Mineral deficiencies Notes

NOTES NOTES MINERAL DEFICIENCIES GENERALLY, WHAT ARE THEY? PATHOLOGY & CAUSES ▪ Inadequate dietary minerals (vital for normal health/function) ▪ Minerals ▫ 5% of average diet CAUSES ▪ Poor diet/required mineral absorption ▪ Macrominerals ▫ Calcium, phosphorus, potassium, sulfur, sodium, chloride, magnesium ▫ Adults > 100mg/day/< 1% of total body weight required ▪ Trace minerals/elements ▫ Iron, zinc, copper, manganese, iodine, fluoride, cobalt, selenium ▫ Adults 1–100mg/day/<0.01% total body weight required 280 OSMOSIS.ORG SIGNS & SYMPTOMS ▪ See individual disorders TREATMENT ▪ See individual disorders DIAGNOSIS ▪ See individual disorders

Chapter 48 Mineral Deficiencies IODINE DEFICIENCY osms.it/iodine-deficiency PATHOLOGY & CAUSES ▪ Insufficient iodine intake → thyroid enlarges to compensate thyroid hormone production demands ▫ Low iodine levels → ↓ T4, T3 production → ↑ thyroid stimulating hormone (TSH) for restoration T4, T3 production → TSH stimulates thyroid growth ▪ World Health Organization (WHO) recommends ▫ < five years old: 90μg/day ▫ 6–12 years old: 120μg/day ▫ > 12 years old: 150μg/day ▫ Pregnant, lactating: 250μg/day CAUSES Malnutrition ▪ Body does not create iodine; diet only source ▪ High deficiency rates ▫ Europe, Africa, Asia ▪ Low deficiency rates ▫ Industrialized countries (most water, salt, bread iodized) RISK FACTORS ▪ Pregnant/nursing, children, vegan/glutenfree individuals SIGNS & SYMPTOMS Goiter ▪ Thyroid enlarges because ↑ TSH ▫ Compensation strategy: decreased thyroid hormone production → goiter formation ▪ Low iodine levels → ↓ T4, T3 production → ↑ thyroid stimulating hormone (TSH) attempts restoration of T4, T3 production → TSH stimulates thyroid growth ▪ Often, goiter diffuse initially; eventually may develop nodules (can enlarge, calcify over time) ▪ If large → choking, difficulty swallowing/ breathing Hypothyroidism ▪ ↓ thyroid hormone levels (iodine necessary for production) ▪ Fatigue, constipation, weight gain, muscle weakness Pregnancy ▪ Miscarriages, premature delivery, fetal congenital abnormalities ▪ Child’s physical growth, mental development decrease Cretinism ▪ Infants, children: untreated iodine deficiency → cretinism (permanent intellectual disability, developmental deficiency) DIAGNOSIS LAB RESULTS ▪ Iodine concentration in urine; site of ~90% ingested iodine, good site for current iodine nutrition measurement ▫ Mild iodine deficiency: 50–99μg/day ▫ Moderate deficiency: 20–49μg/day ▫ Severe deficiency: < 20μg/day OTHER DIAGNOSTICS ▪ Thyroid size measurements (reflect iodine nutrition over extended periods) OSMOSIS.ORG 281

TREATMENT OTHER INTERVENTIONS ▪ Iodine supplementation, iodine enriched foods ▫ Dairy: cheese, milk, yogurt ▫ Meat/alternatives: shellfish, saltwater fish, eggs ZINC DEFICIENCY osms.it/zinc-deficiency PATHOLOGY & CAUSES ▪ Insufficient zinc intake ▪ Recommended doses ▫ Oral intake: 4–15mg/day ▫ Dietary intake: 8mg/day (children), 11mg/day (biologically male), 9mg/day (biologically female) CAUSES ▪ Malnutrition ▪ Malabsorption diseases (chronic inflammatory bowel disease) ▫ Poor zinc absorption; absorbed in small intestine ▪ Prolonged breastfeeding ▫ Individual’s breast milk contains low zinc levels, infant exclusively breastfed ▪ Acrodermatitis enteropathica ▫ Autosomal, recessive, inherited intestinal zinc absorption (partial) defect SIGNS & SYMPTOMS ▪ Skin, nails, hair ▫ Skin lesions, acne, eczema, alopecia, compromised wound healing ▪ Immune dysfunction → respiratory, gastrointestinal infections ▪ Delayed growth/development ▪ Impaired vision, smell, taste ▪ Delayed sexual maturation ▪ Appetite loss DIAGNOSIS LAB RESULTS ▪ Measure zinc biomarkers ▫ Red blood cell linoleic acid to dihomo-ylinolenic acid (LA:DLGA) ratios TREATMENT OTHER INTERVENTIONS ▪ Zinc supplementation, zinc enriched foods ▫ Fortified cereals, whole grains, nuts, meats (oysters, beef, lamb) 282 OSMOSIS.ORG