Minerals Minerals ing to the body needs, minerals are divided into 2 ing to the body needs, minerals are divided into 2 I. I. Macrominerals Macrominerals : : They are required in amounts less than They are required in amounts less than 100 mg/day. They include: iron, copper, 100 mg/day. They include: iron, copper, fluoride, iodine, manganese, selenium fluoride, iodine, manganese, selenium and zinc. and zinc. They are required in amounts greater They are required in amounts greater than 100 mg/day. They include: than 100 mg/day. They include: calcium, phosphorus, magnesium, calcium, phosphorus, magnesium, sodium, potassium and chloride sodium, potassium and chloride II. Microminerals (trace elements): II. Microminerals (trace elements):
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Minerals According to the body needs, minerals are divided into 2 groups: I. Macrominerals: They are required in amounts less than 100 mg/day. They include:
Hormonal regulation of Plasma calcium: 1. Calcitonin: is secreted from thyroid gland in response to increased blood Ca level. It decreases Ca through: A.Mobilization of calcium from blood into bone B. Decrease Ca reabsorption by renal tubules 2. Parathyroid hormone (PTH): secreted from parathyroid gland in response to decreased calcium levels. It increase calcium by: A. Mobilization of calcium from bone to blood (bone resorption) B. Increases Ca reabsorption by renal tubules C. Increase absorption of calcium from small intestine through stimulation of vitamin D activation.
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MineralsMineralsAccording to the body needs, minerals are divided into 2 groups:According to the body needs, minerals are divided into 2 groups:
I. Macrominerals:I. Macrominerals:
They are required in amounts less than 100 mg/day. They They are required in amounts less than 100 mg/day. They
They are required in amounts greater than 100 mg/day. They are required in amounts greater than 100 mg/day.
They include: calcium, phosphorus, magnesium, sodium, They include: calcium, phosphorus, magnesium, sodium,
potassium and chloridepotassium and chloride
II. Microminerals (trace elements):II. Microminerals (trace elements):
I.I. MacromineralsMacromineralsCalciumCalcium
Sources:Sources:
Milk, milk products, beans and egg yolk.Milk, milk products, beans and egg yolk.
Absorption:Absorption:
By active transport system in the upper small intestine by theBy active transport system in the upper small intestine by the
help of vitamin D (1,25 dihydroxy cholicalciferol).help of vitamin D (1,25 dihydroxy cholicalciferol).
Body calcium:Body calcium:
calcium is the most abundant mineral in the body. Most ofcalcium is the most abundant mineral in the body. Most of
calcium (99%) is present in the skeleton (bones and teeth),calcium (99%) is present in the skeleton (bones and teeth),
the remaining 1% are present in body fluids and other tissuesthe remaining 1% are present in body fluids and other tissues
Plasma calcium:Plasma calcium:
normal level ranges from 9-11 mg/dlnormal level ranges from 9-11 mg/dl
Hormonal regulation of Plasma calcium:Hormonal regulation of Plasma calcium:
1. Calcitonin: 1. Calcitonin: is secreted from thyroid gland in response to increasedis secreted from thyroid gland in response to increasedblood Ca level. It decreases Ca through:blood Ca level. It decreases Ca through:
A.A. Mobilization of calcium from blood into boneMobilization of calcium from blood into boneB.B. Decrease Ca reabsorption by renal tubules Decrease Ca reabsorption by renal tubules
2. Parathyroid hormone (PTH): 2. Parathyroid hormone (PTH): secreted from parathyroid gland insecreted from parathyroid gland in
response to decreased calcium levels. It increase calcium by:response to decreased calcium levels. It increase calcium by:
A.A. Mobilization of calcium from bone to blood (bone Mobilization of calcium from bone to blood (bone resorption)resorption)
B.B. Increases Ca reabsorption by renal tubulesIncreases Ca reabsorption by renal tubulesC.C. Increase absorption of calcium from small intestine Increase absorption of calcium from small intestine
through stimulation of vitamin D activation.through stimulation of vitamin D activation.
HypercacemiaHypercacemia: : may be due to:may be due to:
1.1. Hyperparethyrodism due to adenoma ( benign tumor of the gland)Hyperparethyrodism due to adenoma ( benign tumor of the gland)2.2. Excess intake of vitamin D or calciumExcess intake of vitamin D or calcium3.3. Milk-alkali syndrome : patients who receive milk and alkalies for long Milk-alkali syndrome : patients who receive milk and alkalies for long
time, for treatment of peptic ulcertime, for treatment of peptic ulcer4.4. Drugs such as thiazide diureticsDrugs such as thiazide diuretics
Hypocacemia:Hypocacemia: due to: due to:
1.1. HypoparathyrodismHypoparathyrodism2.2. Renal disease where activation of vitamin D is inhibitedRenal disease where activation of vitamin D is inhibited
Requirments: Requirments:
1.1. AdultAdult: 800 mg/day: 800 mg/day2.2. Children, pregnant and lactating womenChildren, pregnant and lactating women: 800-1200 mg/day: 800-1200 mg/day
SodiumSodium Sources:Sources:
The main source is table saltThe main source is table salt Absorption:Absorption:
from small intestine (ileum). It is nearly completely absorbed.from small intestine (ileum). It is nearly completely absorbed.Body sodium:Body sodium:
2/3 of sodium is present in tissues and body fluids. About 1/3 is2/3 of sodium is present in tissues and body fluids. About 1/3 is present in skeleton (bone and teeth) present in skeleton (bone and teeth)
Requirements:Requirements: 5 g/day 5 g/dayAlterations of plasma sodium:Alterations of plasma sodium:HypernatremiaHypernatremia: : excess plasma sodium is caused by:excess plasma sodium is caused by:
1.1. Cushing syndrome. Cushing syndrome. 2.2. Conn's disease due to excessive aldosterone secretionConn's disease due to excessive aldosterone secretion3.3. Diabetes inspidus due to rapid loss of waterDiabetes inspidus due to rapid loss of water4.4. Drugs such as cortisoneDrugs such as cortisone
Hyponatremia: Hyponatremia: decrease plasma sodium caused by:decrease plasma sodium caused by:1.1. Addison's disease: due to deficiency of aldosteroneAddison's disease: due to deficiency of aldosterone2.2. Renal failure where renal reabsorption of sodium is inhibitedRenal failure where renal reabsorption of sodium is inhibited3.3. Dehydration: due to loss of water and sodiumDehydration: due to loss of water and sodium4.4. Thaizide diuretics which block renal reabsorption of sodium Thaizide diuretics which block renal reabsorption of sodium
Toxicity of sodium: Toxicity of sodium: Hypertension in susceptible individuals.Hypertension in susceptible individuals.
PotassiumPotassiumSources: Sources:
vegetables, fruits and nutsvegetables, fruits and nuts
Absorption: Absorption: Readily occur from small intestine Readily occur from small intestine
Body sodium: Body sodium: 2/3 of potassium is present in tissues and body fluids. About 1/32/3 of potassium is present in tissues and body fluids. About 1/3
is present in skeleton (bone and teeth)is present in skeleton (bone and teeth)Requirements: Requirements: 4 g/day4 g/day
Alterations of plasma sodium:Alterations of plasma sodium:
Hyperkalemia:Hyperkalemia: excess plasma potassium is caused by: excess plasma potassium is caused by:
1.1. Addison's disease: due to deficiency of aldosteroneAddison's disease: due to deficiency of aldosterone2.2. Acidosis Acidosis 3.3. Tissue necrosis e.g. major trauma and burns due to leakage of tissue Tissue necrosis e.g. major trauma and burns due to leakage of tissue
potassiumpotassium4.4. Chronic renal failure with oliguriaChronic renal failure with oliguria5.5. Uncontrolled D. M. Lack of insulin prevent potassium from rntering Uncontrolled D. M. Lack of insulin prevent potassium from rntering
cellscells
1.1. alkalosisalkalosis2.2. treatment of hyperglycemia with insulin without taking potassium, as treatment of hyperglycemia with insulin without taking potassium, as
insulin helps potassium ion to enter cellsinsulin helps potassium ion to enter cells3.3. Excessive vomiting and diarrheaExcessive vomiting and diarrhea4.4. Cushing syndromeCushing syndrome5.5. DiureticsDiuretics
Sources: Sources: Liver, heart, kidney, spleen, and fishLiver, heart, kidney, spleen, and fish
Sugarcane syrup (molasses), dates and egg yolkSugarcane syrup (molasses), dates and egg yolk
N.B. Most of dietary iron is present in the ferric stae.N.B. Most of dietary iron is present in the ferric stae.
Absorption: Absorption: from small intestine. Usually 10-20% of dietary iron isfrom small intestine. Usually 10-20% of dietary iron is
only absorbed. Iron is absorbed in ferrous state. only absorbed. Iron is absorbed in ferrous state.
Reducing substances such as vitamin C and SH- of cysteineReducing substances such as vitamin C and SH- of cysteine
of dietary protein help the reducing of ferric ions into the of dietary protein help the reducing of ferric ions into the
absorbable form (ferrous state).absorbable form (ferrous state).
Body iron: Body iron: The total body iron of adult is 3-5 g distributed as follows:The total body iron of adult is 3-5 g distributed as follows:
I -RBCs iron ( haemoglobin) is about 65% of total ironI -RBCs iron ( haemoglobin) is about 65% of total ironII- Tissue iron (32%): includes II- Tissue iron (32%): includes
Available forms (28%) Available forms (28%) i.e. can be used when there body needi.e. can be used when there body need1-Ferritin : 1-Ferritin : is the main storage form of iron. Composed of protein (apoferritin is the main storage form of iron. Composed of protein (apoferritin
+ iron). Present in iron stores: liver, spleen, bone marrow and + iron). Present in iron stores: liver, spleen, bone marrow and intestine.intestine.
2- Haemosiderin: 2- Haemosiderin: These are granules composed of iron, protein and These are granules composed of iron, protein and polysaccharides. Used as another store of ironpolysaccharides. Used as another store of iron
III- Plasma iron: present in the form of:III- Plasma iron: present in the form of:1-plasma iron : ranges from 60- 160 μg/ dl1-plasma iron : ranges from 60- 160 μg/ dl 2- Transferrin : is a glycoprotein which carry iron in ferric state. 2- Transferrin : is a glycoprotein which carry iron in ferric state.
Non available forms (4%): Non available forms (4%): can not be used even there is body need. All these can not be used even there is body need. All these
forms are hemoprotein i.e. contain heme ring. Examples are:forms are hemoprotein i.e. contain heme ring. Examples are:
1.1. Myoglobin:Myoglobin: present in muscle and heart present in muscle and heart
2.2. Cytochromes:Cytochromes: a, b and c: act as electron carriers a, b and c: act as electron carriers
3.3. CCaatalase and peroxidasetalase and peroxidase: act to destroy H: act to destroy H22OO22
Transport and storage of iron:Transport and storage of iron:
1.1. Absorbed iron enters in the portal blood in the ferrous state.Absorbed iron enters in the portal blood in the ferrous state.
2.2. In the plama it is rapidly oxidized to ferric state by the help of protein- In the plama it is rapidly oxidized to ferric state by the help of protein-
Copper is essential component of several metaloenzymes such as:Copper is essential component of several metaloenzymes such as:
1.1. Ceruloplasmin: Ceruloplasmin: which oxidizes ferrous into ferric in plasmawhich oxidizes ferrous into ferric in plasma2.2. Superoxide desmutae: Superoxide desmutae: antioxidant enzymeantioxidant enzyme3.3. Cytochrome oxidaseCytochrome oxidase
Requirements:Requirements: 2-3 mg/day2-3 mg/day
Alterations of plasma copper:Alterations of plasma copper:Hyper cupremiaHyper cupremia (Excess copper and ceruloplasmin) occur in infections (Excess copper and ceruloplasmin) occur in infections
and malignanciesand malignancies
Hypocupremia (decreased plasma copper):Hypocupremia (decreased plasma copper): occure in a disease called occure in a disease called Wilson's disease in which copper accumulate in large amounts in:Wilson's disease in which copper accumulate in large amounts in:
2.2. cornea causing greenish- brown color of the corneal marginecornea causing greenish- brown color of the corneal margine
Kidney causing damage of renal tubules leading to increased excretion of Kidney causing damage of renal tubules leading to increased excretion of
copper and ceruloplasmin resulting in low plasma copper.copper and ceruloplasmin resulting in low plasma copper.
IodineIodineThe only function is formation of T3 and T4 from thyroid gland, so deficiency The only function is formation of T3 and T4 from thyroid gland, so deficiency
of iodine leading to hypothyroidism and disease called Simple Goiter.of iodine leading to hypothyroidism and disease called Simple Goiter.