrual flow. Spontaneous bleeding can also result because of a low platelet count and the reduced ability of the body to clot the blot at appropriate times.

Bruising

The medical term for bruising is purpura. This refers to purple brown or red bruises below the skin, according to National Heart Lung and Blood Institute. Platelets are responsible in the cascade events that lead to clotting of the blood. When the number of platelets is reduced or the platelets are not functional, you can suffer from internal or external bleeding. The National Heart Lung and Blood Institute says that external bleeding that leads to bruising or purpura is usually the first symptom of a low blood platelet count.

Petechial Rash

Individuals who suffer from low platelet counts can also experience pinpoint-sized red purple spots just under the skin, says MayoClinic.com. Although they occur more common only the lower legs, they can present anywhere on the body. They represent minute bleeding or hemorrhage under the skin and are very small, usually 1 to 2 millimeters in diameter. These areas may develop after minor trauma or after no apparent injury.

Nosebleeds

Bleeding from the tissue lining the nose can occur because of very minor irritations or colds, according to MedlinePlus. When platelet counts are reduced, the thin tissue in the nose will bleed even easier and platelets will not be available to clot the blood. Nosebleeds should stop within 20 minutes or you should seek emergency care immediately. If you suffer from thrombocytopenia caused by vitamin B12 deficiency, you may experience nosebleeds that require medical care to stop.

VITAMIN B12 DEFICIENCY PATIENT EDUCATION

Symptoms

Typically, the symptoms associated with vitamin B-12 deficiency develop slowly over the course of several months or years. Without a sufficient supply of vitamin B-12, you may become anemic, which means that you have low red blood cell levels. Symptoms of anemia include weakness, fatigue, pale skin, shortness of breath and heart rate irregularities, the Centers for Disease Control and Prevents reports. Low vitamin B-12 levels may also cause nerve damage and may result in numbness, tingling or burning sensations in your hands or feet. Young children and infants who do not receive enough vitamin B-12 may experience physical and mental development delays, weakness and reduced muscle tone. Seek care from your doctor as soon as possible if you experience vitamin B-12 deficiency symptoms to ensure you receive prompt and appropriate care.

Treatment

The most common treatment for vitamin B-12 deficiency is vitamin B-12 injections. Initially, your doctor may give you daily injections though the frequency of your injections typically diminishes as your vitamin B-12 levels return to normal. Your doctor may also recommend treatment with high doses of oral vitamin B-12 supplements. If you have vitamin B-12 deficiency, consult your physician to discuss which form of vitamin B-12 supplementation is appropriate for you.

Your body requires adequate levels of vitamin B-12 to maintain proper brain function and red blood cell production. If you don't get enough of this water-soluble nutrient, you may be at risk of developing vitamin B-12 deficiency -- one of the most common types of nutritional deficiencies in the world. Consult your doctor for more information if you have any questions or concerns regarding vitamin B-12 deficiency.

Causes

The primary cause of vitamin B-12 deficiency is poor intake of foods that are rich in the vitamin. Each day, adults should consume between 2.4 and 2.8 mcg of vitamin B-12 from dietary sources, such as fish, beef, clams or fortified cereals, or dietary supplements. Vegetarians and vegans are at an increased risk of developing vitamin B-12 deficiency because the main sources of this nutrient are meat products.

Even if you consume enough this nutrient each day, you may still become deficient if your body isn't able to absorb vitamin B-12. Health conditions that may make vitamin B-12 absorption difficult include gastrointestinal problems, such as Crohn's disease and celiac disease, chronic alcoholism, stomach or small intestine surgery and long-term antacid treatment, MedlinePlus explains. Pernicious anemia -- a condition in which your body doesn't generate enough red blood cells -- may also cause vitamin B-12 deficiency because this type of anemia results in the destruction of a cofactor your body needs to absorb vitamin B-12.

Complications

e treatment, vitamin B-12 deficiency may irreversibly affect the way your brain functions and may cause confusion, memory loss or depression. You may also experience difficulty maintaining your balance when you attempt to stand or walk around normally without assistance. Infants who don't receive enough vitamin B-12 may fail to grow appropriate, which may have life-threatening consequences.

Signs & Symptoms of Being Low on B12

Anemia

Since vitamin B12 helps to make red blood cells, deficiency can result in anemia. The type of anemia associated with B12 deficiency is megaloblastic anemia, which means that the red blood cells are unusually large. If you suffer from anemia, you may experience symptoms of fatigue, lightheadedness, shortness of breath, weakness and difficulty with your normal activities. You may also notice that you look pale. Once you begin treatment to correct the deficiency, your anemia should begin improving in one to two weeks.

According to the Centers for Disease Control, vitamin B12 deficiency is present in one out of every 31 people aged 51 years or older. Deficiency of this vitamin can cause anemia and neurologic and psychiatric problems. Vitamin B12 deficiency occurs as a result of inadequate dietary intake or poor absorption, and once it is diagnosed it can be treated with replacement. Fortunately, many of the symptoms of B12 deficiency are correctable once replacement is initiated.

Background

Vitamin B12 is found in foods such as fish, shellfish, meat and dairy products. It helps to make nerve cells and red blood cells as well as the genetic material that makes up cells. As many years' worth of this vitamin can be stored in your body, deficiency of vitamin B12 is uncommon. Elderly people, alcoholics, strict vegetarians, and vegans are prone to vitamin B12 deficiency as are people who have difficulty absorbing the vitamin. Acid blocking agents can also result in a decrease in vitamin B12 levels. Your vitamin B12 level should be over 200 pg per mL, or picograms per milliliter.

Memory Problems

As stated by the American Academy of Family Physicians, vitamin B12 deficiency has been linked to multiple psychiatric disorders. Mild memory impairment and dementia as well as irritability or personality changes are common psychiatric manifestations. Depression can also occur, and psychosis may result in rare situations. Vitamin B12 levels should be checked in an elderly person who develops dementia as deficiency is one of the few reversible conditions associated with dementia.

Nerve Dysfunction

Vitamin B12 deficiency can also cause problems in your nerve cells and specifically in demyelination of cells in your spinal column. Myelin helps with transmitting nerve signals, and these signals may be disrupted in B12 deficiency. You may experience tingling and numbness in your hands or feet and difficulty with walking. Nerve dysfunction related to B12 deficiency is most common in alcoholics or in the elderly. Since these populations have other potential causes of nerve dysfunction, screening for vitamin B12 deficiency is important as early diagnosis can prevent permanent nerve damage.

What Are the Benefits of Vitamin B Injections?

Pernicious Anemia

Pernicious anemia, a specific type of megaloblastic anemia, occurs when the individual has a rare disorder in which the body has difficulty absorbing vitamin B12, according to the U.S. National Institutes of Health at its MedlinePlus website. Normally, a protein called intrinsic factor attaches to vitamin B12 in the stomach, which allows the intestine to absorb this vitamin. In some people, the body destroys the stomach cells that release intrinsic factor. Treatment for pernicious anemia commonly includes vitamin B12 injections.

Vitamin B12 is generally the only B vitamin available by injection outside of a medical setting. As an injection, it is available as the synthetic form called cyanocobalamin. Vitamin B12 injections are beneficial for certain health conditions, and some people take them for an energy boost and a weight loss aid. Vitamin B12 injections are generally safe, according to MayoClinic.com, but may potentially interfere with the effectiveness of certain medications. Consult a qualified health care provider before beginning vitamin B injections.

B12 Deficiency Anemia

Vitamin B12 is necessary for red blood cell production. Insufficient levels of vitamin B12 can lead to anemia, which is a low red blood cell count, explains the Office of Dietary Supplements. This type of anemia involves abnormally large red blood cells, a condition called megaloblastic anemia. Symptoms include fatigue, weakness, lack of appetite, weight loss and constipation.

Energy Boosting

An article published in the February-March 2004 issue of the "Townsend Letter for Doctors and Patients" notes that most doctors believe vitamin B12 injections taken for energy boosting only have a placebo effect unless the individual is deficient in this vitamin. The article discusses a study which provides contrasting evidence. Twenty-eight participants complaining of fatigue but having normal levels of vitamin B12 and hemoglobin, the primary component of red blood cells, were enrolled. About half the group received vitamin B12 injections for two weeks, took a break for two weeks, then received placebo injections for an additional two weeks. The other participants received the placebo first. Those who received placebo first experienced a significant response to vitamin B12 in the indicators of well-being and happiness, with borderline significant improvement in fatigue and appetite. When vitamin B12 was provided first, improvements were similar, but no difference occurred between the response to the vitamin and the placebo. The authors concluded the effects of vitamin B12 lasted long enough to cause these results. The conclusion was supported by blood tests showing continued elevation of vitamin B12 levels four weeks after the last injection.

Neurological Problems

Vitamin B12 is essential for central nervous system function -- neurological symptoms are also connected with low vitamin B12 levels. Symptoms can include numbness or tingling sensations in the feet and hands, balance problems, confusion, depression, poor memory and even dementia. Early treatment with vitamin B12 injections is important to prevent permanent damage, advises MedlinePlus.

Read more: http://www.livestrong.com/article/268861-what-are-the-benefits-of-vitamin-b-injections/#ixzz20Pzocvir

The Symptoms of Low B12 in the Blood

B12 is a vitamin responsible for producing healthy red blood cells in your body. It also facilitates DNA synthesis and is needed for normal nerve function, notes the Merck Manuals Online Medical Library. According to MedlinePlus, the healthy range of vitamin B12 in your blood is from 200 to 900 pg/mL. B12 levels below 200 pg/mL are considered low and can cause certain symptoms.

Anemia

Vitamin B12 deficiency can cause anemia, Merck Manuals notes. Anemia induced by low B12 levels can cause dizziness and elevated heart rate, if severe. Your skin may also appear pale due to insufficient red blood cells. As the anemia worsens, you may become fatigued. The anemia disappears once vitamin B12

Gastrointestinal Problems

Low vitamin B12 levels can cause you to experience nausea and appetite loss, Drugs.com notes. Furthermore, you may notice increased flatulence and severe diarrhea. These symptoms occur gradually; they increase in severity if B12 levels continue to fall.

Muscle Weakness

Persistently low vitamin B12 levels may cause muscle weakness, Merck Manuals notes. Motor skills such as walking may be impaired. This symptom progresses slowly; it may become irreversible if vitamin B12 levels remain low.

Neurological and Optical Problems

Vitamin B12 deficiency can cause neuropathy -- damage to your nerves. Neuropathy may manifest as a tingling sensation in your hands and feet. You may also find it more difficult to determine the position of your arms and legs, notes Merck Manuals. This symptom usually develops in those aged 60 and above. In addition, low vitamin B12 levels can affect your optic nerves, causing vision loss, according to the CDC.

Cognitive Changes

Vitamin B12 deficiency can affect your cognitive functions, causing confusion, hallucinations, changes in personality and even dementia, the Centers for Disease Control and Prevention explains. Violent tendencies may emerge as a result of severe vitamin B12 deficiency.

Shortness of Breath and Arrhythmia

Deficient levels of vitamin B12 can cause shortness of breath, according to the CDC. You may also experience arrhythmia due to low vitamin B12 levels. The combination of shortness of breath and arrhythmia can lead to fatigue. These symptoms may manifest gradually, making diagnosis more difficult.

VITAMIN B-12 DEFICIENCY SIGNS & SYMPTOMS

An estimated 10 to 15 percent of people over age 60 are affected by vitamin B-12 deficiency, according to Linus Pauling Institute at Oregon State University. Without sufficient amounts of this nutrient, your body may have difficulty sending nerve signals through your body and producing red blood cells. Seek additional care from your medical provider if you experience any of the signs and symptoms of vitamin B-12 deficiency to ensure you receive appropriate treatment and care.

Mood or Memory Changes

A low vitamin B-12 level may also affect nerve transmission in your brain. You may experience temporary memory loss or confusion. Mood-related changes, such as irritability or depression, may also arise and may affect your relationship with those around you. Sudden or severe mood or memory changes should be promptly discussed with your physician. These signs of vitamin B-12 deficiency may also be signs of alternate health problems, including a brain tumor or dementia.

Anemia

One of the primary symptoms of vitamin B-12 deficiency is anemia, a condition in which the number of red blood cells in your bloodstream is unusually low. In healthy people, red blood cells function to carry oxygen throughout the body. When red blood cells levels are low, your cells, tissues and organs become oxygen-starved. Without proper oxygen supplies, your body can no longer produce the energy it needs to fuel your physical activities. Consequently, you may experience extreme fatigue, shortness of breath and weakness or your skin may appear unusually pale. Consult your doctor if you exhibit any signs of anemia. In the absence of appropriate treatment, anemia symptoms may become worse.

Stomach Discomfort

Stomach discomfort may arise as a symptom of vitamin B-12 deficiency. You may feel nauseated or have an unusually diminished appetite. Constipation may result in painful, difficult or infrequent bowel movements and may be accompanied by abdominal cramping or bloating. Alternatively, you may develop frequent, urgent, loose bowel movements -- also called diarrhea. Your tongue may appear swollen and inflamed and may be painful to the touch, making it difficult for you to eat. If these symptoms persist, you may begin losing weight. Discuss stomach-related side effects with your medical provider if they are severe or do not subside.

Unusual Body Sensations

Your nerves rely on vitamin B-12 to help transmit signals from one region of your body to another. Low vitamin B-12 levels may cause nerve damage, which may induce numbness, tingling or other unusual sensations. Nerve damage frequently affects the hands and feet and may make it difficult for you to use these regions of your body normally. Unusual body sensations may be accompanied by weakness and may affect your ability to stand and move about without assistance. If you experience prolonged or progressive episodes of numbness, tingling or weakness, seek care from your physician.