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Latest pharmaconutrition posts
The Sodium Vitamin C Transporters (SVCTs) regulate vitamin C homeostasis (system stability) such that excessive intakes result in reduced intestinal absorption and renal reabsorption, and inadequate intakes result in increased intestinal absorption and renal reabsorption.The SVCT1/2 substrate is the reduced form of vitamin C/ascorbic acid ie ascorbate.There are 3 identified SVCTs, being –SVCT1 SVCT1 is responsible …
Multi drug and toxin exclusion transporters (MATE1) and (MATE2) are major efflux transporters involved in the hepatic and renal excretion of many cationic endogenous and xenobiotic substances. As efflux transporters they primarily move lipophobic substances -out of the liver ie hepatic biliary excretion – MATE1,out of the kidneys and into urine ie renal excretion – …
Breast Cancer Resistance Protein (BCRP) seems to be an initial defence against environmental insults such as phototoxic skin lesions, and xenobiotic absorption, and seems to prefer to excrete toxic substances via the biliary pathway. BCRP overlaps with P-glycoprotein (aka P-gp, or MDR1) and to a lesser extent with MRP1 (Multi Resistance Protein) – whether there …
The thiamine transporters Thiamine Transporter 1 (THTR1) and Thiamine Transporter 2 (THTR2) transfer thiamine and pyridoxine, and are associated with two transfer systems, being -THTR1 – the nutrient concentration is low and therefore uptake requires energy,THTR2 – the nutrient concentration is high (thiamine > 2 mmol/L), and therefore uptake involves passive nutrient diffusion.THTR1 and THTR2 …
Sodium Multivitamin Transporter (SMVT) facilitates the uptake of biotin, pantothenic acid, lipoic acid, and iodine from the gut and across the Blood Brain Barrier. SMVT is the only currently known intestinal biotin transporter. SMVT is present in the small and large intestines, liver, kidney, heart, lungs, brain, cornea, retina, and placenta tissues.As a consequence of …
The organic cation transporters regulate the transfer of many essential organic cations across biological membranes and therefore have an essential role in many metabolic processes.OCTs are known as being polyspecific transporters because they recognize and transport a broad range of substances such as the organic amines choline and carnitine, the neurotransmitters dopamine and serotonin, and …
Membrane transporters enable substances to cross impermeable cell membranes. Whilst they primarily transfer endogenous substances such as nutrients, they can also transfer exogenous substances such as toxic metals, pharmaceuticals, and other toxic substances. Membrane transporters function similarly to shuttle buses in that they efficiently move substances from one area to another – some only offer one-way …
Metformin’s role in healthcare management is expanding and is now being considered as a treatment for some cancers, bone health, neurodegeneration, and probably others, as well as its long-recognised role in diabetes management.The mechanisms by which metformin exerts its effects are still not fully understood but it is currently accepted that metformin inhibits glucose production …
The mechanisms by which metformin exerts its effects are not fully understood and current concepts are currently being challenged. However, it is known that metformin inhibits glucose production in the liver and increases glucose uptake in peripheral tissues thereby lowering blood glucose levels.Metformin’s accepted function is that it slows mitochondrial respiration by inhibiting -NADH-ubiquinone oxidoreductase …
Aspects of pyridoxine and pharmaconutrition have been written about in previous posts –Metformin & B6,Elevated pyridoxine and pharmaconutrition,B6 absorption requires an acid environment,Pyridoxine and pharmaconutrition.This post is a summary and update with a focus on metformin’s negative impacts on pyridoxine. Summarized functions Vitamin B6 is a generic name for about 6 different compounds and is important in …
Metformin is a commonly prescribed first line intervention in NIDDM management and its mechanisms of action include decreased intestinal sugar absorption, increased glucose uptake in liver and skeletal muscle, modulation of lactate production, inhibition of gluconeogenesis and protein synthesis, activation of fatty acid β-oxidation, and reduction in appetite.Vitamin D deficiency is being called a pandemic …
Metformin was developed and released in the late 1950’s and within a decade was identified as a cause of B12 deficiency. More recently, other nutrients have also been identified as being negatively impacted by metformin, including magnesium, thiamine, riboflavin, folate, pyridoxine and vitamin D. Cobalamin aka Vitamin B12 is a fully diet-dependent vitamin as it …
In many countries, metformin is the first prescribed therapeutic intervention for those diagnosed with Type 2 diabetes. Metformin primarily increases insulin sensitivity, promotes weight loss, lowers death rates from all causes, decreases cancer risk, and lowers risk of atherosclerosis and heart disease.Folate or folic acid, is an essential vitamin with multiple functions including being essential …
A throw-away comment in a relatively recent paper that metformin was associated with diminishing riboflavin status prompted this post.Although metformin can be prescribed for decades there is remarkably limited evidence in relation to its negative impacts on various nutrients, and especially riboflavin.Riboflavin is important in cancer therapy, malarial infection control, angiogenesis, erythropoiesis, male fertility [by …
Membrane transporters are steadily gaining recognition as important factors in the absorption, distribution, metabolism, and excretion of many nutrients, as well as many xenobiotic compounds such as prescribed medicines, toxic metals, many agricultural chemicals.The combination of polypharmacy and the current regulatory requirements, necessitate all new drugs be evaluated for their impact on a predetermined range …
Metformin is the fourth most commonly prescribed medicine in the world therefore it’s negative impacts on nutritional factors affects a significant percentage of the global population.Hypomagnesaemia in people diagnosed with diabetes is reported to be about 31%, based on a lower acceptable limit for magnesium of 0.70mmol/L. There is a recommendation for a universal lower …
Coagulation (blood clotting) is a process that prevents excessive bleeding when a blood vessel is injured. Usually, a blood clot dissolves once the injury has healed however sometimes a clot will form inside a blood vessel without any obvious injury and/or may not dissolve naturally.Vitamin K is commonly associated with the coagulation process however there …
DOACs (direct oral anticoagulants) are becoming the preferred option for coagulation management because they do not require the management strategies that warfarin administration necessitate such as regular and frequent INR monitoring, significant dietary restrictions, OH&S concerns relating to internal bleeds, etc especially for farmers, and elderly fallers.Evidence indicates the individual macronutrients, being proteins, fats and …
The warfarin-vitamin K interaction is well-known and so those prescribed warfarin are typically “educated” about vitamin K containing foodstuffs, however there is minimal advice regarding warfarin interactions with other foodstuffs.Whilst some warfarin-food interactions are related to Vitamin K content there are other interactions with alternate mechanisms of action.Vitamin K content – inhibits coagulationAvocado – has …
Warfarin is an anticoagulant for which there is a well-known coagulation interaction with vitamin K however its interactions with other nutrients are less well-known.Warfarin is a substrate and inhibitor for the transporters OAT1/2, and it is carried in the blood by albumin and alpha-1 acid glycoprotein.Transporters OAT1-4 mostly shuttle from blood into kidneys.Warfarin also interacts …
Vitamin K encompasses several compounds that have similar structures and physiological functions –vitamin K3 – the basic, simplest form with metabolic intermediary roles; not available in the diet;vitamin K1 – aka phylloquinone, available from plant sources; low bioavailability which is improved with the addition of lipids; relatively heat stable; light sensitive;vitamin K2 variants – aka …
Medications, medicines, drugs are used interchangeably to describe chemical substances that are administered to confer therapeutic benefit; they interact with 3 key groups –Other medicines – aka drug-drug interactions,Nutrients – aka drug-nutrient interactions,Foods – aka drug-food interactions.Drug-drug interactions are well researched, and many facets of these interactions are included in the drug discovery process. The …
Acid-base imbalance is now being associated with a range of Western health disorders including insulin resistance, diabetes, thyroid function resistance, osteoporosis, altered osteoclast and osteoblast activity, heart disease, hypertension, albuminuria, impaired renal function, chronic kidney disease, recurrent nephrolithiasis, impaired growth in children, and increased body fat in children, etc.Similar to steady state concentration, acid-base balance …
Steady state concentration is the period during which the therapeutic levels remain constant. It is achieved when a defined amount of drug excreted is equal to the amount of drug absorbed within a defined timeframe.The elimination half-life of the pharmaceutical determines the time to achieve steady state concentration, as outlined in the table -Steady state …
I now understand why duration of therapeutic effect of the non-insulin diabetes drugs is not an integral part of most clinicians’ toolkits – the information is extraordinarily difficult to access. When I compiled my chart in 2015, I was very lucky as I had identified a good quality resource and was able to access the …
Insulin resistance is defined as a lack of cellular response to insulin – likely due to closed, damaged or insufficient insulin receptor sites, or some form of within-cell impairment. The lack of cellular response to insulin causes elevated blood glucose levels (hyperglycaemia). As a consequence of hyperglycaemia the pancreas increases the rate of insulin secretion …
Insulin is a highly effective anabolic hormone that is primarily produced in the pancreas, and small amounts are also produced in some neurons.Increased plasma glucose levels trigger insulin’s release into the portal blood circulation and so it is transported to the liver which retains 50% of the insulin, the remaining 50% is released into the …
Supported by policies, practices and programs, harm minimisation is essentially a philosophy, in a range of sectors, to minimise harm rather than to prevent harm.Harm minimisation due to harmful substances or behaviours, can be achieved by the introduction of programs and practices that focus on -Demand – reducing ease of accessibility, information and awareness campaigns, …
Denosumab is prescribed for the treatment of bone loss in adults at high risk of bone fractures. It is a human monoclonal antibody that binds to RANKL which inhibits the RANK/RANKL pathway resulting in inhibition of osteoclast formation, function and survival. The consequent outcome is a reduction in bone resorption and therefore increase in bone …
Bone health is so important and so overlooked and is usually only considered once there is a problem.Bone is constantly being remodelled and is fully replaced approximately every 10 years; remodelling enables growth in childhood and repair in adults. Loss of co-ordination between bone formation and bone degradation results in skeletal impairment.Bone has several primary …
A reader sent in this list of prescribed medicines and did not provide any other information.Drug-food interactionsAllopurinol High intake of salicylates is likely to decrease therapeutic benefit. Interacts with caffeine to enhance drug effect. May interact with theophylline to increase duration and extent of theophylline effect; food sources of theophylline include tea.Furosmide/Frusemide Drug may lower threshold for salicylate toxicity …
Neuroinflammation occurs when the brain’s innate immune system is challenged by factors such as injury, infection, toxin exposure, or neurodegeneration, and the responses can be both physiological and biochemical; neuroinflammation can both cause, and be caused by excitotoxicity and oxidative stress.Is there evidence of an association between 3 common neuroinflammation markers and some nutrition factors?Interleukin-1ß …
Costs of inaction is a term typically associated with business decisions – what are the costs if you choose not to purchase this product or that service – would there be loss of revenue, loss of opportunity, loss of expansion, increased risk of harm in some form.If we apply costs of inaction to the health …
Pantothenate is important in many basic physiological functions, and especially as a precursor for Coenzyme A also known as CoA and CoA-SH; CoA is the precursor for the formation of acetylCoA; acetylCoA is an important metabolic intermediary.Acetyl-CoA is the substrate, intermediary, or product of various energy systems as well as being -the actual molecule through …
Caffeine is a commonly consumed foodstuff, typically found in beverages such as coffee, tea, cola, energy drinks, and foods such as guarana, cocoa and chocolate.Caffeine can alter the absorption, distribution, excretion, and induction or inhibition of metabolizing enzymes for a range of prescribed medications by -1. Altering absorptionchanging the dissolution profile – increasing or decreasing …
Astrocytes are overlooked essential intermediaries in neurological physiology. Astrocytes operate on a network system whereby they service hundreds, if not thousands of neurons. Therefore, if anything damages one astrocyte then the harm is expressed extensively.Astrocytes have 2 primary functions -provision of all the substances essential for neurons to survive and thrive,removal of neuronal garbage.If anything …
Elevated blood levels of nutrients are currently neither looked for nor considered to contribute clinically to disease processes and so remain unrecognised and untreated.With the advent of significant “drug” transporter research, our understanding of the extent and potential extent of prescribed medications and other substances on nutrient availability for body function is steadily growing and …
Vitamin B6 (pyridoxine) is important in many body functions and is seemingly now becoming “sexy” to some in the research world …FunctionsB6 has many roles within the cellas a cofactor in several one-carbon metabolic processes,as a coenzyme it is important in 150+ biochemical reactions,as an antioxidant and is similarly as effective as the anti-oxidants vitamins …
Templates are useful for ensuring essential information is passed on without any aspect being overlooked as they can be copied, pasted and modified as required – the days we are tired or rushed or distracted are the days we are likely to overlook something important.These templates focus on statins.Statins interfere early in the cholesterol metabolic …
A nutrient that is very out-of-sight and out-of-mind is pantothenate – is there, or should there be, a pharmaconutrition concern?Pantothenate is a B vitamin that is important -as the precursor for production of Coenzyme A (CoA or CoA-SH),in the synthesis of acyl carrier proteins essential in fatty acid biosynthesis,in the synthesis of pantethine, a naturally …
The combination of identification of physiological transporters and their potential for accessing currently inaccessible-for-pharmaceuticals parts of the body in conjunction with FDA (Food and Drug Administration) requirements to identify potential drug-drug interactions associated with the inhibition and/or inducement actions on the functions of transporters has resulted in a lot of pharmaceutical money being spent globally …
Physiological transporters (aka “drug transporters”) are seemingly a one-way gate for substances to pass from one carrier to another. Using an airport as an analogy, a range of carriers – cars, buses, trains, ferries, trams, other – carry a person from somewhere to the departure lounge of the airport, the person passes through one or …
A recent seminal study (DOI 10.1074/jbc.RA120.013610) found that ThTr1/2 (Thiamine Transporters 1/2) can transport both thiamine and pyridoxine from the brush border membranes of the small intestines into the epithelial cells. This study established 3 key findings, being -the first to identify an intestine-to-epithelium transporter for pyridoxine,that ThTr 1/2 are actually multi-specific transporters that can …
Personalising templates is a more effective use of time than writing each essentially-similar entry from scratch – the days we are tired or rushed or distracted are the days we leave out something important. Another benefit that templates confer is the consistency of the information being passed on which means the readers are more likely to …
This email is based on a question from a reader.I have a curious case study – 89 year old lady with peripheral neuropathy in feet that started a few months ago.No change in medications or supplements – taking Magmin bd, Amlo, temazepan, Panadol osteo, Lyrica, Chlorsig.Lean at 43 kg 153 cm – BMI.Renal function eGFR …
Whilst researching a related topic for a soon-to-be-published MedNut Mail email, I came across this diagram and asked the question “what are the likely mechanisms of action for metformin to alter pyridoxine’s (vitamin B6) metabolic pathway?”There is now early evidence that metformin use is associated with a higher risk of B6 deficiency, with one study …
A fall is defined as an event in which a person inadvertently comes to rest on the ground or other lower level. A fall can result in physical harm such as broken skin and bones, emotional and mental harm such as loss of confidence, and damaged ego as falling is quite inelegant. Falls are the …
Nutrition support products are typically administered if a person has lost weight or has very poor appetite, and their purpose is to improve nutritional health, with success typically being identified as weight gain. They are formulaic drinks based on either water or milk and typically contain a range of added nutrients.The article titled Distribution of …
Templates are useful to ensure inclusion of relevant points and to streamline work efficiency. Further, they can be amended as new research adds to our body of knowledge. These templates have focussed on some of the negative pharmaconutritional impacts of diabetes – a diagnosis that seems to be the forerunner of further poor health.Diabetes drugsXXXXX …
Enter your text here..Constipation is a common side effect of many prescribed medications and contributes to further issues such as increased brittleness in pain management, increased risk of falling, increased confusion, increased frequency and duration of parkinson’s freezing, increased frequency and duration of difficult, resistive, aggressive behaviours, inexplicable vomiting, etc. These consequences typically result in …
