Education Series - JASE Medical

Interesting Facts About Vitamin A

When we think of food sources of vitamin A and what it does for the body we think of carrots and better vision. While this is true, there are some interesting and often overlooked facts about vitamin A.

What is vitamin A?

Vitamin A is a fat-soluble vitamin that is stored in the liver for up to 4 years. It is a subclass of retinoic acids, a family of lipid soluble compounds that includes retinols, beta carotenes and other carotenoids.

  • The active form of vitamin A is called preformed retinol It is found in fish, organ meats, dairy products, egg yolks and some fortified foods.
  • Provitamin A carotenoids are precursors to vitamin A. Foods containing carotenoids are converted through an enzymatic process into vitamin A. Carotenoids are a class of  compounds yellow, orange, or red fat-soluble pigments, including carotene, which give color to plant parts such as ripe tomatoes and autumn leaves: There are more than 600 known carotenoids. Carotenoids are found in fruits, vegetables and some fish, such as in the pink color of salmon. It is also found in supplement form. One such carotenoid is beta-carotene.
  • Beta-carotene converts to vitamin A and is an antioxidant. Antioxidants are manmade or natural substances that protect cells from damage caused by substances called free radicals. It is converted to retinol in the wall of the small intestine.

Function of vitamin A

Vitamin A plays many important roles in health. 

Preformed vitamin A – retinol is important for vision, especially night vision, anti inflammatory, enhances immune system function, important for developing fetal endothelial cell proliferation, produces pigments in retina, maintains healthy teeth, skeletal and soft tissue. In food form can be protective against some forms of cancer. 

Vitamin A deficiency- 

Vitamin A deficiency is considered to be rare except in premature infants, malnourished areas of the world, gastrointestinal disorders such as celiac, pancreatic insufficiency, bile duct disorder and those who cannot convert beta carotene to active vitamin A due to a BCMO1 gene variation– which results in a poor conversion from beta carotene to vitamin A. (It is estimated that approximately 45 percent of the population may have this conversion defect.

Symptoms of vitamin A deficiency:

Vitamin A toxicity

Most toxicity isa result of supplementation and not food sources. 

Symptoms of vitamin A toxicity:

  • drowsiness
  • irritability
  • abdominal pain
  • nausea
  • vomiting
  • increased pressure on the brain

Supplementation 

Seek advice of a qualified health professional before supplementing vitamin A or beta- carotene. Vitamin A is stored in the liver for up to four years so there is little chance of being deficient unless you have a pre existing condition that impairs vitamin A absorption or genetic impairment.  

In addition, a large scale study called the ATBC study— over 29,000 smokers who supplemented with beta carotene (the precursor to vitamin A) was stopped abruptly because of the high incidence of lung cancer that developed during the study.  The researchers concluded that all smokers should not use beta carotene supplements due to this increased risk of lung cancer. 

Measles management in children

Excerpt from Infectious Diseases in Clinical Practice:

“In November 2019, the National Foundation for Infectious Diseases convened a summit that included multidisciplinary subject matter experts from across the United States to discuss the use of vitamin A in US measles management. The resulting Summit recommendations include that all children in the United States presenting with measles should receive an age-appropriate dose of vitamin A as part of a comprehensive measles management protocol. Multiple studies in populations in which vitamin A deficiency is prevalent have shown that this simple, quick means of improving vitamin A status can dramatically reduce the risk of serious complications and death from measles, with minimal detectable incidence of adverse effects.”

- Brooke Lounsbury, RN

Medical Content Writer

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Vitamin D

Vitamin D is a steroid hormone, and sometimes called “activated vitamin D” or “calcitriol.” Steroid hormones are derived from cholesterol and are lipid-soluble molecules. Examples of steroid hormones include the sex hormones (androgens, estrogens, and progesterone) produced by male and female gonads and hormones of the adrenal glands (aldosterone, cortisol, and androgens). It is a fat-soluble vitamin that helps the body absorb and retain calcium and phosphorus. Both are necessary for building bone. Vitamin D also plays a role in bolstering the immune system to fight off viruses and bacteria. In addition, research suggests that vitamin D could play a role in downregulating autoimmune disease. In addition a randomized 5 year clinic trial of high vitamin D supplementation reduced the incidence of advanced cancer without a diagnosis of cancer at the beginning of the study. Much interest and research is ongoing in this promising field of study.

Vitamin D is found in two main forms:

Vitamin D2 (ergocalciferol) – The main source is from plants. Mushrooms, when exposed to UV light produce D2. Fortified cereals are usually fortified with vitamin D2

 

Vitamin D3 (cholecalciferol) – The main source is from animals- Sources of D3 are egg yolks, cod liver oil, fatty fish-salmon, sardines, herring, tuna, beef liver. In addition, when skin is exposed to sunlight vitamin D3 is produced. The body only produces enough vitamin D3 from sunlight as it needs then stops producing it.

The liver metabolizes vitamin D2 and vitamin D3 and form the active compound known as calcifediol. A study done by the National Institute of Health on post-menopausal vitamin D deficient women showed that vitamin D3 yielded twice more calcifediol than an equal amount of vitamin D2.

Excess Vitamin D3 is stored in the bodies adipose tissue and liver and is converted by the kidneys to the active form of vitamin. Excess vitamin D is almost exclusively from supplement sources.

According the NIH:

The amount of vitamin D you need each day depends on your age. Average daily recommended amounts are listed below in micrograms (mcg) and International Units (IU):

Life Stage Recommended Amount
Birth to 12 months 10 mcg (400 IU)
Children 1–13 years 15 mcg (600 IU)
Teens 14–18 years 15 mcg (600 IU)
Adults 19–70 years 15 mcg (600 IU)
Adults 71 years and older 20 mcg (800 IU)
Pregnant and breastfeeding teens and women

15 mcg (600 IU)

 

The 25-hydroxy vitamin D test (a blood test) is the most accurate way to measure how much vitamin D is in your body.

Factors affecting vitamin D deficiency

  • Older adults skin doesn’t absorb vitamin D as well as younger population. Dark skin also doesn’t absorb vitamin D very well either
  • Some diseases- celiac, Crohn’s disease, ulcerative colitits, limit absorption of fats and vitamin D
  • Obesity and gastric bypass may need more vitamin D

Signs of vitamin D deficiency- up to 42 percent of the US population is deficient

  • Rickets in children
  • Osteomalacia in adults
  • Not sleeping well.
  • Bone pain or achiness.
  • Depression or feelings of sadness.
  • Hair loss.
  • Muscle weakness.
  • Lowered immunity to infections-viral and bacterial

Signs of vitamin D toxicity

Vitamin D toxicity is not common, except when extremely high doses of vitamin D is taken in supplement form for a long time (months).

  • Hypercalcemia
  • Nausea, vomiting
  • Can progress to bone pain and kidney stones

How to Improve Your Vitamin D Status

In addition to adequate sunlight exposure, vitamin D requires other nutrients and minerals to work properly. It is always best to get your nutrition from food sources, however long winters and low sunlight may require supplementation. If supplementing with vitamin D, it is best to take with fat since it is a fat-soluble vitamin.

Vitamin K2(MK-7)- activates osteocalcin, which integrates calcium into the bone. Activates matrix GLA protein (MGP) to bind excess calcium and promote arterial flow and flexibility. Food sources include fermented foods, natto

Magnesium- helps convert vitamin D to active form. Food sources include leafy greens, beans, legumes, almonds, cashews

Zinc– synergistic effect- vitamin D enhances zinc action and homeostasis and zinc enhances vitamin D absorption. Food sources include oysers, red meat, poultry

Boron– increases vitamin D in the blood. Food sources include coffee, milk, apples, dried and cooked beans, and potatoes

Cold water fish– salmon, herring, sardines, tuna

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Vitamin K1 and K2, They Are the Same, Right?

There is confusion surrounding vitamin K. We know vitamin K as the clotting vitamin, found in large amounts in leafy green vegetables. When someone is on blood thinners they are usually cautioned about their intake of greens and how it can interfere with the effectiveness of the medication. But did you know there is a vitamin K1 and K2?

There are two forms of vitamin K, K1 and K2

Vitamin K is the generic name for a family of similar compounds that are fat soluble, are found in food and are also found in supplement form. These compounds include phylloquinone (vitamin K1) and a series of menaquinones also known as MKs (vitamin K2). Vitamin K2 can be divided into subtypes: short-chain (i.e., menaquinone-4; MK-4- most bioavailable) and long-chain (MK-7, MK-8, and MK-9)

Vitamin K1 is found in spinach, cabbage, and kale. K1 can also be found in fruits like avocado, kiwi and grapes. Absorption of K1 is increased when eaten with fat, such as butter or oils.

Vitamin k2 is found in fermented food (sauerkraut and vegetables), meat, and dairy. Other sources of K2 are chicken meat, egg yolks, beef and salmon. K2 is synthesized by bacteria, and a small amount is produced by the bacteria in the gut. Absorption is also increased when eaten with fats such as butter or oils.

Vitamin K1 is retained in the liver, where it assists with and works with other compounds to manufacture the body’s clotting factors. In contrast, vitamin K2, particularly long chain derivatives, are redistributed to the circulation and are available for other tissues, such as bone and vascular system.

Health benefits of both vitamin K1 and K2

Both vitamin K1 and K2 are vital to health. They work in drastically different ways and on different parts of the body. About 10-15% of vitamin K1 is absorbed by the body compared to 50% of vitamin K2. The Standard American Diet (SAD) intake of vitamin K1 is higher than K2.

Vitamin k1 health benefits

  • Assists with bleeding and bruising regulation in the body
  • Acts as an anti-inflammatory and protects against oxidative stress
  • Is a cofactor to make prothrombin ( clotting factors)
  • Precursor to K2
  • Bone health

Vitamin K2 health benefits

Factors that prevent absorption of vitamin K absorption

  • Health problems that can prevent your body from absorbing vitamin K, such as gallbladder or biliary disease, cystic fibrosis, celiac disease, and Crohn’s disease
  • Liver disease
  • Taking blood thinners, such as warfarin (Coumadin)
  • Long-term hemodialysis
  • Serious burns
  • Consumption of trans fats (k2 absorption)
  • Broad spectrum antibiotic use (k2 absorption)
  • Dilantin
  • Fat blocking medications such as Orlistat

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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“Normal” Won’t be Returning Anytime Soon

5 Steps to Help You Navigate These Challenging Times

You are not alone. We are all feeling tensions both globally and at home. We are on the precipice of World War 3, out of control energy and food prices, still reeling from the pandemic, layoffs, consumer debt hitting record highs, severe weather extremes, supply chains disrupted leading to drug and medical supply shortages- these are affecting all our lives. No one is immune to this assault.

To overcome and eventually prosper in this ever changing landscape, we must be solution oriented. Difficult times are here, and it doesn’t look like our “normal” will be returning anytime soon. Our families, communities and our very lives depend on how we face the challenges we are experiencing and will be experiencing over the coming months and years.

Below are 5 steps to guide you through these rocky times. 

  1. Focus on solutions
  • “We become what we think about” Earl Nightingale
  • “When you focus on problems, you get more problems. When you focus on possibilities, you have more opportunities.” Zig Ziglar
  • “Good health is true wealth.” – Urijah Faber “

What challenges are you and your family facing right now? Financial? Health related? Whatever the challenge is there is a solution. We need to acknowledge our problems, shortcomings and unexpected turns our lives take. Absorb and realize the impact these have in our daily living. However it isn’t healthy for you or anyone around us to dwell too long in this. Focus on possibilities. This will lead to opportunities.

2. Plan success = Reduce stress

Solutions start with a realistic plan 

Take time out, away from the noise of media, work, and technology each week. Set priorities to work on during the week. Start each day reviewing this list, set aside time for tasks that take precedent over others. Review your plan and goals. Make sure they are realistic and allow enough time to implement them. What can you do NOW that can make your day run smoother and more efficiently? Prioritize your days tasks; work towards accomplishing them. Move undone tasks to the next day. And so on.

Download our Goal Setting PDF to help you make and track your goals!

Finances-a major stressor

The out-of-control gas, energy and food prices have caught many off guard. You are not alone.

Financial Stress Has a Surprising Link to People’s Health, Relationships, Sleep, and More according to a white paper by Thriving Wallet, Discover and Thrive Global. Their survey included 3,000 adults. 90 percent stated that finances played a major part in wellbeing and stress levels. 

U.S. credit card debt jumps 18.5% and hits a record $930.6 billion 

If you are experiencing financial struggles, there are agencies that can help you budget and plan your finances. Consumer Review lists the top 7 financial consolidation companies. They work with you to consolidate and work with companies you owe money to. Some offer financial coaching and budget planning and clasess on financial education.  

Health

If you are having difficulty affording your prescription drugs, paying for insurance and copays, office visits, etc check with your local care provider and county health and welfare offices for any programs you may qualify for. 

Physical health-If you are out of shape, work on an exercise and diet program with your healthcare provider. Many chronic health conditions respond positively to lifestyle and food choices. Reduce or eliminate alcohol. Alcohol has empty calories and is a depressant.  In some cases, lifestyle changes can reduce or eliminate the need for prescription drugs. 

 Check out online exercise classes- You Tube has many classes geared for beginner to advanced levels. These are free, easily accessed and can be done around your schedule. Plan meals. Restaurant food is convenient but expensive and in many cases not as good tasting or nutritious as a home cooked meal. Make a meal plan and grocery list and don’t shop when hungry. 

Emotional health– If you are experiencing anxiety, are depressed, or feeling stressed talk your healthcare provider. Find meaningful work, volunteer, or take up a hobby. Plan a coffee date with a friend. We are wired for connection. Deep breathing exercises along with mediation or prayer can have profound effects on our health. 

Be prepared for minor emergencies

Urgent care visits may or may not be entirely covered by your health insurance. Depending on deductible you may have to pay out of pocket for the visit. As of this writing, the cost of an urgent care visit, without tests or treatments is a minimum of 75 dollars. Having basic knowledge and supplies for minor emergencies can reduce cost, exposure to diseases, travel time and cost(gas). Enroll in a basic first aid and cpr class if you aren’t medically trained. Keep an updated list of medications, medical conditions and allergies for all members of the family readily available. Look into telehealth visits for minor emergencies. Keep your medical supply kit stocked. In addition, a Jase case , contains antibiotics that cover a wide variety of infections, along with a consultation with a doctor if you have questions. This alone can keep you or your loved one out of the doctor’s office and on the road to recovery.

3. Implement plan- the most important step

A well thought out plan will free up time in your day to reach your goals. Taking charge of your finances will reduce stress and free up cash for necessities. Health is wealth, don’t neglect your health! Carve out time each day to put your plan in place. Stick to the plan, revise as necessary. The most important part is consistency.

4. Assess plan-weekly

Set aside time for assessing your plan. Did you reach your goals? If not, why? What barriers did you encounter? What went well? Were you able to free up time in your day for exercise or hobby? Assess your plan at least once a week will help you tweak and improve your plan and reach your goals.

5. Adjust and revise as necessary- or the only thing consistent in life is change

Plans are not meant to be set in stone. What worked well one day or week may not work at all for the following week. Schedules change- planned and unplanned events and life-come and go. If you get off track, jump back in. You will reach your goals!

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Caring for Wounds – The Right Way

There have been many misconceptions and wives tales when it comes to how to properly care for a wound. One of the more dangerous is spreading butter or other grease on a burn to relieve the pain. In reality, any type of grease can cause more harm by trapping heat, suffocating the tissue and trapping any harmful bacteria against the burn. Another is pouring alcohol or peroxide directly into an open wound to cleanse it. Again, this practice causes further destruction of the tissue, and delays the healing process.

How to care for an open wound

To begin with, assess the wound. What type of wound is it- A puncture wound? A slice caused by a sharp object such as a knife or outdoor equipment? Is it a jagged, irregular wound such as a chainsaw injury, where a lot of debris is in the wound? A scraped knee with gravel embedded?

All wounds are a break in the integrity of the skin, the largest organ in your body. It is the first line of defense between you and the outside world. Once that defense has been breached, how you care for it will determine the outcome of the healing process.

Steps to care for a wound

Once you have assessed what type of wound you are dealing with take the following steps

  1. Stop or control bleeding if excessive or not well controlled. A little bleeding helps clear out invading pathogens and debris.
  2. Remove any obvious debris, gravel or other objects from the wound. Use tweezers, or manually pick out debris. Flush out with plain water. Tap water is fine.
  3. Continue to flood the wound with water, further cleansing the area. Be sure to clean and rinse around and away from the wound. This will prevent bacteria from entering the wound. Rinse with copious amounts of water. If you have access to a syringe or any way to deliver water under pressure, use it. This will help flush out any debris, bacteria or other matter that may not be visible to the naked eye. DO NOT use rubbing alcohol or hydrogen directly in the wound. This can cause further destruction to the skin integrity and delay the healing process.
  4. Once all debris has been removed, and area adequately flooded and flushed with water, pat dry with clean gauze if you have it. If not, a clean, free of lint piece of cloth will do.
  5. Cover with dressing. Do not use specialized dressings, ointments or creams unless instructed by your care provider. Products such as Neosporin do not prevent cellulitis. In fact, there is some evidence emerging that use of Neosporin or similar products may slow the healing process.
  6. If the wound is caused by an animal or human bite, seek medical attention as soon as possible. The mouth is full of pathogenic bacteria, and a prophylactic antibiotic may be necessary to prevent a systemic infection or cellulitis. This also goes for wounds that have been exposed to contamination and couldn’t be properly cleaned, puncture wounds and other wounds that you were unable to effectively clean.
  7. Change dressing daily. There will be some clear or even discolored exudate- this is normal, your body is healing itself. However, if the wound smells, or is swollen, the surrounding skin is hot or red to the touch, any red lines traveling from the wound outward, excessive drainage (cloudy, yellow or grey) seek medical attention. Also seek medical attention if fever over 100.4 (see below-signs a wound needs an antibiotic)
  8. If any of the above complications arise and you are unable to get to the doctor, there are two antibiotics in the Jase case that are effective in most cases of infected wounds or wounds that have a high likelihood of infection– One is amoxicillin clavulanate and the other one is doxycycline. The Jase case includes a booklet to help you identify when an antibiotic may be necessary. This is especially helpful when unable to seek medical care or medical care isn’t available.

How to tell if a wound requires an antibiotic

In many cases a wound will heal nicely on its own. The body is equipped with an amazing ability to heal itself. There are some instances, however when an antibiotic may be necessary, either to prevent infection in high-risk wounds or to treat active infections

Signs a wound needs an antibiotic

  • The wound is red, swollen and hot to the touch
  • The wound is substantially more painful than the initial injury
  • Excessive drainage – foul smelling, yellow and/or grey
  • Chills or fever over 100.4
  • Red streak spreading from the wound

Antibiotics needed prophylactically

  • Diabetic, heart valve disease or immune compromised- all are at high risk for infection
  • Puncture type wounds from animal bites-cats, some rodents, etc. or human bites- These bites contain bacteria that is almost impossible to thoroughly clean with pressurized water.
  • Other types of puncture wounds- nails, fencing, needles, garden tools and implements
  • Contaminated wounds-wounds exposed to manure, feces, swampy or bad water
  • Open fractures where bone breaks through the skin

- Shawn Rowland, MD

CEO & Founder of Jase Medical

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.