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Related Concept Videos

Vitamins01:30

Vitamins

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Vitamins, derived from the Latin word for life, are essential organic substances required in small quantities for optimal growth and overall well-being. Unlike other organic nutrients, vitamins don't act as sources of energy or building materials but rather facilitate these nutrients' utilization by the body. Vitamins are predominantly coenzymes, assisting enzymes in specific chemical actions, like the oxidation of glucose for energy involving B vitamins. Most vitamins are not produced...
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Disorders of Hemostasis01:24

Disorders of Hemostasis

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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Oxidation of Phenols to Quinones01:17

Oxidation of Phenols to Quinones

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In the presence of oxidizing agents, phenols are oxidized to quinones. Quinones can be easily reduced back to phenols using mild reducing agents. The electron-donating hydroxyl group enhances the reactivity of the aromatic ring, enabling oxidation of the ring even in the absence of an α hydrogen.
o-hydroxy phenols are oxidized to o-quinones and p-hydroxy phenols to p-quinones. Such redox reactions involve the transfer of two electrons and two protons. The reversible redox...
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Coagulation01:09

Coagulation

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The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
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Extrinsic and Intrinsic Pathways of Hemostasis01:20

Extrinsic and Intrinsic Pathways of Hemostasis

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Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
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Reversible coagulopathy associated with vitamin E excess.

Timothy David Green1, David M Williams2, Jack Sharman3

  • 1Diabetes and Endcrinology, Swansea Bay University Health Board, Port Talbot, UK timdg10@gmail.com.

BMJ Case Reports
|June 11, 2025
PubMed
Summary

Excessive vitamin E intake can lead to coagulopathy, a blood clotting disorder. This case highlights the need for careful monitoring of vitamin E supplementation, especially in patients with absorption issues, to prevent adverse effects.

Keywords:
Contraindications and precautionsDrugs and medicinesNutrition

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Area of Science:

  • Biochemistry
  • Hematology
  • Nutritional Science

Background:

  • Vitamin E is a crucial dietary antioxidant.
  • Excessive vitamin E can impair blood coagulation, particularly with compromised vitamin K status.
  • Bariatric surgery, like biliopancreatic diversion, can lead to micronutrient deficiencies.

Purpose of the Study:

  • To report a case of vitamin E-induced coagulopathy in a patient with a history of bariatric surgery.
  • To emphasize the importance of monitoring vitamin E levels and patient adherence to supplementation protocols.

Main Methods:

  • Case report of an elderly female patient.
  • Review of coagulation parameters (INR, APTT) before and after vitamin E over-administration.
  • Assessment of response to vitamin E cessation and vitamin K supplementation.

Main Results:

  • The patient developed prolonged INR and APTT after accidental over-administration of vitamin E.
  • Coagulation abnormalities resolved upon discontinuation of vitamin E and administration of vitamin K.
  • No active bleeding complications were observed.

Conclusions:

  • Excessive vitamin E supplementation can induce a reversible coagulopathy.
  • Careful patient education and regular monitoring are essential for vitamin replacement therapy.
  • This case underscores the potential risks of high-dose vitamin E in susceptible individuals.