GI Minerals Flashcards
What are the macrominerals? How much of these are needed per day?
Ca, Na, K, Mg, P
> 100mg/day
What are the microminerals (trace mineral)? How much of these are needed per day?
Fe, Zn, Cu, Mn, F, Se
Between 1-100mg/day
What are the ultra trace minerals? How much of these are needed per day?
As, B, Cr, I, Si, Ni, V
<1mg/day
What are some dietary trends associated with specific mineral deficiencies?
1) Adolescents - Eating disorders? - Fe and Ca
2) Weight loss - varies from diet to diet, but Fe, Ca, Zn are big concerns
3) Vegetarians - Fe, Zn
What are some medical conditions associated with multiple mineral deficiencies?
1) COPD - high metabolic demand
2) Cancer - high metabolic demand
3) Malabsorption - Celiac, IBD, atrophic gastritis
4) Gastric bypass - Fe, Ca, Cu
5) Elderly - low intake/mobility, depression, atrophic gastritis, low appetite
Anyone on steroids or anti-seizure meds should worry about Ca deficiency
How common is Iron (Fe) deficiency? Who gets it? How does it present?
- Most common deficiency worldwide - 1-1.5 billion
- Seen most commonly in women and the elderly. After 6 months, infants who start drinking Cow’s milk will lose Fe from breast milk. Phyates (from nuts) decrease absorption.
- Hypochromic, microcytic anemia (ferritin <40). Lethargy, poor functional performance, developmental delays, low birth weight
What is Iron’s biochemical role? Where does it come from in the diet?
- Heme iron (Fe II - meat/fish) absorbed better than non-heme (Fe III - vegetable, fortified cereals). Absorbed in the duodenum (IFC)
- Involved in the function of enzymes related to energy production, DNA/RNA synthesis, and general synthetic processes.
Where does iron toxicity come from and how does it present - in adults vs. kids. How is it treated?
Adults: Hemochromatosis (AR, 1:3000), presents with “bronze diabetes,” cirrhosis, cardiomyopathy. Also from repeated transfusions (thalassemia?) and Bantu pots. Signs are transferrin sat >45%, Ferritin >300.
Kids: O.D. on fortified vitamins/supplements. Presents w/ fever, lethargy, vomiting, diarrhea, GI bleeding, and gastric scarring/stenosis.
Use deferoxamine (iron chelator) or phlebotomy
What is Zinc (Zn) used for? Where does it come from? How does deficiency present?
- Structural role in enzymes and other proteins. Found in meats, nuts, and lentils
- Common deficiency world-wide. Often presents sub-clinically with ? impaired immune response.
- More severe deficiency presents as growth restriction, hypogonadism, immune dysfunction, and dysgeusia.
Where is Copper (Cu) found? What are its roles in the body?
- Found in vegetables, grains, and legumes.
- Involved in a variety of enzymes, including Superoxide Dismutase, Factor V, and Cytochrome Oxidase. It is carried by ceruloplasmin
How does one get Copper deficient and how does it present? What about overloaded?
Deficiency: Decreased absorption from intestine due to Menke’s disease (genetic), bariatric surgery, dialysis, or malabsorption. Presents with fragile hair, muscle weakness, neuro abnormalities, wound healing, and microcytic, hypochromic anemia (involved in Fe metabolism).
Toxicity: Wilson’s Disease (1:30,000) - GI irritation, renal failure, cardiac failure, cirrhosis, neuro symptoms, Kayser-Fleischer Rings, low ceruloplasmin.
What is Iodine (I) used for in the body? Where does it come from in the diet? What about medically? What happens if we give too much iron to someone with hypothyroidism? What about someone with thyroiditis?
- Synthesis of thyroid hormone.
- Found in seafood (kelp/seaweed), vegetables, fortified food, salt, contrast dyes.
- Meds: Amiodarone, iodine topicals (pvoidone iodine, iodine douches), expectorants, anti-cellulite medications.
- If hypothyroid + Iodine -> hyperthryoid
- If thyroiditis + Iodine -> hypothyroid (Wolff-Chaikoff effet)
Where does Chromium (Cr) come from? What forms are toxic and what do they cause? Who is deficient and what does deficiency cause?
- Grains, cereals, fruits, vegetables, processed meats have Cr 3+ - active form.
- Cr 5+, 6+ are inhaled toxic forms -> lung cancer, ulcers, contact dermatitis
- Patients on TPN are deficient -> issues with glucose metabolism and insulin action.
Where do we find Fluoride (F)? What is it used for, and what are the acute and chronic toxicities
- In water, either absorbed from minerals or supplemented.
- Incorporated in tooth enamel and bone (not more resistant to fx, however).
- Acute - GI, renal, and cardiac issues -> death
- Chronic - Fluorosis, weak bones, mottled teeth
Where do we find Selenium (Se)? What is it used for? What are the effects of deficiency? toxicity?
- Seafood, meats, supplements - in seleno-Amino Acids (Se-cysteine, Se-methionine)
-Involved in enzymes, antioxidant reactions, and thyroid hormone synthesis. May be associated with cancer protection?
D - Skeletal muscle and immune system dysfunction, mood disorders. Cancer?
T - GI, alopecia, neuropathy
