Jyoti Balmiki, profile picture
Uploaded byJyoti Balmiki
252 views

Role of minerals, ions and water in.pptx

This document discusses the roles of various minerals in life processes. It describes how minerals like calcium, phosphorus, magnesium, sodium, potassium and others perform vital functions in the body. These include roles in bone formation, muscle contraction, blood coagulation, acid-base balance and enzyme activation. The document also covers dietary sources of minerals, deficiency diseases, and conditions caused by abnormal mineral levels.

Embed presentation

Download to read offline
1 / 123
2 / 123
3 / 123
4 / 123
5 / 123
6 / 123
7 / 123
8 / 123
9 / 123
10 / 123
11 / 123
12 / 123
13 / 123
14 / 123
15 / 123
16 / 123
17 / 123
18 / 123
19 / 123
20 / 123
21 / 123
22 / 123
23 / 123
24 / 123
25 / 123
26 / 123
27 / 123
28 / 123
29 / 123
30 / 123
Most read
31 / 123
32 / 123
33 / 123
34 / 123
35 / 123
36 / 123
37 / 123
38 / 123
39 / 123
40 / 123
41 / 123
42 / 123
43 / 123
44 / 123
45 / 123
46 / 123
47 / 123
48 / 123
49 / 123
50 / 123
51 / 123
52 / 123
53 / 123
54 / 123
55 / 123
56 / 123
57 / 123
58 / 123
59 / 123
60 / 123
61 / 123
62 / 123
63 / 123
64 / 123
65 / 123
66 / 123
67 / 123
68 / 123
69 / 123
70 / 123
71 / 123
72 / 123
73 / 123
74 / 123
75 / 123
76 / 123
77 / 123
78 / 123
79 / 123
80 / 123
81 / 123
82 / 123
83 / 123
84 / 123
85 / 123
86 / 123
87 / 123
88 / 123
89 / 123
90 / 123
91 / 123
92 / 123
93 / 123
94 / 123
95 / 123
Most read
96 / 123
97 / 123
98 / 123
99 / 123
Most read
100 / 123
101 / 123
102 / 123
103 / 123
104 / 123
105 / 123
106 / 123
107 / 123
108 / 123
109 / 123
110 / 123
111 / 123
112 / 123
113 / 123
114 / 123
115 / 123
116 / 123
117 / 123
118 / 123
119 / 123
120 / 123
121 / 123
122 / 123
123 / 123
Role of minerals, ions and water in life processes
Minerals • The mineral (inorganic) elements constitute only a small proportion of the body weight. • There is a wide variation in their body content. For instance, calcium constitutes about 2% of body weight while cobalt about 0.00004%.
General functions: • Mineral perform several vital functions which are absolutely essential for the very existence of the organism. • These include calcification of bone, blood coagulation, neuromuscular irritability, acid-base equilibrium, fluid balance and osmotic regulation. • Certain mineral are integral components of biologically important compounds such as hemoglobin (Fe), thyroxine (I), insulin(Zn) and vitamin B12(Co). • Sulfur is present in thiamine, biotin, lipoic acid and coenzyme A. • Several minerals participates as cofactors for enzymes in metabolism (e.g. Mg, Mn, Cu, Zn, K). • Some elements are essential constituents of certain enzymes (e.g. Co, Mo, Se)
Classification • The minerals are classified as principal elements and trace elements. The seven principal elements (macro-minerals) constituents 60-80% of the body’s inorganic material. These are calcium, phosphorus, magnesium, sodium, potassium, chloride and sulfur. • The principal elements are required in amounts greater than 100 mg/day. The micro-minerals are required in amounts less 100mg/day. They are subdivided into three categories. • Essential trace elements : Iron, copper, iodine, manganese, zinc, molybdenum, cobalt, fluorine, selenium and chromium. • Possibly essential trace elements: Nickel, vanadium, cadmium and barium. • Non-essential trace elements: Aluminium, lead, mercury, boron, sliver, bismuth etc.
Macro-elements • Calcium • Phosphorus • Magnesium • Sodium • Potassium • Chlorine • Sulfur
Calcium • Calcium is the most abundant among the minerals in the body. • The total content of calcium in an adult man is about 1 to 1.5kg. As much as 99% of it is present in the bones and teeth. • A small fraction (1%) of the calcium, found outside the skeletal tissue, performs a wide variety of functions.
Biochemical functions • Development of bones and teeth: Calcium, along with phosphate, is required for the formation (of hydroxyapatite) and physical strength of skeletal tissue. Bone is regarded as a mineralized connective tissue. Bones which are in dynamic state serve as reservoir of Ca. Osteoblasts result in demineralization. • Muscle contraction: Ca+ interacts with troponin C to trigger muscle contraction. Calcium also activates ATPase, increases the interaction between actin and myosin. • Blood coagulation: Several reactions in the cascade of blood clotting process are dependent on Ca+ (factor IV) • Nerve transmission: Ca+ is necessary for the transmission of nerve impulse. • Membrane integrity and permeability: Ca+ influences the membrane structure and transport of water and several ions across it.
Biochemical functions • Activation of enzymes: Ca+ is needed for the direct activation of enzymes such as lipase (pancreatic), ATPase and succinate dehydrogenase. • Calmodulin mediated action of Ca2+: Calmodulin (mol. wt. 17,000) is a calcium binding regulatory protein. Ca- calmodulin complex activates certain enzymes e.g. adenylate cyclase, Ca2+ dependent protein kinase, myosin kinase, phospholipase C, glycogen synthase. • Calcium as intracellular messenger: Certain hormones exert their action through the mediation of Ca2+ (instead of cAMP). Calcium is regarded as a second messenger for such hormonal action e.g. epinephrine in liver glycogenolysis. Calcium serves as a third messenger for some hormones e.g. antidiuretic hormone (ADH) acts through cAMP, and then Ca2+.
Biochemical functions • Release of hormones: The release of certain hormones (insulin, PTH, calcitonin) form the endocrine glands is facilitated by Ca2+. • Secretory processes: Ca2+ regulate microfilament and microtubule mediated processes such as endocytosis, exocytosis and cell motility. • Contact inhibition: Calcium is believed to be involved in cell to cell contact and adhesion of cells in a tissue. The cell to cell communication may also required Ca2+. • Action on heart: Ca2+ acts on myocardium and prolongs systole.
Dietary requirements • Adult man and women – 800mg/day • Women during pregnancy, lactation , post- menopause – 1.5g/day Sources: • Best source –Milk and milk products • Good source – Beans, leafy vegetables, fish, cabbage, egg yolk.
Deficiency/disease states • The blood Ca level is maintained within a narrow range by the homeostatic control, most predominantly by PTH. Hence abnormalities in Ca metabolism are mainly associates with alteration in PTH. • Hypercalcemia • Hypocalcemia
Hypercalcemia • Elevation in serum Ca level (normal 9-11 mg/dl) is hypercalcemia. • Hypercalcemia is associated with hyperparathyroidism caused by increased activity of parathyroid glands. • Decreased in serum phosphate (due to increased renal loss) and increase in alkaline phosphate activity are also found in hyperparathyroidism. • Elevation in the urinary excretion of Ca and P, often resulting in the formation of urinary calculi, is also observed in these pateints.
Hypercalcemia • The determination of ionized serum calcium (elevated or 6-9mg/dl) is more useful for the diagnosis of hyperparathyroidism. • It has been observed that some of the patients may have normal levels of total calcium in the serum but differ with regard to ionized calcium. • The symptoms of hypercalcemia include lethargy, muscle weakness, loss of appetite, constipation, nausea, increased myocardial contractility and susceptibility to fracture.
Hypocalcemia • Hypocalcemia is a more serious and life threatening condition. It is characterized by a fall in the serum Ca to below 7mg/dl, causing tetany. • The symptoms of tetany include neuromuscular irritability, and convulsions. • Hypocalcemia is mostly due to hypoparathyroidism. This may happen after an accidental surgical removed of parathyroid glands or due to an autoimmune disease. • Treatment: Supplementation of oral calcium with vitamin D is commonly employed. In severe cases of hypocalcemia , calcium gluconate is intravenously administered.
Rickets • Rickets is a disorder of defective calcification of bones. • This may be due to a low levels of vitamin D in the body or due to a dietary deficiency of Ca and P or both. • The concentration of serum Ca and P may be low or normal. • An increase in the activity of or normal. • An increase in the activity of alkaline phosphatase is a characteristic feature of rickets.
Renal rickets • Renal rickets is associated with damage to renal tissue, causing impairment in the synthesis of calcitriol. • It does not respond to vitamin D in ordinary doses, therefore, some workers regard this as vitamin D resistant rickets. • Renal rickets can be treated by administration of calcitriol.
Osteoporosis • Osteoporosis is characterized by demineralization of bone resulting in the progressive loss of bone mass. • Occurrence: The elderly people (over 60yr.) of both sexes are at risk for osteoporosis. However, it more predominantly occurs in the post- menopausal women. • Osteoporosis results in frequent bone fractures which are a major cause of disability among the elderly. • It is estimated that more than 50% of the fractures in USA are due to this disorder. Osteoporosis may be regarded as a silent thief.
Treatment • Estrogen administration along with calcium supplementation (in combination with vitamin D) to postmenopausal women reduces the risk of fractures. • Higher dietary intake of Ca (about 1.5g/dl) is recommended for elderly people.
Osteopetrosis (marble bone disease) • Osteopetrosis is characterized by increased bone density. • This is primarily due to inability to resorb bone. • This disorder is mostly observed is mostly observed in associated with renal tubular acidosis (due to a defects in the enzyme carbonic anhydrase)and cerebral calcification.
Phosphorus • An adult body contains about 1kg phosphate and it is found in every cell of the body. • Most of it (about 80%) occurs in combination with Ca in the bones and teeth. • About 10% of body P is found in muscles and blood in association with proteins, carbohydrates and lipids. • The remaining 10% is widely distribution in various chemical compounds.
Biochemical functions • Phosphorus is essential for the development of bones and teeth. • It plays a central role for the formation and utilization of high- energy phosphate compounds e.g. ATP, GTP, creatine phosphate etc. • Phosphorus is required for the formation of phospholipids, phosphoproteins and nucleic acids (DNA and RNA) • It is as essential component of several nucleotide coenzymes e.g. NAD+, NADP+, pyridoxal phosphate, ADP, AMP. • Several proteins and enzymes are activated by phosphorylation. • Phosphate buffer system is important for the maintenance of pH in the blood (around 7.4) as well as in the cells.
Dietary requirement • The recommended dietary allowance (RDA) of phosphate is based on the intake of calcium. • The ratio of Ca: P of 1:1 is recommended (i.e. 800mg/day) for an adult. • For infants, however, the ratio is around 2:1, which is based on the ratio found in human milk. • Calcium and phosphate are distributed in the majority of nature foods in 1:1 ratio. • Therefore, adequate intake of Ca generally takes care of the P requirement also
Sources • Milk, cereals, leafy vegetables, meat, eggs.
Deficiency/disease states • Serum phosphate level is increased in hypoparathyroidism and decreased in hyperpara- thyroidism. • In severe renal diseases, serum phosphate content is elevated causing acidosis. • Vitamin D deficient rickets is characterized by decreased serum phosphate (1-2mg/dl). • Renal rickets is associated with low serum phosphate levels and increased alkaline phosphatase activity. • In diabetes mellitus, serum content of organic phosphate is lower while that of inorganic phosphate is higher.
Magnesium • The adult body contains about 20 g magnesium, 70% of which is found in bones in combination with calcium and phosphorus. The remaining 30% occurs in the soft tissues and body fluid. • Biochemical functions: • Magnesium is required for the formation of bones and teeth. • Mg2+ serves as a cofactor for several enzymes requiring ATP e.g. hexokinase, glucokinase, phosphofructokinase, adenylatecyclase. • Mg2+is necessary for proper neuro-muscular function. Low Mg2+ levels lead to neuromuscular irritability.
Dietary requirement • Adult man – 350mg/day • Adult women – 300mg/day • Sources: • Cereals, nuts, beans, vegetables (cabbage, cauliflower), meat, milk, fruits. • Deficiency/disease states: • Magnesium deficiency causes neuro-muscular irritation, weakness and convulsions. • These symptoms are similar to that observed in tetany (Ca deficiency) which are relieved only by Mg. Malnutrition, alcoholism and cirrhosis of liver may lead to Mg deficiency. • Low levels of Mg may be observed in uremia, rickets and abnormal pregnancy.
Sodium • Sodium is the chief cation of the extracellular fluid. About 50% of body sodium is present in the bones, 40% in the extracellular fluid and the remaining (10%)in the soft tissues. • Biochemical functions: • In association with chloride and biocarbonate, sodium regulates the body’s acid-base balance. • Sodium is required for the maintenance of osmotic pressure and fluid balance. • It is necessary for the normal muscle irritability and cell permeability. • Sodium is involved in the intestinal absorption of glucose, galactose and amino acids. • It is necessary for initiating and maintaining heart beat.
Dietary requirements • For normal individuals, the requirement of sodium is about 5-10 g/day which is mainly consumed as NaCl. • For persons with a family history of hypertension, the daily NaCl intake should be less than 5g. • For patients of hypertension, around 1g/day is recommended. • It may be noted that 10g of NaCl contains 4g of sodium. • The daily consumption of Na is generally higher than required due to its flavor
Sources • The common salt (NaCl) used in the cooking medium is the cooking medium is the major source of sodium. • The ingested foods also contribute to sodium. • The good sources of sodium include bread, whole grains, leafy vegetables, nuts eggs and milk.
Deficiency/disease states • Hyponatremia • This is a condition in which the serum sodium level falls below the normal. • Hyponatremia may occur due to diarrhea, vomiting, chronic renal diseases, adrenocortical insufficiency (Addison’s disease). • Administration of salt free fluids to patients may also cause hypoaremia. • This is due to overhydration. • Deceased serum sodium concentration is also observed in edema which occurs in cirrhosis or congestive heart failure. • The manifestations of hyponatremia include reduced blood pressure and circulatory failure.
Hypernatremia • This condition is characterized by an elevation in the serum sodium level. • They symptoms include increase in blood volume and blood pressure. • It may occur due to hyperactivity of adrenal cortex (Cushing’s syndrome), prolonged administration of cortisone, ACTH and /or sex hormones. • Loss of water from the body causing dehydration, as it occurs in diabetes insipidus, results in hypernatremia. Rapid administration of sodium salts also increases serum sodium concentration. • It may be noted that in pregnancy, steroid and placental hormones cause sodium and water retention in the body, leading to edema. • In edema, along with water, sodium concentration in the body is also elevated. Administration of diuretic drugs increases the urinary output of water along with sodium. • In the patients of hypertension and congestive cardiac failure salt (Na+) restriction is advocated.
Potassium • Potassium is the principal intracellular cation. It is equally important in the extracellular fluid for specific functions. • Biochemical functions: • Potassium maintains intracellular osmotic pressure. • It is required for the regulation of acid-base balance and water balance in the cells. • The enzyme pyruvate kinase (of glycolysis) is dependent on K+ for optimal activity. • Potassium is required for the transmission of nerve impulse. • Adequate intracellular concentration K+ is necessary for proper biosynthesis of proteins by ribosomes. • Extracellular K+ influence cardiac muscles activity.
Dietary requirements • About 3-4 g/days • Sources: • Banana, orange , pineapple, potato, beans, chicken and liver. Tender coconut water is a rich source of potassium.
Deficiency/disease states • Serum potassium concentration is maintained within a narrow range. Either high or low concentrations are dangerous since potassium effects the contractility of heart muscle. • Hypokalemia: Decreased in the concentration of serum potassium is observed due to overactivity of adrenal cortex (Cushing’s syndrome), prolonged cortisone therapy, intravenous administration of K+ free fluids, treatment of diabetic coma with insulin, prolonged diarrhea and vomiting. The symptoms of hypokalemia include irritability, muscular weakness, tachycardia , cardiomegaly and cardiac arrest. Changes in the ECG are observed (flattened waves with inverted T wave)
Hyperkalemia • Increase in the concentration of serum potassium is observed in renal failure, adrenocortical insufficiency (Addison’s disease), diabetic coma, severe dehydration, intravenous administration of fluids with excessive potassium salts. • The manifestations of hyperkalemia include depression of central nervous system, mental confusion, numbness, bradycardia with reduced heart sounds and finally, cardiac arrest. Changes in ECG are also observed (elevated T wave).
Chlorine • Chlorine is a constituent of sodium chloride. Hence, the metabolism of chlorine and sodium are intimately related. • Biochemical functions: • Chlorine is involved in the regulation of acid-base equilibrium, fluid balance and osmotic pressure. These functions are carried out by the interaction of chlorine with Na+ and K+. • Chlorine is necessary for the formation of HCL in the gastric juice. • Chlorine shift involved the active participation of Cl-. • The enzyme salivary amylase is activated by chloride.
Dietary requirement • The daily requirement of chloride as NaCl is 5-10g. Adequate intake of sodium will satisfy the chloride requirement of the body. • Sources: • Common salt as cooking medium, whole grains, leafy vegetables, eggs and milk. • Deficiency/disease states: • Hypochloremia: A reduction in the serum Cl- level may occur due to vomiting, diarrhea, respiratory alkalosis, Addison’s disease and excessive sweating. • Hyperchloremia: An increase in serum Cl- concentration may be due to dehydration, respiratory acidosis and Cushing’s syndrome.
Sulfur • Sulfur of the body is mostly present in the organic form. Meithionine, cysteine and cysteine are the three sulfur-containing amino acids present in the proteins. Generally, proteins contains about 1% sulfur by weight. • Biochemical functions: • Sulfur-containing amino acids are very essential for the structural conformation and biological functions of proteins (enzymes, hormones, structural proteins etc.). The disulfide linkages( -S – S-) and sulfhydryl groups (- SH) are largely responsible for this. • The vitamins thiamine, biotin, lipoic acid, and coenzyme A of pantothenic acid contain sulfur.
Biochemical functions • Heparin, chondroitin sulfate, glutathione, taurocholic acid are some other important sulfur- containing compounds. • Phosphoadenosine phosphosulfate(PAPS) is the active sulfate utilized for several reactions e.g. synthesis of glycosaminoglycans, detoxification mechanism. • The sulfur-containing amino acid methionine (as S- adenosylmethionine) is actively involved in transmethylation reactions.
Dietary requirements • Dietary requirements: • There is no specific dietary requirement for sulfur. • Sources: • Adequate intake of sulfur-containing essential amino acid methionine will meet the body need. Food proteins rich in methionine and cysteine are the sources of sulfur.
Deficiency / disease states: • Sulfur is part of methionine and cysteine, which are amino acids needed in the making of proteins. So, if there is too little sulfur, or a sulfur deficiency, it could lead to reduced protein synthesis. • The sulfur-containing amino acid cysteine is also needed for making glutathione, which is somewhat of a superhero in body because it works as a potent antioxidant that protects cells from damage. So we see that a sulfur deficiency can cause a cascade of other problems. For instance, without sufficient sulfur to make cysteine, there could be reduced glutathione synthesis, which may contribute to cell damage
Deficiency / disease states: • Sulfur is also needed to create connective tissues that support joints, such as cartilage, tendons and ligaments. • So, connection, have a deficiency of sulfur could contribute to joint pain or disease. • In fact, sulfur contained in medications designed for joint health.
Micro-elements • Iron • Copper • Iodine • Manganese • Zinc • Molybdenum • Cobalt • Fluorine • Selenium • Chromium
Iron • The total content of iron is an adult body id 3-5g. About 70% of this occurs in the erythrocytes of blood as a constituent of hemoglobin. • At least 5% of body iron is present in myoglobin of muscle. • Heme is the most predominant iron containing substance. • It is a constituent of several proteins/enzymes (hemoproteins)- hemoglobin, myoglobin, cytochromes, xanthine oxidase, catalase, tryptophan pyrrolase, peroxidase. • Certain other proteins contain non-heme ion e.g. transferrin, ferritin, hemosiderin.
Biochemical functions • Iron mainly exerts its functions through the compounds in which it is present. Hemoglobin and myoglobin are required for the transport of O2 and CO2. • Cytochromes and certain non-heme proteins are necessary for electron transport chain and oxidative phosphorylation. • Peroxidase, the lysosomal enzyme, is required for phagocytosis and killing of bacteria by neutrophils. • Iron is associated with effective immuno- competence of the body.
Dietary requirements • Adult man –10 mg/day • Menstruating woman – 18 mg/day • Sources: • Rich sources – Organ meats (liver, heat, kidney). • Good sources – Leafy vegetables, pulses, cereals, fish, apples, dried fruits, molasses, jaggery. • Poor sources – Milk, wheat, polished rice.
Disease states • Iron deficiency anemia: :This is the most prevalent nutritional disorder worldover, including the well developed countries (e.g. USA). • Several factors may contribute to iron deficiency anemia. • These include inadequate intake or defective absorption of iron, chronic blood loss, repeated pregnancies and hookworm infections. • Strict vegetarian are more prone for iron deficiency anemia. This is due to the presence of inhibitors of iron absorption in the vegetarian foods, besides the relatively low content of iron. Iron deficiency anemia mostly occurs in growing children, adolescent girls, pregnant and lactating women. It is characterized by microcytic hypochromic anemia with reduced blood hemoglobin levels(<12g/dl). The other manifestation include apathy (dull and inactive), sluggish metabolic activities, related growth and loss of appetite. • Treatment: Iron deficiency is treated by supplementation of iron along with folic acid and vitamin C.
Disease states • Hemosiderosis: • This is a less common disorder and is due to excessive iron in the body, frequently referred to as iron toxicity. • It is commonly observed in subjects receiving repeated blood transfusions over the years, e.g. patients of hemolytic anemia, hemophilia. • As already stated, iron is a one-way compound, once it enters the body, it cannot escapes. • Excessive iron is deposited as ferritin and hemosiderin. Hemosiderosis is commonly observed among the bantu tribe in south Africa. • This is attributed to a high intake of iron from their staple diet corn and their habit of cooking food in iron pots.
Disease states • Hemochromatosis: This is a rate disease in which iron is directly deposited in the tissues (liver, spleen, pancreas and skin). • Hemosiderosis is sometimes accompanied by hemochromatosis. • Bronzed- pigmentation of the skin, cirrhosis of liver, pancreatic fibrosis are the manifestations of this disorder. • Hemochromatosis causes a condition known as bronze diabetes.
Copper • The body contains about 100mg copper distributed in different organs. It is involved in several important functions. • Biochemical functions: • Copper is an essential constituent of several enzymes. These include cytochrome oxidase, catalase, tyrosine, superoxide dismutase, monoamine oxidase, ascorbic acid oxidase, ALA synthase, phenol oxidase and uricase. Due to its presence in a wide variety of enzymes, copper is involved in many metabolic reactions. • Copper is necessary for the synthesis of hemoglobin (Cu is a constituent of ALA synthase, needed for heme synthesis). • Lysyl oxidase ( a copper containing enzyme) is required for the conversion of certain lysine residues of collagen and elastin to allysine which are necessary for cross-linking these structural proteins.
Biochemical functions • Ceruloplasmin serves as ferroxidase and is involved in the conversion of iron from Fe2+ to Fe3+ in which form iron (transferrin) is transported in plasma. • Copper is necessary for the synthesis of melanin and phospholipids. • Development of bone and nervous system (myelin) requires Cu. • Certain copper containing non-enzymatic proteins have been identified, although their functions are not clearly known. These include hepatocuprein (storage form in liver), cerebrocuprein (in brain) and hemocuprein (in RBC). • Hemocyanin, a copper protein complex in invertebrates, functions like hemoglobin for O2 transport.
Dietary requirements • Adults – 2-3 mg/day • Infants and children – 0.5-2 mg/day • Sources: • Liver, kidney, meat, egg yolk, cereals, nuts and green leafy vegetables. Milk is a poor source.
Deficiency /disease states • Copper deficiency: Several deficiency of copper causes demineralization of bones, demyelination of neural tissue, anemia, fragility of arteries, myocardial fibrosis, hypopigmentation of skin, greying of hair. • Menke’s disease: This disorder is due to a defect in the intestinal absorption of copper. It is possible that copper may be trapped by metallothionein in the intestinal cells. The symptoms of Menke’s disease include decreased copper in plasma and urine, anemia and depigmentation of hair.
Deficiency /disease states • Wilson’s disease: Wilson’s disease (hepatolenticular degeneration) is a rare disorder (1:50,000) of abnormal copper metabolism and is characterized by the following manifestations. • Copper is deposited in abnormal amounts in liver and lenticular nucleus of brain. This may lead to hepatic cirrhosis and brain necrosis. • Low levels of copper and ceruloplasmin in plasma (reference range 20-50mg/dl) with increased excretion of copper in urine. • Copper deposition in kidney causes renal damage. This leads to increased excretion of amino acid, glucose, peptides and hemoglobin in urine. • Intestinal absorption of copper is very high, about 4-6 times higher than normal.
Iodine • The total body contains about 20mg iodine most of it (80%) being present in the thyroid gland. Muscle, salivary glands and ovaries also contain some amount of iodine. • Biochemical functions: • The only known function of iodine is its requirement for the synthesis of thyroid hormones namely, thyroxine (T4) and trriodothyronine (T3). T3 is more active in its biological functions than T4.
Biochemical functions • Influence on the metabolic rate: Thyroid hormones stimulate the metabolic activities and increases the oxygen consumption in most of the tissues of the body (exception- brain, lungs, testes and retina) • Effect on protein synthesis: Thyroid hormones act like steroid hormones in promoting protein synthesis by acting at the transcriptional level (activated DNA to produce RNA). Thyroid hormones, thus, function as anabolic hormones and cause positive nitrogen balance and promote growth and development.
Biochemical functions • Influence on carbohydrate metabolism: Thyroid hormones promote intestinal absorption of glucose and its utilization. These hormones increase gluconeogenesis and glycogenolysis, with an overall effect of enhancing blood glucose level (hyperglycemia). • Effect on lipid metabolism: Lipid turnover and utilization are stimulated by thyroid hormones. Hypothyroidism is associated with elevated plasma cholesterol levels which can be reversed by thyroid hormone administration.
Dietary requirements • Adults- 100-150µg/day • Pregnant women - 200µg/day • Sources: • Sea foods, drinking water, vegetables, fruits (grown on seaboard). High altitudes are deficient in iodine content in water as well as soil. Plant and animal foods of these areas, therefore, contain lesser amount of iodine. In these regions iodine is added to drinking water or table salt.
Deficiency /disease states • Goiter: Any abnormal increase in the size of the thyroid gland is known as goiter. Enlargement of thyroid gland is mostly to compensate the deceased synthesis of thyroid hormones and is associated with elevated TSH. Goiter is primarily due to a failure in the auto regulation of T3and T4 synthesis. This may be caused by deficiency or excess of iodine. • Goitrogenic substances (goitrogens): These are the substances that interfere with the production of thyroid hormones. These include thiocyanates, nitrates and perchlorates and the drugs such as thiourea, thiouracil, thiocarbamide etc. certain plant foods – cabbage, cauliflower and turnip – contain goitrogenic factors (mostly thiocyanates).
Deficiency /disease states • Simple endemic goiter: This is due to iodine deficiency in the diet. It is mostly found in the geographical regions away from sea coast where the water and soil are low in iodine content. Consumption of iodized salt is advocated to overcome the problem of endemic goiter. In certain cases, administration of thyroid hormone is also employed. • Hyperthyroidism: This is also known as thyrotoxicosis and is associated with over- production of thyroid hormones. Hyperthyroidism is characterized by increased metabolic rate (higher BMR) nervousness, irritability, anxiety, rapid heart rate, loss of weight despite increased appetite, weakness, diarrhea, sweating sensitivity to heart and often protrusion eyeballs (exophthalmos).
Hyperthyroidism • Hyperthyroidism is caused by Grave’s disease (particularly in the developed countries) or due to increased intake of thyroid hormones. Grave’s disease is due to elevated thyroid stimulating IgG also known as long acting thyroid stimulator (LATS) which activates TSH and, thereby , increases thyroid hormonal production. • Hypothyroidism: This is due to an impairment in the function of thyroid gland that often causes decreased circulatory levels of T3 and T4. Disorder of pituitary or hypothalamus also contribute to hypothyroidism. Women are more susceptible than men. Hypothyroidism is characterized by reduced BMR, slow heart rate, weight gain, sluggish behaviour, constipation, sensitivity to cold, dry skin etc. Hypothyroidism in children is associated with physical and mental retardation, collectively known as cretinism.
Manganese • The total body content of manganese is about 15mg. The liver and kidney are rich in Mn. Within the cells, Mn is mainly found in the nuclei in association with nucleic acids. • Biochemical functions: • Mn serve as a cofactor for several enzymes. These include arginase, pyruvate carboxylase, isocitrate dehydrogenase, superoxidase dismutase (mitrochondrial) peptidase. • Mn is required for the formation of bone, proper reproduction and normal functioning of nervous system.
Biochemical functions • Mn is necessary for the synthesis of mucopolysaccharides and glycoproetins. • Hemoglobin synthesis involves Mn. • Mn inhibits lipid peroxidation. • Mn is necessary for cholesterol biosynthesis
Dietary requirements • The exact requirement of Mn is not known. About 2- 9mg/day is recommended for an adult. • Sources: • Cereals, nuts ,leafy vegetables and fruits. Tea is rich sources of Mn.
Deficiency/ disease states • Mn deficiency in animals causes: • Retarded growth, bone deformities and, in severe deficiency, sterility. • Accumulation of fat in liver. • Increased activity of serum alkaline phosphatase, and • Diminished activity of β- cells of pancreas (low insulin).
Zinc • The total content of zinc in an adult blood is about 2g. Prostate gland is very rich in Zn (100mg/g). Zinc is mainly an intracellular element. • Biochemical functions: • Zn is an essential component of several enzymes e.g. carbonic anhydrase, alcohol dehydrogenase, alkaline phosphatase, carboxy-peptidase, superoxidase dismutase (cytosolic). • Zinc may be regarded as an antioxidant since the enzyme superoxide dismutase (Zn containing ) protects the body against free radicals damage.
Biochemical functions • The storage and secretion of insulin form the β- cells of pancreas require Zn. • Zn is necessary to maintain the normal levels of vitamin A in serum. Zn promotes the synthesis of retinol binding protein. • It is required for wound healing . Zn enhances cell growth and division, besides stabilizing biomembranes. • Gusten, a zinc containing protein of the saliva, is important for taste sensation. • Zn is essential for proper reproduction.
Dietary requirements • Zinc requirement for an adult is 10 -15 mg/day. It is increased (by about 50%) in pregnancy and lactation. • Sources: • Meat, fish, eggs, milk, beans, nuts.
Deficiency / disease states • Zinc deficiency is associated with growth retardation, poor wound healing, anemia, loss of appetite , loss of taste sensation, impaired spermatogenesis etc. • It is reported that Zn deficiency in pregnant animals causes congenital malformations of the fetus. • Deficiency of Zn may result in depression, dementia and other psychiatric disorders. • The neuropsychiatric manifestations of chronic alcoholism may be partly due to zinc deficiency.
Deficiency / disease states • Acrodermatitis enteropathica is a rare inherited metabolic disease of zinc deficiency caused by a defect in the absorption of Zn from, the intestine. • Zinc toxicity is often observed in welders due to inhalation of zinc oxide fumes. The manifestations of Zn toxicity include nausea, gastric ulcer, pancreatitis, anemia and excessive salivation.
Molybdenum • Molybdenum is a constituent of the enzymes xanthine oxidase, aldehyde oxidase and sulfite oxidase. • Nitrite reductase (containing Mo)is a plant enzyme, required for nitrogen fixation. • The requirements of Mo are not clearly known. • However, it is widely distributed in the natural foods. Dietary Mo is effectively (60%-70%) absorbed by the small intestine. • Some workers have reported that Mo decreases the mobilization and utilization of copper in the body. • Molybdenosis is a rare disorder caused by excessive consumption of Mo. • Its manifestations include impairment in growth, diarrhea and anemia. • Intestinal absorption of copper is diminished.
Biochemical functions • The molybdoenzymes in man are sulphite oxidase, xanthine oxidase/dehydrogenase and aldehyde oxidase. • The former is essential for detoxication of the sulphite arising from metabolism of sulphur- containing amino acids, from ingestion of bisulphite preservative and from inhalation of sulphur dioxide, an atmospheric pollutant. • The reactions catalysed by xanthine oxidase/dehydrogenase and aldehyde oxidase are necessary for human well-being has yet to be established
Dietary requirements • Adult men and women is 109 and 76 μg/day • Sources: • Legumes, such as beans, lentils, and peas, are the richest sources of molybdenum. Grain products and nuts are considered good sources, while animal products, fruit, and many vegetables are generally low in molybdenum
Deficiency /Disease states • The deficiency caused intellectual disability, seizures, opisthotonus, and lens dislocation. • Molybdenum deficiency resulting in sulfite toxicity occurred in a patient receiving long- term TPN (Total parenteral nutrition). • Symptoms were tachycardia, tachypnea, headache, nausea, vomiting, and coma
Cobalt • Cobalt is only important as a constituent of vitamin B12 (cobalamin) cobalt content of vitamin B12 is about 4% by weight. • The functions of cobalt are the same as that of vitamin B12. • Administration of cobalt stimulates the production of the hormones erythropoietin, which promotes erythropoiesis. • Prolonged administration of cobalt is toxic as it results in polycythemia (increased RBC in blood).
Biochemical functions • Cobalt is an essential trace element that is an integral part of vitamin B12, which is essential in the metabolism of folic acid and fatty acids. • Besides cobalt is involved in the production of red blood cells and is important for the proper functioning of the nervous system as it can help in creating a myelin sheath. • Dietary requirements: • The average adult intake of cobalt is 5–8 mcg per day. A safe Recommended Dietary Allowance (RDA) for cobalt hasn't been set yet.
Sources • Meat, liver, kidneys, milk, oysters, muscles, fish, shellfish. Smaller amounts of cobalt are found in mushrooms (especially shitake). In fruits and vegetables, usually there are no cobalt (with the exception of legumes, spinach, cabbage, lettuce, turnips, cabbage, figs). • Deficiency /Disease states: • If you have a cobalt deficiency, this also means you have a vitamin B-12 deficiency. Anemia is a main cause of a cobalt deficiency. This is the case with pernicious anemia. Symptoms can include numbness, fatigue and tingling in hand and feet.
Fluorine • Fluorine is mostly found in bones and teeth. The beneficial effects of fluoride in trace amounts are overshadowed by its harmful effects caused by excess consumption. • Biochemical functions: • Fluorine prevents the development of dental caries. It forms a protective layer of acid resistant fluoroapatite with hydroxyapatite of the enamel and prevents the tooth decay by bacterial acids. Further, inhibits the bacterial enzymes and reduces the production of acids. • Fluorine is necessary for the proper development of bones. • It inhibits the activities of certain enzymes. Sodium fluoride inhibits enolase (of glycolysis) while fluoroacetate inhibits aconitase (of citric acid cycle).
Dietary requirements • An intake of less than 2 ppm of fluorine will meet the daily requirements. • Sources: • Drinking water is the main sources. • Deficiency/Disease states: • Dental caries: It is clearly established that drinking water containing less than 0.5ppm of fluoride is associated with the development of dental caries in children. • Fluorosis: Excessive intake of fluoride is harmful to the body. An intake above 2ppm (particularly >5ppm)in children causes mottling of enamel and discoloration of teeth. The teeth are weak and become rough with characteristic brown or yellow patches on their surface. These manifestations are collectively referred to as dental fluorosis.
Selenium • Selenium was originally identified as an element that causes toxicity to animals (alkali disease) in some parts of USA, containing large amounts of Se in the soil. Later work, however, has shown that Se in smaller amounts is biologically important. • Biochemical functions: • Selenium, along with vitamin E, prevents the development of hepatic necrosis and muscular dystrophy. • Se is involved in maintaining structural integrity of biological membranes. • Se as selenocysteine is an essential component of the enzyme glutathione peroxidase. This enzyme protects the cells against the damage caused by H2O2. It appears from recent studies that selenocysteine is directly incorporated during protein biosynthesis. Therefore, selenocysteine is considered as a separate amino acid.
Dietary Requirements • A daily intake of 50-200mg of Se has been recommended for adults. • Sources: • The good sources of Se are organ meats (liver, kidney) and sea foods. • Deficiency / Disease states: • Deficiency: Se deficiency in animals leads to muscular dystrophy, pancreatic fibrosis and reproductive disorders. In humans, keshan disease, an endemic cardiomyopathy (in china) is attributed to the deficiency of Se. Epidemiological studies reveal that low serum Se levels are associated with increased risk of cardiovascular disease, and various cancers.
Chromium • The total human body contains about 6mg chromium. The Cr content of blood is about 20mg/dl. • Biochemical functions: • In association with insulin, Cr promotes the utilization of glucose. Cr is a component of a protein namely chromodulim which facilities the binding of insulin to cell receptor sites. • Cr lowers the total serum cholesterol level. • It is involved in lipoprotein metabolism. Cr decreases serum low density lipoproteins (LDL) and increases high density lipoproteins (HDL) and, thus, promotes health. • It is believed that Cr participates in the transport of amino acids into the cells (heart and liver)
Dietary requirements • The dietary requirement of Cr is not known. It is estimated that an adult man consumed about 10 to 100mg/day. • Sources: • The good sources of Cr include brewer’s yeast, grains, cereals, cheese and meat. • Deficiency /Disease states: • Chromium deficiency causes disturbances in carbohydrate, lipid and protein metabolisms. Excessive intake of Cr results in toxicity, leading to liver and kidney damage.
Ions • Electrolytes are the compound which readily dissociate in solution and exist as ions i.e. positively and negatively charged particles. • For instance, NaCl does not exist as such, but it exist as cation (Na+) and anion (Cl-). • The concentration of electrolytes are expressed as milliequivalents (mEq/l) rather than milligrams. • A gram equivalent weight of a compound is defined as its weight in grams that can combine or displace 1g of hydrogen. One gram equivalent weight is equivalent to 1,000 milliequivalents. • The following formula is employed to convert the concentration mg/l to mEq/l • mEq/l= 𝑚𝑔 𝑝𝑒𝑟 𝑙𝑖𝑡𝑟𝑒×𝑉𝑎𝑙𝑒𝑛𝑐𝑦 𝐴𝑡𝑜𝑚𝑖𝑐 𝑤𝑒𝑖𝑔ℎ𝑡
Electrolyte composition of body fluid • Electrolytes are well distributed in the body fluids in order to maintain the osmotic equilibrium and water balance. • A comparison of electrolytes present in extracellular (plasma) and intracellular (muscles) fluid is given in table below:
Extracellular fluid (plasma) Intracellular fluid (muscle) Cations Anion Cations Anion Na+ 142 Cl- 103 K+ 150 HPO2- 4 140 K+ 5 HCO- 3 27 Na+ 10 HCO- 3 10 Ca2+ 5 HPO 2- 4 2 Mg2+ 40 Cl- 2 Mg2+ 3 SO2- 4 1 Ca2+ 2 SO2- 4 5 Proteins 16 Proteins 40 6 Organic acids 5 Organic acids 155 155 202 202
Electrolyte composition of body fluid • The total concentration of cations and anions in reach in each body compartment (ECF or ICF) is equal to maintain electrical neutrality . • There is a marked difference in the concentration of electrolytes (cations and anions) between the extracellular and intracellular fluids. • Na+ is the principle extracellular cation while K+ is the intracellular cation. • This difference in the concentration is essential for the cell survival which is maintained by Na+ - K+ pump. • As regards anions, Cl- and HCO- 3 predominantly occur in extracellular fluids, while HPO- 4, proteins and organic acids are found in the intracellular fluids.
Osmolarity and osmolality of body fluid • There are two ways of expressing the concentration of molecules with regard to the osmotic pressure. • Osmolarity: The number of moles (or millimoles) per liter of solution. • Osmolality: The number of moles ( or millimoles) per kg of solvent. • If the solvent is pure water, there is almost no difference between osmolarity and osmolality. However, for biological fluids (containing molecules such as proteins), the osmolality is more commonly used. This is about 6% greater than osmolarity.
Osmolality of plasma • Osmolality is a measure of the solute particles present in the fluid medium. The osmolality of plasma is in the range of 285-295 milliosmoles/kg. Constituent (solute ) Osmolality (mosm/kg) Sodium 135 Associated anions 135 Potassium 3.5 Associated anions 3.5 Calcium 1.5 Associated anions 1.5 Magnesium 1.0 Associated anions 1.0 Urea 5.0 Glucose 5.0 Protein 1.0 Total 293
Osmolality of ECF and ICF • Movement of water across the biological membranes is dependent on the osmotic pressure differences between the intracellular fluid (ICF) and extracellular fluid(ECF). • In a healthy state, the osmotic pressure of ECF, mainly due to Na+ ions, is equal to the osmotic pressure of ICF which is predominantly due to K+ ions. • As such, there is no net passage of water molecules in or out of the cells, due to this osmotic equilibrium.
Regulation of electrolyte balance • Electrolyte and water balance are regulated together and the kidneys play a predominant role in this regard. The regulation is mostly achieved through the hormones aldosterone, ADH and renin-angiotensin. • Aldosterone: It is a mineralocorticoid produced by adrenal cortex. Aldosterone increases Na+ reabsorption by the renal tubules at the expense of K+ and H+ ions. The net effect is the retention of Na+ in the body. • Antidiuretic hormone (ADH): An increase in the plasma osmolality (most due to Na+) stimulates hypothalamus to release ADH, ADH effectively increases water reabsorption by renal tubules. • Renin-angiotensin: The secretion of aldosterone is controlled by renin-angiotensin system. Decrease in the blood pressure (due to a fall in ECF volume) is sensed by juxtaglomerular apparatus of the nephron which secrete renin. Renin acts on angiotensinogen to produce angiotensin I. The latter is then converted to angiotensin II which stimulates the release of aldosterone.
Regulation of electrolyte balance • The relation between renin, angiotensin and aldosterone in the regulation of Na+ balance is depicted in figure. • Aldosterone and ADH coordinate with each other to maintain the normal fluid and electrolyte balance. • Atrial natriuretic factor (ANF): ANF or atriopeptin is a 28 amino acids containing peptide. • It is produced in the atrium of heart in response to increased blood volume, elevated blood pressure and high salt intake. • ANF acts on kidneys to increase GFR, sodium excretion and urine output. • Thus ANF opposes the actions of renin and aldosterone (which increase salt retention and blood pressure).
Na+ concentration and ECF • It is important to realize that Na+ and its anions (mainly Cl-) are confined to the extracellular fluid. • And the retention of water in the ECF is directly related to the osmotic effects of these ions (Na+ and Cl-). • Therefore, the amount of Na+ in the ECF ultimately determines its volume.
Dietary intake and electrolyte balance • Generally, the consumption of a well-balanced diet supplies the body requirement of electrolytes. • Humans do not possess the ability to distinguish between the salt hunger and water hunger. • Thirst, however, may regulate electrolyte intake also. • In hot climates, the loss of electrolyte intake also. • In hot climates, the loss of electrolyte is usually higher. • Sometimes it may be necessary to supplement drinking water with electrolytes.
Dehydration • Dehydration is a condition characterized by water depletion in the body. It may be due to insufficient intake or excessive water loss or both. Dehydration is generally classified into two types. • Due to loss of water alone. • Due to deprivation of water and electrolytes. • Causes of dehydration: • Dehydration may occur as a result of diarrhea, vomiting, excessive sweating, fluid loss in burns, adrenocortical dysfunction, kidney diseases (e.g. renal insufficiency), deficiency of ADH (diabetes insipidus) etc.
Characteristics features of dehydration • There are three degrees of dehydration mild, moderate and severe. The salient features of dehydration are given hereunder. • The volume of the extracellular fluid (e.g. plasma) is decreased with a concomitant rise in electrolyte concentration and osmotic pressure. • Water is drawn from the intracellular fluid that result in shrunken cells and distributed metabolism e.g. increased protein breakdown.
Characteristics features of dehydration • ADH secretion is increased. This causes increased water retention in the body and consequently urine volume is very low. • Plasma protein and blood urea concentrations are increased. • Water depletion is often accompanied by a loss of electrolytes from the body (Na+, K+ etc.) • The principal clinical symptoms of severe dehydration include increased pulse rate, low blood pressure, sunken eyeballs, decreased skin turgor, lethargy, confusion and coma.
Treatment • The treatment of choice for dehydration is intake of plenty of water. • In the subjects who cannot take orally, water should be administered intravenously in an isotonic solution (usually 5% glucose). • If the dehydration is accompanied by loss of electrolytes, the same should be administered by oral or intravenous routes. • This has to be done by carefully monitoring the water and electrolyte status of the body
Osmotic imbalance and dehydration in cholera • Cholera is transmitted through water and foods, contaminated by the bacterium vibrio cholerae. • This bacterium produces a toxin which stimulates the intestinal cells to secrete various ions (Cl-, Na+, K+, HCO- 3 etc.) into the intestinal lumen. • These ions collectively raise the osmotic pressure and suck the water into lumen. • This results in diarrhea with a heavy loss of water (5- 10liters/ day). • If not treated in time, the victims of cholera will die due to dehydration and loss of dissolved salts. • Thus, cholera and others forms of severe diarrhea are the major killer of young children in many developing countries • Oral redehydration therapy (ORT) is commonly used to treat cholera and other diarrheal diseases.
Overhydration • Overhydration or water intoxication is caused by excessive retention of water in the body. • This may occur due to excessive intake of large volumes of salt free fluids, renal failure overproduction of ADH etc. • Overhydration is observed after major trauma or operation, lung infections etc. • Water intoxication is associated with dilution of ECF and ICF with a decrease in osmolality. • The clinical symptoms include headache, lethargy and convulsions. • The treatment advocated is stoppage of water intake and administration of hypertonic saline.
Water tank model • The distribution of body water (in the ECF and ICF) dehydration and overhydration can be better understood by a water tank model. • The tank has an inlet and outlet, respectively, representing the water intake (mostly oral) and water output (mainly urine) by the body. • Dehydration is caused when the water output exceed the intake. • One the other hand, overhydration is due to more water intake and less output.
Metabolism of electrolytes • The body distribution, dietary intake, intestinal absorption and biochemical functions of individual electrolytes. • The electrolyte disorders, particularly hypernatremia and hyponatremia (of sodium); hyperkalemia and hypokalemia (of potassium)must also be referred. • Diuretics in the treatment of edema and hypertension: • Diuretics are the drugs that stimulate water and sodium excretion, so that urine volume is increased. • The commonly used diuretics are bendrofluazide, frusemide, spironolactone and mannitol. • Diuretics are important in the treatment of edema, heart failure and hypertension.
Water in life processes • Water is the solvent of life. Undoubtedly, water is more important than any other single compound to life. It is involved in several body functions. • Function of water: • Water provides the aqueous medium to the organism which is essential for the various biochemical reactions to occur. • Water directly participates as a reactant in several metabolic reactions. • It serves as a vehicle for transport of solutes. • Water is closely associated with the regulation of body temperature.
Distribution of water • Water is the major body constituent. An adult human contains about 60% water (men 55-70%, women 45-60%). • The women and obese individuals have relatively less water which is due to the higher content of stored fat in an anhydrous form. • A 70 kg normal man contains about 42 liters of water. • This is distributed in intracellular (inside the cells 28l) and extracellular (outside the cell 14l) compartments, respectively known as intracellular fluid (ICF) and extracellular fluid (ECF). • The ECF is future divided into interstitial fluid (10.5l) and plasma (3.5l). • The distribution of water in man is given in table below:
Compartment % Body weight Volume (l) Total 60 42 Intracellular fluid (ICF) 40 28 Extracellular fluid (ECF) 20 14 Interstitial fluid 15 10.5 Plasma 5 3.5
Water turnover and balance • The body possesses tremendous capacity regulate its water content. In a healthy individual, this is achieved by balancing the daily water intake and water output. • Water intake: • Water is supplied to the body by exogenous and endogenous sources • Exogenous water: Ingested water and beverage, water content of solid foods constitute the exogenous source of water. • Water intake is highly variable which may range from 0.5-5 litres. It largely depends on the social habits and climate. • In general, people living in hot climate drink more water. Ingestion of water is mainly controlled by a thirst centre located in the hypothalamus. • Increased in the osmolality of plasma causes increased water intake by stimulating thirst centre.
Water turnover and balance • Endogenous water: The metabolic water produce within the body is the endogenous water. • This water (300-350ml/day) is derived from the oxidation of foodstuffs. • It is estimated that 1g each of carbohydrate, protein and fat, respectively, yield 0.6ml, 0.4ml and 1.1ml of water. • On an average, about 125ml of water is generated for 1,000Cal consumed by the body.
Water output • Water losses from the body are variable. There are four distinct routes for the elimination of water the body-urine, skin , lungs and feces. • Urine: • This is the major route for water loss from the body. In a healthy individual, the urine output is about 1 -2l/day. • Water loss through kidneys although highly variable, is well regulated to meet the body demands-to get rid of water or to retain. • It should, however, be remembered that man cannot completely shut down urine production, despite there being no water intake. • This is due to the fact that some amount of water (about 500ml/day) is essential as the medium to eliminate the waste products from the body.
Hormonal regulation of urine production • It is indeed surprising to know that about 180litres of water is filtered by the glomeruli into the renal tubules everyday. However, most of this is reabsorbed and only 1-2 litres is excreted as urine. Water excretion by the kidney is tightly controlled by vasopressin also known as antidiuretic hormone (ADH) of the posterior pituitary gland. The secretion of ADH is regulated by the osmotic pressure of plasma. An increase in osmolality promotes ADH secretion that leads to an increased water reabsorption from the renal tubules (less urine output). On the other hand, a decrease in osmolality suppresses ADH secretion that results in reduced water reabsorption from the renal tubules (more urine output). Plasma osmolality is largely dependent on the sodium concentration, hence sodium indirectly controls the amount of water in the body. • Diabetes insipidus is a disorder characterized by the deficiency of ADH which results in an increased loss of water from the body.
Skin • Loss of water (450ml/day) occurs through the body surface by perspiration. • This is an unregulated process by the body which mostly depends on the atmospheric temperature and humidity. • The loss is more in hot climate. Fever causes increased water loss through the skin. • It is estimated that for every 1ºC rise in body temperature, about 15% increase is observed in the loss of water (through skin).
Lungs • During respiration, some amount of water (about 400ml/day) is lost through the expired air. • The latter is saturated with water and expelled from the body. • In hot climates and / or when the person is suffering from fever, the water loss through lungs is increased. • The loss of water by perspiration (via skin) and respiration(via lungs) is collectively referred to as insensible water loss.
Feces • Most of the water entering the gastrointestinal tract is reabsorbed by the intestine. • About 150ml/day is lost through feces in a healthy individual. • Fecal loss of water is tremendously increased in diarrhea. • A summary of the water intake and output in the body is depicted in below figure:
Body water 42,000ml Foodstuffs (700ml) Drinking water and beverages (1,500ml) Metabolic water (300ml) Feces (150 ml) Lungs (400ml) Skin(450ml) Urine (1,500ml)
Feces • It may be noted that water balance of the body is regulated predominantly by controlling the urine output. • This happens after an obligatory water loss via skin, lungs and feces. • The abnormalities associated with water balance dehydration and over hydration will be described, following a discussion on electrolytes balance.

More Related Content

PPTX
Pharmaceutical analysis,
byRavi Sheoran
 
PPTX
Introduction to pharmaceutical chemistry, source types of errors & impurities...
byGulam Muheyuddeen
 
PPTX
Lymphatic System (B PHARM, D, PHARM).pptx
bySHUBHAM KUMAR MAURYA
 
PPTX
Limit test for iron
byShikha Agrawal
 
PPTX
limit test for iron
byTAUFIK MULLA
 
PPTX
Gastro ia ppt
byavinash thalkari
 
PPTX
Limit test for sulphate
byShikha Agrawal
 
PPTX
limit test for arsenic
byTAUFIK MULLA
 
Pharmaceutical analysis,
byRavi Sheoran
 
Introduction to pharmaceutical chemistry, source types of errors & impurities...
byGulam Muheyuddeen
 
Lymphatic System (B PHARM, D, PHARM).pptx
bySHUBHAM KUMAR MAURYA
 
Limit test for iron
byShikha Agrawal
 
limit test for iron
byTAUFIK MULLA
 
Gastro ia ppt
byavinash thalkari
 
Limit test for sulphate
byShikha Agrawal
 
limit test for arsenic
byTAUFIK MULLA
 

What's hot

PPTX
Evaluation of suppositories
bySIHAS
 
PPTX
Isotonic solutions
byMedical Knowledge
 
PPTX
Electrolyte replenishers
bykencha swathi
 
PPTX
Experiment no. 2 Limit test for sulphates.pptx
byanumalagundam sreekanth
 
PPT
Integumentary System SMP B. Pharm Sem I.ppt
byshraddhaparab530
 
PPTX
To prepare and submit compouns ferrous phosphate syrup WPS Office.pptx
byDr. Sudipta Roy
 
PPTX
4.limit test for iron
byDR.Gopinathan Narasimhan
 
PPTX
Pharmaceutics Unit -3.pptx
byNikita Gupta
 
PPTX
To prepare and submit Piperazine Citrate Elixir B.P. WPS Office.pptx
byDr. Sudipta Roy
 
PPTX
Limit test for chloride
byDR.Gopinathan Narasimhan
 
PPTX
Limit test of Arsenic
bySonali Pawar
 
PPTX
Monophasic liquid dosage form B.Pharmacy 1st Sem PTU by pankaj kumar maurya
byPankaj Maurya
 
PPTX
12. acidifying reagents or acidifiers
byNikithaGopalpet
 
PPTX
Heamatinics.pptx
byknowtoday1
 
PDF
Non-aq. Titration.pdf
byJasmine Chaudhary
 
PDF
Limit test for iron
byDr Yogi Pandya
 
PPTX
Pharmaceutics Unit - 5.pptx
byNikita Gupta
 
PPTX
General introduction of limit test and limit test for chloride.
byMahima Dubey
 
PPTX
Haematinics
byAADHIBHAGAWAN COLLEGE OF PHARMACY, THIRUVANNAMAI, TAMIL NADU
 
PDF
ANTACID AND ITS PREPARATION
bySURAJKUMARSHRIVASTAV1
 
Evaluation of suppositories
bySIHAS
 
Isotonic solutions
byMedical Knowledge
 
Electrolyte replenishers
bykencha swathi
 
Experiment no. 2 Limit test for sulphates.pptx
byanumalagundam sreekanth
 
Integumentary System SMP B. Pharm Sem I.ppt
byshraddhaparab530
 
To prepare and submit compouns ferrous phosphate syrup WPS Office.pptx
byDr. Sudipta Roy
 
4.limit test for iron
byDR.Gopinathan Narasimhan
 
Pharmaceutics Unit -3.pptx
byNikita Gupta
 
To prepare and submit Piperazine Citrate Elixir B.P. WPS Office.pptx
byDr. Sudipta Roy
 
Limit test for chloride
byDR.Gopinathan Narasimhan
 
Limit test of Arsenic
bySonali Pawar
 
Monophasic liquid dosage form B.Pharmacy 1st Sem PTU by pankaj kumar maurya
byPankaj Maurya
 
12. acidifying reagents or acidifiers
byNikithaGopalpet
 
Heamatinics.pptx
byknowtoday1
 
Non-aq. Titration.pdf
byJasmine Chaudhary
 
Limit test for iron
byDr Yogi Pandya
 
Pharmaceutics Unit - 5.pptx
byNikita Gupta
 
General introduction of limit test and limit test for chloride.
byMahima Dubey
 
Haematinics
byAADHIBHAGAWAN COLLEGE OF PHARMACY, THIRUVANNAMAI, TAMIL NADU
 
ANTACID AND ITS PREPARATION
bySURAJKUMARSHRIVASTAV1
 

Similar to Role of minerals, ions and water in.pptx

PPTX
Calcium biochemical role, rda and deficiency
byJasmineJuliet
 
PPTX
6 Minerals.pptxbiochemistryyyyyyyyyyyyyy
byAnnaKhurshid
 
PPT
MINERALS lecture for pharmacy undergrad level students
byhafizayyub
 
PPT
Water and mineral metabolism
byKuldeep Bansod
 
PPTX
CALCIUM METABOLISM
byYESANNA
 
PPTX
Ca& P/ biochemistry/ ca and P/ biochemistry
byDrJyoti Arora
 
PPTX
Overview of calcium in human muscles.pptx
bysafaparvin28
 
PPTX
calcium and oral health
byShweta Deolekar
 
PPTX
Mineral metabolism
byAreeba Ghayas
 
PDF
Calcium, phosphorus, potassium
byiqra ejaz
 
PPTX
mineral metabolism book pdf gonna be good
byAnindyaSaha39
 
PPT
Water and Mineral Metabolism (Na,K,Ca,P,Cl).ppt
bybalootkhan9
 
PPTX
MATABOLISM OF CALCIUM & PHOSPHOROUS
byYESANNA
 
PPTX
SOURCES ,BIOCHEMICAL FUNCTION AND CLINICAL SIGNIFICANCES OF CALCIUM AND PH...
byAqsa Mushtaq
 
PPTX
VITAMIN D, CALCIUM, PHOSPHATE METABOLISM
byK.L.E.V.K.INSTITUTE OF DENTAL SCIENCES
 
PPTX
CALCIUM AND ITS CLINICAL IIMPORTANCE
byMatavalam siva kumar reddy
 
PPTX
Major minerals
byAkanksha Dubey
 
PPTX
calcium and phosphate lecture for medical students.pptx
byDrMAmjidAfridi
 
PPTX
CALCIUM IN BIOLOGICAL SYSTEM
bySPCGC AJMER
 
PPT
Cal. po4 by dr tasnim
bydr Tasnim
 
Calcium biochemical role, rda and deficiency
byJasmineJuliet
 
6 Minerals.pptxbiochemistryyyyyyyyyyyyyy
byAnnaKhurshid
 
MINERALS lecture for pharmacy undergrad level students
byhafizayyub
 
Water and mineral metabolism
byKuldeep Bansod
 
CALCIUM METABOLISM
byYESANNA
 
Ca& P/ biochemistry/ ca and P/ biochemistry
byDrJyoti Arora
 
Overview of calcium in human muscles.pptx
bysafaparvin28
 
calcium and oral health
byShweta Deolekar
 
Mineral metabolism
byAreeba Ghayas
 
Calcium, phosphorus, potassium
byiqra ejaz
 
mineral metabolism book pdf gonna be good
byAnindyaSaha39
 
Water and Mineral Metabolism (Na,K,Ca,P,Cl).ppt
bybalootkhan9
 
MATABOLISM OF CALCIUM & PHOSPHOROUS
byYESANNA
 
SOURCES ,BIOCHEMICAL FUNCTION AND CLINICAL SIGNIFICANCES OF CALCIUM AND PH...
byAqsa Mushtaq
 
VITAMIN D, CALCIUM, PHOSPHATE METABOLISM
byK.L.E.V.K.INSTITUTE OF DENTAL SCIENCES
 
CALCIUM AND ITS CLINICAL IIMPORTANCE
byMatavalam siva kumar reddy
 
Major minerals
byAkanksha Dubey
 
calcium and phosphate lecture for medical students.pptx
byDrMAmjidAfridi
 
CALCIUM IN BIOLOGICAL SYSTEM
bySPCGC AJMER
 
Cal. po4 by dr tasnim
bydr Tasnim
 

More from Jyoti Balmiki

PPTX
FIXATION Histopathology and Cytopathology
byJyoti Balmiki
 
PPTX
Cyto-pathology medical laboratory 3rd year
byJyoti Balmiki
 
PPTX
DECALCIFICATION histopathology and cytopathology
byJyoti Balmiki
 
PPTX
Staining methods.pptx
byJyoti Balmiki
 
PPTX
vitamins.pptx
byJyoti Balmiki
 
PPTX
Examination of urine.pptx
byJyoti Balmiki
 
PPTX
Effusions pericardial.pptx
byJyoti Balmiki
 
PDF
Online marketing course for all the students
byJyoti Balmiki
 
PPTX
Clinical Pathology unit -1.pptx
byJyoti Balmiki
 
PPTX
Cytological tests Histopathology and cytopathology CMLT 3rd year
byJyoti Balmiki
 
PPTX
Viruses.pptx
byJyoti Balmiki
 
PPTX
UNIT 1 biochem and micro.pptx
byJyoti Balmiki
 
PPT
Hema II Chapter 4_OFT.ppt
byJyoti Balmiki
 
PPTX
Etiology of cancer (carcinogenic agents).pptx
byJyoti Balmiki
 
PPTX
Effusions peritoneal fluids.pptx
byJyoti Balmiki
 
PDF
National Health Policy 2019_DoHS Annual Report_Public Health Update.pdf
byJyoti Balmiki
 
PPTX
Frozen section ((cryosection)Histopathology and cytology Medical Laboratory 3...
byJyoti Balmiki
 
PPTX
Effusions pleural.pptx
byJyoti Balmiki
 
PPTX
Viruses.pptx
byJyoti Balmiki
 
PPTX
Cytological tests.pptx
byJyoti Balmiki
 
FIXATION Histopathology and Cytopathology
byJyoti Balmiki
 
Cyto-pathology medical laboratory 3rd year
byJyoti Balmiki
 
DECALCIFICATION histopathology and cytopathology
byJyoti Balmiki
 
Staining methods.pptx
byJyoti Balmiki
 
vitamins.pptx
byJyoti Balmiki
 
Examination of urine.pptx
byJyoti Balmiki
 
Effusions pericardial.pptx
byJyoti Balmiki
 
Online marketing course for all the students
byJyoti Balmiki
 
Clinical Pathology unit -1.pptx
byJyoti Balmiki
 
Cytological tests Histopathology and cytopathology CMLT 3rd year
byJyoti Balmiki
 
Viruses.pptx
byJyoti Balmiki
 
UNIT 1 biochem and micro.pptx
byJyoti Balmiki
 
Hema II Chapter 4_OFT.ppt
byJyoti Balmiki
 
Etiology of cancer (carcinogenic agents).pptx
byJyoti Balmiki
 
Effusions peritoneal fluids.pptx
byJyoti Balmiki
 
National Health Policy 2019_DoHS Annual Report_Public Health Update.pdf
byJyoti Balmiki
 
Frozen section ((cryosection)Histopathology and cytology Medical Laboratory 3...
byJyoti Balmiki
 
Effusions pleural.pptx
byJyoti Balmiki
 
Viruses.pptx
byJyoti Balmiki
 
Cytological tests.pptx
byJyoti Balmiki
 

Recently uploaded

PPTX
RENAL DISEASES IN CHILDREN PPT BY DIVYAJYOTHI THOTA
bydivyajyothithota03
 
PPTX
PPT MA 8 WEEK 3-4.pptx Music and Arts Grade 8
byEdenGraceLopez1
 
PDF
The Art of Tajweed - Perfecting Your Quran Recitation
byArshiya Firdous
 
PDF
Grade 8 - Mathematics Quarter 3 week2 2025
byafterschoolwork8
 
PDF
Loktantra 2.0 (2025) - Finals by Nandakumar N
byNandakumar N
 
PPTX
Production Technology in Turmeric Crop.pptx
byShubham Thapa
 
PDF
LH_Lecture Note on Spices , AI And Importance in Human Life.pdf
bybisensharad
 
PDF
Flower Bud Differentiation in Horticultural Crops LH_Lecture on FBD.pdf
bybisensharad
 
PPTX
Capsules & Pellets -Industrial pharmacy UNIT-3, B Pharm III YEAR (V Semester)...
byARUN KUMAR
 
PPTX
Talks, Proposals & Agenda in Odoo 18 Events
byCeline George
 
PDF
"Navigating the Future of Aerospace: Global Challenges and Strategic Opportun...
byEOI Escuela de Organización Industrial
 
PDF
AI and ICT for Teaching and Learning, Induction-cum-Training Programme, 5th 8...
byProf. Vinod Kumar Kanvaria
 
PPTX
Masterclass on Cybercrime, Scams & Safety Hacks.pptx
bykalkidirwhytap
 
PDF
What is Digital Engineering, and how can it be used to enhance Project Manage...
byAssociation for Project Management
 
PPTX
How to create a Pass-Fail quality check in Odoo 18 Quality
byCeline George
 
PDF
DIFFRENCE BETWEEN SOCIETY AND COMMUNITY.pdf
byJhasketan Kuanar
 
PDF
Loktantra 2.0 (2025) - Prelims by Nandakumar N
byNandakumar N
 
PPTX
kklklklklklklklk;lkpoipor[3rjdkjoe99759893058085
bypreetheshparmar
 
PPTX
English 5 Q3 W3 Describing the Character Traits Using Literal or Implied Mean...
byAizaPanganiban3
 
PPTX
Anim na Hilig Ayon kay Johnn Holland.pptx
byNoelCespon
 
RENAL DISEASES IN CHILDREN PPT BY DIVYAJYOTHI THOTA
bydivyajyothithota03
 
PPT MA 8 WEEK 3-4.pptx Music and Arts Grade 8
byEdenGraceLopez1
 
The Art of Tajweed - Perfecting Your Quran Recitation
byArshiya Firdous
 
Grade 8 - Mathematics Quarter 3 week2 2025
byafterschoolwork8
 
Loktantra 2.0 (2025) - Finals by Nandakumar N
byNandakumar N
 
Production Technology in Turmeric Crop.pptx
byShubham Thapa
 
LH_Lecture Note on Spices , AI And Importance in Human Life.pdf
bybisensharad
 
Flower Bud Differentiation in Horticultural Crops LH_Lecture on FBD.pdf
bybisensharad
 
Capsules & Pellets -Industrial pharmacy UNIT-3, B Pharm III YEAR (V Semester)...
byARUN KUMAR
 
Talks, Proposals & Agenda in Odoo 18 Events
byCeline George
 
"Navigating the Future of Aerospace: Global Challenges and Strategic Opportun...
byEOI Escuela de Organización Industrial
 
AI and ICT for Teaching and Learning, Induction-cum-Training Programme, 5th 8...
byProf. Vinod Kumar Kanvaria
 
Masterclass on Cybercrime, Scams & Safety Hacks.pptx
bykalkidirwhytap
 
What is Digital Engineering, and how can it be used to enhance Project Manage...
byAssociation for Project Management
 
How to create a Pass-Fail quality check in Odoo 18 Quality
byCeline George
 
DIFFRENCE BETWEEN SOCIETY AND COMMUNITY.pdf
byJhasketan Kuanar
 
Loktantra 2.0 (2025) - Prelims by Nandakumar N
byNandakumar N
 
kklklklklklklklk;lkpoipor[3rjdkjoe99759893058085
bypreetheshparmar
 
English 5 Q3 W3 Describing the Character Traits Using Literal or Implied Mean...
byAizaPanganiban3
 
Anim na Hilig Ayon kay Johnn Holland.pptx
byNoelCespon
 

Role of minerals, ions and water in.pptx

  • 1.
    Role of minerals,ions and water in life processes
  • 2.
    Minerals • The mineral(inorganic) elements constitute only a small proportion of the body weight. • There is a wide variation in their body content. For instance, calcium constitutes about 2% of body weight while cobalt about 0.00004%.
  • 3.
    General functions: • Mineralperform several vital functions which are absolutely essential for the very existence of the organism. • These include calcification of bone, blood coagulation, neuromuscular irritability, acid-base equilibrium, fluid balance and osmotic regulation. • Certain mineral are integral components of biologically important compounds such as hemoglobin (Fe), thyroxine (I), insulin(Zn) and vitamin B12(Co). • Sulfur is present in thiamine, biotin, lipoic acid and coenzyme A. • Several minerals participates as cofactors for enzymes in metabolism (e.g. Mg, Mn, Cu, Zn, K). • Some elements are essential constituents of certain enzymes (e.g. Co, Mo, Se)
  • 4.
    Classification • The mineralsare classified as principal elements and trace elements. The seven principal elements (macro-minerals) constituents 60-80% of the body’s inorganic material. These are calcium, phosphorus, magnesium, sodium, potassium, chloride and sulfur. • The principal elements are required in amounts greater than 100 mg/day. The micro-minerals are required in amounts less 100mg/day. They are subdivided into three categories. • Essential trace elements : Iron, copper, iodine, manganese, zinc, molybdenum, cobalt, fluorine, selenium and chromium. • Possibly essential trace elements: Nickel, vanadium, cadmium and barium. • Non-essential trace elements: Aluminium, lead, mercury, boron, sliver, bismuth etc.
  • 5.
    Macro-elements • Calcium • Phosphorus •Magnesium • Sodium • Potassium • Chlorine • Sulfur
  • 6.
    Calcium • Calcium isthe most abundant among the minerals in the body. • The total content of calcium in an adult man is about 1 to 1.5kg. As much as 99% of it is present in the bones and teeth. • A small fraction (1%) of the calcium, found outside the skeletal tissue, performs a wide variety of functions.
  • 7.
    Biochemical functions • Developmentof bones and teeth: Calcium, along with phosphate, is required for the formation (of hydroxyapatite) and physical strength of skeletal tissue. Bone is regarded as a mineralized connective tissue. Bones which are in dynamic state serve as reservoir of Ca. Osteoblasts result in demineralization. • Muscle contraction: Ca+ interacts with troponin C to trigger muscle contraction. Calcium also activates ATPase, increases the interaction between actin and myosin. • Blood coagulation: Several reactions in the cascade of blood clotting process are dependent on Ca+ (factor IV) • Nerve transmission: Ca+ is necessary for the transmission of nerve impulse. • Membrane integrity and permeability: Ca+ influences the membrane structure and transport of water and several ions across it.
  • 8.
    Biochemical functions • Activationof enzymes: Ca+ is needed for the direct activation of enzymes such as lipase (pancreatic), ATPase and succinate dehydrogenase. • Calmodulin mediated action of Ca2+: Calmodulin (mol. wt. 17,000) is a calcium binding regulatory protein. Ca- calmodulin complex activates certain enzymes e.g. adenylate cyclase, Ca2+ dependent protein kinase, myosin kinase, phospholipase C, glycogen synthase. • Calcium as intracellular messenger: Certain hormones exert their action through the mediation of Ca2+ (instead of cAMP). Calcium is regarded as a second messenger for such hormonal action e.g. epinephrine in liver glycogenolysis. Calcium serves as a third messenger for some hormones e.g. antidiuretic hormone (ADH) acts through cAMP, and then Ca2+.
  • 9.
    Biochemical functions • Releaseof hormones: The release of certain hormones (insulin, PTH, calcitonin) form the endocrine glands is facilitated by Ca2+. • Secretory processes: Ca2+ regulate microfilament and microtubule mediated processes such as endocytosis, exocytosis and cell motility. • Contact inhibition: Calcium is believed to be involved in cell to cell contact and adhesion of cells in a tissue. The cell to cell communication may also required Ca2+. • Action on heart: Ca2+ acts on myocardium and prolongs systole.
  • 10.
    Dietary requirements • Adultman and women – 800mg/day • Women during pregnancy, lactation , post- menopause – 1.5g/day Sources: • Best source –Milk and milk products • Good source – Beans, leafy vegetables, fish, cabbage, egg yolk.
  • 12.
    Deficiency/disease states • Theblood Ca level is maintained within a narrow range by the homeostatic control, most predominantly by PTH. Hence abnormalities in Ca metabolism are mainly associates with alteration in PTH. • Hypercalcemia • Hypocalcemia
  • 13.
    Hypercalcemia • Elevation inserum Ca level (normal 9-11 mg/dl) is hypercalcemia. • Hypercalcemia is associated with hyperparathyroidism caused by increased activity of parathyroid glands. • Decreased in serum phosphate (due to increased renal loss) and increase in alkaline phosphate activity are also found in hyperparathyroidism. • Elevation in the urinary excretion of Ca and P, often resulting in the formation of urinary calculi, is also observed in these pateints.
  • 14.
    Hypercalcemia • The determinationof ionized serum calcium (elevated or 6-9mg/dl) is more useful for the diagnosis of hyperparathyroidism. • It has been observed that some of the patients may have normal levels of total calcium in the serum but differ with regard to ionized calcium. • The symptoms of hypercalcemia include lethargy, muscle weakness, loss of appetite, constipation, nausea, increased myocardial contractility and susceptibility to fracture.
  • 15.
    Hypocalcemia • Hypocalcemia isa more serious and life threatening condition. It is characterized by a fall in the serum Ca to below 7mg/dl, causing tetany. • The symptoms of tetany include neuromuscular irritability, and convulsions. • Hypocalcemia is mostly due to hypoparathyroidism. This may happen after an accidental surgical removed of parathyroid glands or due to an autoimmune disease. • Treatment: Supplementation of oral calcium with vitamin D is commonly employed. In severe cases of hypocalcemia , calcium gluconate is intravenously administered.
  • 16.
    Rickets • Rickets isa disorder of defective calcification of bones. • This may be due to a low levels of vitamin D in the body or due to a dietary deficiency of Ca and P or both. • The concentration of serum Ca and P may be low or normal. • An increase in the activity of or normal. • An increase in the activity of alkaline phosphatase is a characteristic feature of rickets.
  • 18.
    Renal rickets • Renalrickets is associated with damage to renal tissue, causing impairment in the synthesis of calcitriol. • It does not respond to vitamin D in ordinary doses, therefore, some workers regard this as vitamin D resistant rickets. • Renal rickets can be treated by administration of calcitriol.
  • 20.
    Osteoporosis • Osteoporosis ischaracterized by demineralization of bone resulting in the progressive loss of bone mass. • Occurrence: The elderly people (over 60yr.) of both sexes are at risk for osteoporosis. However, it more predominantly occurs in the post- menopausal women. • Osteoporosis results in frequent bone fractures which are a major cause of disability among the elderly. • It is estimated that more than 50% of the fractures in USA are due to this disorder. Osteoporosis may be regarded as a silent thief.
  • 22.
    Treatment • Estrogen administrationalong with calcium supplementation (in combination with vitamin D) to postmenopausal women reduces the risk of fractures. • Higher dietary intake of Ca (about 1.5g/dl) is recommended for elderly people.
  • 23.
    Osteopetrosis (marble bonedisease) • Osteopetrosis is characterized by increased bone density. • This is primarily due to inability to resorb bone. • This disorder is mostly observed is mostly observed in associated with renal tubular acidosis (due to a defects in the enzyme carbonic anhydrase)and cerebral calcification.
  • 25.
    Phosphorus • An adultbody contains about 1kg phosphate and it is found in every cell of the body. • Most of it (about 80%) occurs in combination with Ca in the bones and teeth. • About 10% of body P is found in muscles and blood in association with proteins, carbohydrates and lipids. • The remaining 10% is widely distribution in various chemical compounds.
  • 26.
    Biochemical functions • Phosphorusis essential for the development of bones and teeth. • It plays a central role for the formation and utilization of high- energy phosphate compounds e.g. ATP, GTP, creatine phosphate etc. • Phosphorus is required for the formation of phospholipids, phosphoproteins and nucleic acids (DNA and RNA) • It is as essential component of several nucleotide coenzymes e.g. NAD+, NADP+, pyridoxal phosphate, ADP, AMP. • Several proteins and enzymes are activated by phosphorylation. • Phosphate buffer system is important for the maintenance of pH in the blood (around 7.4) as well as in the cells.
  • 27.
    Dietary requirement • Therecommended dietary allowance (RDA) of phosphate is based on the intake of calcium. • The ratio of Ca: P of 1:1 is recommended (i.e. 800mg/day) for an adult. • For infants, however, the ratio is around 2:1, which is based on the ratio found in human milk. • Calcium and phosphate are distributed in the majority of nature foods in 1:1 ratio. • Therefore, adequate intake of Ca generally takes care of the P requirement also
  • 28.
    Sources • Milk, cereals,leafy vegetables, meat, eggs.
  • 29.
    Deficiency/disease states • Serumphosphate level is increased in hypoparathyroidism and decreased in hyperpara- thyroidism. • In severe renal diseases, serum phosphate content is elevated causing acidosis. • Vitamin D deficient rickets is characterized by decreased serum phosphate (1-2mg/dl). • Renal rickets is associated with low serum phosphate levels and increased alkaline phosphatase activity. • In diabetes mellitus, serum content of organic phosphate is lower while that of inorganic phosphate is higher.
  • 30.
    Magnesium • The adultbody contains about 20 g magnesium, 70% of which is found in bones in combination with calcium and phosphorus. The remaining 30% occurs in the soft tissues and body fluid. • Biochemical functions: • Magnesium is required for the formation of bones and teeth. • Mg2+ serves as a cofactor for several enzymes requiring ATP e.g. hexokinase, glucokinase, phosphofructokinase, adenylatecyclase. • Mg2+is necessary for proper neuro-muscular function. Low Mg2+ levels lead to neuromuscular irritability.
  • 32.
    Dietary requirement • Adultman – 350mg/day • Adult women – 300mg/day • Sources: • Cereals, nuts, beans, vegetables (cabbage, cauliflower), meat, milk, fruits. • Deficiency/disease states: • Magnesium deficiency causes neuro-muscular irritation, weakness and convulsions. • These symptoms are similar to that observed in tetany (Ca deficiency) which are relieved only by Mg. Malnutrition, alcoholism and cirrhosis of liver may lead to Mg deficiency. • Low levels of Mg may be observed in uremia, rickets and abnormal pregnancy.
  • 33.
    Sodium • Sodium isthe chief cation of the extracellular fluid. About 50% of body sodium is present in the bones, 40% in the extracellular fluid and the remaining (10%)in the soft tissues. • Biochemical functions: • In association with chloride and biocarbonate, sodium regulates the body’s acid-base balance. • Sodium is required for the maintenance of osmotic pressure and fluid balance. • It is necessary for the normal muscle irritability and cell permeability. • Sodium is involved in the intestinal absorption of glucose, galactose and amino acids. • It is necessary for initiating and maintaining heart beat.
  • 34.
    Dietary requirements • Fornormal individuals, the requirement of sodium is about 5-10 g/day which is mainly consumed as NaCl. • For persons with a family history of hypertension, the daily NaCl intake should be less than 5g. • For patients of hypertension, around 1g/day is recommended. • It may be noted that 10g of NaCl contains 4g of sodium. • The daily consumption of Na is generally higher than required due to its flavor
  • 35.
    Sources • The commonsalt (NaCl) used in the cooking medium is the cooking medium is the major source of sodium. • The ingested foods also contribute to sodium. • The good sources of sodium include bread, whole grains, leafy vegetables, nuts eggs and milk.
  • 37.
    Deficiency/disease states • Hyponatremia •This is a condition in which the serum sodium level falls below the normal. • Hyponatremia may occur due to diarrhea, vomiting, chronic renal diseases, adrenocortical insufficiency (Addison’s disease). • Administration of salt free fluids to patients may also cause hypoaremia. • This is due to overhydration. • Deceased serum sodium concentration is also observed in edema which occurs in cirrhosis or congestive heart failure. • The manifestations of hyponatremia include reduced blood pressure and circulatory failure.
  • 38.
    Hypernatremia • This conditionis characterized by an elevation in the serum sodium level. • They symptoms include increase in blood volume and blood pressure. • It may occur due to hyperactivity of adrenal cortex (Cushing’s syndrome), prolonged administration of cortisone, ACTH and /or sex hormones. • Loss of water from the body causing dehydration, as it occurs in diabetes insipidus, results in hypernatremia. Rapid administration of sodium salts also increases serum sodium concentration. • It may be noted that in pregnancy, steroid and placental hormones cause sodium and water retention in the body, leading to edema. • In edema, along with water, sodium concentration in the body is also elevated. Administration of diuretic drugs increases the urinary output of water along with sodium. • In the patients of hypertension and congestive cardiac failure salt (Na+) restriction is advocated.
  • 39.
    Potassium • Potassium isthe principal intracellular cation. It is equally important in the extracellular fluid for specific functions. • Biochemical functions: • Potassium maintains intracellular osmotic pressure. • It is required for the regulation of acid-base balance and water balance in the cells. • The enzyme pyruvate kinase (of glycolysis) is dependent on K+ for optimal activity. • Potassium is required for the transmission of nerve impulse. • Adequate intracellular concentration K+ is necessary for proper biosynthesis of proteins by ribosomes. • Extracellular K+ influence cardiac muscles activity.
  • 40.
    Dietary requirements • About3-4 g/days • Sources: • Banana, orange , pineapple, potato, beans, chicken and liver. Tender coconut water is a rich source of potassium.
  • 41.
    Deficiency/disease states • Serumpotassium concentration is maintained within a narrow range. Either high or low concentrations are dangerous since potassium effects the contractility of heart muscle. • Hypokalemia: Decreased in the concentration of serum potassium is observed due to overactivity of adrenal cortex (Cushing’s syndrome), prolonged cortisone therapy, intravenous administration of K+ free fluids, treatment of diabetic coma with insulin, prolonged diarrhea and vomiting. The symptoms of hypokalemia include irritability, muscular weakness, tachycardia , cardiomegaly and cardiac arrest. Changes in the ECG are observed (flattened waves with inverted T wave)
  • 42.
    Hyperkalemia • Increase inthe concentration of serum potassium is observed in renal failure, adrenocortical insufficiency (Addison’s disease), diabetic coma, severe dehydration, intravenous administration of fluids with excessive potassium salts. • The manifestations of hyperkalemia include depression of central nervous system, mental confusion, numbness, bradycardia with reduced heart sounds and finally, cardiac arrest. Changes in ECG are also observed (elevated T wave).
  • 43.
    Chlorine • Chlorine isa constituent of sodium chloride. Hence, the metabolism of chlorine and sodium are intimately related. • Biochemical functions: • Chlorine is involved in the regulation of acid-base equilibrium, fluid balance and osmotic pressure. These functions are carried out by the interaction of chlorine with Na+ and K+. • Chlorine is necessary for the formation of HCL in the gastric juice. • Chlorine shift involved the active participation of Cl-. • The enzyme salivary amylase is activated by chloride.
  • 44.
    Dietary requirement • Thedaily requirement of chloride as NaCl is 5-10g. Adequate intake of sodium will satisfy the chloride requirement of the body. • Sources: • Common salt as cooking medium, whole grains, leafy vegetables, eggs and milk. • Deficiency/disease states: • Hypochloremia: A reduction in the serum Cl- level may occur due to vomiting, diarrhea, respiratory alkalosis, Addison’s disease and excessive sweating. • Hyperchloremia: An increase in serum Cl- concentration may be due to dehydration, respiratory acidosis and Cushing’s syndrome.
  • 45.
    Sulfur • Sulfur ofthe body is mostly present in the organic form. Meithionine, cysteine and cysteine are the three sulfur-containing amino acids present in the proteins. Generally, proteins contains about 1% sulfur by weight. • Biochemical functions: • Sulfur-containing amino acids are very essential for the structural conformation and biological functions of proteins (enzymes, hormones, structural proteins etc.). The disulfide linkages( -S – S-) and sulfhydryl groups (- SH) are largely responsible for this. • The vitamins thiamine, biotin, lipoic acid, and coenzyme A of pantothenic acid contain sulfur.
  • 46.
    Biochemical functions • Heparin,chondroitin sulfate, glutathione, taurocholic acid are some other important sulfur- containing compounds. • Phosphoadenosine phosphosulfate(PAPS) is the active sulfate utilized for several reactions e.g. synthesis of glycosaminoglycans, detoxification mechanism. • The sulfur-containing amino acid methionine (as S- adenosylmethionine) is actively involved in transmethylation reactions.
  • 47.
    Dietary requirements • Dietaryrequirements: • There is no specific dietary requirement for sulfur. • Sources: • Adequate intake of sulfur-containing essential amino acid methionine will meet the body need. Food proteins rich in methionine and cysteine are the sources of sulfur.
  • 48.
    Deficiency / diseasestates: • Sulfur is part of methionine and cysteine, which are amino acids needed in the making of proteins. So, if there is too little sulfur, or a sulfur deficiency, it could lead to reduced protein synthesis. • The sulfur-containing amino acid cysteine is also needed for making glutathione, which is somewhat of a superhero in body because it works as a potent antioxidant that protects cells from damage. So we see that a sulfur deficiency can cause a cascade of other problems. For instance, without sufficient sulfur to make cysteine, there could be reduced glutathione synthesis, which may contribute to cell damage
  • 49.
    Deficiency / diseasestates: • Sulfur is also needed to create connective tissues that support joints, such as cartilage, tendons and ligaments. • So, connection, have a deficiency of sulfur could contribute to joint pain or disease. • In fact, sulfur contained in medications designed for joint health.
  • 50.
    Micro-elements • Iron • Copper •Iodine • Manganese • Zinc • Molybdenum • Cobalt • Fluorine • Selenium • Chromium
  • 51.
    Iron • The totalcontent of iron is an adult body id 3-5g. About 70% of this occurs in the erythrocytes of blood as a constituent of hemoglobin. • At least 5% of body iron is present in myoglobin of muscle. • Heme is the most predominant iron containing substance. • It is a constituent of several proteins/enzymes (hemoproteins)- hemoglobin, myoglobin, cytochromes, xanthine oxidase, catalase, tryptophan pyrrolase, peroxidase. • Certain other proteins contain non-heme ion e.g. transferrin, ferritin, hemosiderin.
  • 52.
    Biochemical functions • Ironmainly exerts its functions through the compounds in which it is present. Hemoglobin and myoglobin are required for the transport of O2 and CO2. • Cytochromes and certain non-heme proteins are necessary for electron transport chain and oxidative phosphorylation. • Peroxidase, the lysosomal enzyme, is required for phagocytosis and killing of bacteria by neutrophils. • Iron is associated with effective immuno- competence of the body.
  • 53.
    Dietary requirements • Adultman –10 mg/day • Menstruating woman – 18 mg/day • Sources: • Rich sources – Organ meats (liver, heat, kidney). • Good sources – Leafy vegetables, pulses, cereals, fish, apples, dried fruits, molasses, jaggery. • Poor sources – Milk, wheat, polished rice.
  • 54.
    Disease states • Irondeficiency anemia: :This is the most prevalent nutritional disorder worldover, including the well developed countries (e.g. USA). • Several factors may contribute to iron deficiency anemia. • These include inadequate intake or defective absorption of iron, chronic blood loss, repeated pregnancies and hookworm infections. • Strict vegetarian are more prone for iron deficiency anemia. This is due to the presence of inhibitors of iron absorption in the vegetarian foods, besides the relatively low content of iron. Iron deficiency anemia mostly occurs in growing children, adolescent girls, pregnant and lactating women. It is characterized by microcytic hypochromic anemia with reduced blood hemoglobin levels(<12g/dl). The other manifestation include apathy (dull and inactive), sluggish metabolic activities, related growth and loss of appetite. • Treatment: Iron deficiency is treated by supplementation of iron along with folic acid and vitamin C.
  • 55.
    Disease states • Hemosiderosis: •This is a less common disorder and is due to excessive iron in the body, frequently referred to as iron toxicity. • It is commonly observed in subjects receiving repeated blood transfusions over the years, e.g. patients of hemolytic anemia, hemophilia. • As already stated, iron is a one-way compound, once it enters the body, it cannot escapes. • Excessive iron is deposited as ferritin and hemosiderin. Hemosiderosis is commonly observed among the bantu tribe in south Africa. • This is attributed to a high intake of iron from their staple diet corn and their habit of cooking food in iron pots.
  • 56.
    Disease states • Hemochromatosis:This is a rate disease in which iron is directly deposited in the tissues (liver, spleen, pancreas and skin). • Hemosiderosis is sometimes accompanied by hemochromatosis. • Bronzed- pigmentation of the skin, cirrhosis of liver, pancreatic fibrosis are the manifestations of this disorder. • Hemochromatosis causes a condition known as bronze diabetes.
  • 57.
    Copper • The bodycontains about 100mg copper distributed in different organs. It is involved in several important functions. • Biochemical functions: • Copper is an essential constituent of several enzymes. These include cytochrome oxidase, catalase, tyrosine, superoxide dismutase, monoamine oxidase, ascorbic acid oxidase, ALA synthase, phenol oxidase and uricase. Due to its presence in a wide variety of enzymes, copper is involved in many metabolic reactions. • Copper is necessary for the synthesis of hemoglobin (Cu is a constituent of ALA synthase, needed for heme synthesis). • Lysyl oxidase ( a copper containing enzyme) is required for the conversion of certain lysine residues of collagen and elastin to allysine which are necessary for cross-linking these structural proteins.
  • 58.
    Biochemical functions • Ceruloplasminserves as ferroxidase and is involved in the conversion of iron from Fe2+ to Fe3+ in which form iron (transferrin) is transported in plasma. • Copper is necessary for the synthesis of melanin and phospholipids. • Development of bone and nervous system (myelin) requires Cu. • Certain copper containing non-enzymatic proteins have been identified, although their functions are not clearly known. These include hepatocuprein (storage form in liver), cerebrocuprein (in brain) and hemocuprein (in RBC). • Hemocyanin, a copper protein complex in invertebrates, functions like hemoglobin for O2 transport.
  • 59.
    Dietary requirements • Adults– 2-3 mg/day • Infants and children – 0.5-2 mg/day • Sources: • Liver, kidney, meat, egg yolk, cereals, nuts and green leafy vegetables. Milk is a poor source.
  • 60.
    Deficiency /disease states •Copper deficiency: Several deficiency of copper causes demineralization of bones, demyelination of neural tissue, anemia, fragility of arteries, myocardial fibrosis, hypopigmentation of skin, greying of hair. • Menke’s disease: This disorder is due to a defect in the intestinal absorption of copper. It is possible that copper may be trapped by metallothionein in the intestinal cells. The symptoms of Menke’s disease include decreased copper in plasma and urine, anemia and depigmentation of hair.
  • 61.
    Deficiency /disease states •Wilson’s disease: Wilson’s disease (hepatolenticular degeneration) is a rare disorder (1:50,000) of abnormal copper metabolism and is characterized by the following manifestations. • Copper is deposited in abnormal amounts in liver and lenticular nucleus of brain. This may lead to hepatic cirrhosis and brain necrosis. • Low levels of copper and ceruloplasmin in plasma (reference range 20-50mg/dl) with increased excretion of copper in urine. • Copper deposition in kidney causes renal damage. This leads to increased excretion of amino acid, glucose, peptides and hemoglobin in urine. • Intestinal absorption of copper is very high, about 4-6 times higher than normal.
  • 62.
    Iodine • The totalbody contains about 20mg iodine most of it (80%) being present in the thyroid gland. Muscle, salivary glands and ovaries also contain some amount of iodine. • Biochemical functions: • The only known function of iodine is its requirement for the synthesis of thyroid hormones namely, thyroxine (T4) and trriodothyronine (T3). T3 is more active in its biological functions than T4.
  • 63.
    Biochemical functions • Influenceon the metabolic rate: Thyroid hormones stimulate the metabolic activities and increases the oxygen consumption in most of the tissues of the body (exception- brain, lungs, testes and retina) • Effect on protein synthesis: Thyroid hormones act like steroid hormones in promoting protein synthesis by acting at the transcriptional level (activated DNA to produce RNA). Thyroid hormones, thus, function as anabolic hormones and cause positive nitrogen balance and promote growth and development.
  • 64.
    Biochemical functions • Influenceon carbohydrate metabolism: Thyroid hormones promote intestinal absorption of glucose and its utilization. These hormones increase gluconeogenesis and glycogenolysis, with an overall effect of enhancing blood glucose level (hyperglycemia). • Effect on lipid metabolism: Lipid turnover and utilization are stimulated by thyroid hormones. Hypothyroidism is associated with elevated plasma cholesterol levels which can be reversed by thyroid hormone administration.
  • 65.
    Dietary requirements • Adults-100-150µg/day • Pregnant women - 200µg/day • Sources: • Sea foods, drinking water, vegetables, fruits (grown on seaboard). High altitudes are deficient in iodine content in water as well as soil. Plant and animal foods of these areas, therefore, contain lesser amount of iodine. In these regions iodine is added to drinking water or table salt.
  • 66.
    Deficiency /disease states •Goiter: Any abnormal increase in the size of the thyroid gland is known as goiter. Enlargement of thyroid gland is mostly to compensate the deceased synthesis of thyroid hormones and is associated with elevated TSH. Goiter is primarily due to a failure in the auto regulation of T3and T4 synthesis. This may be caused by deficiency or excess of iodine. • Goitrogenic substances (goitrogens): These are the substances that interfere with the production of thyroid hormones. These include thiocyanates, nitrates and perchlorates and the drugs such as thiourea, thiouracil, thiocarbamide etc. certain plant foods – cabbage, cauliflower and turnip – contain goitrogenic factors (mostly thiocyanates).
  • 67.
    Deficiency /disease states •Simple endemic goiter: This is due to iodine deficiency in the diet. It is mostly found in the geographical regions away from sea coast where the water and soil are low in iodine content. Consumption of iodized salt is advocated to overcome the problem of endemic goiter. In certain cases, administration of thyroid hormone is also employed. • Hyperthyroidism: This is also known as thyrotoxicosis and is associated with over- production of thyroid hormones. Hyperthyroidism is characterized by increased metabolic rate (higher BMR) nervousness, irritability, anxiety, rapid heart rate, loss of weight despite increased appetite, weakness, diarrhea, sweating sensitivity to heart and often protrusion eyeballs (exophthalmos).
  • 68.
    Hyperthyroidism • Hyperthyroidism iscaused by Grave’s disease (particularly in the developed countries) or due to increased intake of thyroid hormones. Grave’s disease is due to elevated thyroid stimulating IgG also known as long acting thyroid stimulator (LATS) which activates TSH and, thereby , increases thyroid hormonal production. • Hypothyroidism: This is due to an impairment in the function of thyroid gland that often causes decreased circulatory levels of T3 and T4. Disorder of pituitary or hypothalamus also contribute to hypothyroidism. Women are more susceptible than men. Hypothyroidism is characterized by reduced BMR, slow heart rate, weight gain, sluggish behaviour, constipation, sensitivity to cold, dry skin etc. Hypothyroidism in children is associated with physical and mental retardation, collectively known as cretinism.
  • 69.
    Manganese • The totalbody content of manganese is about 15mg. The liver and kidney are rich in Mn. Within the cells, Mn is mainly found in the nuclei in association with nucleic acids. • Biochemical functions: • Mn serve as a cofactor for several enzymes. These include arginase, pyruvate carboxylase, isocitrate dehydrogenase, superoxidase dismutase (mitrochondrial) peptidase. • Mn is required for the formation of bone, proper reproduction and normal functioning of nervous system.
  • 70.
    Biochemical functions • Mnis necessary for the synthesis of mucopolysaccharides and glycoproetins. • Hemoglobin synthesis involves Mn. • Mn inhibits lipid peroxidation. • Mn is necessary for cholesterol biosynthesis
  • 71.
    Dietary requirements • Theexact requirement of Mn is not known. About 2- 9mg/day is recommended for an adult. • Sources: • Cereals, nuts ,leafy vegetables and fruits. Tea is rich sources of Mn.
  • 72.
    Deficiency/ disease states •Mn deficiency in animals causes: • Retarded growth, bone deformities and, in severe deficiency, sterility. • Accumulation of fat in liver. • Increased activity of serum alkaline phosphatase, and • Diminished activity of β- cells of pancreas (low insulin).
  • 73.
    Zinc • The totalcontent of zinc in an adult blood is about 2g. Prostate gland is very rich in Zn (100mg/g). Zinc is mainly an intracellular element. • Biochemical functions: • Zn is an essential component of several enzymes e.g. carbonic anhydrase, alcohol dehydrogenase, alkaline phosphatase, carboxy-peptidase, superoxidase dismutase (cytosolic). • Zinc may be regarded as an antioxidant since the enzyme superoxide dismutase (Zn containing ) protects the body against free radicals damage.
  • 74.
    Biochemical functions • Thestorage and secretion of insulin form the β- cells of pancreas require Zn. • Zn is necessary to maintain the normal levels of vitamin A in serum. Zn promotes the synthesis of retinol binding protein. • It is required for wound healing . Zn enhances cell growth and division, besides stabilizing biomembranes. • Gusten, a zinc containing protein of the saliva, is important for taste sensation. • Zn is essential for proper reproduction.
  • 75.
    Dietary requirements • Zincrequirement for an adult is 10 -15 mg/day. It is increased (by about 50%) in pregnancy and lactation. • Sources: • Meat, fish, eggs, milk, beans, nuts.
  • 76.
    Deficiency / diseasestates • Zinc deficiency is associated with growth retardation, poor wound healing, anemia, loss of appetite , loss of taste sensation, impaired spermatogenesis etc. • It is reported that Zn deficiency in pregnant animals causes congenital malformations of the fetus. • Deficiency of Zn may result in depression, dementia and other psychiatric disorders. • The neuropsychiatric manifestations of chronic alcoholism may be partly due to zinc deficiency.
  • 77.
    Deficiency / diseasestates • Acrodermatitis enteropathica is a rare inherited metabolic disease of zinc deficiency caused by a defect in the absorption of Zn from, the intestine. • Zinc toxicity is often observed in welders due to inhalation of zinc oxide fumes. The manifestations of Zn toxicity include nausea, gastric ulcer, pancreatitis, anemia and excessive salivation.
  • 78.
    Molybdenum • Molybdenum isa constituent of the enzymes xanthine oxidase, aldehyde oxidase and sulfite oxidase. • Nitrite reductase (containing Mo)is a plant enzyme, required for nitrogen fixation. • The requirements of Mo are not clearly known. • However, it is widely distributed in the natural foods. Dietary Mo is effectively (60%-70%) absorbed by the small intestine. • Some workers have reported that Mo decreases the mobilization and utilization of copper in the body. • Molybdenosis is a rare disorder caused by excessive consumption of Mo. • Its manifestations include impairment in growth, diarrhea and anemia. • Intestinal absorption of copper is diminished.
  • 79.
    Biochemical functions • Themolybdoenzymes in man are sulphite oxidase, xanthine oxidase/dehydrogenase and aldehyde oxidase. • The former is essential for detoxication of the sulphite arising from metabolism of sulphur- containing amino acids, from ingestion of bisulphite preservative and from inhalation of sulphur dioxide, an atmospheric pollutant. • The reactions catalysed by xanthine oxidase/dehydrogenase and aldehyde oxidase are necessary for human well-being has yet to be established
  • 80.
    Dietary requirements • Adultmen and women is 109 and 76 μg/day • Sources: • Legumes, such as beans, lentils, and peas, are the richest sources of molybdenum. Grain products and nuts are considered good sources, while animal products, fruit, and many vegetables are generally low in molybdenum
  • 81.
    Deficiency /Disease states •The deficiency caused intellectual disability, seizures, opisthotonus, and lens dislocation. • Molybdenum deficiency resulting in sulfite toxicity occurred in a patient receiving long- term TPN (Total parenteral nutrition). • Symptoms were tachycardia, tachypnea, headache, nausea, vomiting, and coma
  • 82.
    Cobalt • Cobalt isonly important as a constituent of vitamin B12 (cobalamin) cobalt content of vitamin B12 is about 4% by weight. • The functions of cobalt are the same as that of vitamin B12. • Administration of cobalt stimulates the production of the hormones erythropoietin, which promotes erythropoiesis. • Prolonged administration of cobalt is toxic as it results in polycythemia (increased RBC in blood).
  • 83.
    Biochemical functions • Cobaltis an essential trace element that is an integral part of vitamin B12, which is essential in the metabolism of folic acid and fatty acids. • Besides cobalt is involved in the production of red blood cells and is important for the proper functioning of the nervous system as it can help in creating a myelin sheath. • Dietary requirements: • The average adult intake of cobalt is 5–8 mcg per day. A safe Recommended Dietary Allowance (RDA) for cobalt hasn't been set yet.
  • 84.
    Sources • Meat, liver,kidneys, milk, oysters, muscles, fish, shellfish. Smaller amounts of cobalt are found in mushrooms (especially shitake). In fruits and vegetables, usually there are no cobalt (with the exception of legumes, spinach, cabbage, lettuce, turnips, cabbage, figs). • Deficiency /Disease states: • If you have a cobalt deficiency, this also means you have a vitamin B-12 deficiency. Anemia is a main cause of a cobalt deficiency. This is the case with pernicious anemia. Symptoms can include numbness, fatigue and tingling in hand and feet.
  • 85.
    Fluorine • Fluorine ismostly found in bones and teeth. The beneficial effects of fluoride in trace amounts are overshadowed by its harmful effects caused by excess consumption. • Biochemical functions: • Fluorine prevents the development of dental caries. It forms a protective layer of acid resistant fluoroapatite with hydroxyapatite of the enamel and prevents the tooth decay by bacterial acids. Further, inhibits the bacterial enzymes and reduces the production of acids. • Fluorine is necessary for the proper development of bones. • It inhibits the activities of certain enzymes. Sodium fluoride inhibits enolase (of glycolysis) while fluoroacetate inhibits aconitase (of citric acid cycle).
  • 86.
    Dietary requirements • Anintake of less than 2 ppm of fluorine will meet the daily requirements. • Sources: • Drinking water is the main sources. • Deficiency/Disease states: • Dental caries: It is clearly established that drinking water containing less than 0.5ppm of fluoride is associated with the development of dental caries in children. • Fluorosis: Excessive intake of fluoride is harmful to the body. An intake above 2ppm (particularly >5ppm)in children causes mottling of enamel and discoloration of teeth. The teeth are weak and become rough with characteristic brown or yellow patches on their surface. These manifestations are collectively referred to as dental fluorosis.
  • 87.
    Selenium • Selenium wasoriginally identified as an element that causes toxicity to animals (alkali disease) in some parts of USA, containing large amounts of Se in the soil. Later work, however, has shown that Se in smaller amounts is biologically important. • Biochemical functions: • Selenium, along with vitamin E, prevents the development of hepatic necrosis and muscular dystrophy. • Se is involved in maintaining structural integrity of biological membranes. • Se as selenocysteine is an essential component of the enzyme glutathione peroxidase. This enzyme protects the cells against the damage caused by H2O2. It appears from recent studies that selenocysteine is directly incorporated during protein biosynthesis. Therefore, selenocysteine is considered as a separate amino acid.
  • 88.
    Dietary Requirements • Adaily intake of 50-200mg of Se has been recommended for adults. • Sources: • The good sources of Se are organ meats (liver, kidney) and sea foods. • Deficiency / Disease states: • Deficiency: Se deficiency in animals leads to muscular dystrophy, pancreatic fibrosis and reproductive disorders. In humans, keshan disease, an endemic cardiomyopathy (in china) is attributed to the deficiency of Se. Epidemiological studies reveal that low serum Se levels are associated with increased risk of cardiovascular disease, and various cancers.
  • 89.
    Chromium • The totalhuman body contains about 6mg chromium. The Cr content of blood is about 20mg/dl. • Biochemical functions: • In association with insulin, Cr promotes the utilization of glucose. Cr is a component of a protein namely chromodulim which facilities the binding of insulin to cell receptor sites. • Cr lowers the total serum cholesterol level. • It is involved in lipoprotein metabolism. Cr decreases serum low density lipoproteins (LDL) and increases high density lipoproteins (HDL) and, thus, promotes health. • It is believed that Cr participates in the transport of amino acids into the cells (heart and liver)
  • 90.
    Dietary requirements • Thedietary requirement of Cr is not known. It is estimated that an adult man consumed about 10 to 100mg/day. • Sources: • The good sources of Cr include brewer’s yeast, grains, cereals, cheese and meat. • Deficiency /Disease states: • Chromium deficiency causes disturbances in carbohydrate, lipid and protein metabolisms. Excessive intake of Cr results in toxicity, leading to liver and kidney damage.
  • 91.
    Ions • Electrolytes arethe compound which readily dissociate in solution and exist as ions i.e. positively and negatively charged particles. • For instance, NaCl does not exist as such, but it exist as cation (Na+) and anion (Cl-). • The concentration of electrolytes are expressed as milliequivalents (mEq/l) rather than milligrams. • A gram equivalent weight of a compound is defined as its weight in grams that can combine or displace 1g of hydrogen. One gram equivalent weight is equivalent to 1,000 milliequivalents. • The following formula is employed to convert the concentration mg/l to mEq/l • mEq/l= 𝑚𝑔 𝑝𝑒𝑟 𝑙𝑖𝑡𝑟𝑒×𝑉𝑎𝑙𝑒𝑛𝑐𝑦 𝐴𝑡𝑜𝑚𝑖𝑐 𝑤𝑒𝑖𝑔ℎ𝑡
  • 92.
    Electrolyte composition ofbody fluid • Electrolytes are well distributed in the body fluids in order to maintain the osmotic equilibrium and water balance. • A comparison of electrolytes present in extracellular (plasma) and intracellular (muscles) fluid is given in table below:
  • 93.
    Extracellular fluid (plasma)Intracellular fluid (muscle) Cations Anion Cations Anion Na+ 142 Cl- 103 K+ 150 HPO2- 4 140 K+ 5 HCO- 3 27 Na+ 10 HCO- 3 10 Ca2+ 5 HPO 2- 4 2 Mg2+ 40 Cl- 2 Mg2+ 3 SO2- 4 1 Ca2+ 2 SO2- 4 5 Proteins 16 Proteins 40 6 Organic acids 5 Organic acids 155 155 202 202
  • 94.
    Electrolyte composition ofbody fluid • The total concentration of cations and anions in reach in each body compartment (ECF or ICF) is equal to maintain electrical neutrality . • There is a marked difference in the concentration of electrolytes (cations and anions) between the extracellular and intracellular fluids. • Na+ is the principle extracellular cation while K+ is the intracellular cation. • This difference in the concentration is essential for the cell survival which is maintained by Na+ - K+ pump. • As regards anions, Cl- and HCO- 3 predominantly occur in extracellular fluids, while HPO- 4, proteins and organic acids are found in the intracellular fluids.
  • 95.
    Osmolarity and osmolalityof body fluid • There are two ways of expressing the concentration of molecules with regard to the osmotic pressure. • Osmolarity: The number of moles (or millimoles) per liter of solution. • Osmolality: The number of moles ( or millimoles) per kg of solvent. • If the solvent is pure water, there is almost no difference between osmolarity and osmolality. However, for biological fluids (containing molecules such as proteins), the osmolality is more commonly used. This is about 6% greater than osmolarity.
  • 96.
    Osmolality of plasma •Osmolality is a measure of the solute particles present in the fluid medium. The osmolality of plasma is in the range of 285-295 milliosmoles/kg. Constituent (solute ) Osmolality (mosm/kg) Sodium 135 Associated anions 135 Potassium 3.5 Associated anions 3.5 Calcium 1.5 Associated anions 1.5 Magnesium 1.0 Associated anions 1.0 Urea 5.0 Glucose 5.0 Protein 1.0 Total 293
  • 97.
    Osmolality of ECFand ICF • Movement of water across the biological membranes is dependent on the osmotic pressure differences between the intracellular fluid (ICF) and extracellular fluid(ECF). • In a healthy state, the osmotic pressure of ECF, mainly due to Na+ ions, is equal to the osmotic pressure of ICF which is predominantly due to K+ ions. • As such, there is no net passage of water molecules in or out of the cells, due to this osmotic equilibrium.
  • 98.
    Regulation of electrolytebalance • Electrolyte and water balance are regulated together and the kidneys play a predominant role in this regard. The regulation is mostly achieved through the hormones aldosterone, ADH and renin-angiotensin. • Aldosterone: It is a mineralocorticoid produced by adrenal cortex. Aldosterone increases Na+ reabsorption by the renal tubules at the expense of K+ and H+ ions. The net effect is the retention of Na+ in the body. • Antidiuretic hormone (ADH): An increase in the plasma osmolality (most due to Na+) stimulates hypothalamus to release ADH, ADH effectively increases water reabsorption by renal tubules. • Renin-angiotensin: The secretion of aldosterone is controlled by renin-angiotensin system. Decrease in the blood pressure (due to a fall in ECF volume) is sensed by juxtaglomerular apparatus of the nephron which secrete renin. Renin acts on angiotensinogen to produce angiotensin I. The latter is then converted to angiotensin II which stimulates the release of aldosterone.
  • 99.
    Regulation of electrolytebalance • The relation between renin, angiotensin and aldosterone in the regulation of Na+ balance is depicted in figure. • Aldosterone and ADH coordinate with each other to maintain the normal fluid and electrolyte balance. • Atrial natriuretic factor (ANF): ANF or atriopeptin is a 28 amino acids containing peptide. • It is produced in the atrium of heart in response to increased blood volume, elevated blood pressure and high salt intake. • ANF acts on kidneys to increase GFR, sodium excretion and urine output. • Thus ANF opposes the actions of renin and aldosterone (which increase salt retention and blood pressure).
  • 101.
    Na+ concentration andECF • It is important to realize that Na+ and its anions (mainly Cl-) are confined to the extracellular fluid. • And the retention of water in the ECF is directly related to the osmotic effects of these ions (Na+ and Cl-). • Therefore, the amount of Na+ in the ECF ultimately determines its volume.
  • 102.
    Dietary intake andelectrolyte balance • Generally, the consumption of a well-balanced diet supplies the body requirement of electrolytes. • Humans do not possess the ability to distinguish between the salt hunger and water hunger. • Thirst, however, may regulate electrolyte intake also. • In hot climates, the loss of electrolyte intake also. • In hot climates, the loss of electrolyte is usually higher. • Sometimes it may be necessary to supplement drinking water with electrolytes.
  • 103.
    Dehydration • Dehydration isa condition characterized by water depletion in the body. It may be due to insufficient intake or excessive water loss or both. Dehydration is generally classified into two types. • Due to loss of water alone. • Due to deprivation of water and electrolytes. • Causes of dehydration: • Dehydration may occur as a result of diarrhea, vomiting, excessive sweating, fluid loss in burns, adrenocortical dysfunction, kidney diseases (e.g. renal insufficiency), deficiency of ADH (diabetes insipidus) etc.
  • 104.
    Characteristics features ofdehydration • There are three degrees of dehydration mild, moderate and severe. The salient features of dehydration are given hereunder. • The volume of the extracellular fluid (e.g. plasma) is decreased with a concomitant rise in electrolyte concentration and osmotic pressure. • Water is drawn from the intracellular fluid that result in shrunken cells and distributed metabolism e.g. increased protein breakdown.
  • 105.
    Characteristics features ofdehydration • ADH secretion is increased. This causes increased water retention in the body and consequently urine volume is very low. • Plasma protein and blood urea concentrations are increased. • Water depletion is often accompanied by a loss of electrolytes from the body (Na+, K+ etc.) • The principal clinical symptoms of severe dehydration include increased pulse rate, low blood pressure, sunken eyeballs, decreased skin turgor, lethargy, confusion and coma.
  • 106.
    Treatment • The treatmentof choice for dehydration is intake of plenty of water. • In the subjects who cannot take orally, water should be administered intravenously in an isotonic solution (usually 5% glucose). • If the dehydration is accompanied by loss of electrolytes, the same should be administered by oral or intravenous routes. • This has to be done by carefully monitoring the water and electrolyte status of the body
  • 107.
    Osmotic imbalance anddehydration in cholera • Cholera is transmitted through water and foods, contaminated by the bacterium vibrio cholerae. • This bacterium produces a toxin which stimulates the intestinal cells to secrete various ions (Cl-, Na+, K+, HCO- 3 etc.) into the intestinal lumen. • These ions collectively raise the osmotic pressure and suck the water into lumen. • This results in diarrhea with a heavy loss of water (5- 10liters/ day). • If not treated in time, the victims of cholera will die due to dehydration and loss of dissolved salts. • Thus, cholera and others forms of severe diarrhea are the major killer of young children in many developing countries • Oral redehydration therapy (ORT) is commonly used to treat cholera and other diarrheal diseases.
  • 108.
    Overhydration • Overhydration orwater intoxication is caused by excessive retention of water in the body. • This may occur due to excessive intake of large volumes of salt free fluids, renal failure overproduction of ADH etc. • Overhydration is observed after major trauma or operation, lung infections etc. • Water intoxication is associated with dilution of ECF and ICF with a decrease in osmolality. • The clinical symptoms include headache, lethargy and convulsions. • The treatment advocated is stoppage of water intake and administration of hypertonic saline.
  • 109.
    Water tank model •The distribution of body water (in the ECF and ICF) dehydration and overhydration can be better understood by a water tank model. • The tank has an inlet and outlet, respectively, representing the water intake (mostly oral) and water output (mainly urine) by the body. • Dehydration is caused when the water output exceed the intake. • One the other hand, overhydration is due to more water intake and less output.
  • 111.
    Metabolism of electrolytes •The body distribution, dietary intake, intestinal absorption and biochemical functions of individual electrolytes. • The electrolyte disorders, particularly hypernatremia and hyponatremia (of sodium); hyperkalemia and hypokalemia (of potassium)must also be referred. • Diuretics in the treatment of edema and hypertension: • Diuretics are the drugs that stimulate water and sodium excretion, so that urine volume is increased. • The commonly used diuretics are bendrofluazide, frusemide, spironolactone and mannitol. • Diuretics are important in the treatment of edema, heart failure and hypertension.
  • 112.
    Water in lifeprocesses • Water is the solvent of life. Undoubtedly, water is more important than any other single compound to life. It is involved in several body functions. • Function of water: • Water provides the aqueous medium to the organism which is essential for the various biochemical reactions to occur. • Water directly participates as a reactant in several metabolic reactions. • It serves as a vehicle for transport of solutes. • Water is closely associated with the regulation of body temperature.
  • 113.
    Distribution of water •Water is the major body constituent. An adult human contains about 60% water (men 55-70%, women 45-60%). • The women and obese individuals have relatively less water which is due to the higher content of stored fat in an anhydrous form. • A 70 kg normal man contains about 42 liters of water. • This is distributed in intracellular (inside the cells 28l) and extracellular (outside the cell 14l) compartments, respectively known as intracellular fluid (ICF) and extracellular fluid (ECF). • The ECF is future divided into interstitial fluid (10.5l) and plasma (3.5l). • The distribution of water in man is given in table below:
  • 114.
    Compartment % Bodyweight Volume (l) Total 60 42 Intracellular fluid (ICF) 40 28 Extracellular fluid (ECF) 20 14 Interstitial fluid 15 10.5 Plasma 5 3.5
  • 115.
    Water turnover andbalance • The body possesses tremendous capacity regulate its water content. In a healthy individual, this is achieved by balancing the daily water intake and water output. • Water intake: • Water is supplied to the body by exogenous and endogenous sources • Exogenous water: Ingested water and beverage, water content of solid foods constitute the exogenous source of water. • Water intake is highly variable which may range from 0.5-5 litres. It largely depends on the social habits and climate. • In general, people living in hot climate drink more water. Ingestion of water is mainly controlled by a thirst centre located in the hypothalamus. • Increased in the osmolality of plasma causes increased water intake by stimulating thirst centre.
  • 116.
    Water turnover andbalance • Endogenous water: The metabolic water produce within the body is the endogenous water. • This water (300-350ml/day) is derived from the oxidation of foodstuffs. • It is estimated that 1g each of carbohydrate, protein and fat, respectively, yield 0.6ml, 0.4ml and 1.1ml of water. • On an average, about 125ml of water is generated for 1,000Cal consumed by the body.
  • 117.
    Water output • Waterlosses from the body are variable. There are four distinct routes for the elimination of water the body-urine, skin , lungs and feces. • Urine: • This is the major route for water loss from the body. In a healthy individual, the urine output is about 1 -2l/day. • Water loss through kidneys although highly variable, is well regulated to meet the body demands-to get rid of water or to retain. • It should, however, be remembered that man cannot completely shut down urine production, despite there being no water intake. • This is due to the fact that some amount of water (about 500ml/day) is essential as the medium to eliminate the waste products from the body.
  • 118.
    Hormonal regulation ofurine production • It is indeed surprising to know that about 180litres of water is filtered by the glomeruli into the renal tubules everyday. However, most of this is reabsorbed and only 1-2 litres is excreted as urine. Water excretion by the kidney is tightly controlled by vasopressin also known as antidiuretic hormone (ADH) of the posterior pituitary gland. The secretion of ADH is regulated by the osmotic pressure of plasma. An increase in osmolality promotes ADH secretion that leads to an increased water reabsorption from the renal tubules (less urine output). On the other hand, a decrease in osmolality suppresses ADH secretion that results in reduced water reabsorption from the renal tubules (more urine output). Plasma osmolality is largely dependent on the sodium concentration, hence sodium indirectly controls the amount of water in the body. • Diabetes insipidus is a disorder characterized by the deficiency of ADH which results in an increased loss of water from the body.
  • 119.
    Skin • Loss ofwater (450ml/day) occurs through the body surface by perspiration. • This is an unregulated process by the body which mostly depends on the atmospheric temperature and humidity. • The loss is more in hot climate. Fever causes increased water loss through the skin. • It is estimated that for every 1ºC rise in body temperature, about 15% increase is observed in the loss of water (through skin).
  • 120.
    Lungs • During respiration,some amount of water (about 400ml/day) is lost through the expired air. • The latter is saturated with water and expelled from the body. • In hot climates and / or when the person is suffering from fever, the water loss through lungs is increased. • The loss of water by perspiration (via skin) and respiration(via lungs) is collectively referred to as insensible water loss.
  • 121.
    Feces • Most ofthe water entering the gastrointestinal tract is reabsorbed by the intestine. • About 150ml/day is lost through feces in a healthy individual. • Fecal loss of water is tremendously increased in diarrhea. • A summary of the water intake and output in the body is depicted in below figure:
  • 122.
    Body water 42,000ml Foodstuffs (700ml) Drinking water and beverages(1,500ml) Metabolic water (300ml) Feces (150 ml) Lungs (400ml) Skin(450ml) Urine (1,500ml)
  • 123.
    Feces • It maybe noted that water balance of the body is regulated predominantly by controlling the urine output. • This happens after an obligatory water loss via skin, lungs and feces. • The abnormalities associated with water balance dehydration and over hydration will be described, following a discussion on electrolytes balance.