Complex blood test for vitamins (Vitamins A, D, E, K, C, B1, B5, B6) (venous blood) in Moscow

Osteoporosis is a chronic, systemic, progressive pathology of the musculoskeletal system, which occurs when calcium metabolism is disturbed and is characterized by the predominance of processes of bone tissue destruction over its creation. As a result, bone strength decreases and the risk of fractures increases.

Medical research statistics today place osteoporosis as the fourth most common non-communicable disease. The leading diseases are cardiovascular diseases, cancer pathology and diabetes mellitus. The percentage of mortality and disability from osteoporosis is very high, but with complex, balanced treatment it is possible not only to improve the patient’s condition, normalize motor activity, minimize the risk of fractures, but also slow down bone resorption and stimulate bone formation.

When do you need to take a comprehensive blood test for vitamins (Vitamins A, D, E, K, C, B1, B5, B6)?

1. Suspicion of a decrease or increase in the level of a particular vitamin;
2. To assess the quality of food;
3. Intestinal diseases accompanied by impaired absorption of nutrients;
4. Prolonged diarrhea;
5. Anemia;
6. Steatorrhea is an increased content of fats in the stool due to their insufficient absorption in the intestines;
7. Chronic alcohol intoxication;
8. Long-term maintenance of the body with parenteral nutrition;
9. Pregnancy and lactation;
10. Condition after gastric resection.

Drugs for the treatment of osteoporosis

Drug treatment of osteoporosis is multi-purpose. A balanced intake of drugs normalizes metabolic processes, slows down the destruction of bone tissue and optimizes bone remodeling, improves blood circulation, relieves pain, relieves inflammation and stimulates the immune system. The complex of drugs for the treatment of osteoporosis includes:

• drugs to relieve pain and inflammation: Reopirin, Ortofen, Ibuprofen, etc.;
• multi-action agents: vitamin D, Calcium D3 nycomed, Osteochin;
• drugs to suppress bone resorption: estrogens (Raloxifene), strontium drugs, calcitonin, bisphosphonates (Etidronate, Ibandronate, Zoledronate, Aclasta, KSIcream);
• medications to stimulate bone formation: parathyroid hormones (Teriparatide), fluoride salts, somatotropic hormones, bisphosphonates (Etidronate, Zoledronate, Aclasta, KSIcream).

Detailed description of the study

Vitamins are substances that are vital for the normal functioning of body cells, tissue respiration, and ensuring basic metabolic processes. They are involved in most metabolic processes, and their deficiency (hypovitaminosis) or excess (hypervitaminosis) affects the functioning of the entire body.

All vitamins are divided into water- and fat-soluble. The first group includes B vitamins and vitamin C, the second group includes vitamins A, D, E, K.

A lack of vitamins can be a consequence of:

1. Malnutrition;
2. Use of certain medications;
3. Alcohol abuse;
4. Diseases of the gastrointestinal tract.

An overabundance of vitamins is usually associated with long-term intake of large doses of vitamins in the form of nutritional supplements.

Vitamin A. In the human body it is found in the form of retinol. Sufficient vitamin A content ensures normal skin and vision. It is involved in bone formation and also helps the normal functioning of the immune and reproductive systems.

Vitamin A enters the body from food. Meat products contain vitamin A in the form of retinol; vegetables and fruits - in the form of carotene, which is transformed into vitamin A in the liver.

It accumulates in liver cells and adipose tissue. Liver cells ensure that vitamin A is released from stores as needed.

One of the first symptoms of vitamin A deficiency is the so-called. “Night blindness” is a decrease in visual acuity in poor lighting at night. The toxic effect of vitamin A is associated with long-term use of inadequate doses of vitamin supplements and is usually expressed in the form of abdominal pain, nausea, other digestive disorders, increased fatigue, etc.

Vitamin D. This is a group of compounds that the body needs for the full growth and development of teeth and bones. There are two types of vitamin D: D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D2 is found in plants. Vitamin D3 is the main source of active vitamin D and is synthesized in the skin under the influence of sunlight. In the liver, D2 and D3 are transformed into their active form, 1,25-dihydroxyvitamin D.

The main function of vitamin D is to regulate the levels of calcium, phosphorus and magnesium in the body. It is vital for bone growth and health. Vitamin D also affects the immune system.

A deficiency can lead to deformations and impaired bone growth (rickets, osteoporosis), increased fatigue, and a decrease in the body's defenses. An excess is dangerous due to the deposition of calcium on the walls of internal organs (kidneys, heart) and disruption of their functioning.

Vitamin E. This is a group of compounds that act as antioxidants. They prevent damage to the cell membrane by reactive oxygen species. Vitamin E is involved in the synthesis of hemoglobin, as well as maintaining the normal structure of the vascular wall. Contained in plant sources: oils, nuts, cereals, greens.

Vitamin deficiency manifests itself in the form of neurological disorders, hemolytic anemia (due to increased breakdown of red blood cells), and liver damage.

Vitamin K. Necessary for the formation of some blood clotting factors, protein C and S. Also involved in the formation of bone tissue.

There are three types of vitamin K:

1. Vitamin K1 (phylloquinone/phytomenadione)
   Natural form of vitamin K. Comes from foods - green vegetables, dairy products, vegetable oils.
2. Vitamin K2 (menaquinone)
   Produced by bacteria of normal intestinal flora.
3. Vitamin K3 (menadinone)
   An artificial chemical compound used as a vitamin supplement.

A lack of vitamins in this group is manifested by heavy bleeding (uterine, nasal, gingival), as well as hematomas on the skin.

Vitamin C , or ascorbic acid. Acts as an antioxidant and enters the body with food - berries, fruits, greens. Participates in the synthesis of collagen, strengthens the walls of blood vessels, increases the body's defenses, participates in the synthesis of interferon and some hormones.

The deficiency is manifested by a violation of the resistance of blood vessels to damage, increased bleeding of the gums and a tendency to hemorrhage. Hair loss and increased fragility, dry skin, apathy, and increased heart rate are also observed.

B vitamins . Necessary for the body to ensure normal metabolism and energy production.

A deficiency of vitamins in this group can be manifested by general symptoms, which include: skin rash, dermatitis, redness of the skin, tingling sensation in the arms and legs, and increased fatigue.

Vitamin B1 (thiamine). Participates in the metabolism of glucose, some amino acids, and fats. Necessary for the proper functioning of the nervous system, heart, and muscles. Contained in cereals, pasta, fish, pork, legumes. A lack of vitamin B1 is manifested by muscle cramps and pain. In severe cases of vitamin B1 deficiency caused by congenital metabolic disorders, cancer and a number of other pathologies, muscle atrophy or paralysis is possible.

Vitamin B5 (pantothenic acid). Helps break down fats, proteins and carbohydrates. The deficiency is manifested by increased fatigue, weight loss, anemia, and impaired wound healing.

Vitamin B6 (pyridoxal phosphate). As a coenzyme, it participates in the metabolism of amino acids and the synthesis of hemoglobin. Also necessary for the normal functioning of the nervous and immune systems. Contained in poultry meat, fish and offal.

The deficiency is manifested by weakness, weight loss, digestive disorders, skin rashes, cracks in the corners of the mouth, weakened immunity. Excess causes severe nerve damage, causing a person to lose control of their movements. The presence of a deficiency or excess of vitamins in the human body can be assessed by their level in the blood serum.

Calcium, Vitamin D and Bone Health

General information

Osteoporosis is a disease in which the mineral content of bone tissue is reduced. Bone mass decreases, bones become more porous, thinner and less strong, and the risk of fractures increases. The number of people suffering from osteoporosis is increasing worldwide. The reasons for this increase are the aging population, changing lifestyles and the quality of food consumed. The occurrence of osteoporosis is identified with insufficient calcium intake, menopause in women and old age. Of course it is. But alcohol abuse, lack of protein in food, smoking, taking certain medications, lack of physical activity and other modern lifestyle factors also affect the health of the skeletal system. We often hear about the need to maintain a diet containing sufficient amounts of calcium throughout our lives. It is known that dairy products and other foods rich in calcium are essential for the development and maintenance of strong skeletal system. But you also need to know that in addition to calcium, for proper nutrition of bone tissue, you need a sufficient amount of the second important element - vitamin D. Calcium Calcium is a vital building material for bone tissue, protecting against the development of osteoporosis. But calcium cannot perform its function without a sufficient amount of vitamin D. In turn, bones act as a “depot” or “reservoir” of calcium to maintain the required amount of this element in the blood. Table 1

Vitamin D ​Vitamin D is found in small amounts in some foods (see Table 2), but food is not the main source of this vitamin. The main amount of vitamin D is formed in the skin under the influence of sunlight. Foods (without special supplements) do not provide sufficient amounts of vitamin D. An international study that examined more than 2,500 postmenopausal women with osteoporosis found that most of them were vitamin D deficient. The discovery of vitamin D as an important The nutritional supplement was made after it was observed that children fed cod liver oil (which is rich in vitamin D) did not develop rickets (bone deformation in early childhood). It was later discovered that exposure to sunlight has the same effect. Despite the study of the problem and preventive measures, cases of rickets in children are still recorded. It is believed that important reasons for this are both a lack of vitamin D in the mother’s body during pregnancy (and children are born already deficient in this vitamin), and excessive protection of children from sunlight. Throughout life, vitamin D and calcium are equally important in maintaining skeletal health. Vitamin D has many functions, but bone health is its primary function.

• Vitamin D promotes complete absorption of calcium. With a lack of vitamin D, most of the calcium in food is not absorbed by the digestive system.
• Vitamin D is essential for normal bone mineralization and growth.
• Vitamin D supplementation reduces incoordination and the risk of falls in older women, possibly due to improved neuromuscular function.
• Experimental evidence supports the importance of vitamin D in the functioning of the immune system and in the regulation of blood pressure.
• Studies have shown that replenishing calcium and vitamin D reduces the incidence of fractures in older women.

Table 2. Foods containing vitamin D.

Vitamin D is the “sunshine” vitamin. Vitamin D is often called the “sunshine” vitamin. Typically, about 90% of your vitamin D requirement comes from exposure to sunlight (ultraviolet rays, UV), which penetrates the skin and converts the vitamin D precursor molecule into its active form. The amount of vitamin D produced in the skin is usually much greater than the amount obtained from food. The exact amount of vitamin D formed under the influence of ultraviolet rays and, accordingly, the required duration of daily sun exposure depends on:

• skin pigmentation; dark skin needs more UV to produce vitamin D;
• season, time of day (the lower the intensity of sunlight, the more time it takes to produce vitamin D);
• the area of ​​open areas of the body not protected by clothing and sunscreen;
• presence of obstacles to UV penetration (glass, plastic).

Therefore, people at risk of developing vitamin D deficiency include:

• adults with dark skin color;
• children with dark skin color, especially if they have a deficiency of iron in the blood;
• people who constantly cover their entire body with clothing for religious or other reasons (especially women and children);
• pregnant women with vitamin D deficiency, whose newborn children will inherit the deficiency of this vitamin;
• newborns and infants who are exclusively breastfed for more than 6 months, do not receive additional vitamin D and are deprived of the opportunity to sunbathe;
• elderly people who are unable to leave the house, or who are in hospitals or social institutions, rarely leave the premises and do not receive vitamin D as a food supplement.

What is the required duration of sun exposure? This need is individual for each individual and is determined, for example, by place of residence, the time of day at which a person usually goes outside. If it is not possible to get your daily dose of UVB, the recommended daily oral dose of vitamin D is 400 IU (10 micrograms). During the summer, most people who expose their face, arms, or legs to the sun can usually get enough vitamin D from occasional exposure to the sun, excluding peak solar activity times. People with sun-sensitive skin need about 5 minutes of sun exposure before 11 a.m. or after 4 p.m. to get enough vitamin D. People with less sensitive skin types or people with dark skin tones need a longer period of time (about 20 minutes). minutes of sun exposure). Doctors are knowledgeable about the risk factors for osteoporosis and can help determine whether you have dietary deficiencies and are at risk for developing osteoporosis. If a deficiency of calcium or vitamin D is detected, the doctor may recommend medications to compensate for this deficiency.

The role of bisphosphonates in the treatment of osteoporosis

Bisphosphonates belong to a new class of drugs that have powerful effects on bone tissue, preventing bone destruction and stimulating bone formation. Normally, bone tissue, like all tissues of the body, is constantly renewed. This occurs due to the balanced function of bone tissue-creating cells (osteoblasts) and destructive cells (osteoclasts). In osteoporosis and some other bone diseases, the activity of osteoclasts prevails, which suppresses the recovery processes. Bisphosphonates regulate the number of osteoclasts, activating their self-destruction. In addition, they normalize calcium metabolism in bone tissue. The effect of bisphosphonates on bone tissue can vary significantly due to their chemical structure. Accordingly, groups of drugs are distinguished:

• based on zoledronic acid (Zoledronate, Aclasta, Zometa), which selectively affect bone tissue, have a pronounced antitumor effect, suppress bone resorption without having an undesirable effect on the processes of its formation, mineralization and mechanical properties;
• based on sodium ibandronate (Bonviva, Boniva, Bondronat), suppressing the activity of osteoclasts without affecting their number. Most effective as a prophylactic agent;
• based on alendronic acid (Fosomax, Forosa, Ostalon), which are non-hormonal correctors of bone tissue metabolism, promoting the formation of proper bone structure;
• nitrogen-free - simple bisphosphonates (Etidronate, Clodronate, Tiludronate).