Fluids, Electrolytes & Nutrition: Minerals

General Physiology

Definition

  • Mineral Definition: Essential Inorganic Micronutrients
  • Types:
    • Macrominerals: Body Requires Larger Amounts (> 100 mg/Day)
    • Trace Minerals (Microminerals): Body Requires Smaller Amounts (< 100 mg/Day)
    • Ultra-Trace Minerals: Body Requires Minimal Amounts (< 1 mg/Day)

Macrominerals

  • Sodium (Na)
  • Chloride (Cl)
  • Potassium (K)
  • Calcium (Ca)
  • Magnesium (Mg)
  • Phosphorous (P)
  • Sulfur (S)
  • *See Electrolytes

Trace Minerals

  • Iron (Fe)
  • Zinc (Zn)
  • Copper (Cu)
  • Fluoride (F)
  • Iodine (I)
  • Manganese (Mn)

Ultra-Trace Minerals

  • Chromium (Cr)
  • Selenium (Se)
  • Cobalt (Co)
  • Molybdenum (Mo)
  • Arsenic (As)
  • Boron (B)

Trace Mineral Deficiency

Iron (Fe)

  • Effects:
    • Iron Deficiency Anemia (IDA) – Microcytic
    • Pica (Compulsion to Eat Non-Food Substances) & Ice Craving
    • Lethargy
    • Developmental Delay
  • Causes:
    • Blood Loss
    • Deficiency in Diet
    • Bariatric Surgery & Gastric Bypass
    • Pregnancy
  • Iron Studies:
    • Serum Iron – Measure of Serum Iron
      • Low in Iron Deficiency & Anemia of Chronic Disease
    • Transferrin – Proteins That Bind & Transport Iron in Blood
      • Increased in Iron Deficiency but Decreased in Anemia of Chronic Disease
      • Total Iron Binding Capacity (TIBC) – Measure of the Amount of Iron Which Can Be Bound to Transferrin, Directly Proportional to Transferrin (TIBC = Transferrin x 1.389)
      • Transferrin Saturation – Ratio of Serum Iron to TIBC (Iron/TIBC x 100)
    • Ferritin – Intracellular Protein That Stores Iron
      • A Small Amount is Secreted into Plasma – What is Measured
      • Also Acts as an Acute Phase Reactant (Elevated in Inflammatory Processes & Anemia of Chronic Disease)
      • May Be Low in Iron Deficiency Although Can Be Falsely Normal-Elevated

Zinc (Zn)

  • Effects:
    • Hypogonadism
    • Dwarfism
    • Impotence
    • Alopecia
    • Skin Lesions – Erythematous Pustular Lesions of Extremities
    • Poor Wound Healing
    • Dysgeusia (Loss of Taste)
  • Causes:
    • Malnutrition
    • Chronic Alcoholism
    • Bariatric Surgery & Gastric Bypass
    • Crohn’s Disease
    • Chronic Total Parenteral Nutrition (TPN) with Inadequate Supplementation

Copper (Cu)

  • Effects:
    • Fragile Hair
    • Skin Depigmentation
    • Muscle Weakness
    • Ataxia & Peripheral Neuropathy
    • Pancytopenia (Anemia, Neutropenia or Thrombocytopenia)
  • Causes:
    • Malnutrition
    • Bariatric Surgery & Gastric Bypass – Most Common Cause
    • Crohn’s Disease
    • Chronic Total Parenteral Nutrition (TPN) with Inadequate Supplementation

Fluoride (F)

  • Effects:
    • Dental Carries
  • Causes:
    • Inadequate Source in the Diet – Community Drinking Water is Often Fluorinated to Supplement

Iodine (I)

  • Effects:
    • Goiter
    • Hypothyroidism
    • Intellectual Disability & Cretinism
  • Causes:
    • Inadequate Source in the Diet, Non-Iodized Salt
    • Pregnancy

Manganese

  • Effects:
    • Scaly Dermatitis
    • Dyslipidemia
  • Causes:
    • Highly Restricted Diets – Extremely Rare in Humans

Ultra-Trace Mineral Deficiency

Chromium (Cr)

  • Effects:
    • Hyperglycemia in Diabetic Patients Mn
  • Causes:
    • Chronic Total Parenteral Nutrition (TPN) with Inadequate Supplementation

Selenium (Se)

  • Effects:
    • Muscle Dysfunction
    • Cardiomyopathy Mn
    • Mood Disorders
  • Causes:
    • Inadequate Source in the Diet
    • Chronic Total Parenteral Nutrition (TPN) with Inadequate Supplementation

Mnemonic

Effects of Ultra-Trace Mineral Deficiencies

  • “Chrome Dome” – Fat Bald Guy with Diabetes
    • Chromium Deficiency Has Hyperglycemia
  • Beautiful Selene (Goddess of the Moon) Breaks Hearts
    • Selenium Deficiency Has Cardiomyopathy