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Calcium

Calcium helps prevent bone demineralization, proper muscle contraction, and nerve impulses.

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“Calcium is one of the most abundant elements in the human body and is a major component of the mineralized tissues where more than 99% of total body calcium is contained. It plays a key role in skeleton mineralization and is required for normal growth, development, and bone strength. Moreover, it has a role in a wide range of biological functions, such as muscle contraction and nerve impulse transmission. Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. For best therapeutic effect, it is recommended minimum doses of 1200 mg of calcium, and 800 IU of vitamin D (for combined calcium plus vitamin D supplementation). The evidence suggests that calcium supplementation could reduce risk of preeclampsia.

Previous evidence showed an inverse relationship between high blood pressure and calcium intake. Numerous epidemiological and clinical studies, and later a series of systematic reviews also demonstrated this association. Their results have suggested that calcium supplements (>/=1 g/day) could lower the risk of preeclampsia. As a result, the World Health Organization (WHO) has recommended to supplement calcium for pregnant women especially to high-risk population with a low calcium diet.”

Copper

Copper is important in the formation of red blood cells, helps prevent anemia and provides an immune effect.

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“Copper is critical for the proper function of organs and metabolic processes such as hemoglobin synthesis, iron oxidation, neurotransmitter biosynthesis, cellular respiration, pigment formation, antioxidant defense peptide amidation, and connective tissue formation.

Copper deficiency affects physiologic systems such as bone marrow hematopoiesis, optic nerve function, and the nervous system. Copper deficiency anemia is treated with oral or intravenous copper replacement in the form of copper gluconate, copper sulfate, or copper chloride. Hematological manifestations are fully reversible with copper supplementation. However, neurological manifestations are only partially reversible with copper supplementation. The essential trace element copper is required for a range of physiologic processes, including wound healing and functioning of the immune system.

The clinical features of Cu deficiency are mainly hematologic and neurologic, reflecting the requirement for Cu in erythropoiesis and synthesis of myelin. The most common features are microcytic or normocytic anemia, unresponsive to Fe supplementation, and neutropenia. Cu deficiency is also implicated in increased oxidative stress and deterioration in cognitive function for patients with Alzheimer’s disease.

There is evidence from numerous sources that Cu deficiency impairs the activity of the immune system, thereby predisposing to bacterial infection. The main biological function of copper is to take part in maintaining hematopoietic function, affect energy metabolism and neurobehavioral and immune function.

A deficit of copper can result in impaired energy production, abnormal glucose and cholesterol metabolism, increased oxidative damage, increased tissue iron accrual, altered structure and function of circulating blood and immune cells, abnormal neuropeptide synthesis and processing, aberrant cardiac electrophysiology, impaired myocardial contractility, and persistent effects on neurobehavior and the immune system.”

Chondroitin

Chondroitin aids in the improvement of symptomatic osteoarthritis due to its anti-inflammatory activity. It is usually associated with glucosamine.

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“It shows clinical benefits in symptomatic osteoarthriti of the finger, knee, hip joints, low back, facial joints and other diseases due to its anti-inflammatory activity. It also helps in osteoarthritis by providing resistance to compression, maintaining the structural integrity, homeostasis, slows breakdown and reduces pain in sore muscles. It is most often used in combination with glucosamine to treat osteoarthritis.

It is approved in the USA as a dietary supplement for osteoarthritis, and it is used as a symptomatic slow-acting drug (SYSADOA) in Europe and some other countries. Any significant side effects or overdoses have not been reported in clinical trials suggesting its long-term safety. A double-blind, randomized, multicenter study suggests that a daily administration of an oral sachet of 1200 mg of chondroitin sulfate allows a significant clinical improvement compared to a placebo, and a similar improvement when compared to a regimen of three daily capsules of 400 mg of the same active ingredient. A meta-analysis shows that glucosamine and chondroitin sulfate may delay radiological progression of osteoarthritis of the knee after daily administration for over 2 or 3 years.”

Glucosamine

Glucosamine helps decrease pain and improve joint function in osteoarthritis.

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“Over the last 20 years, several studies have investigated the ability of glucosamine sulfate to improve the symptoms (pain and function) and to delay the structural progression of osteoarthritis. There is now a large, convergent body of evidence that glucosamine sulfate, given at a daily oral dose of 1,500 mg, is able to significantly reduce the symptoms of osteoarthritis in the lower limbs. This dose of glucosamine sulfate has also been shown, in two independent studies, to prevent the joint space narrowing observed at the femorotibial compartment in patients with mild-to-moderate knee osteoarthritis. This effect also translated into a 50 % reduction in the incidence of osteoarthritis-related surgery of the lower limbs during a 5-year period following the withdrawal of the treatment.
A meta-analysis suggests that diacerein and glucosamine are equally efficacious for symptom relief in knee osteoarthritis, but that the former has more side effects.

The investigation demonstrates the potency of diacerein and glucosamine in the treatment of osteoarthritis of the knee. Glucosamine shows significant improvements in pain score but does not decrease risk of adverse effects and does not have a clinically relevant effect in slowing progression of joint space narrowing in osteoarthritis knee. Diacerein has a higher risk of adverse gastrointestinal events when compared to glucosamine. Diacerein also does not decrease risk of adverse effects and has no clinically relevant effect in delaying progression of joint space narrowing in osteoarthritis of the knee. When compared to diacerein, glucosamine is the better treatment choice for osteoarthritis of the knee. It has been reported that cartilage metabolism (type II collagen degradation) is enhanced in endurance athletes with intense joint loading. Notably, glucosamine shows a chondroprotective action on osteoarthritis by inhibiting type II collagen degradation.

It was evaluated the action of glucosamine on cartilage metabolism in soccer and rugby players with intense joint loading.

The observations suggest that cartilage metabolism (type II collagen degradation) is increased in endurance athletes (such as soccer and rugby players), and glucosamine demonstrates a chondroprotective action on these athletes by preventing type II collagen degradation but maintaining type II collagen synthesis). However, the effect disappears after withdrawal of administration. Thus, glucosamine should be continuously administered for the joint health of endurance athletes.”

Iron

Iron is essential in the prevention of iron deficiency anemia at all stages of life.

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“Iron deficiency is the depletion of total-body iron, especially of macrophage and hepatocyte iron stores. Because the largest amount of iron is consumed for hemoglobin (Hb) synthesis to produce 200 billion erythrocytes daily, anemia is the more evident sign of iron deficiency, and iron deficiency anemia is often considered synonymous with iron deficiency. However, iron deficiency is a broader condition that often precedes the onset of anemia or indicates deficiency in organs/tissues other than those involved in erythropoiesis, such as skeletal muscles and the heart, the latter highly iron dependent for myoglobin and energy production to sustain mechanical contraction.

With regard to oral iron suppementation, iron salts such as iron sulfate, fumarate, and gluconate remain a mainstay of therapy in absolute iron deficiency. The alternative for patients intolerant or unresponsive to oral compounds is IV iron. Iron-deficiency anaemia is highly prevalent among non-pregnant women of reproductive age (menstruating women) worldwide, although the prevalence is highest in lower-income settings. Iron-deficiency anaemia has been associated with a range of adverse health outcomes, which restitution of iron stores using iron supplementation has been considered likely to resolve.

Daily iron supplementation effectively reduces the prevalence of anaemia and iron deficiency, raises haemoglobin and iron stores, improves exercise performance and reduces symptomatic fatigue. Anaemia is a global public health problem and is more prevalent in pregnant women and young children. Iron deficiency anaemia impairs thyroid metabolism and may negatively affect growth and develpment of children. Hypothyroidism is associated with anemia and adding iron to thyroxine therapy improves both conditions compared to thyroxine therapy alone.”

Lutein

Lutein helps improve visual performance in maculopathy and reduces the risk of cataracts.

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“Lutein and zeaxanthin supplementation is a safe strategy for improving visual performance of age-related macular degeneration patients, which mainly showed in a dose-response relationship.
Dietary lutein and zeaxanthin intake is associated with a reduced risk of age-related cataract, especially nuclear cataract in a dose-response manner, indicating a beneficial effect of lutein and zeaxanthin in age-related cataract prevention. A randomized, placebo-controlled clinical trial with the objetive to determine whether or not supplementation with lutein + zeaxanthin could improve cognitive function in young (age 18–30), healthy adults, found that the supplementation increased macular pigment optical density significantly over the course of the year, vs. placebo. Daily supplementation resulted in significant improvements in spatial memory, reasoning ability and complex attention. In conclusion, supplementation with lutein + zeaxanthin improves CNS xanthophyll levels and cognitive function in young, healthy adults.”

Magnesium

Magnesium is essential for the regulation of muscle contraction, protein synthesis, and nerve transmission.

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Magnesium has been recognized as a cofactor for more than 300 enzymatic reactions, where it is crucial for adenosine triphosphate (ATP) metabolism. Magnesium is required for DNA and RNA synthesis, reproduction, and protein synthesis. Moreover, magnesium is essential for the regulation of muscular contraction, blood pressure, insulin metabolism, cardiac excitability, vasomotor tone, nerve transmission and neuromuscular conduction. Imbalances in magnesium status-primarily hypomagnesemia as it is seen more common than hypermagnesemia-might result in unwanted neuromuscular, cardiac or nervous disorders. Low levels of magnesium have been associated with a number of chronic diseases, such as Alzheimer’s disease, insulin resistance and type-2 diabetes mellitus, hypertension, cardiovascular disease (e.g., stroke), migraine headaches, and attention deficit hyperactivity disorder (ADHD). Magnesium has been recognized as a cofactor for moren than 300 metabolic reactions in the body. Some of the processes in which magnesium is a cofactor include, but are not limited to, protein synthesis, cellular energy production and storage, reproduction, DNA and RNA synthesis, and stabilizing mitochondrial membranes. Magnesium also plays a critical role in nerve transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor tone, blood pressure, and glucose and insulin metabolism. Because of magnesium’s many functions within the body, it plays a major role in disease prevention and overall health. Low levels of magnesium have been associated with a number of chronic diseases including migraine headaches, Alzheimer’s disease, cerebrovascular accident (stroke), hypertension, cardiovascular disease, and type 2 diabetes mellitus. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. Magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders. There is strong data to suggest a role for magnesium in migraine and depression, and emerging data to suggest a protective effect of magnesium for chronic pain, anxiety, and stroke. More research is needed on magnesium as an adjunct treatment in epilepsy, and to further clarify its role in Alzheimer’s and Parkinson’s. Overall, the attributes of magnesium in neurological diseases indicate the mineral as a potential target for neurological disease prevention and treatment.

Potassium

Potassium supports maintaining a stable blood pressure, in addition, at adequate levels it prevents arrhythmias.

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“Fruits and vegetables, especially the potato, are excellent sources of potassium and play important roles in protecting against hypertension and, perhaps, in improving bone health. The organic potassium salts in foods have a broad range of health benefits to the heart, kidney, bone, and other tissues. Potassium chloride supplementation seemingly benefits blood pressure, but not bone. Evidence from trials on blood pressure suggests 3600–3800 mg/d may be reasonable for heart and bone health. This is still 1000 mg higher than the current mean consumption of potassium. Improving the potassium:sodium intake ratio has a stronger advantage to heart health than either dietary constituent in isolation. This may be true for bone health also because these minerals have opposing actions on calcium excretion. Hypokalemia is a common electrolyte disturbance, observed in > 20% of hospitalized patients.

Individuals with mildly decreased potassium levels (3.0-3.5 mmol/L) may be asymptomatic, but patients with more pronounced decreases may report symptoms including muscle weakness, fatigue, and constipation. Very low serum potassium levels (≤ 2.5 mmol/L) can lead to muscle necrosis, paralysis, cardiac arrhythmias, and impaired respiration, which can be life-threatening.

Because small potassium deficits in serum represent large body losses, potassium repletion requires substantial and prolonged supplementation. For patients with known risk factors for hypokalemia (e.g. hypertension, heart failure, or diabetes), careful monitoring is crucial to avoid the adverse sequelae associated with potassium deficits and to ensure that adequate and timely preventive measures can be taken. Potassium supplementation in hypertensives was generally associated with decreased blood pressure, particularly in high sodium consumers, subjects not on hypertensive drug treatment, and those in the lowest category of potassium intake. An adequate dietary intake of potassium, in the order of 90 mmol/day, should be achieved for blood pressure control.

Overall, a meta-analysis results suggest that long-term ‘moderate’ supplementation with potassium salts can reduce BP in hypertensives, and that such effect may be particularly relevant in individuals not on drug treatment, having a high sodium intake, and characterized by a baseline potassium intake < 90 mmol/day. Currently available evidence also indicate that the amount of supplementation considered in the trials is substantially safe.”

Selenium

Selenium helps provide an antioxidant, antiviral, and anti-inflammatory effect. In addition, it collaborates in the production of thyroid hormone.

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“Selenium is incorporated into selenoproteins that have a wide range of pleiotropic effects, ranging from antioxidant and anti-inflammatory effects to the production of active thyroid hormone.

Low selenium status has been associated with increased risk of mortality, poor immune function, and cognitive decline. Selenium supplementation has antiviral effects, is essential for successful male and female reproduction, and reduces the risk of autoimmune thyroid disease. As an antioxidant, selenium is one of the necessary trace elements in human body and has been suggested as a dietary supplement for health benefit.

Selenium deficiency is observed in multiple metabolic diseases, including hyperglycaemia, hyperlipidaemia, and hyperphenylalaninemia. Supplementation of selenium may improve atherosclerosis, hypercholesterolemia, type 1 diabetes mellitus, and phenylketonuria, but its action remains controversial for type 2 diabetes mellitus.

Literarture indicates the therapeutic potential of selenium supplementation as an antioxidant in the treatment of metabolic disorders. Selenoproteins, in which selenium is present as selenocysteine, present an important role in many body functions, such as antioxidant defense and the formation of thyroid hormones. Some selenoprotein metabolites play a role in cancer prevention. In the immune system, selenium stimulates antibody formation and activity of helper T cells, cytotoxic T cells and Natural Killer (NK) cells. A deficiency can cause reproductive disorders.

Selenium is an essential component of selenoproteins playing an important role in many biological functions, such as antioxidant defense, formation of thyroid hormones, DNA synthesis, fertility and reproduction. Selenium can be converted in the organism into various metabolites. Some, like methylselenol, play a role in cancer prevention. Selenium has also a role, besides vitamin E, in muscle function by improving endurance and recovery and slowing the ageing process.”

Sodium

Sodium maintains the adequate volume in the blood vessels, allows the transmission of the nervous impulse.

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“Sodium is a necessary dietary macromineral that tended to be sparsely distributed in mankind’s environment in the past.

Sodium deficiency triggers the activation of hormonal systems and neural circuits to engage processes that elicit a craving for salty substances and a state of reward when salty foods are consumed. Sodium deficiency also appears to be associated with aversive psychological states including anhedonia, impaired cognition, and fatigue. Hyponatremia is the most common electrolyte disorder encountered in clinical practice, and even mild hyponatremia is associated with cognitive deficits, increased mortality, and increased risk of falls and fractures.

Hyponatremia is especially common in the elderly. Hyponatremia may progress to a chronic disorder.

It is also becoming increasingly apparent that patients with even mild hyponatremia, which was historically thought to be relatively asymptomatic, also have excess mortality compared with patients with normal plasma. It is widely accepted that sodium is an essential nutritional electrolyte and its deficiency is associated with neurological sequelae and poor growth.

Neonates, and especially preterm infants, are at risk of developing total body sodium deficiency, compared with older children. Sodium deficiency is associated with significant morbidity such as poor neurological outcome, cerebral palsy, intracranial hemorrhage, sensorineural hearing loss, and poor growth.”

Vitamin B1 (Thiamine)

Vitamin B1 (Thiamine) is important for growth, development and cellular function in general, and neuronal specifically.

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“The earliest and perhaps best example of an interaction between nutrition and dementia is related to thiamine. Throughout the last century, research showed that thiamine deficiency is associated with neurological problems, including cognitive deficits and encephalopathy. The 2 classical clinical forms of thiamin deficiency are Wernicke-Korsakoff syndrome and beriberi; the latter can be classified as wet beriberi, dry beriberi, and infantile beriberi.
Wernicke-Korsakoff syndrome presents 2 clinical foci: Wernicke’s encephalopathy and Korsakoff’s syndrome, often referred to in conjunction as Wernicke-Korsakoff syndrome.
In adults, thiamin deficiency presents as encephalopathy, dry beriberi (with neurological signs and symptoms), or wet beriberi (with cardiovascular signs and symptoms). Vitamin B1 plays a critical role in energy metabolism and, therefore, in the growth, development, and function of cells. Clinical features of severe vitamin B1 deficiency include cardiovascular and neurologic complications, such as heart failure, neuropathy, ataxia, paralysis, delirium and confusion.”

Vitamin B2 (Riboflavin)

Vitamin B2 (Riboflavin) helps to relieve migraine and in anemia to improve iron absorption.

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“Riboflavin is well tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient’s migraine headache frequency. The role of riboflavin has also been dealt in the prevention of a wide array of health diseases like migraine, anemia, cancer, hyperglycemia, hypertension, diabetes mellitus, and oxidative stress directly or indirectly.
The riboflavin deficiency has profound effect on iron absorption, metabolism of tryptophan, mitochondrial dysfunction, gastrointestinal tract, brain dysfunction, and metabolism of other vitamins as well as is associated with skin disorders. Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system. Riboflavin plays an important role in myelin formation, and its deficiency is implicated as a risk factor for multiple sclerosis. Research to date generally supports the role of riboflavin in MS outcomes. However, further observational and interventional studies on human populations are warranted to validate the effects of riboflavin.”

Vitamin B3 (Niacin)

Vitamin B3 (Niacin) is useful because it helps maintain proper neuronal function.

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A growing quantity of evidence highlights the key role of vitamin B3 in neuronal health. What is emerging is that niacin bioavailability is crucial for neuronsurvival and functions: indeed, vitamin deficiency has been recognized as a pathogenic factor for neurological deficits and dementia, as well as for neuronal injury and psychiatric disorders. Although further research is needed, it may be speculated that optimal dietary intake of the vitamin will support neuronal health and delay neurodegeneration. Niacin deficiency due to excessive alcohol consumption, certain drugs or inadequate uptake in diet causes pellagra, a photosensitivity dermatitis. Severe niacin deficiency presents in humans as the disease pellagra, which is characterized by the “4 Ds” (dermatitis, dementia, diarrhea, and death).

Vitamin B5 (Pantothenic Acid)

Vitamin B5 (Pantothenic Acid) contributes to the structure and function of brain cells and improves wound healing.

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Pantothenic acid improves surgical wounds healing. Its deficiency leads to reduced cortisol production, increased arthritic pain, myalgia, fatigue, headache, depression, insomnia, and widespread “proinflammatory” effects on the immune-system. This vitamin is a substrate for the synthesis of the ubiquitous coenzyme A (CoA). Beyond its role in oxidative metabolism, CoA contributes to the structure and function of brain cells via its involvement in the synthesis of cholesterol, amino acids, phospholipids, and fatty acids. Of particular relevance, pantothenic acid, via CoA, is also involved in the synthesis of multiple neurotransmitters and steroid hormones. The results from this randomized, double-blind, placebo-controlled study indicate that the administration of a pantothenic acid-based dietary supplement in healthy adults with facial acne lesions is safe, well tolerated and reduced total facial lesion count versus placebo after 12 weeks of administration. Secondary analysis shows that the study agent significantly reduced area-specific and inflammatory blemishes. Further randomized, placebo-controlled trials are warranted.

Vitamin B6 (Pyridoxine)

Vitamin B6 (Pyridoxine) intervenes in human immunity and contributes to the normal metabolism of macronutrients.

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Vitamin B6 (pyridoxine) is closely associated with the functions of the nervous, immune and endocrine systems. It also participates in the metabolic processes of proteins, lipids and carbohydrates. Pyridoxine deficiency may result in neurological disorders including convulsions and epileptic encephalopathy and may lead to infant abnormalities. The Intravenous administration of pyridoxine to patients results in a dramatic cessation of seizures. Based on the current limited data, it can be concluded that very low doses of daily pyridoxine are required to prevent peripheral neuropathy. There is inadequate evidence to support routine pyridoxine supplementation in patients with disorders of peripheral nervous system. Supplementation with pyridoxine at doses greater than 50 mg/d for extended duration may be harmful and should be discouraged. For mild symptoms of nausea and emesis of pregnancy, pyridoxine, was associated with greater benefit than placebo. For moderate symptoms, pyridoxine-doxylamine, was associated with greater benefit than placebo.

Vitamin B7 (Biotin)

Vitamin B7 (Biotin) helps treatment to prevent hair loss and seborrheic dermatitis.

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Biotin administration may improve the treatment of hair loss when deficiency is detected on the basis of a careful patient history, clinical examination and the determination of serum biotin levels. The use of biotin is justified in seborrheic dermatitis as the vitamin intercepts the main metabolic pathways underlying the pathogenesis of the disease. Treatment with biotin could also be useful in comedonal acne characterized by a high rate of seborrhea, and may be helpful for acne treated with topical retinoids, contributing to the control of flaking and irritation. Clinical trials have shown an improvement in firmness, hardness, and thickness of brittle nails with oral biotin. There are some case reports and series demonstrating that oral biotin may improve trachyonychia, and habit tic nail deformity. Oral biotin has been used to treat several nail conditions with promising results. Further larger clinical trials with controls are necessary to determine efficacy and optimal dosing. It is well know now that biotin plays important roles in a variety of critical metabolic reactions in the cell, and thus, is essential for normal human health, growth and development. This is underscored by the serious clinical abnormalities that occur in conditions of biotin deficiency, which include, among other things, growth retardation, neurological disorders, and dermatological abnormalities.

Vitamin B9 (Folic Acid)

Vitamin B9 (Folic Acid) is recommended in the prevention of fetal abnormalities in pregnancy and also strengthens the immune system.

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“Daily folic acid supplementation in the periconceptional period can prevent neural tube defects. Neural tube defects are major birth defects of the brain and spine that occur early in pregnancy due to improper closure of the embryonic neural tube, which may lead to a range of disabilities or death. Localization of folate receptor protein isoforms, reduced folate transporter, and proton-coupled folate transporter is normally present in several eye tissues. There is therefore no doubt that our eyes need folic acid and that this is essential for eyes at all ages. This justifies the importance of taking this vitamin in order to have healthy eyes and good vision.

Several studies have demonstrated that FA plays an important role in the prevention of some congenital anomalies such as neural tube defects and spina bifida, congenital heart defects, and orofacial clefts, as well as in chronic diseases in adults, such as cancer, depression, and age-related hearing loss. Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.”

Vitamin C

Vitamin C is a powerful antioxidant and helps improve the immune system.

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Vitamin C is a potent antioxidant and a cofactor for a family of biosynthetic and gene regulatory enzymes. It contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. Vitamin C supports epithelial barrier function against pathogens and promotes the oxidant scavenging activity of the skin, thereby potentially protecting against environmental oxidative stress. Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. Vitamin C deficiency results in impaired immunity and higher susceptibility to infections. Sepsis is a life-threatening medical condition. Vitamin C plays a role in mediating inflammation through antioxidant activities and is also important in the synthesis of cortisol, catecholamines, and vasopressin, which are key mediators in the disease process. Emerging evidence provides cursory data in support of the administration of vitamin C in addition to standard therapy to ameliorate the effects of inflammation and improve hemodynamic stability in patients with sepsis and septic shock; however, further evidence is needed to support this practice. In doses up to 25 g, IV vitamin C can safely be used to treat presumptive ascorbate deficiency based on symptoms and could favourably affect clinical parameters such as inflammation, fatigue, and qol. Using a rational, evidence-based approach, clinicians can safely provide IV vitamin C as supportive care to patients with cancer.

Vitamin D

Vitamin D helps improve intestinal absorption of calcium, improving bone mineralization. It also helps the immune system.

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Vitamin D participates in a significant number of processes in metabolism such as calcium and phosphate absorption in the intestine, the balance of calcium levels, bone mineralization. However, it also plays an important role in other systems and is associated with the presence of various chronic health problems (cancer, dementia, falls and fractures, rheumatic diseases, high blood pressure, depression, among others). Induces the absorption of phosphorus. In fact, the absorption of 80% of phosphorus from nutrition is related to adequate levels of vitamin D. In this way, thanks to vitamin D, an adequate phosphocalcic profile in blood is achieved. This will allow bone mineralization, the main function of vitamin D Recent studies have been focusing on vitamin D deficiency as a risk factor for the development of dementia and alterations in cognitive functions.

Vitamin E

Vitamin E is a powerful antioxidant with anti-inflammatory properties. It is also used in cancer treatments and cardiovascular diseases.

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Vitamin E is potent antioxidants, capable of neutralizing free radicals directly by donating hydrogen from its chromanol ring. α-Tocopherol is regarded the dominant form in vitamin E as the α-tocopherol transfer protein in the liver binds mainly α-tocopherol, thus preventing its degradation. Nevertheless, tocotrienols have been shown to possess superior antioxidant and anti-inflammatory properties over α-tocopherol. Aside from cancer, vitamin E has also been shown protective in bone, cardiovascular, eye, nephrological and neurological diseases. The function of vitamin E has been traditionally ascribed to the nutrient’s antioxidant activity. This notion is based on vast literature that documents tocopherol’s efficacy in neutralizing unstable lipid peroxy-radicals generated from polyunsaturated fatty acids. Recent studies implicate abnormal vitamin E status in multiple disorders of the central nervous system, including those that impair memory, learning, and emotive responses. Current literature suggests that vitamin E with their antioxidant and anti-inflammatory capabilities may mitigate age-associated skeletal dysfunction and enhance muscle regeneration, thus attenuating sarcopenia. Limited number of human cross-sectional observational studies reveal positive associations between serum tocopherol level and muscle strength. Several factors (difficulties in validating vitamin E intake and deficiency, variations in muscle-protective activity and metabolism of diverse forms of vitamin E, and lack of understanding of the mechanisms of action) preclude randomized clinical trials of vitamin E in people with sarcopenia.

Vitamin K

Vitamin K is very helpful in maintaining a functioning clotting system.

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Vitamin K, a fat soluble vitamin, is a necessary cofactor for the activation of coagulation factors II, VII, IX, X, and protein C and S. In neonatal period, vitamin K deficiency may lead to Vitamin K Deficiency Bleeding. The commonly used dosage of vitamin K2 in human studies is 45 mg/day and its application can be an interesting strategy in benefitting bone and vascular health, especially to osteoporotic post-menopausal women. Vitamin K2 in the form of MK-7 has been shown to be a bioactive compound in regulating osteoporosis, atherosclerosis, cancer and inflammatory diseases without risk of negative side effects or overdosing.

Iodine

Iodine is essential for the synthesis of thyroid hormones that are essential for life.

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“Iodine deficiency in early life impairs cognition and growth, but iodine status is also a key determinant of thyroid disorders in adults. Severe iodine deficiency causes goitre and hypothyroidism because, despite an increase in thyroid activity to maximise iodine uptake and recycling in this setting, iodine concentrations are still too low to enable production of thyroid hormone. In mild-to-moderate iodine deficiency, increased thyroid activity can compensate for low iodine intake and maintain euthyroidism in most individuals, but at a price: chronic thyroid stimulation results in an increase in the prevalence of toxic nodular goitre and hyperthyroidism in populations. Health consequences of iodine deficiency:

• All ages: goitre including toxic nodular goitre; increased occurrence of hypothyroidism in moderate-to-severe iodine defi ciency; reduced occurrence of hypothyroidism in mild-to-moderate iodine defi ciency; enhanced susceptibility of the thyroid gland to nuclear radiation.
• Fetus: abortion, stillbirth, congenital anomalies, perinatal mortality
• Neonate: infant mortality; endemic cretinism.
• Child and adolescent: impaired mental function; delayed physical development.
• Adults: impaired mental function. Iodine deficiency during pregnancy is an important global public health issue and the leading preventable cause of neurodevelopmental impairments worldwide. The effects of severe iodine deficiency during pregnancy, including adverse obstetric outcomes and decreased child intelligence quotient, have been clearly established.

Pregnant and lactating women have higher iodine requirements than other adults; intakes of 220 to 250 µg/d in pregnancy and 250 to 290 µg/d in lactation.

Importantly studies have established the safety of iodine supplementation in reasonable doses. Iodine supplementation is recommended for pregnant, lactating and preconception women in regions where mild-to-moderate iodine deficiency persists. “

Zinc

Zinc helps repair the skin, participates in immune function and acts as an antioxidant.

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“The essential trace element zinc plays a key role in the development, differentiation and growth of various human tissues.

Disturbances in zinc metabolism may give rise to disorders that typically manifest themselves on the skin.

Oral zinc replacement therapy frequently leads to clinical remission within a few days.

Various reports of cases with different etiologies describe similar cutaneous manifestations of acquired zinc deficiency. Acquired zinc deficiency too predominantly presents with well-delineated, erythematous, sometimes scaly and crusted plaques and erosions. Similar to hereditary zinc deficiency, the typical lesions primarily occur in acral and periorificial areas as well as intertriginous regions. Other concurrent findings commonly seen include hair loss or alopecia, paronychia, glossitis or cheilitis. Zinc is a cofactor for many metalloenzymes required for cell membrane repair, cell proliferation, growth and immune system function. The pathological effects of zinc deficiency include the occurrence of skin lesions, growth retardation, impaired immune function and compromised would healing.

Zinc is a micronutrient that is essential to human health. Zinc plays a major role in regulating every phase of the wound healing process; ranging from membrane repair, oxidative stress, coagulation, inflammation and immune defence, tissue re-epithelialization, angiogenesis, to fibrosis/scar formation. Several human disorders accompanied with skin manifestations are caused by mutations or dysregulation in Zn transporters; acrodermatitis enteropathica, the spondylocheiro dysplastic form of Ehlers-Danlos syndrome, transient neonatal Zn deficiency, and epidermodysplasia verruciformis. Additionally, acquired Zn deficiency is deeply involved in the development of some diseases related to nutritional deficiencies (acquired acrodermatitis enteropathica, necrolytic migratory erythema, pellagra, and biotin deficiency), alopecia, and delayed wound healing.”