Minerals
Gastroenterology physiology
Macrominerals (>100mg/day) ?aka electrolytes
Macrominerals (>100mg/day) ?aka electrolytes
- Sodium
- normal serum levels can miss depleted whole body stores > poor grow > what for in prems
- Potassium
- Chloride
- Calcium
- Phosphate
- Magnesium
- Iron
- Duodenal CytochromB enzyme reduces Ferric (Fe3) to soluble Ferrous (Fe2) at brush border
- Absorbed from duodenum > Jej, enhanced by Vit C, impeded by Ca
- Binds to transferrin and transported to marrow
- Deficiency
- Lethargy
- Irreversible developmental delay
- Microcytic hypochromic anaemia
- Toxicity
- Hereditary haemochromatosis: cardiomyopathy, liver cirrhosis, diabetes, and arthritis
- Zinc
- majority absorbed in first half of intestine
- Deficiency: growth acrodermatitis, delayed sexual maturation, impotence, hypogonadism, oligospermia, alopecia, dysgeusia (impaired taste), immune dysfunction, night blindness, impaired wound healing, and various skin lesions. The dermatologic changes occur primarily in the extremities or around body orifices and are often characterized by erythematous, vesiculobullous, and pustular lesions (picture 1) [165]. Other signs and symptoms of zinc deficiency include loss of taste, change in hair color, and easy pluckability of hair. Also seen but not specific are night blindness, impaired appetite, delayed wound healing, decubitus ulcers,
- Toxicity: GIT symptoms, Copper deficiency
- Copper (900 mcg daily)
- absorbed: stomach and proximal small intestine
- incorporated into ceruloplasmin by liver on first pass
- Toxicity (Wilson's disease IEM)
- copper is deposited in tissue: cardiac dysfunction, liver cirrhosis, pancreatic dysfunction, and neurological
- Rx Chelation and Zn (completes for absorption)
- Deficiency (Menke's disease IEM)
- fragile, kinky hair, depigmentation of the skin, muscle weakness, edema, hepatosplenomegaly, osteoporosis, ataxia, neuropathy, and cognitive deficits
- Manganese
- Absorbed through small intestine
- Deficiency: scaly dermatitis and dyslipidemia
- Toxicity: dyscoordination, loss of balance, and confusion
- Fluoride
- absorbed stomach and small intestine
- Toxicity: chronic, fluorosis of teeth, fluorosis of bone (brittle), calcification of ligaments /tendons > stiffness
- Arsenic
- Boron,
- Chromium (20 to 35 mcg per day)
- Deficiency: increased hyperglycemia in diabetes
- Toxicity: nil
- Iodine (RDI: 90 mcg 1-8yo, 120mcg 9-13yo, 150 mcg >13yo)
- absorbed in proximal small bowel
- Deficiency: hypothyroidism: goitre, mental retardation, mortality
- Toxicity: unlikely unless iodine correcting iodine def > can cause hyper thyroidism while TSH still high, or Hashimotos > can make hypothyroidism worse
- Selenium
- Deficiency: skeletal muscle dysfunction, cardiomyopathy, mood disorders, impaired immune function, macrocytosis, and whitened nailbeds
- Toxicity: nausea, emesis, diarrhea, hair loss, nail changes, mental status changes, and peripheral neuropathy
- Silicon
- Nickel
- Vanadium