beta-carotene and Vitamin-K-Deficiency

Routine vitamin supplementation for the elderly has been advocated by many. Specific vitamin deficiencies are rare in free-living elderly, but are not uncommonly encountered in hospitalized and institutionalized patients. Deficiency may result from interactions with medications or overall poor dietary intake. Low blood or plasma vitamin concentration is not necessarily indicative of a deficient state. Specific vitamin supplements are useful in the treatment and prevention of a deficient state. However, there is little, if any benefit from supplementation for reasons other than replacement therapy. The incidence and clinical symptoms of thiamine (vitamin B1), riboflavin (B2), pyridoxine (vitamin B6), vitamin B12, C, D, folate, niacin, vitamin A, E, beta carotene, and K deficiency and their treatment and prevention in the elderly are discussed.

Topics: Aged; Ascorbic Acid Deficiency; beta Carotene; Folic Acid Deficiency; Humans; Niacin; Riboflavin Deficiency; Thiamine Deficiency; Vitamin A Deficiency; Vitamin B 12 Deficiency; Vitamin B 6 Deficiency; Vitamin D; Vitamin E Deficiency; Vitamin K Deficiency; Vitamins

Plasma vitamin K concentrations and prothrombin coagulation activity were determined in 26 normal adults who had received daily beta-carotene supplementation (0, 15, 30, or 60 mg) for six months. Neither plasma vitamin K nor coagulation activity were significantly decreased at any supplementation level. Thus, chronic beta-carotene supplementation, even at high daily doses, is not expected to result in clinical vitamin K deficiency. The data suggest separate mechanisms for intestinal absorption of beta-carotene and vitamin K.

Topics: Aged; beta Carotene; Carotenoids; Clinical Trials as Topic; Diet; Double-Blind Method; Drug Administration Schedule; Female; Humans; Intestinal Absorption; Male; Middle Aged; Prothrombin Time; Vitamin K; Vitamin K Deficiency

Patients with extensive small-bowel resection may experience malabsorption and nutrient deficiencies. We evaluated the ability to absorb fat and fat-soluble vitamins in a short-gut patient. For 18 wk after stopping intravenous lipid, while consuming a low-lactose, low-fat diet, he exhibited no clinical manifestations of essential fatty acid deficiency (EFAD). Serum 20:4n-6 (20:4 omega-6) and 18:2n-6 fatty acid concentrations were normal, whereas the concentration of 20:3n-9 remained less than or equal to 0.1% of total serum fatty acids. Although serum vitamin A was normal, beta-carotene was undetectable despite oral supplementation. Prothrombin time was elevated until parenteral vitamin K was given. This patient has fat absorption adequate to prevent EFAD but inadequate absorption of fat-soluble vitamins. In patients with short bowel, the requirements for parenteral lipids and fat-soluble vitamins should be determined independently.

Topics: Absorption; Adult; Avitaminosis; beta Carotene; Carotenoids; Fats; Fatty Acids, Essential; Humans; Infusions, Parenteral; Lipids; Male; Prothrombin Time; Short Bowel Syndrome; Solubility; Vitamin K; Vitamin K Deficiency