1
00:00:01,160 --> 00:00:03,840
Some easy points that you can 
get on the boards. 

2
00:00:04,640 --> 00:00:07,720
It's kind of like Farm where I 
talk about their freebie 

3
00:00:07,720 --> 00:00:12,920
questions, but it's not farm, 
it's actually vitamins and 

4
00:00:12,920 --> 00:00:16,320
minerals. 
Their application identification

5
00:00:16,400 --> 00:00:21,320
uses contraindication side 
effects, same thing as farm. 

6
00:00:21,800 --> 00:00:25,280
So same approach that we have. 
But these are easy points if you

7
00:00:25,280 --> 00:00:30,000
see them, and easy to correlate 
to different disease processes 

8
00:00:30,000 --> 00:00:34,720
or treatments or side effects. 
So pick up these easy points 

9
00:00:34,960 --> 00:00:37,960
kind of little rapid review like
I'm going to do at farm here 

10
00:00:37,960 --> 00:00:40,200
coming up in the next episode or
so. 

11
00:00:41,080 --> 00:00:43,360
So let's go through our water 
soluble vitamins. 

12
00:00:44,080 --> 00:00:48,360
The first one is B1B1 is 
thymine. 

13
00:00:49,280 --> 00:00:52,040
We talked about this in 
alcoholism. 

14
00:00:52,800 --> 00:00:56,760
So what does this cause? 
Wernicky Korsakoff, Wernicky's 

15
00:00:56,760 --> 00:00:59,640
encephalopathy. 
Encephalopathy being what? 

16
00:00:59,680 --> 00:01:02,640
Encephalo being brain pathy 
being pathology. 

17
00:01:03,600 --> 00:01:10,680
And what happens in thymine 
deficiency in that alcoholism is

18
00:01:10,800 --> 00:01:16,240
we get this receptive and 
expressive aphasia. 

19
00:01:16,240 --> 00:01:20,720
So how do I describe that? 
Well, aphasia, the inability to 

20
00:01:20,720 --> 00:01:25,040
understand speak. 
We've got that receptive 

21
00:01:25,240 --> 00:01:29,120
inability to understand speech, 
and we got that expressive 

22
00:01:29,160 --> 00:01:34,400
inability to speak. 
So receptively, I don't 

23
00:01:34,400 --> 00:01:38,600
understand what you're saying. 
Expressively, you don't know 

24
00:01:38,600 --> 00:01:41,760
what I'm saying. 
So when you think about somebody

25
00:01:41,760 --> 00:01:47,960
who's had way too many to drink,
who is thyme deficient at this 

26
00:01:47,960 --> 00:01:51,680
point, do you think you 
understand what they're saying 

27
00:01:51,680 --> 00:01:53,200
while they're slurring all their
words? 

28
00:01:53,760 --> 00:01:56,000
Probably not. 
And do you think you're going to

29
00:01:56,000 --> 00:01:59,320
get through to them, meaning are
they going to be able to receive

30
00:01:59,400 --> 00:02:02,080
what you're saying? 
Probably not. 

31
00:02:02,800 --> 00:02:04,720
That's that expressive and 
receptive aphasia. 

32
00:02:05,640 --> 00:02:12,080
The next one is vitamin B3. 
Vitamin B3 is niacin and this 

33
00:02:12,080 --> 00:02:16,480
one is used for high cholesterol
or hyperlipidemia. 

34
00:02:16,480 --> 00:02:22,360
It is over the counter, but the 
thing about this, it causes 

35
00:02:22,760 --> 00:02:26,320
flushing. 
It's not an anaphylactic 

36
00:02:26,320 --> 00:02:31,760
reaction, it's just flushing. 
So give them an NSAID. 

37
00:02:33,680 --> 00:02:37,280
The next one I want to talk 
about is vitamin B9. 

38
00:02:37,720 --> 00:02:40,560
Many of you know it as folate or
folic acid. 

39
00:02:40,560 --> 00:02:43,640
And when you think of folic 
acid, typically we think of what

40
00:02:44,240 --> 00:02:49,760
pregnancy. 
So folic acid will help prevent 

41
00:02:49,800 --> 00:02:53,680
neural tube defects. 
Do we start it when we get 

42
00:02:53,680 --> 00:02:57,040
pregnant or when we have the 
thought of conception or we're 

43
00:02:57,040 --> 00:02:59,680
trying to conceive? 
When we're trying to conceive? 

44
00:03:00,440 --> 00:03:04,480
So we've got 400 to 800 
micrograms a day. 

45
00:03:04,760 --> 00:03:07,560
This is what we're looking at 
when we're taking our prenatals.

46
00:03:08,920 --> 00:03:13,320
The next one is vitamin B12, 
Cobalammine. 

47
00:03:14,760 --> 00:03:18,760
Anybody that's out there knows 
my story where I talk about 

48
00:03:18,760 --> 00:03:23,320
people that are out talking 
about and trying to educate 

49
00:03:24,120 --> 00:03:26,760
about vitamins and minerals and 
what supplements they should 

50
00:03:26,760 --> 00:03:28,680
take. 
And I talk about these people 

51
00:03:28,680 --> 00:03:31,760
that are out there that have no 
education, but they look good. 

52
00:03:31,760 --> 00:03:36,040
They've got a huge following and
they call it cobalamin or 

53
00:03:36,040 --> 00:03:38,640
cobalamin. 
And I'm like, no, no, no, you 

54
00:03:38,640 --> 00:03:41,640
know, it's cobalammine. 
Make sure you do your due 

55
00:03:41,640 --> 00:03:44,520
diligence when you listen to 
whoever is teaching you, make 

56
00:03:44,520 --> 00:03:46,240
sure they know what they're 
talking about or they're 

57
00:03:46,240 --> 00:03:47,880
educated in what they're 
teaching you. 

58
00:03:48,640 --> 00:03:55,280
Cobalammine, which is vitamin 
B12, can cause pernicious 

59
00:03:55,640 --> 00:03:58,800
anemia. 
Meaning if we don't have enough 

60
00:03:58,800 --> 00:04:01,400
vitamin B12, we developed this 
pernicious anemia. 

61
00:04:01,920 --> 00:04:05,760
We use B12 with an intrinsic 
factor to be able to be 

62
00:04:05,760 --> 00:04:11,560
absorbed, but we develop 
neuropathy if we don't have 

63
00:04:11,560 --> 00:04:13,480
enough. 
We can develop memory loss as 

64
00:04:13,480 --> 00:04:16,240
well to paresthesia. 
But the thing about vitamin B12 

65
00:04:16,240 --> 00:04:21,240
is it's in meat, poultry, fish, 
eggs, things of that nature, and

66
00:04:21,240 --> 00:04:26,640
we get stores for years. 
So if you decide to convert into

67
00:04:27,000 --> 00:04:34,080
veganism, then yeah, maybe you 
will develop it over years. 

68
00:04:34,400 --> 00:04:39,000
But it's the people that are 
born into these lifestyles that 

69
00:04:39,000 --> 00:04:42,440
don't consume meat, poultry, 
fish, eggs, things of that 

70
00:04:42,440 --> 00:04:46,360
nature that are going to 
actually be at risk for B12. 

71
00:04:46,360 --> 00:04:48,920
So we supplement it. 
We supplement it. 

72
00:04:50,480 --> 00:04:54,720
The next water soluble vitamin 
is vitamin C, also known as 

73
00:04:54,840 --> 00:04:59,520
asorbic acid. 
And with this, the boards love 

74
00:04:59,520 --> 00:05:04,840
to ask what works with it 
synergistically. 

75
00:05:04,960 --> 00:05:09,200
It's iron. 
Iron absorption and vitamin C go

76
00:05:09,200 --> 00:05:12,160
hand in hand. 
So we're talking about anemia or

77
00:05:12,160 --> 00:05:17,280
we're talking about vitamin C 
Think about taking them at the 

78
00:05:17,280 --> 00:05:21,240
same time. 
But ultimately, our overall 

79
00:05:21,240 --> 00:05:26,840
health is super important 
because I am a huge fan of all 

80
00:05:26,840 --> 00:05:30,440
these natural vitamins and 
minerals, which leads me to talk

81
00:05:30,440 --> 00:05:35,600
about something that I consume 
on a daily basis, day and night.

82
00:05:35,880 --> 00:05:39,760
I'm consuming this product 
called Magic Mind. 

83
00:05:39,800 --> 00:05:43,360
I'm talking about for focus 
during the day and sleep during 

84
00:05:43,360 --> 00:05:46,760
the night. 
And I literally take a shot in 

85
00:05:46,760 --> 00:05:48,480
the morning, a shot in the 
night. 

86
00:05:48,480 --> 00:05:53,320
It's all natural. 
And during the day, it's got 

87
00:05:53,320 --> 00:05:55,320
this like time released 
caffeine. 

88
00:05:55,800 --> 00:05:59,720
So it keeps me super focused and
at night time and you can 

89
00:05:59,720 --> 00:06:02,560
imagine my mind goes 1,000,000 
miles an hour. 

90
00:06:02,800 --> 00:06:07,320
I need to unwind and relax. 
So I take the sleep version of 

91
00:06:07,320 --> 00:06:11,520
this at night time. 
The fact of Magic Mind is it's 

92
00:06:11,520 --> 00:06:17,080
studied by 200 different 
scientific studies behind every 

93
00:06:17,080 --> 00:06:21,600
single ingredient in there, 
which is huge and it's doctor 

94
00:06:21,600 --> 00:06:26,280
validated. 
So not only that, but they're 

95
00:06:26,280 --> 00:06:28,160
also donating. 
And those of you that know me, 

96
00:06:28,640 --> 00:06:32,080
then you know that I'm a big fan
of mental health. 

97
00:06:32,080 --> 00:06:34,360
I'm a huge, huge advocate of 
mental health. 

98
00:06:34,880 --> 00:06:39,360
They're even donating proceeds 
from each bottle sold to mental 

99
00:06:39,360 --> 00:06:42,680
health charities to help 
different communities around the

100
00:06:42,880 --> 00:06:46,240
US. 
So some of the things that I'm 

101
00:06:46,240 --> 00:06:50,840
really, really big on in here is
they've got that Ashwagandha, 

102
00:06:50,840 --> 00:06:53,880
that time release, caffeine, 
some lion's mane. 

103
00:06:54,520 --> 00:06:57,480
These are things that are 
natural, that are going to help 

104
00:06:57,520 --> 00:07:00,400
our health. 
And right now to our students, 

105
00:07:00,680 --> 00:07:04,760
you can get the both packs, the 
focus, the Daytime 1 and the 

106
00:07:04,760 --> 00:07:10,600
Sleep bundle for 45% off to our 
students, 45% off to our 

107
00:07:10,600 --> 00:07:18,840
students at magicmind.com/high 
Yield Jan, High Yield Jan Jan as

108
00:07:18,840 --> 00:07:22,960
in January for 45% off for Magic
Mind. 

109
00:07:23,120 --> 00:07:27,920
Now we move on to our fat 
soluble vitamins, ADEK. 

110
00:07:27,920 --> 00:07:29,960
And there's a lot of great 
mnemonics in order to remember 

111
00:07:29,960 --> 00:07:32,680
them. 
But Adek, it's not too hard to 

112
00:07:32,720 --> 00:07:37,720
remember four of these fat 
soluble vitamins starting with 

113
00:07:37,720 --> 00:07:41,080
vitamin A. 
So the thing about these 

114
00:07:41,080 --> 00:07:43,240
vitamins is that they are stored
in fat. 

115
00:07:44,080 --> 00:07:49,520
Because they're stored in fat, 
we can develop toxicity because 

116
00:07:49,520 --> 00:07:53,720
we don't just rid of them, they 
stay in our system. 

117
00:07:53,720 --> 00:07:56,240
So the more and more we consume,
the more and more they build up.

118
00:07:56,480 --> 00:08:01,120
So toxicity is a big deal with 
both of these. 

119
00:08:02,520 --> 00:08:08,400
The first one, arguably the most
important one tested on the 

120
00:08:08,400 --> 00:08:13,880
boards is vitamin A. 
And it's not that it's just for 

121
00:08:13,880 --> 00:08:17,320
vision or deficiency can cause 
night blindness. 

122
00:08:18,480 --> 00:08:23,080
The real part is the derivatives
of vitamin A. 

123
00:08:24,400 --> 00:08:30,800
The derivatives of vitamin A are
going to be used for acne, 

124
00:08:31,240 --> 00:08:37,440
especially isotretinoin. 
That is the highest yield drug 

125
00:08:38,000 --> 00:08:43,039
in this entire lecture that you 
should know why Isotretinoin is 

126
00:08:43,039 --> 00:08:46,440
a vitamin A derivative. 
It's a retinoid. 

127
00:08:47,720 --> 00:08:50,840
And the thing about this is 
because it's used for acne, 

128
00:08:51,040 --> 00:08:53,160
Think about the population 
that's used for acne. 

129
00:08:53,560 --> 00:08:56,160
We're talking about potentially 
starting from teenage years 

130
00:08:56,160 --> 00:09:02,560
where hormones take off, moving 
on up, meaning that a population

131
00:09:02,560 --> 00:09:09,800
of women consuming isotretinoin 
because of acne needs to be 

132
00:09:09,800 --> 00:09:13,800
educated because this is highly,
highly teratogenic. 

133
00:09:14,960 --> 00:09:18,080
So we have to make sure that 
they are not pregnant. 

134
00:09:18,280 --> 00:09:25,040
We must do a pregnancy test in 
order to rule out pregnancy 

135
00:09:25,040 --> 00:09:30,520
because it is so teratogenic. 
If we decide to start them on 

136
00:09:30,520 --> 00:09:36,960
it, we must educate them that 
they must be on 2 forms of birth

137
00:09:36,960 --> 00:09:39,920
control. 2 forms of birth 
control. 

138
00:09:41,320 --> 00:09:46,360
We must monitor their LFTS. 
We must monitor their lipid 

139
00:09:46,360 --> 00:09:50,360
panel. 
This is a drug that causes 

140
00:09:50,680 --> 00:09:55,080
photosensitivity. 
So remember the mnemonic SAT for

141
00:09:55,080 --> 00:09:56,320
a photo? 
OK, hold on one second. 

142
00:09:56,320 --> 00:09:58,800
Actually, we're about to change 
SAT for a photo up. 

143
00:09:59,320 --> 00:10:02,160
Those of you that remember SAT 
for a photo, it's sulfa, 

144
00:10:02,680 --> 00:10:08,200
amiodarone, tetracyclines, the F
we added in for fluoroquinolones

145
00:10:08,680 --> 00:10:14,440
sat for a photo, meaning photo 
sensitivity, but the brand name 

146
00:10:14,440 --> 00:10:16,760
is Accutane. 
So what I'm going to do this is 

147
00:10:16,760 --> 00:10:20,040
like on the spot while I'm 
making this podcast is what 

148
00:10:20,040 --> 00:10:24,280
we're going to do is we're going
to add in sulfa, obviously is 

149
00:10:24,280 --> 00:10:28,720
there and with amiodarone, let's
add in Accutane. 

150
00:10:29,520 --> 00:10:33,320
So SAT for a photo. 
So SAT is going to be two as 

151
00:10:33,600 --> 00:10:37,320
it's going to be amiodarone and 
accutane and tetracyclines. 

152
00:10:37,440 --> 00:10:40,400
The F we added in those of you 
that watch the weekly Zoom, I 

153
00:10:40,400 --> 00:10:41,800
did that on the spot as well 
too. 

154
00:10:42,520 --> 00:10:46,800
We're going to add in that F for
fluoroquinolones and for a photo

155
00:10:47,400 --> 00:10:50,360
because all of these drugs cause
photosensitivity, which means we

156
00:10:50,360 --> 00:10:53,480
must educate our patients. 
We must educate them. 

157
00:10:53,640 --> 00:10:57,960
Wear a hat, wear long sleeve 
clothes, don't go out in the sun

158
00:10:57,960 --> 00:10:59,680
without sunscreen. 
As a matter of fact, if we can 

159
00:10:59,680 --> 00:11:02,400
avoid the sun, avoid the sun, 
don't go out to the beach, don't

160
00:11:02,400 --> 00:11:07,320
go out to those outdoor 
concerts, avoid the sun because 

161
00:11:07,520 --> 00:11:13,040
it causes photo sensitivity. 
So again, sat for a photo, we're

162
00:11:13,040 --> 00:11:16,400
going to modify that. 
We'll update that on our website

163
00:11:16,400 --> 00:11:18,560
and all that good stuff on our 
quick tips as well too. 

164
00:11:18,560 --> 00:11:24,120
So we're going to make that SAT 
with 2A's for amiodarone and 

165
00:11:24,120 --> 00:11:29,280
accutane, which is isotripanoin.
The next one is vitamin D 

166
00:11:29,400 --> 00:11:33,800
Vitamin D helps with calcium 
absorption, so it helps with the

167
00:11:33,800 --> 00:11:40,000
bones. 
Use vitamin D and calcium at the

168
00:11:40,000 --> 00:11:45,320
same time. 
Then last one is I'm going to 

169
00:11:45,320 --> 00:11:47,680
skip vitamin E, but I'm going to
go into vitamin K. 

170
00:11:48,520 --> 00:11:51,760
Vitamin K, we're talking about 
blood clotting because what is 

171
00:11:51,760 --> 00:11:54,120
it? 
The antidote to warfarin. 

172
00:11:54,720 --> 00:11:57,800
So again, when you see vitamin 
K, more than likely you're going

173
00:11:57,800 --> 00:12:02,120
to see it in a question 
regarding the antidote for for 

174
00:12:02,120 --> 00:12:08,400
warfarin overdose. 
The major minerals that we're 

175
00:12:08,400 --> 00:12:13,720
going to talk about, calcium, 
magnesium, potassium, sodium. 

176
00:12:14,520 --> 00:12:18,760
We touched on iron and we'll end
it off with zinc. 

177
00:12:18,840 --> 00:12:21,480
So starting with calcium, again,
we talked about that with 

178
00:12:21,480 --> 00:12:26,720
vitamin D, bone health, but 
calcium also is predominantly 

179
00:12:27,000 --> 00:12:31,440
responsible for the atrium 
portion of the heart. 

180
00:12:31,960 --> 00:12:35,960
So we're looking at 
dysrhythmias, we're looking at 

181
00:12:36,000 --> 00:12:39,640
nerve conduction. 
We're also talking about tetany 

182
00:12:39,920 --> 00:12:44,680
when we're dealing with 
hypocalcemia, hypocalcemia when 

183
00:12:44,680 --> 00:12:49,600
we get rid of the parathyroids 
potentially in a thyroidectomy. 

184
00:12:49,800 --> 00:12:54,880
So how do we see tetany, 
chopstack sign, trousseau sign, 

185
00:12:55,320 --> 00:12:58,760
then magnesium? 
We talk about magnesium in a 

186
00:12:58,760 --> 00:13:02,280
couple of different places and I
get into this in depth more, but

187
00:13:02,280 --> 00:13:04,160
we're just kind of doing a 
little rapid review here. 

188
00:13:04,800 --> 00:13:09,360
But magnesium, we talk about it 
in diuretics and alcohol, 

189
00:13:10,280 --> 00:13:14,440
alcoholism where we're losing so
much magnesium. 

190
00:13:14,760 --> 00:13:17,440
We developed these tremors or 
these shakes. 

191
00:13:17,800 --> 00:13:21,040
Think about somebody that's 
hungover, they've depleted their

192
00:13:21,040 --> 00:13:24,480
magnesium, they've peed it out 
because they were drinking so 

193
00:13:24,480 --> 00:13:26,840
much. 
Or somebody that is on a 

194
00:13:26,840 --> 00:13:29,880
diuretic that pees it out 
because they're on a diuretic 

195
00:13:29,880 --> 00:13:36,040
and they get tremors. 
So that nerve stability is big 

196
00:13:36,040 --> 00:13:40,240
with magnesium, but that nerve 
stability also comes in the form

197
00:13:40,480 --> 00:13:45,680
of the brain, The nerves in the 
brain that neurological 

198
00:13:45,680 --> 00:13:50,640
stability in where preeclampsia 
to prevent seizures, 

199
00:13:50,720 --> 00:13:57,200
neurological stability. 
So magnesium, potassium, again 

200
00:13:57,320 --> 00:14:01,200
hypo or hyperkalemic. 
I talk about this with Asgraf. 

201
00:14:02,000 --> 00:14:08,640
The Big 1 is going to be V fib, 
V fib, V fib, and the last one 

202
00:14:08,960 --> 00:14:14,040
is sodium. 
The Big 1 is when somebody 

203
00:14:14,040 --> 00:14:20,800
becomes severely hyponatremic, 
meaning their sodium levels are 

204
00:14:20,800 --> 00:14:26,240
like 120 when they should be 
between 1:35 and 1:45, but 

205
00:14:26,240 --> 00:14:30,120
they've severely dropped with 
whatever reason, some sort of 

206
00:14:30,120 --> 00:14:32,600
water intoxication, whether it 
be some endocrinology, 

207
00:14:33,120 --> 00:14:37,160
endocrinological issue. 
But ultimately what we're 

208
00:14:37,160 --> 00:14:41,160
worried about is seizures. 
We're worried about seizures. 

209
00:14:41,200 --> 00:14:44,560
And again, we talked about this 
in depth in the on demand or in 

210
00:14:44,560 --> 00:14:49,040
the course, because we talked 
about this in endocrine, we 

211
00:14:49,040 --> 00:14:52,040
talked about this in pediatric 
nutrition. 

212
00:14:52,040 --> 00:14:54,560
We talk about this in a lot of 
different places, in a lot of 

213
00:14:54,560 --> 00:14:58,560
different places while talking 
about hyponatremia and seizures.

214
00:15:00,040 --> 00:15:07,880
So ultimately ending it with 
zinc, with minerals and all over

215
00:15:07,920 --> 00:15:12,520
in the news articles coming out,
I'm sure on social media, people

216
00:15:12,520 --> 00:15:15,920
talk about the importance of 
zinc and help building that 

217
00:15:15,920 --> 00:15:16,960
immune system.