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Vitamin K is a family of structurally similar, fat-soluble vitamers found in foods and marketed as dietary supplements. [1] The human body requires vitamin K for post-synthesis modification of certain proteins that are required for blood coagulation ("K" from Danish koagulation, for "coagulation") or for controlling binding of calcium in bones and other tissues. [2]
This combination can lead to vitamin K deficiency and later onset bleeding. Vitamin K deficiency leads to the risk of blood coagulation problems due to impaired production of clotting factors II, VII, IX, X, protein C and protein S by the liver. More rarely VKDB can be caused by maternal medicines causing vitamin K deficiency in the newborn. [2]
VKAs diminish vitamin K levels in the body and inhibit the synthesis of vitamin K dependent clotting factors. [27] Thus, by inhibiting vitamin K, a key element by which the body produces clots, the risk of prolonged bleeding increases. [28] Traditionally, vitamin K has been used as a reversal agent for VKAs.
Newborn infants are a special case. Plasma vitamin K is low at birth, even if the mother is supplemented during pregnancy, because the vitamin is not transported across the placenta. Vitamin K deficiency bleeding (VKDB) due to physiologically low vitamin K plasma concentrations is a serious risk for premature and term newborn and young infants.
Phytomenadione, also known as vitamin K 1 or phylloquinone, is a vitamin found in food and used as a dietary supplement. [4] [5] It is on the World Health Organization's List of Essential Medicines. [6] It is used to treat certain bleeding disorders, [5] including warfarin overdose, vitamin K deficiency, and obstructive jaundice. [5]
Vitamin K 1-deficiency may occur by disturbed intestinal uptake (such as would occur in a bile duct obstruction), by therapeutic or accidental intake of a vitamin K 1-antagonist such as warfarin, or, very rarely, by nutritional vitamin K 1 deficiency. As a result, Gla-residues are inadequately formed and the Gla-proteins are insufficiently active.
Tolerable upper intake levels (UL), to caution against excessive intake of nutrients (like vitamin A and selenium) that can be harmful in large amounts. This is the highest level of sustained daily nutrient consumption that is considered to be safe for, and cause no side effects in, 97.5% of healthy individuals in each life stage and sex group.
Vitamin A deficiency affects one third of children under age 5 around the world, [33] leading to 670,000 deaths and 250,000–500,000 cases of blindness. [34] Vitamin A supplementation has been shown to reduce all-cause mortality by 12 to 24%.
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