MINERALS A compound containing a metal, nonmetal, radical that is needed for proper body function and maintenance of health

h Major minerals essential mineral nutrients found in the human body in amounts larger than 5g e.g. calcium, phosphorus, potassium, sulfur, chloride, magnesium Trace minerals essential mineral nutrients found in the human body in amounts smaller than 5g e.g. iron, zinc, copper, manganese, iodine, selenium TRACE MINERALS 1. Iron (ferrous sulfate, fumarate) Vital for hemoglobin regeneration 60% of iron is found in hemoglobin A normal diet contains 5 to 20 mg of iron per day Food sources: liver, lean meats, egg yolks, dried beans, green vegetables Food and antacids slows iron absorption Megadoses of iron during first trimester of pregnancy is contraindicated bec. Of possible teratogenic effect Ferrous sulfate tablet is 325 mg, 65mg of which is elemental iron Pharmacokinetic Absorbed by the intestines and enters the plasma as heme and stored as ferritin Vitamin C slightly increase iron absorption Tetracycline and antacids decreases absorption Pharmacodynamics Iron replacement give primarily to correct iron deficiency anemia Positive lab. Findings for IDA are microcytic (small), hypochromic (pale) erythrocytes Clinical signs and symptoms includes: fatigue, weakness, SOB, pallor and GI bleeding (severe) Onset of action takes days 2. Iodine Ion form of iodine is called iodide Distribution The adult body normally contains 20-30 mg of iodine About 70-80% or about 8 mg is concentrated in the thyroid gland and the rest is widely diffused throughout all tissues, especially in the ovaries, muscles and blood Functions For the synthesis of thyroxin, a hormone in the thyroid gland Food sources: sea foods, sea weeds, iodized salt

Effects of deficiency 1. Goiter enlargement of the thyroid gland 2. Cretinism caused by insufficient iodine intake of a mother during pregnancy which deprives the fetus of the nutrient and the baby born becomes a cretin The child suffers from hypothyroidism, physically dwarfed, mentally retarded, with thick pasty skin and protruding abdomen 3. Myxedema adults who had problems with low iodine intake throughout their childhood and adolescence 3. Copper Needed for the formation of RBCs and connective tissues Cofactor of many enzymes Necessary for the production of neurotransmitters norepinephrine and dopamine Excess serum copper levels is associated with Wilsons disease (an inborn errors of metabolism charac, by accumulation of cooper in the liver, brain, cornea or kidneys Prolong copper deficiency results in anemia RDA for copper is 1.5 to 3mg per day Food sources: shellfish (crab, oysters), liver, nuts, seeds, legume s and cocoa 4. Zinc Important in enzymatic reactions Essential for normal growth and tissue repair, wound healing and taste and smell Adult RDA is 12 to 19 mg Food sources: beef, eggs, leafy and root vegetables Large doses (>150mg) may cause: (1) copper deficiency (2) decrease in high density lipoprotein (HDL) a good cholesterol (3) weakened immune response 5. Chromium Helpful in the control of type 2 DM (NIDDM) Helps to normalize blood glucose by increasing the effects of insulin on the cells Promotes weight loss and muscle building No RDA, but 50 to 200 mcg is considered within normal for adults and children >6 y.o Food sources: meats, whole grains cereals and yeast 6. Selenium Acts as a cofactor for an antioxidant enzyme that protects protein and nucleic acids from oxidative damage Works with Vitamin E

 Has an anti-carcinogenic effect Excess doses of >200 mcg causes weakness, loss of hair, dermatitis, nausea, diarrhea and abdominal pain RDA for selenium is 40 to 75 mcg Food sources: meats (esp. liver), seafood, eggs and dairy products 7. Fluoride Distribution Fluoride is found primarily in the bones and teeth and trace amounts in the thyroid gland and skin Functions It forms a more stable compound in the dentine and enamel of the teeth thus reducing sental caries and minimizing bone loss It is effective in the treatment of osteoporosis Food sources Water is the major source of fluorine. It may be obtained from natural sources (fluorine in water) or through fluoridation Deficiency: dental caries Excess 1. dental fluorosis melting of the enamel 2. osteosclerosis 3. growth depression 4. fatal poisoning 8. Manganese Distribution Only about 10-20 mg of manganese is present in the adult body It is concentrated in the liver, kidneys with small amounts in the other tissues such as the retina, bones and salivary glands Functions An activator of a number of metabolic reactions Acts as catalyst of a number of enzymes necessary in glucose and fat metabolism Increases storage of thiamin Food sources Nuts Whole grain cereals Dried legumes Tea Green leafy vegetables Dried fruits Fresh fruits Non-leafy vegetables 9. Cobalt Distribution

Cobalt is found only in trace amounts in the body Functions Constituent of B12 Essential factor which is necessary for RBC formation Essential for normal functions of all cells Food sources Liver Kidney Oysters Clams Lean beef Poultry Salt water fish Milk Requirements Nutritional requirement is restricted to the bodys need for vit B12 as the body cannot utilize cobalt to synthesize the vitamin Deficiency pernicious anemia Excess Polycythemia (increased in the number of RBC)

MAJOR MINERALS 1. POTASSIUM 20 times more prevalent in the cells (ICF) Normal value: 3.5-5 milliequivalents per liter (mEq/L) <3.5 mEq/L Hypokalemia, >5 mEq/L Hyperkalemia Poorly stored in the body RDA: 40-60 mEq/L Food sources: fruit juices, vegetables, bananas, dried fruits, cantaloupe, potatoes, broccoli Function Necessary for the transmission and conduction of nerve impulse and for the contraction of skeletal, cardiac and smooth muscles Promotes glycogen storage in the liver Helps in the regulation of osmolality of cellular fluids Potassium Imbalance: 1. Hypokalemia Potassium level below 3.5 mEq/L Causes: a. trauma, injury, burns, surgery (cells are damaged) b. vomiting and diarrhea c. certain drugs i.e Potassium wasting diuretics d. Increased aldosterone

e. metabolic Alkalosis Signs and symptoms: - nausea and vomiting - dysrhythmias- cardiac arrest - abdominal distension - diminished DTR - flaccid paralysis - respiratory arrest 2. Hyperkalemia Serum potassium level above 5 mEq/L Causes: a. renal insufficiency b. administration of large doses i.e potassium sparing diuretic c. excessive intake d. metabolic acidosis e. extensive trauma Signs and symptoms - nausea, diarrhea, oliguria, tachycardia, bradycardia (later), weakness, numbness and tingling sensation, cardiac arrest 2. SODIUM Major cation in the ECF Normal serum level is 135 to 145 mEq/L <135 mEq/L Hyponatremia >145 mEq/L Hypernatremia RDA: 2-4 gm Food sources: bacon, beef cubes, catsup, corned beef, coffee, ham, tomato juice, soda, crackers Functions Major electrolytes that regulates body fluids Promotes the transmission and conduction of nerve impulse Promote acid base balance Part of sodium-potassium pump Sodium imbalance 1. Hyponatremia Causes a. vomiting b. diarrhea c. surgery d. potent diuretics e. restricted Na intake f. diaphoresis/Fever g. edema/ascites Signs and symptoms: - muscle weakness - headache - lethargy - confusion - abdominal cramps - anorexia, nausea and vomiting - tachycardia and postural hypotension 2. Hypernatremia

Sodium level >145 mEq/L Causes: a. high Na intake b. rapid infusion of saline (IV) c. hyperventilation/diarrhea d. certain drugs i.e. cortisone preparation, cough medication and selected ATBC Signs and symptoms: - flushed dry skin - elevated body temp - elevated blood pressure - rough, dry tongue - anorexia, nausea and vomiting - tachycardia - hyperreflexia

3. CALCIUM Found equally proportional in the ICF and ECF Normal value: 4.5-5.5 mEq/L or 9-11 mg/dl <4.5 mEq/L Hypocalcemia >5.5 mEq/L Hypercalcemia Half of the calcium in the body bound to protein Functions Promotes normal nerve and muscle activity Increases contraction of the heart promotes blood clotting by converting prothrombin to thrombin Needed for the formation of bone and teeth Food sources Kuhol Malungay leaves Milk Dilis Hipon Talangka Cheese Bagoong Dried fish Sardines Dried dilis Dairy products Calcium imbalance 1. Hypocalcemia Causes: a. inadequate calcium intake b. hypoparathyroidism c. Vit. D deficiency d. multiple blood transfusion e. decrease parathyroid hormone f. increase calcitonin g. increase phosphorus Signs and symptoms - irritability

- tetany (twitching around the mouth, tingling and numbness of fingers, carpopedal spasm, spasmodic contraction, laryngeal spasm and convulsion) - nausea, vomiting and diarrhea - osteoporosis/fracture - dysrhythmias cardiac arrest 2. Hypercalcemia Causes a. hyperparathyroidism b. hypophosphatemia c. tumors of the bone d. prolonged immobilization e. multiple fracture f. drugs. Thiazide diuretic, increased vit. D g. decreased phosphorus Signs and symptoms: - bone pain, osteoporosis (fracture) - kidney stones - decreased DTR - muscle fatigue - constipated - lethargy - coma 4. MAGNESIUM Sister cation to potassium Loss of potassium results to loss of magnesium Normal value: 1.5 to 2.5 mEq/L or 1.8 to 3 mg/dl Deficit hypomagnesemia Excess hypermagnesemia RDA: 8-20 mEq Functions: Promotes the transmission of neuromuscular activity Promotes contraction of myocardium Activates many enzymes for the metabolism of carbohydrates and protein Responsible for the transmission of sodium and potassium across cell membranes Food sources Nuts Soybeans Meat Milk Cocoa Sea foods Whole grains Dried beans peas Magnesium imbalance 1. Hypomagnesemia Causes a. prolong malnutrition b. Malabsorption syndrome

c. hypercalcemia d. sodium inhibits tubular absorption of magnesium e. diuretics, some ATBC, laxatives & steroids promotes Mg loss Mg deficit increases the release of acetylcholine from the pre-synaptic membrane of the nerve fiber increase neuromuscular excitability Signs and symptoms: - convulsion - paresthesia - cramps - spasticity - tetany - tachycardia dysrhythmias - increase DTR 2. Hypermagnesemia Causes a. renal failure b. excess intake of Mg salts laxatives (e.g. Mg sulfate, Milk of Magnesia, Mg citrate), Antacids (e.g Maalox, Mylanta, Di-gel) Increase Mg blocks acetylcholine release at the synapse decreases excitability of muscle Signs and symptoms - hypotension - loss of DTR - drowsiness - decrease heart rate

5. PHOSPHORUS Major anion with concentration in the ICF Found in association with calcium Decreased by PTH stimulation Normal value: 1.7-2.6 mEq/L 50% is ionized (free), 45% is protein bound Functions: Essential in bone and teeth formation and for neuromuscular activity Important component of nucleic acid (DNA/RNA) Maintains cellular osmotic pressure and acid-base balance Food sources Cheese Milk Dairy products Meat Poultry Fish Eggs Dried beans

Imbalances 1. Hypophosphatemia Signs and symptoms - muscle weakness - tremors, paresthesia - bone pain - hyporeflexia, seizures - hyperventilation - anorexia, dysphagia 2. Hyperphosphatemia Signs and symptoms - hyperreflexia - tetany (with decreased calcium - flaccid paralysis - muscular weakness - tachycradia - nause, diarrhea, abdominal cramps

secretions during continued vomiting, diarrhea or tube drainage

6. SULFUR Distribution Sulfur occurs in almost every protein cell and comprises about 0.25% of body weight It is concentrated in the cytoplasm but is found in highest concentration in the hair, skin and nails Functions Maintains protein structure Activates enzymes Participates in detoxificatiom reactions Food sources Protein contains 1% sulfur, so a diet adequate in protein will contain enough sulfur

7. CHLORIDE Distribution Chlorine is a major anion in the extracellular fluid CSF has the highest concentration of chloride Normal range: 95-105 mEq/liter or 340-370 mg/100 ml Large amount of ionized chlorine is found in the GI secretion as HCL Functions Maintains fluid and electrolyte balance, acid balance Contributes to necessary acidity in the stomach (HCL) Food sources Table salt Deficiency Alkalosis results when there is an excessive loss of chloride ions from the gastric