Grasp the precautions about Atorvastatin calcium.😎😎😎

Atorvastatin calcium is a commonly used statin lipid-lowering drug. Indications are patients with hypercholesterolemia and primary hypercholesterolemia. It is including patients with familial hypercholesterolemia or mixed hyperlipidemia. If diet therapy and other non-drug treatments are not satisfactory, it can be used to treat elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), elevated apolipoprotein B and triglyceride (TG) increased.

1. Dosage

The usual starting dose is 10 mg once a day and adjust the dose every 4 weeks or longer. The maximum dose is 80 mg once a day.

• It takes at least 4 weeks for statins to achieve the maximum lipid-lowering effect, so the interval between dose adjustments should be 4 weeks or longer.
• Atorvastatin calcium contains very little amount of calcium which does not affect calcium supplementation.

Kidney disease: It neither affect the blood concentration nor affect its lipid-lowering effect. So there is no need to adjust the dose.

• Patients with active liver disease, pregnant women or women of childbearing age who may conceive are prohibited.

Elderly patients (≥65 years old): The blood concentration is about 40% higher than young people. Any dose of atorvastatin can lower low-density lipoprotein (LDL-C) significantly higher than young people.

• When using atorvastatin, the elderly need to pay special attention to adverse muscle reactions. When there is unexplained muscle weakness, muscle tenderness, muscle pain, neck pain, joint swelling, especially when it is accompanied by discomfort or fever, it is necessary to timely medical treatment.

2. Medication time

The half-life of atorvastatin is 14 hours. The half-life of active metabolites is 20-30 hours. The lipid-lowering effect of atorvastatin is mainly (about 70%) related to active metabolites. Compared with the morning administration, the blood concentration of the evening administration is reduced by about 30%. However, no matter when it is administered during the day, its cholesterol-lowering effect is the same.

• The daily dose of atorvastatin can be taken at any time during the day and is not affected by meals.
• The peak time of cholesterol synthesis is from 0:00 to 3:00 and other statins with shorter half-lives need to be taken before going to bed.

3. Lipid-lowering intensity

The lipid-lowering intensity of statins (including atorvastatin) is related to the dose. However, even if the dose is doubled, the lipid-lowering intensity only increases by about 6%.

• Statins can effectively reduce triglycerides. Patients with hypercholesterolemia and high triglycerides should first choose statin lipid-lowering drugs.

Dose-response relationship of Atorvastatin
	10mg	20mg	40mg	80mg
LDL-C	-39%	-43%	-50%	-60%
HDL-C	+6%	+9%	+6%	+5%
TG	-19%	-26%	-29%	-37%
TC	-29%	-33%	-37%	-45%

4. Interaction

Atorvastatin is metabolized by cytochrome CYP3A4. When combined with a strong CYP3A4 inhibitor, the blood concentration and bioavailability of atorvastatin increase.

Grapefruit juice: Avoid taking with grapefruit or grapefruit juice.

Gemfibrozil and Niacin: The risk of myopathy/rhabdomyolysis is increased, so avoid combined with gemfibrozil or niacin.

Combined with Clarithromycin: The initial dose of atorvastatin is 10 mg once a day. The maximum dose is 20 mg once a day.

Combined with Itraconazole: The initial dose of atorvastatin is 10 mg once a day. The maximum dose is 40 mg once a day.

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Obesity should be seen as a potentially chronic disease.🍨🍩🍪

Obesity is not just a physical problem, but a disease that needs attention and treatment. In December 2016, the American Association of Clinical Endocrinologists and the American Endocrinologists Association issued a statement suggesting that a new medical diagnostic term for obesity-based chronic diseases. It was intended to emphasize that obesity affect health and need to control and manage complications as the chronic diseases. 

With the improvement of living standards and changes in lifestyles, the incidence of obesity is showing an obviously increasing. People are paying more and more attention to chronic diseases. The incidences of hypertension, hyperlipidemia and diabetes are also increasing year by year. More researches believe that obesity has become one of the important predisposing factors for many chronic diseases. World Health Organization recognize obesity as the fifth largest risk factor affecting health and can easily lead to many serious complications.

1. Obesity and cardiovascular disease

Obesity can cause the body's fat metabolism disorder which further leads to the occurrence of hyperlipidemia and hypertension. With the increase of BMI, the incidence of hyperlipidemia and hypertension gradually increases.

Adipocytes proliferate and increase in number, the number of insulin receptors on the surface of hypertrophic adipocytes is relatively reduced and insulin affinity decreases. It results in insulin resistance. This may be one of the reasons that obesity leads to abnormal lipid metabolism and causes hyperlipidemia. The mechanism of obesity-induced hypertension may be related to the comprehensive effects of  the immune system, the sympathetic nervous system and the renin-angiotensin system. 

2. Obesity and diabetes

Overweight and obesity are one of the important risk factors related to the onset of diabetes. As the BMI level increases, the risk of disease increases.

The possible mechanism is that excessive eating will cause a large increase in blood sugar and stimulate the islet cells to secrete a large amount of insulin to maintain blood sugar in the normal blood sugar range. It cannot meet the body's requirement for glucose metabolism regulation and cause increased blood sugar. The excess body fat of overweight and obese people leads to the enhancement of fat degradation. Glycogen utilization is impaired, glucose oxidative metabolism decreases and blood sugar rises. In addition, the liver intake of insulin is reduced which leads to an increase in insulin concentration in the body. It leads to hyperinsulinemia and causes down-regulation of insulin receptor expression and insulin resistance.

3. Obesity and hyperuricemia

Uric acid is the end product of purine metabolism which is mainly derived from the enzyme decomposition of nucleic acids and other purine compounds and purine components in food. More and more studies have shown that hyperuricemia is an important component of metabolic syndrome. It has a certain relationship with obesity. Obese people are more likely to suffer from hyperuricemia. Obesity, especially abdominal obesity, is closely related to hyperuricemia. 

The possible mechanisms are: 

1. Too much energy intake, increased purine synthesis in the body and increased uric acid. 

2. Too much eating and too little consumption. It leads to the accumulation of excessive visceral fat and when the liver fatty acid synthesis is hyperactive. It eventually leads to the synthesis of triglyceride and the production of uric acid are hyperactive. 

3. Insulin resistance leads to a decrease in uric acid excretion.

Insulin resistance is one of the main pathophysiological mechanisms of metabolic syndrome and obesity is the theory that leads to the most evidence of insulin resistance.

4. Obesity and other complications

Lungs: The lungs are squeezed by fat. The breathing becomes difficult and it is difficult for the blood to carry out effective oxygen circulation. That can damage the immune system and cause high blood pressure.

Joint: Obesity will increase the weight-bearing of joints such as wrists and knees. It cause osteoarthritis. Obese people are much more likely to develop arthritis than ordinary people.

Intestinal: The fat accumulated around the internal organs will continue to secrete a large number of hormones or chemicals, which will cause changes in metabolism and cause type 2 diabetes. In addition, the secreted hormones can cause endocrine disorders and cause polycystic ovary syndrome, which can have a certain impact on women's future fertility.

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The cognitive of breastfeeding women show better than non-breastfeeding.👶👶👶

It is well known about breastfeeding is good for the babies, but there were few studies have focused on the health effects of breastfeeding on mothers. Recently, a research showed that breastfeeding may also have long-term benefits for the mother's own health. Compared with women who have not breastfed their children, women who have breastfed their children carried out better performance on cognitive ability after the age of 50. 

The relationship between cognitive ability and Alzheimer's disease

Cognitive ability is closely related to the health of the elderly. However, cognitive ability will continue to be declined after the age of 50 and it may also become a important factor in predicting Alzheimer's disease (AD). Alzheimer's disease is one of the main manifestations of dementia and one of the main causes of damage to the health of the elderly. Moreover, women are more likely to suffer from AD than men. 

Breastfeeding benefit to the mother's cognitive ability

There were some studies have found that breastfeeding can help improve baby's emotion, reduce mother's stress and the risk of postpartum depression. This suggests that breastfeeding may be have great benefit to the mother's neurocognitive ability and may strengthen the mother's long-term cognitive ability.

In that research, the researchers investigate more than a hundred women with or with out depression. All participants completed a series of comprehensive psychological tests that measured learning ability, executive function, processing speed and so on. They also answered a questionnaire about their reproductive life history which included the age at they began menstruation, the number of complete and incomplete pregnancies, the length of time each baby was breastfeeding and their menopausal age. None of the participants were diagnosed with dementia or other mental illnesses such as bipolar disorder, alcohol or drug dependence, neurological disorders. They had been prevented to take any psychoactive drugs during the research. There were also no significant differences between depressed and non-depressed participants in terms of age, race, education or other cognition. Whether they were depression, the results also showed that women who had breastfed performed better than women who had not breastfed.

Whether they were depression or not, the results also showed that women who had breastfed was performed better than women who had not breastfed.

Researches need to explore the relationship between breastfeeding history and cognitive performance in a larger and more diverse group of women. It is important to better understand the impact of breastfeeding on women's health.

For more detail, read the research article👇👇👇

Women who breastfeed exhibit cognitive benefits after age 50. https://doi.org/10.1093/emph/eoab027

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Application of glucocorticoids in clinical diseases.👀

The applications of glucocorticoids are very extensive and vary with the dose.
Glucocorticoids secreted under physiological conditions mainly affect the metabolism of substances. It will cause metabolic disorders and death when lacking. When glucocorticoids are pharmacological doses, in addition to affecting substance metabolism, it also have immunosuppressive , anti-inflammatory, detoxify and anti-shock effects.

1. Classification and difference of common glucocorticoids

According to the duration of action, glucocorticoids can be divided into three categories:

Category	Drug	Dose equivalent (mg)	Effective drug duration (hours)
Short-acting	Cortisone	25	8-12
	Hydrocortisone	20
Medium-acting	Prednisone	5	12-36
	Prednisolone	5
	Methylprednisolone	4
Long-acting	Dexamethasone	0.75	36-54
	Betamethasone	0.6

2. Glucocorticoid treatment course and withdrawal

Pulse therapy: The course of treatment is usually less than 5 days. It indicated for rescue of critically ill patients. The drug can be withdrawn quickly.

Short-term treatment: The course of treatment is less than 1 month. It indicated for infection or allergic diseases. Withdraw the drug by gradually reducing.

Medium-term treatment: The course of treatment is during within 3 months. It indicated for long term and multiple organ involvement disease. Withdraw the drug by gradually reducing.

Long-term treatment: The course of treatment is more than 3 months. It indicated for chronic autoimmune diseases, such as systemic lupus erythematosus. Before stopping the drug, the drug treatment should be gradually transitioned to alternate day therapy, then reduce the dose gradually and slowly.

Alternative therapy: Lifetime use. It indicated for primary or secondary chronic adrenocortical insufficiency.

3. Application of glucocorticoids in common diseases

Hyperthyroidism crisis: The level of thyroid hormones is sudden increase in the body. It is always related to the patients with insufficient treatment in severe or chronic hyperthyroidism. 

Treatment: Inorganic iodides, antithyroid drugs, β-receptor blockers and glucocorticoids (glucocorticoids can inhibit the conversion of peripheral T4 to T3).

Graves' ophthalmopathy: It is an organ-specific autoimmune disease related to the thyroid. It mainly manifests as exophthalmos, eyelid contracture, periorbital edema, bulbar conjunctival edema and eyeball activity dysfunction.

Treatment: For mild, the main treatment is to control hyperthyroidism or hypothyroidism. For moderate to severe, intravenous or oral glucocorticoid therapy is the main treatment.

Autoimmune hemolytic anemia: It is caused by lymphocytes function abnormally. Lymphocytes produce antibodies against the red blood cells, which accelerates the destruction of red blood cells in the body.

Treatment: For acute hemolytic attacks, intravenous infusion of dexamethasone or methylprednisolone is the first choice. Oral prednisone is the first choice for milder conditions (Taken in the morning).

Idiopathic thrombocytopenic purpura: The patient produces anti-platelet autoantibodies in the body.

Treatment: Glucocorticoids are the first choice. Immunosuppressants are needed for ineffectiveness and large doses of intravenous γ-globulin are used for severe bleeding.

Aplastic anemia: Abnormal activation and hyperfunction of T lymphocytes cause bone marrow damage.

Treatment: Antithymus/lymphocyte globulin (daily simultaneous application of glucocorticoids to prevent allergic reactions) and cyclosporine are commonly used.

Graft-versus-host disease: It is the most common complication of allogeneic hematopoietic stem cell transplantation and involving a variety of immune cells and inflammatory cytokines.

Treatment: For acute, use glucocorticoids (common use methylprednisolone and prednisone) combined with calcineurin inhibitors. For chronic, use cyclosporine A combined with glucocorticoids.

Nephrotic syndrome: It is characterized by massive proteinuria and it often accompanied by hypoalbuminemia (≤30g/L), edema and hyperlipidemia.

Treatment: Glucocorticoids or combined immunosuppressive agents (cyclophosphamide, cyclosporine A, mycophenolate mofetil, etc.).

Lupus nephritis: It refers to systemic lupus erythematosus complicated by kidney damage. It has varying clinical manifestations, such as hematuria, tubular urine, persistent proteinuria or decreased renal function.

Treatment: Oral glucocorticoid therapy is the main treatment. If it is necessary, glucocorticoid pulse therapy or other immunosuppressive agents should be added.

Adrenal crisis: Acute reduction of adrenal cortex function induced by infection, trauma and other stress conditions or withdrawal of hormones. It leads to high fever, drop in blood pressure and so on. 

Treatment: Intravenous infusion of glucocorticoid (hydrocortisone), correction of dehydration and electrolyte disturbances and treatment of hypoglycemia.

Systemic lupus erythematosus: It is an autoimmune-mediated diffuse connective tissue disease characterized by immune inflammation.

Treatment: For mild, use no or small doses glucocorticoids. For medium, glucocorticoids + other immunosuppressive agents (cyclophosphamide or mycophenolate mofetil). For severe conditions, it is required large doses of glucocorticoids + other immunosuppressive agents. If it is necessary pulse treatment, methylprednisolone can be used.

Bronchial asthma: Asthma is a chronic airway inflammatory disease involving a variety of cells and cellular components.

Treatment: Inhaled glucocorticosteroids (ICS) are the first choice for long-term treatment of asthma. For chronic severe persistent asthma that cannot be controlled by high-dose ICS + LABA (Long-acting beta-agonists, such as formoterol.), low-dose oral glucocorticoid maintenance therapy can be added. Generally use a short half-life glucocorticoids (such as prednisone.), and take it in the morning. 

Idiopathic pulmonary fibrosis (IPF): It is a chronic, progressive and fibrotic interstitial pneumonia of unknown etiology. The median survival time from diagnosis is only 2 to 3 years.

Treatment: Anti-fibrosis agents pirfenidone and nintedanib can delay the decline of pulmonary function in patients with IPF. Patients with acute exacerbations should be treated with glucocorticoids as appropriate and avoiding glucocorticoids in the stable phase is beneficial to prolong the natural progress of the disease.

Ulcerative colitis (UC): Inflammatory bowel disease refers specifically to inflammatory bowel disease of unknown etiology, including ulcerative colitis and Crohn's disease. The cause is unknown and there is no cure for the time being. The lesions of UC were distributed continuously.

Treatment: For mild, use aminosalicylic acid preparations (such as mesalazine). For moderate, adequate aminosalicylic acid preparations are not well controlled and switch to glucocorticoid therapy. Thiopurine drugs can be used for glucocorticoid-ineffective or dependent patients. If the above treatments are ineffective, it should consider using infliximab.

Crohn's disease: Crohn's disease is also an inflammatory bowel disease of unknown etiology and the lesions are distributed in segments.

Treatment: For mild, use aminosalicylic acid preparations (such as mesalazine). For moderate to severe, use glucocorticoid. For those who fail to treat glucocorticoids or sulfa drugs, switch to or add azathioprine, cyclosporine and other immunosuppressive agents Agent. If the above treatments are ineffective, consider using infliximab.

Ankylosing spondylitis: It is a chronic inflammatory disease that mainly affects the sacroiliac joints, spine, paraspinal soft tissues and peripheral joints. It may be accompanied by extra-articular manifestations. In severe cases, spinal deformity and rigidity can occur.

Treatment: First using the drugs  to improve symptoms and disease progress, such as NSAIDs, sulfasalazine and anti-TNFα antagonists. Systemic corticosteroid therapy is generally not recommended. Glucocorticoids are usually used as local adjuvant drugs to improve Symptoms (such as injection into the joint cavity).

Rheumatoid arthritis: It is an autoimmune disease with erosive arthritis as the main clinical manifestation. It can occur at any age.

Treatment: The first choice is methotrexate alone. If it does not achieve treatment effect, it combined with leflunomide, sulfasalazine, and tocilizumab. Patients with moderate/high disease activity, combined with glucocorticoid therapy to quickly control symptoms.

👉When taking glucocorticoids for a long time, calcium and active vitamin D should be supplemented regularly to prevent osteoporosis and femoral head necrosis.

👉Patients with long-term use of glucocorticoids should check their weight, blood pressure, blood lipids, blood sugar, electrolytes, growth and development regularly.

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The use of oral ibuprofen and its precautions.😎😎😎

Ibuprofen is an antipyretic and analgesic which is commonly used clinically. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It inhibits cyclooxygenase, reduces the synthesis of prostaglandins and produces analgesic and anti-inflammatory effects. It has an antipyretic effect through the hypothalamic body temperature regulation center.

Ibuprofen precaution for children:

Rectal temperature ≥ 39.0°C, oral temperature ≥ 38.5°C, axillary temperature ≥ 38.2°C or fever children who are uncomfortable and depressed due to fever. Ibuprofen or acetaminophen is recommended.

Acetaminophen can be used for children ≥ 2 months and ibuprofen can be used for children ≥ 6 months. Acetaminophen combined with ibuprofen is not recommended for children's fever nor alternate acetaminophen and ibuprofen.

The dose of oral ibuprofen for children is 10mg/kg each time. The shortest interval is 6-8 hours and no more than 4 times within 24 hours. If symptoms are not relieved after taking it for three consecutive days, see a doctor as soon as possible.

Ibuprofen precaution for adults:

1. Anti-arthritis: 0.4g-0.6g each time, 3-4 times a day, the dosage of rheumatoid arthritis is larger than osteoarthritis.

2. Mild to moderate pain: 0.2-0.4g each time every 4-6 hours. The maximum daily dose is 2.4g.

Ibuprofen can weaken the antiplatelet effect of low-dose aspirin. Patients who are taking low-dose aspirin should not use ibuprofen. Use acetaminophen instead of ibuprofen.

Ibuprofen precaution for breastfeeding women:

When breastfeeding women take ibuprofen, no serious adverse reactions have been found in the breastfed infants. The intake of ibuprofen by the breastfed infants is 0.0008% of the mother's dose. Lactating women can use ibuprofen with caution.

Ibuprofen precaution for pregnant women:

Taking ibuprofen in early pregnancy can cause cardiovascular malformations and cleft palate. Taking ibuprofen in late pregnancy can lead to unclosed arterial ducts and myocardial degenerative changes. Therefore, pregnant women should not use ibuprofen.

Common side effects:

Common side effects are nausea, dyspepsia, gastric ulcer bleeding and allergic reactions. Long-term use of ibuprofen can cause kidney damage, bleeding and increase the risk of cardiovascular disease.

It can be taken with food to avoid indigestion or stomach irritation.

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Drinking 100 ml of sugared beverages a day can increase the risk of cancer by 18%!!😱😱😱

Whenever you see a attractive beverage on the supermarket shelves, do you always want to drink a bottle and make yourself happy all day? In fact, the sugar in the drink has sneaked into your body at this time. If you don't control drinking, you may become a high sugar intake group unknowingly. 

So, what exactly is high sugar intake? High sugar intake refers to high added sugar intake. Added sugars include sucrose, sweeteners, honey and fruit juice, which are extracted and refined and added to foods or beverages to improve taste.

Will high sugar intake release "happiness factors" and relieve stress?

The intake of sugar will stimulate our brain to secrete dopamine. Dopamine is a kind of nerve substance that transmits excitement and happiness. It can make people feel happy. Therefore eating sugar can really make people happy and relieve stress.

What are the hazards of high sugar intake to the body?

Short term: High sugar intake will increase systemic inflammation and increase the risk of acne. This is why some people start to get acne after eating a lot of sweets.

Long term: Long-term high sugar intake will increase the risk of dental caries. Studies have found that 3 cups of sugared beverages a day will double the risk of dental caries. The effect of sugar to dental caries is not limited to modern times. In fact, as early as 500 years ago, excessive sugar consumption caused European aristocrats to have dental caries.

High sugar intake will also increase the risk of obesity. It is because added sugar is an "empty calorie food (most calorie and less nutrient in the food)". You are already full but you can still continue to enjoy a dessert after a meal. This is how sugar affects the satiety. Therefore, it is easy to eat too much sugar, which leads to excessive calorie intake and leads to obesity. In addition, high sugar intake can also increase the risk of diabetes. Added sugar can be quickly absorbed by the body and has a great impact on blood sugar fluctuations. Studies have shown that people who consume a lot of sugared beverages have an 18% increase in the risk of type 2 diabetes. 

Why does high sugar intake increase the risk of cancer?

In 2019, a study of more than 100,000 people showed that drinking 100 ml of sugared beverages a day would increase the overall risk of cancer by 18%. The researchers proposed some possible explanations for these results. It was including the effect of sugar in sugared beverages on visceral fat, blood sugar levels and inflammatory. All are associated with increased cancer risk. Long-term high sugar intake can lead to obesity and insulin resistance. It is resulting in oxidative stress, endocrine disorders and immune dysfunction in the body and leading to an increased risk of tumors.

After the tumor has occurred, the cancer cells will use the anaerobic glycolysis as the main energy supply method. So ordinary people and tumor patients both should control the intake of added sugar.

How to reduce sugar intake?

The World Cancer Research Fund (WCRF) and the American Cancer Institute (AICR) put forward the top ten recommendations for cancer prevention which include "limit the intake of sugared beverages."

We must learn to say goodbye to sweetness, reduce the intake of disserts and sweet drinks, eat more complex carbohydrates (coarse grains), drink more boiled water, lemonade or soda water.

Learn to look at the nutrient composition table on the food packaging to find out the hidden sugar.

If you really want to eat something sweet, we can choose fruit. While providing sweetness, it also provides vitamins, minerals and dietary fiber that are beneficial to health. 100% fruit juice is also a sugared beverage, so it is not recommended to use fruit juice instead of fruit. We can also choose suitable sugar substitute products and see if there are low-sugar/no-sugar products as alternatives when purchasing.

Try to reduce sugar intake, keep you healthy.👍

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What are the manifestations of various vitamin deficiencies and excesses?😵😵😵

Vitamins are a class of organic compounds that are necessary in the process of human life activities. They have three characteristics:

1. Exist in natural foods.

2. The human body generally cannot be synthesized and must be supplied by food.

3. It is neither a raw material for body tissues nor does it provide energy. Its physiological needs are small, but it is indispensable for the human body.

Deficiency or excess of vitamins will have a strong effect on human health.

Name	Origin	Solubility
Vitamin A (Retinol)	Cod liver oil, green vegetables	Fat soluble
Vitamin B1 (Thiamine)	Liver, yeast, cereal, meat, soy	Water soluble
Vitamin B2 (Riboflavin)	Liver, yeast, egg, vegetables	Water soluble
Vitamin B3 (Niacin)	Liver, cereal, yeast	Water soluble
Vitamin B5 (Pantoic acid)	Liver, yeast, vegetables, cereal	Water soluble
Vitamin B6 (Pyridoxine)	Liver, yeast, dairy products, egg, cereal	Water soluble
Vitamin B7 (Biotin)	Liver, yeast, cereal	Water soluble
Vitamin B9 (Folic acid)	Liver, vegetable leaf	Water soluble
Vitamin B12 (Cobalamins)	Liver, egg, fish, meat	Water soluble
Choline	Liver, dairy products, soy, yolk	Water soluble
Inositol	Meat	Water soluble
Vitamin C (Ascorbic acid)	Fruit, fresh vegetables	Water soluble
Vitamin D (Calciferol)	Cod liver oil, yeast, dairy products, yolk	Fat soluble
Vitamin E (Tocopherol)	Liver, vegetable oil, egg, fish	Fat soluble
Vitamin K (Naphthoquinones)	Liver, spinach	Fat soluble

Vitamin deficiency

Vitamins participate in all links in the process of life activitie. It maintains the normal
function of the nervous system, participate in the synthesis and metabolism of protein and fat, participate in the synthesis of various enzymes and antibodies and so on. Vitamin deficiency will seriously affect the normal metabolism of physiological functions and even threaten life.

Causes of vitamin deficiency:

Vitamin A: Night blindness, dry skin, dry cornea and desquamation.

Vitamin B1 (Thiamine): The oxidation of sugar in the tissue is affected by Vitamin B1. It also has the effect of inhibiting cholinesterase activity. When it is lacking, the enzyme activity is too high. Acetylcholine (one of the neurotransmitters) is destroyed in a large amount and nerve conduction is affected. It can cause slow gastrointestinal peristalsis, reduced secretion in the digestive tract, indigestion, loss of appetite, neuritis, beriberi and growth retardation.

Vitamin B2 (Riboflavin): Oral ulcers, glossitis, angular cheilitis, cleft lip, keratitis, dermatitis, etc.

Vitamin B3 (Niacin): It is manifested as neurotrophic disorder. The whole body is weak at first and then symmetrical dermatitis appears on the hands, cheeks, left and right forehead and other exposed parts.

Vitamin B5 (Pantoic acid): Because of its ubiquity, no typical cases of deficiency have been found in the human body.

Vitamin B6 (Pyridoxine): Causes vomiting, cramps and other symptoms. Since food is rich in vitamin B6 and can also be synthesized by intestinal bacteria, vitamin B6 deficiency rarely occurs.

Vitamin B7 (Biotin): Including eczema, dermatitis, hyperesthesia, atrophic glossitis, fatigue, muscle pain, anorexia, hair loss and mild anemia.

Vitamin B9 (Folic acid): White blood cells are reduced, the volume of red blood cells become larger and giant cell anemia occurs. Neutrophils are abnormal. Human intestinal bacteria can synthesize folic acid, so deficiency diseases are generally less likely to occur. However,  when malabsorption, metabolic disorders or tissue requirements are too high, and long-term use of intestinal antibacterial drugs (such as sulfonamides), etc., can cause folic acid deficiency.

Vitamin B12 (Cobalamins): Megaloblastic anemia.

Choline: Abnormal liver function, the liver accumulates a large amount of lipids (mainly triglycerides), which eventually fills the entire liver cells. It also harms kidney function. Genetic damage and mutant cell can form tumors cell survive and proliferate. Infertility, growth retardation, bone abnormalities, hematopoietic disorders and hypertension related to dietary low choline have also been reported.

Inositol: Hair is easy to turn white and eczema.

Vitamin C: Scurvy and decreased resistance.

Vitamin D: Kids: Rickets; Adults: Osteoporosis.

Vitamin E: Infertility, abortion, muscle atrophy, etc.

Vitamin Overdose

Excessive intake of vitamins will not only destroy the stability of the human body's environment, but even cause poisoning.

Vitamin A overdose: 

Adults who consume more than 50,000 IU a day for several months can cause poisoning. If children intake more than 18500IU in a day, it will cause poisoning.

Main manifestations: Due to the enhanced activity of osteoclasts, bone decalcification, increased bone fragility, growth inhibition, thickening of long bones and bone and joint pain. dry skin, itching, scaly skin, rash, peeling, hair loss, finger (toe) nails are fragile. Irritability, fatigue, headache, nausea, vomiting, muscle weakness, restlessness. Reduced appetite, abdominal pain, diarrhea, hepatosplenomegaly, jaundice. Blood hemoglobin and potassium are reduced, clotting time is prolonged and bleeding is easy.

Vitamin D overdose:

Vitamin D is an important medicine for the prevention and treatment of rickets, but the consequences of overdose are more dangerous than suffering from rickets. If a child takes 20,000 units a day for a few weeks or months, it causes headache, anorexia, nausea, vomiting, thirst, drowsiness, polyuria, dehydration, high fever and coma, protein and red blood cells appear in the urine. If it is not stopped in time, death can be caused by hypercalcemia and renal failure.

Vitamin A and D poisoning has the highest incidence in infants and children aged 6 months to 3 years. It is mostly caused by parents taking too much cod liver oil for children.

Vitamin B1 overdose:

Large amount of vitamin B1 intaking can cause dizziness, diarrhea, edema, arrhythmia and so on. If the intramuscular injection is overdose, erythema, rubella, contact dermatitis, bronchial asthma and even anaphylactic shock can occur. Overdose in pregnant women can cause postpartum hemorrhage.

Vitamin B2 overdose:

Large dose injection of vitamin B2 can block the renal tubules and resulting in renal dysfunction such as oliguria.

Vitamin B3 overdose:

It can cause skin flushing, fever, itching and fotmication (Feeling like there are some ant walking on skin). Symptoms such as palpitation, vomiting and nausea can also occur.

Vitamin B6 overdose

If pregnant women use a large dose of 25 mg or more, it can affect the supply of fetal nutrition and cause fetal development obstacles. Anaphylactic shock can also occur if the intramuscular injection is overdose.

Vitamin B9 overdose

There will be bitter taste in the mouth, anxiety and abnormal sleep patterns.

Vitamin B12 overdose

Allergic reactions such as asthma, urticaria, eczema, drug rash and facial edema can occur, as well as precordial pain and palpitation. Therefore, it can aggravate the condition of patients with angina or increase the number of attacks.

Vitamin C overdose

Long-term large intaking can cause nausea, vomiting, abdominal pain and diarrhea. If reducing the dosage suddenly, it is more likely to suffer from scurvy than before taking vitamin C. The urine is acidified and oxalate increases rapidly, causing kidney stones are easily formed. Rapid intravenous injection of large doses of vitamin C can cause red blood cell lysis or venous thrombosis, which is fatal. Babies who take a lot of vitamin C often suffer from restless sleep, indigestion, edema, diarrhea, and urticaria. Repeated intravenous injections of vitamin C can cause itchy papules and even anaphylactic shock and death.

Vitamin E overdose

If the daily dosage is more than 400 mg, long-term application may cause thrombosis and also cause menorrhagia or amenorrhea. When the dose is 2000 to 12000 mg, it will affect the fertility. For diabetic patients with severe hypertension, myocardial damage and insulin therapy, vitamin E should be used with extreme caution. At the beginning, 100 mg per day, then gradually increase the dose, otherwise it is easy to cause platelet aggregation and thrombosis.

Vitamin K overdose

It can cause hemolytic anemia and liver cell damage, as well as allergic reactions.

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