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Vitamin A Deficiency

Mango Salad.
Mango Salad.

What Is Vitamin A?

[dropcap]V[/dropcap]itamin A is a family of fat-soluble compounds that are essential for health, vision, protection of the body, reproduction, and normal growth of children before and after birth.

Q: What is the family of vitamin A?

A: The natural vitamin A family members are called retinoids. Retinoids are found only in animal food sources. They include retinol (alcohol form), retinal (aldehyde form), and retinoic acid (acid form).

In the plant kingdom, pigments called carotenoids can yield retinoids on metabolism in the body. Carotenoids that can converted to retinol include β-carotene, α-carotene, and β-cryptoxanthin.1

There are hundreds of various carotenoids although only a few have been researched including beta-carotene, lycopene, lutein and zeaxanthin.

Fruits and vegetables that are a rich source of carotenoids are thought to provide health benefits by decreasing the risk of various diseases, particularly eye diseases and certain cancers (esophageal, stomach, pancreatic, bladder and cervical). In this respect, research shows that the regular consumption of fruits and vegetables may prevent 20% of most types of cancers.2

In part, the beneficial effects of carotenoids are thought to be due to their role as antioxidants. Lutein and zeaxanthin may be protective in eye disease because they absorb damaging blue light that enters the eye.3

The antioxidant effects appear to be highest in fresh fruit as compared to preserved fruit. A study of fresh peach pulps and peel in animals demonstrated highest antioxidant and anti-inflammatory effects in fresh fruits preventing against induced damage in animal tissues.4

A study investigating the specific anti-inflammatory and anti-oxidant micronutrients that reduce oxidative stress showed that adolescents with metabolic syndrome (MetS) had consistently lower carotenoid concentrations compared with their counterparts without MetS. MetS prevalence was estimated at 7% among boys and 3% among girls.5

What Is Vitamin A Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Maggio M, de Vita F, Lauretani F, et al. Relationship between Carotenoids, Retinol, and Estradiol Levels in Older Women. Nutrients. 2015 Aug 5;7(8):6506-19. doi: 10.3390/nu7085296. [↩]
  2. Gasparotto J, Somensi N, Bortolin RC, Moresco KS, Girardi CS, Klafke K, Rabelo TK, Morrone Mda S, Vizzotto M, Raseira Mdo C, Moreira JC, Gelain DP. Effects of different products of peach (Prunus persica L. Batsch) from a variety developed in southern Brazil on oxidative stress and inflammatory parameters in vitro and ex vivo. J Clin Biochem Nutr. 2014 Sep;55(2):110-9. doi: 10.3164/jcbn.13-97. Epub 2014 Sep 1. [↩]
  3. Krinsky NI1, Johnson EJ. Carotenoid actions and their relation to health and disease. ((Mol Aspects Med. 2005 Dec;26(6):459-516. [↩]
  4. Gasparotto J, Somensi N, Bortolin RC, Moresco KS, Girardi CS, Klafke K, Rabelo TK, Morrone Mda S, Vizzotto M, Raseira Mdo C, Moreira JC, Gelain DP. Effects of different products of peach (Prunus persica L. Batsch) from a variety developed in southern Brazil on oxidative stress and inflammatory parameters in vitro and ex vivo. J Clin Biochem Nutr. 2014 Sep;55(2):110-9. doi: 10.3164/jcbn.13-97. [↩]
  5. TGBeydoun MA, Canas JA, Beydoun HA, Chen X, Shroff MR, Zonderman AB. Serum antioxidant concentrations and metabolic syndrome are associated among U.S. adolescents in recent national surveys. J Nutr. 2012 Sep;142(9):1693-704. doi: 10.3945/jn.112.160416. [↩]

Xerophthalmia

Parathyroid gland anatomyWhat Is Idiopathic Hypoparathyroidism?

[dropcap]I diopathic hypoparathyroidism is a metabolic condition that results from reduced secretion or impaired action of parathyroid hormone (PTH) which results in a combination of low calcium and elevated phosphorus levels in the body.

Calcium and phosphorus are minerals that act in opposition to each other in the body. Idiopathic means the cause is not known.

Parathyroid hormone is produced by the four pea sized parathyroid glands that are located on the thyroid gland in the front of the neck. Partly because the thyroid and parathyroid glands share the same anatomic place in the body and partly because they have similar names, they are often confused although they have completely different actions.

Q: What does parathyroid hormone do in the body?

A: This vital hormone maintains a correct balance of calcium and phosphorous in the bloodstream and ultimately has an effect on all organs because of the complexity of intracellular calcium physiology.1 

Parathyroid hormone is required to sustain life, therefore undetected or misdiagnosed hypoparathyroidism may pose a significant threat to health outcomes, as its presence may increase disease and mortality in affected individuals.

The clinical consequences of parathyroid hormone deficiency or impaired receptor action involve many body functions. In some patients, however, its manifestation may be non-specific, and in these cases the correct diagnosis may be easily missed.

Digestive manifestations of hypoparathyroidism are few and consist mainly of steatorrhea due to insufficient meal-stimulated cholecystokinin secretion by the duodenal mucosa.2

Laboratory measurements show hypocalcemia (low blood calcium level), hyperphosphatemia (high blood phosphate level), and inappropriately low or undetectable parathyroid hormone levels. Treatment consists of oral calcium supplementation and vitamin D derivatives.3

Idiopathic hypoparathyroidism is rare, although there is a growing incidence of the autoimmune form of hypoparathyroidism, which may occur in combination with other autoimmune diseases such as celiac disease.

What Is Idiopathic Hypoparathyroidism In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Abboud B, Daher R, Boujaoude J. Digestive manifestations of parathyroid disorders. World J Gastroenterol. 2011 Sep 28;17(36):4063-6. doi: 10.3748/wjg.v17.i36.4063. [↩]
  2. Abboud B, Daher R, Boujaoude J. Digestive manifestations of parathyroid disorders. World J Gastroenterol. 2011 Sep 28;17(36):4063-6. doi: 10.3748/wjg.v17.i36.4063. [↩]
  3. Krysiak R, Handzlik-Orlik G, Kedzia A, Machnik G, Okopień B. Hypoparathyroidism: the present state of art. Wiad Lek. 2013;66(1):18-29. [↩]

Keratomalacia

Image From Gray's Anatomy. Courtesy Wikipedia.org
Image  of Pancreas From Gray’s Anatomy. Courtesy Wikipedia.org

What Is Pancreatic Insufficiency?

[dropcap]P ancreatic insufficiency is a disorder characterized by insufficient exocrine production of pancreatic enzymes for normal digestion of fats, proteins, and carbohydrates that results in maldigestion of these foodstuffs.

Pancreatic insufficiency also causes malabsorption of the fat-soluble vitamins: vitamin A, vitamin D, vitamin E, and vitamin K.

Q: What are the exocrine enzymes produced by the pancreas?

A: Exocrine enzymes produced by the pancreas include amylase for the digestion of carbohydrates, lipase for the digestion of fats, and protease for the digestion of proteins.

While lipases and amylase are secreted in the active form, proteases are secreted as pro-enzymes (need to be activated). Trypsinogen is converted to its active form trypsin in the duodenum by enterokinase, a protease secreted by the enterocytes (surface cells that line the duodenum), and trypsin in turn activates the other pancreatic proteases.1

Pancreatic enzymes are released by the pancreas into the internal pancreatic duct that empties into the common bile duct from which they are pumped through the Sphincter of Odi directly into the duodenum as needed. Tthe Sphincter of Odi is a strong circular muscle that controls the entrance of pancreatic enzymes into the duodenum.

After a meal, enzyme secretion into the duodenum increases quickly reaching peak output within the first 20 to 60 minutes, then decreasing to a stable level before reaching an interdigestive level at the end of the digestive period, that is, about 4 hours after meal intake.2

Medical treatment is with medication that contains enzymes to break down carbohydrates, fats, and protein in food at mealtime. This treatment is safe, effective, and has few side effects.

What Is Pancreatic Insufficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73. doi: 10.2147/CEG.S17634. [↩]
  2. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73. doi: 10.2147/CEG.S17634. [↩]