Download MBBS Biochemistry PPT 54 Minerals Lecture Notes

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What are Minerals?

Minerals

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v Minerals are Inorganic elements
v Not biosynthesized in human

body

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v Widely distributed in nature
v Present in foods of Plant and

Animal origin
Minerals In Human body

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?Minerals in human body

serve for various structural

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and functional roles

?Hence it is essential to

ingest Minerals through

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diet.
Human Body Ingests

Seven Food Nutrients

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Dietary Fiber

Minerals

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Water

Food Substances

Vitamins

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Proteins

Lipids

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Carbohydrates

Minerals In Human body

v Minerals are Nutrient Of

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Human Food

v Essential Nutrient
v Micro Nutrient

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v Non Calorific Nutrient
Characteristics Of Minerals

Minerals ? Natural in Occurrence

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? Solid in nature
? Inorganic
? Definite chemical

composition

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? Crystal structure due

to internal

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arrangement of atoms


v Minerals ingested are not

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changed in the body.

v Minerals are not destroyed by

heat, light, acid or mixing

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Classification Of Minerals
Body Minerals

q30 Chemical elements are

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identified as Minerals.

qImportant for human

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growth, development and

regulation of vital functions

?Minerals are classified

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based on:

vFunctional need to body
vIts daily requirement

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Two Broad Classes Of Minerals

? Macro Minerals ? 60-80 %
? Micro Minerals- 20%

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?Macro/Principle/Chief

Minerals

? Body needs Macro Minerals

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relatively in large quantities

? Minerals present in body tissues at

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concentrations >50 mg/kg

? Requirement of these Minerals is

>100 mg/day

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7 Names Of Macro/Chief Minerals

1. Calcium (Ca)
2. Phosphorus (P)
3. Sulfur (S)

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4. Magnesium (Mg)
5. Sodium (Na)
6. Potassium (K)
7. Chloride (Cl)

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? Micro Minerals /Trace Elements

? Body needs Micro Minerals

relatively in less amount

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? Present in body tissues at

concentrations <50 mg/kg

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? Requirement of these

Minerals is 100 mg/day
Subclasses Of Micro/Trace Minerals

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? Essential Trace Elements
? Possibly Essential Trace

Elements

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? Non Essential Trace Elements

Name Of 10 Essential

Micro/Trace Elements

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1. Iron (Fe)

2. Copper (Cu)

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3. Cobalt (Co)

4. Chromium (Cr)

5. Fluoride (F)

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6. Iodine (I)

7. Manganese (Mn)

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8. Molybdenum (Mo)

9. Selenium (Se)

10.Zinc (Zn)

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Possibly Essential Elements

for Humans

Ni, Si, Sn, V, Ba, Li

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Non Essential

Trace Elements

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Of Humans

Pb, Hg, Al, Ag, Bo
Body Minerals

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C

H

N

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O

S

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P

Na

K

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Ca

Mg

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Cl

Biological forms of minerals in living

systems

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Fe

Zn

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Cu

Mn

Se

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Co

V

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Si

As

Mo

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I

Br

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F

Nutritional y Important Minerals

Macro Minerals

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Trace Elements

Element

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g/kg

Element

mg/kg

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Ca

15

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Fe

20-50

P

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10

Zn

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10-50

K

2

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Cu

1-5

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Na

1.6

Mo

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1-4

Cl

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1.1

Se

1-2

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S

1.5

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I

0.3-0.6

Mg

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0.4

Mn

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0.2-0.5

Co

0.02-0.1

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Minerals in the Body

General Characteristic Features

Of

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Human Body Minerals
Sources Of Minerals

To Human Body

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?A mixed diet of varied

foods

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?Is the best source of

Minerals
Minerals in Foods

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? Minerals are found in al food

groups.

? More reliably found in

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?Fresh Fruits

?Vegetables

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?Animal products

Factors Affecting Mineral Requirements

? Form of Mineral fed - Inorganic

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vs Organic forms

? Interactions with other minerals
? Tissue storage

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? Physiological State
Site for Mineral Absorption

?Small intestine
?Large intestine

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Variable Bioavailability of Minerals
Bioavailability Of Minerals

? Bioavailability (absorption capacity) of

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Minerals is influenced by :

?Genetics
? Aging

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? Nutritional Status
?Other food compounds

Nutrient Interactions

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vSome food components bind with

Minerals reducing their bioavailability

vMineral interactions can affect another

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minerals absorption, and excretion


? Often other substances in

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foods decrease absorption

(bioavailability) of Minerals:

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?Oxalate, found in spinach,

prevents absorption of most

Calcium in spinach.

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?Phytate, in most plants

makes minerals poorly

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available

Oxalate

Phytate

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Factors Affecting Requirements

? Interactions with other Minerals

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? Phosphorous binds with

Magnesium in the small

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intestine.

? So Magnesium absorption is

limited when Phosphorous

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intakes are high
Uptake And Transportation

Of Minerals

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v Some Minerals require no carriers

to transport into intestinal wall.

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v Some Minerals require carriers to

enter into intestinal wall.
? Excretion and Regulation

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Site Of Minerals.

?Smal intestine
?Kidneys

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General Functions of Minerals
? Minerals with structural functions:

Ca, P ,Mg in bones; S in Keratin.

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? Minerals serve as Inorganic Cofactors:

participate with Enzymes in metabolic

processes .

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? Role of Minerals in Acid-Base and Water

balance: Na+, K+ and Cl-

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? Minerals have role in Nerve & Muscle

Function : Ca, Na, K, Mg

? Minerals are components of certain

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biomolecules:

?Fe- Heme,

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?Co- Vitamin B12

?I2-Thyroid hormones.
Mineral Deficiencies and Excesses

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Mineral Balance

Minerals Inn=Minerals Out
? Most Minerals have an optimal

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range in blood/body.

?Minerals below range leads to

deficiency symptoms

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?Minerals above range leads to

toxicity symptoms

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? Deficiency and excess of

Minerals in human body

? Affect the normal health

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and vitality of human body

? Which may lead to suffer

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from various manifestations.
Note

?Mineral content of

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soils

?Dictates Mineral

status of plants.

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? Mineral deficiencies usual y are rare

? As they are widely distributed and

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essentially taken through food.

? However there are many deficiency

cases noted of

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? Iron , Iodine and Calcium

deficiencies.
? It may take many months to

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develop Mineral toxicity.

?The time taken to develop

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is impacted by body

stores.

Study Of Specific Minerals

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Study Of Macrominerals

Calcium Metabolism
? Symbol : Ca+2
? Divalent Cation

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? Atomic Weight : 40 g/mol
? Atomic Number: 20
? Nature :Soft Grey Alkaline

Earth Metal

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? Calcium is the most

essential abundant

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Macromineral of human

body.

? Fifth most abundant

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element in Earth?s crust
Calcium Occurrence In

Nature

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? Natural y Calcium does not

exist freely

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? Calcium occurs in form of Salts

?Limestone (CaCO3)

?Gypsum (CaSO4*2H2O)

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?Fluorite (CaF2)

Calcium In the Human Body

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vCalcium is the most

abundant Macro

Mineral

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vAverage adult body

contains approx. 1.5 kg

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of Calcium.
? 99% of the body Calcium is

associated to skeleton (Bones

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and Teeth).


? 1% Calcium is present in other

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tissues and body fluids.

vCalcium in bones is in dynamic

state

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vCalcium of bones may serve as

large reservoirs storing excess

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Calcium

vBones releases Calcium when

extracel ular fluid Calcium

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concentration decreases.
RDA

Recommended

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Daily Amount

Of Calcium

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Calcium Dietary Requirements

?Adult : 800 mg/day
?Pregnancy, lactation and post-menopause:

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1500mg/day/1.5 g/day

?Growing Children: (1-18 yrs): 1200 mg/day
?Infants: (< 1 year): 300-500 mg /day
Ca ? Daily Requirements

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Age/ sex

Ca (mg)

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1-3

350

4-6

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450

7-10

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550

11-18 M

1000

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11-18 F

800

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19 +

700

Dietary Sources Of Calcium

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Dietary Calcium sources

? Rich Calcium Sources

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- Milk and Milk Products
- Mil et (Ragi)
- Wheat-Soy flour
- Black strap molasses

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Ragi/Red Millet/Finger Millet
? Calcium Good sources

- Yoghurt, sour cream, ice cream

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- Tofu

- Gauva ,Figs

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- Cereals

- Egg yolk

- Legumes

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- Green leafy vegetables as collard,

kale , Broccolli, Cabbage and raw

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turnip

- Small Fish as trout, salmon and

sardines with bones

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- Meat

- Almonds, brazil nuts, dried figs,

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hazel nuts

- Also soybean flour and cottonseed

flour

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Ca ? Dietary Sources

? Milk ? 100 ml =120mg

? Cheese ? 15gm = 110mg

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? Yoghurt pot ? 80gm = 160mg

Absorption Of Calcium
?Absorption of Calcium

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occurs in the smal

intestine

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?In Duodenum and first

half Jejunum

?Calcium must be in a

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soluble and ionized

form for its absorption.

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?Calcium salts are

unabsorbable forms.
Calcium Absorption

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?Absorption depends on

need of Calcium to body:

?Particularly high during

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growth, pregnancy and

lactation

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Calcium

Transport Mechanism

Across Intestinal Mucosal

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Membrane
Ca Absorption Simple diffusion/Passive

Mechanism

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An active transport involving Ca pump

Calcium Passive Transport

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? Is a non saturable,

paracellular

? It is less efficient process

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? Is not affected by calcium

status or parathyroid

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hormone
?Active Absorption of Calcium:

? Against electrical and

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concentration gradient, by an

energy dependent active

process.

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Calcium Active Transportation

?Regulated by the active form of

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Vitamin D/Calcitriol.

?Which involves Calbindin

(Calcium-Binding Protein) ?

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Factors Promoting

Calcium Absorption

Parathyroid Hormone

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(PTH) indirectly
enhances Ca absorption
through the increased
activation of Calcitriol.

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Calcitriol

vCalcitriol /activated Vitamin D ,

induces the synthesis of Ca binding

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protein Calbindin

vCalbindin in the intestinal

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epithelial cel s then promotes Ca

absorption.

Acidity (low pH)

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vAcidity is more favorable for Ca

absorption.

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qCalcium salts are soluble in acid

solutions

qSo acidity increases the absorption

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of Calcium.
vLactose , Citric acid

promotes Calcium

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uptake by intestinal cell.

? Amount of Proteins in Diet:

? Amino acids Lysine and

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Arginine form soluble

complexes with Calcium

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? Hence high protein diet

favors the absorption of

Calcium.

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? Concentration of

Calcium in diet:

? Higher the concentration

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of Calcium

? More is the absorption of

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Calcium.

Factors Inhibiting

Calcium Absorption

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? Phytates and Oxalates

present in plant origin diet

form insoluble salts and

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interfere with Ca

absorption.

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? The high content of dietary

Phosphates results in the

formation of insoluble Ca

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phosphate and prevent Ca uptake.

? Dietary ratio of Ca : P ---1:1 / 2:1
? is ideal for Ca absorption.

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?The Free Fatty acids

react with Ca to form

insoluble Ca soaps.

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?The Alkaline condition

(high pH) is

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unfavorable for Ca

absorption.
?Low Estrogen levels in

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postmenopausal

women lowers Calcium

absorption.

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?Since Estrogen increases

Calcitriol levels

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?High content of Dietary

fiber,Caffeine,Sodium

interferes with Ca

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absorption.
? Amount of Magnesium in diet:

Excess Magnesium in diet

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inhibits Calcium absorption.

? As Magnesium competes with

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Calcium for absorption.

Calcium

Absorption and Excretion at

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GIT
?Usual Ca intake is1000

mg/day.

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?About 35 % is absorbed

(350 mg/day) by the

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intestine.

? Remaining Calcium in the

intestine is excreted in the

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feces

? 250 mg/day enters

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intestine via secreted

gastrointestinal juices and

sloughed mucosal cells

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90 % (900 mg/day) of the

daily intake is excreted in

the feces

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10 % (100 mg/day) of the

ingested calcium is

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excreted in the urine.

Body Distribution Of

Calcium

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?Total content of Calcium in

an Adult body is 1-1.5 Kg.

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?Calcium constitutes 2% of

total body weight.

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BODY CALCIUM

?99% of Calcium is in Bones
?0.8% of Calcium is in soft

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tissues (ICF)

?0.1% in Blood ( ECF)

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PLASMA CALCIUM

Three Forms of Circulating Ca2+
Diffusible Calcium

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? 50% Ca2+ Ionized/Physiological y

active form.

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? 10% combined with anions (Citrate,

Phosphate) ?Non-dissociated/Non

ionizable form.

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Non diffusible Calcium

? 40% combined with plasma

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proteins

? Combination with proteins

depends on pH 0.2 mmol/l ,Ca2+ on

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each pH unit
Blood Calcium Levels

?The normal serum

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total calcium is:

? 9-11 mg/dL

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? 2 -3 mmol/L

? Normal levels of the

ionized/free/diffusible/physiological

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form of Calcium is

?4.5-5.6 mg/dL

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?1.1-1.4 mmol/L
?Protein bound Calcium

(Mostly bound to

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Albumin)/Non

diffusible/Bound form of

Calcium: 4 mg%.

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?Calcium Salts /Bound

form/Inorganic

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Salts/Diffusible:

? Calcium Phosphate and

Calcium Citrate=1mg%

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Erythrocytes

Almost Contain

No Calcium

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Calcium In Alkalosis

? Alkalosis favors binding of

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more Calcium with

Proteins.

? This consequently lowers

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ionized Calcium.
Acidosis Favors Ionization of Calcium

Multiple Biological

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Functions of Calcium
?Calcium is widely

distributed in the body

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? Involved with many

functions to keep the

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body vital and active.

1. Structural Role Of Calcium

?Calcium is a major

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structural element in

the vertebrate skeleton

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forms bones and teeth.
? Calcium along with

Phosphorous, Magnesium

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forms the inorganic matrix of

the bone as Hydroxyapatite

crystals

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? Which gives the tensile

strength to the bones and

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teeth.

? In the form of Calcium

Phosphate(Ca10(PO4)6(OH)2

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known as Hydroxyapatite
?Osteoblasts are

responsible for bone

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formation


?While Osteoclasts are for

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bone resorption.

?Bones undergo

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mineralization during

osteoblastic activity

? Demineralization during

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osteoclastic activity.
Bone Act As Major Reservoir Of

Calcium

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? Osteoclasts secrete acid,

causing the release of calcium

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and phosphate into the

bloodstream.

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? There is constant exchange of

calcium between bone and

blood.

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Cross section through

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trebecular and cortical

bone revealing the

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internal architecture

surrounded by marrow

tissue.

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Cortical bone with

Halversion system (a

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series of channels

supplying nutrients).

Black dots are

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osteocytes

Leg bone of a horse

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showing the trebecular

(spongy) bone and the

Trebecular bone of

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cortical (solid) bone. This

the lower spine.

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bone is able to withstand

Changes with aging.

forces generated by this

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1,500 lb animal

Demineralized bone: Shown is the organic

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matrix consisting mostly of collagen upon

which the bone crystals are laid.

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Hydroxyapatite (crystal structure)

Ca10(PO4)6 OH2

Ca

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P

O

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H

Remember/Note

? During growth , pregnancy and lactation

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phase

? To give strength for building bones and teeth.

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? One should take adequate amounts of

dietary Calcium and Phosphorous
2. Calcium Role in Muscle Contraction

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? The ionized free form of

Calcium interacts with

? Muscle Protein Troponin C to

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trigger muscle contraction.

? Calcium also activates Ca-ATP ase

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and increases the interaction

between Actin and Myosin during

muscle contraction.

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? Thus Calcium has role in excitation

and contraction of muscle fibers.
3. Role Of Calcium In Nerve Impulse

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Conduction

?Ionized Calcium transmits

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nerve impulses

?From pre-synaptic to post-

synaptic region.

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4. Role of Calcium in Hormonal

Actions

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? Calcium serves as second and

third messenger for certain

hormonal activities.

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? Calcium ?Calmodulin

complex mediates the

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hormonal action.
? Calmodulin is a Calcium binding

regulatory Protein which binds

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with 4 Calcium ions.

? Calmodulin serve as messenger

during hormonal action by

--- Content provided by​ FirstRanker.com ---

stimulating Protein Kinases.

? Epinephrine require

--- Content provided by​ FirstRanker.com ---

Calcium as second

messenger at the time of its

action.

--- Content provided by‍ FirstRanker.com ---

? ADH require Calcium as

third messenger during its

--- Content provided by⁠ FirstRanker.com ---

action.
5. List Of Enzymes Activated By

Calcium and Mediated By Calmodulin

--- Content provided by⁠ FirstRanker.com ---

? Adenyl Cyclase
? Glycerol-3-PO4 Dehydrogenase
? Glycogen Synthase
? Pyruvate Carboxylase
? Pyruvate Dehydrogenase

--- Content provided by​ FirstRanker.com ---

? Pyruvate Kinase

6. Calcium as Chelating Agent In Blood

Clotting Mechanism.

--- Content provided by‍ FirstRanker.com ---

? Calcium as Clotting factor IV

serves as a cofactor for several

--- Content provided by⁠ FirstRanker.com ---

reactions in the Cascade of blood

clotting process.

? Calcium serves as chelating agent

--- Content provided by‌ FirstRanker.com ---

during Thrombin formation.
7.Calcium act as a Cofactor of

Enzymes

--- Content provided by‍ FirstRanker.com ---

? Calcium serve as an inorganic

cofactor of: (Direct action)

--- Content provided by‍ FirstRanker.com ---

?Pancreatic Lipase
?ATPase
?Succinate Dehydrogenase

8.Calcium Role in Secretion of

--- Content provided by‍ FirstRanker.com ---

Hormones

? Calcium stimulates to release

--- Content provided by‌ FirstRanker.com ---

of fol owing Hormones:

?PTH
?Insulin
?Calcitonin

--- Content provided by‌ FirstRanker.com ---

?Vasopressin/ADH
9.Calcium Transport Across The

Biomembranes

--- Content provided by‌ FirstRanker.com ---

? The cel membrane is general y

impermeable to Calcium ions.

? Calcium influx into cel s is via

--- Content provided by FirstRanker.com ---

Calcium channels by Na /Ca

exchange mechanism.

--- Content provided by‌ FirstRanker.com ---

?There are different

Calcium Channels

located in the

--- Content provided by​ FirstRanker.com ---

membranes of various

cell organelles.
10. Calcium Prolongs Systole

--- Content provided by‌ FirstRanker.com ---

?Calcium acts on Heart

and prolongs Systole.

--- Content provided by FirstRanker.com ---

?Hypercalcemia may lead

to Cardiac arrest in

Systole.

--- Content provided by‍ FirstRanker.com ---

Remember

?When Calcium is

--- Content provided by‍ FirstRanker.com ---

administered intra venously

?It should be infused very

slowly to avoid the cardiac

--- Content provided by FirstRanker.com ---

arrest.
11.Calpains ? Calcium Dependent

Cysteine Proteases

--- Content provided by​ FirstRanker.com ---

? Calpains are involved in:

?Cel mobility
?Cel cycle progression

--- Content provided by⁠ FirstRanker.com ---

?Cel membrane fusion

events

?Cell fusion in Myoblasts

--- Content provided by‍ FirstRanker.com ---

?Neural vesicle Exocytosis
?Platelet aggregation
?Increased concentration

of Calcium in cells.

--- Content provided by‍ FirstRanker.com ---

?Increases Calpain

activation.

--- Content provided by FirstRanker.com ---

? Increased Calpains causes

unregulated proteolysis .

? Hyperactivity of Calpains

--- Content provided by FirstRanker.com ---

consequent leads to

irreversible tissue damage.
? Calcium is a key component

--- Content provided by‍ FirstRanker.com ---

in the maintenance of the

cel structure

--- Content provided by⁠ FirstRanker.com ---

? Membrane rigidity,

permeability and viscosity

are partly dependent on local

--- Content provided by​ FirstRanker.com ---

calcium concentrations

?11. Calcium promotes

--- Content provided by‍ FirstRanker.com ---

? Transportation of water and

ions across the membranes.

? Excitability of cell membranes.

--- Content provided by‌ FirstRanker.com ---

?Calcium regulates

cellular secretory

process such as :

--- Content provided by FirstRanker.com ---

?Endocytosis
?Exocytosis
?Cell motility

--- Content provided by FirstRanker.com ---

? Calcium has role in:

?Cel to Cel contact
?Cel to cel communication
?Cel adhesion in tissues

--- Content provided by⁠ FirstRanker.com ---

?Calcium is added to

mothers milk during

lactation phase of

--- Content provided by⁠ FirstRanker.com ---

women.

Calcium Active Role:

--- Content provided by FirstRanker.com ---

- In the relaxation and constriction

of muscles

- In nerve impulse transmission

--- Content provided by‍ FirstRanker.com ---

- As an intracel ular signal

- In cel aggregation and movement

--- Content provided by FirstRanker.com ---

- In secretion of hormones

- In cel division
Calcium Passive Role:

--- Content provided by⁠ FirstRanker.com ---

- As a cofactor for many

enzymes (e.g. Lipase) and

--- Content provided by FirstRanker.com ---

proteins

- As component in the

--- Content provided by⁠ FirstRanker.com ---

blood clotting cascade
Homeostasis Of Blood

Calcium

--- Content provided by​ FirstRanker.com ---

OR

Regulation of Blood Calcium

? The normal levels of total

--- Content provided by​ FirstRanker.com ---

serum Calcium is 9-11 mg%.

? It is very essential to maintain

--- Content provided by FirstRanker.com ---

the constant range of Calcium.

? For normal health and

survivallence of human body.

--- Content provided by‍ FirstRanker.com ---

? Most important is the ionized or

physiological form of Calcium

present in blood

--- Content provided by‍ FirstRanker.com ---

? This plays an important roles in

various physiological and

--- Content provided by​ FirstRanker.com ---

metabolic functions of human

body.

--- Content provided by‍ FirstRanker.com ---

? Maintenance of calcium

homeostasis.

?Regulation in dietary absorption

--- Content provided by FirstRanker.com ---

?Storage

?Excretion of Ca
Factors Regulating Blood Calcium

--- Content provided by‍ FirstRanker.com ---

Levels

?Parathyroid Hormone (PTH)
?Vitamin D- Calcitriol

--- Content provided by‌ FirstRanker.com ---

?Calcitonin

? The PTH , Calcitriol and

Calcitonin cooperatively

--- Content provided by⁠ FirstRanker.com ---

works

? To regulate the transiently

--- Content provided by‌ FirstRanker.com ---

increased and decreased

levels of serum Calcium .

--- Content provided by‌ FirstRanker.com ---

Parathyroid hormone

(PTH)

q PTH is secreted by two pairs

--- Content provided by⁠ FirstRanker.com ---

of parathyroid glands.

v PTH is initially synthesized as a

--- Content provided by FirstRanker.com ---

precursor, preProPTH.

v Two proteolytic cleavages

produce the ProPTH and the

--- Content provided by‍ FirstRanker.com ---

secreted form of PTH (84 aa).
?The secretion of PTH

are promoted

--- Content provided by⁠ FirstRanker.com ---

?By low Ca2+

concentration in blood.

Regulation of PTH Secretion and

--- Content provided by FirstRanker.com ---

Biosynthesis

? Extracel ular Ca 2+ regulates secretion of

--- Content provided by​ FirstRanker.com ---

PTH

?Low Ca 2+ increases PTH levels
?High Ca 2+ decreases PTH levels
Mechanism of action of PTH

--- Content provided by⁠ FirstRanker.com ---

? PTH is the most important

endocrine regulator of Ca and

--- Content provided by⁠ FirstRanker.com ---

Phosphorous concentration.

? Function:

?Elevate serum Ca level.

--- Content provided by FirstRanker.com ---

?PTH has 3 independent

tissues to exert its action.

--- Content provided by⁠ FirstRanker.com ---

?Intestine (Indirectly)
?Bone (Directly)
?Kidney (Directly)
? PTH Regulates through

--- Content provided by‍ FirstRanker.com ---

3 Main Effects:

-Stimulating activation of

vitamin D intestinal

--- Content provided by⁠ FirstRanker.com ---

Ca absorption

-Stimulating bone

--- Content provided by‍ FirstRanker.com ---

resorption

-Increasing renal tubular

calcium reabsorption

--- Content provided by FirstRanker.com ---

Actions of Parathyroid Hormone

On Bone
?Parathyroid hormone

--- Content provided by​ FirstRanker.com ---

acts directly on bone to

stimulate resorption

--- Content provided by FirstRanker.com ---

?This releases Ca2+ into

the extracellular space

and fluids (slowly)

--- Content provided by FirstRanker.com ---

PTH Action on the Bone

? Decalcification or Demineralization

--- Content provided by‍ FirstRanker.com ---

of bone, carried out by osteoclasts.

? blood Ca level
? Note: this is being done at the

--- Content provided by‌ FirstRanker.com ---

expense of loss of Ca from bone,

particularly in dietary Ca deficiency.

--- Content provided by FirstRanker.com ---

? Gs protein-coupled receptors in

osteoblasts increase cAMP and

activate Protein Kinase Activity

--- Content provided by‌ FirstRanker.com ---

(PKA)

? This Inhibits osteoblast

--- Content provided by FirstRanker.com ---

function

? This occurs when PTH is

secreted continuously.

--- Content provided by‍ FirstRanker.com ---

Circulating Forms of PTH

Action Of PTH

--- Content provided by‍ FirstRanker.com ---

on the Kidney and Intestine

?Action on the Kidney: increase

--- Content provided by‌ FirstRanker.com ---

the Ca reabsorption.

?Action on the Intestine:

indirect, increase the intestine

--- Content provided by​ FirstRanker.com ---

absorption of Ca by promoting

the synthesis of Calcitriol.
? PTH Effects in Kidney

--- Content provided by‌ FirstRanker.com ---

?Parathyroid hormone

acts directly on kidney

--- Content provided by​ FirstRanker.com ---

?To increase calcium

reabsorption and

phosphate excretion

--- Content provided by​ FirstRanker.com ---

(rapid)

? Gs protein-coupled receptors

--- Content provided by‌ FirstRanker.com ---

? Parathyroid hormone acts on

distal tubule

? Increases renal reabsorption

--- Content provided by​ FirstRanker.com ---

of Calcium.

? Adds Calcium to blood

--- Content provided by‍ FirstRanker.com ---

regulating its levels.


Role Of Calcitriol/ Activated

--- Content provided by‌ FirstRanker.com ---

Vitamin D

- Calcitriol several effects on the

intestine and kidneys that

--- Content provided by FirstRanker.com ---

increase absorption of calcium

and phosphate into the

--- Content provided by‍ FirstRanker.com ---

extracellular fluid

- Important effects on bone

deposition and bone absorption

--- Content provided by⁠ FirstRanker.com ---

PTH and Calcitriol By their Activity

Increases Blood Calcium Levels

? Calcium levels below

--- Content provided by​ FirstRanker.com ---

subnormal levels

? Stimulates the secretion of

--- Content provided by⁠ FirstRanker.com ---

PTH

? PTH then stimulates the

Vitamin D activation to

--- Content provided by FirstRanker.com ---

Calcitriol.


Calcitriol (1,25-dihydroxy-

--- Content provided by​ FirstRanker.com ---

cholecalciferol, 1,25 DHCC)
Activation of Vitamin D3

- Cholecalciferol formed in the skin

--- Content provided by FirstRanker.com ---

by sun

- Converted in liver and Kidney to

--- Content provided by⁠ FirstRanker.com ---

- 1,25 DHCC Control ed by PTH

- Plasma calcium concentration

--- Content provided by⁠ FirstRanker.com ---

inversely regulates 1,25 DHCC

?PTH and Calcitriol then

--- Content provided by⁠ FirstRanker.com ---

acts on three target

organs

?They try to increase the

--- Content provided by‌ FirstRanker.com ---

blood Calcium levels by

their Hypercalcemic

--- Content provided by‍ FirstRanker.com ---

action.
Action On Intestinal Mucosal cel s

? Calcitriol enters intestinal mucosal cells.
? Acts like Steroidal hormone

--- Content provided by⁠ FirstRanker.com ---

? Stimulate the biosynthesis of Calbindin

a Calcium binding Protein by gene

expression.

--- Content provided by‍ FirstRanker.com ---

? Calbindin binds with dietary Calcium in

GIT, promotes it absorption and diffuse

--- Content provided by‍ FirstRanker.com ---

in blood.
Calcitriol Action On Renal Tubules

? Calcitriol acts on renal tubules and

--- Content provided by FirstRanker.com ---

increases tubular renal absorption of

Calcium from plasma ultra filtrate

there by decreasing excretion of

--- Content provided by⁠ FirstRanker.com ---

Calcium.

? The reabsorbed Calcium by renal

--- Content provided by⁠ FirstRanker.com ---

tubules add Calcium to blood these by

increasing blood Calcium levels.

Action On Bones

--- Content provided by⁠ FirstRanker.com ---

? PTH hormone directly acts on bones

causing decalcification of bones

--- Content provided by FirstRanker.com ---

? To release bound form of Calcium into

free form, catalyzed by increased

activity of ALP

--- Content provided by FirstRanker.com ---

? Which increases the levels blood

Calcium to blood there by increasing

--- Content provided by​ FirstRanker.com ---

blood Calcium levels to attain a normal

level of 9-11 mg%
Remember

--- Content provided by FirstRanker.com ---

? The low intake of dietary Calcium may

increase the bone resorption by PTH to

regulate blood Calcium levels.

--- Content provided by‌ FirstRanker.com ---

? This may decrease the blood Calcium

content of bones

--- Content provided by⁠ FirstRanker.com ---

? Leading to weakness in bones

manifesting bone pain and recurrent

bone fractures.

--- Content provided by‌ FirstRanker.com ---

Calcitonin

? Calcitonin a peptide hormone

--- Content provided by⁠ FirstRanker.com ---

(32 aa) secreted by the

parafol icular cel s of Thyroid

gland

--- Content provided by‍ FirstRanker.com ---

- Calcitonin tends to decrease

plasma Calcium

--- Content provided by‍ FirstRanker.com ---

concentration
Role Of Calcitonin In Decreasing The

Blood Calcium Views

--- Content provided by‍ FirstRanker.com ---

? When ever the blood Calcium

goes above 11 mg%

? The Calcitonin by its

--- Content provided by​ FirstRanker.com ---

Hypocalcemic action

? Tries to lower the increased the

--- Content provided by‌ FirstRanker.com ---

blood Calcium levels.

? Calcitonin promotes the

bone mineralization or

--- Content provided by‍ FirstRanker.com ---

Calcification of bones.

? The blood Calcium is taken

--- Content provided by​ FirstRanker.com ---

up by bones and reserved.
? Thus Calcitonin increases

Osteoblasts activity

--- Content provided by FirstRanker.com ---

? Enhances bone mineralization.
? Promotes bone growth
? Reduces increased blood

Calcium levels to attain 9-11

--- Content provided by‍ FirstRanker.com ---

mg%.

-Calcitonin adds

--- Content provided by‌ FirstRanker.com ---

Calcium to bones

and increases bone

mineralization.

--- Content provided by​ FirstRanker.com ---

Role Of Calcitonin (CT)

?CT has the ability to decrease blood Ca and P
levels and its major target cells also in bone,
kidney and intestine.

--- Content provided by​ FirstRanker.com ---

1. Bone: Stimulate Osteogenesis.
2. Intestine: Inhibit absorption of Ca.
3. Kidney: enhance of Ca excretion from

--- Content provided by‍ FirstRanker.com ---

urine.

?PTH and Calcitonin are

antagonistic in actions.

--- Content provided by‌ FirstRanker.com ---

?OR

?Action of Calcitonin is

--- Content provided by‍ FirstRanker.com ---

opposite to that of PTH.
Hormonal Regulators

? Calcitonin (CT)

--- Content provided by FirstRanker.com ---

?Lowers Ca++ in the blood

?Stimulates Osteoblasts

?Inhibits Osteoclasts

--- Content provided by‌ FirstRanker.com ---

?Parathormone (PTH)

?Increases Ca++ in the

--- Content provided by‌ FirstRanker.com ---

blood

?Stimulates Osteoclasts

--- Content provided by‍ FirstRanker.com ---

? Calcitriol

?Increases Ca++ in the

blood

--- Content provided by‍ FirstRanker.com ---

?Increase Ca++ uptake

from the gut

--- Content provided by⁠ FirstRanker.com ---

?Stimulates osteoclasts

(+)

--- Content provided by‌ FirstRanker.com ---

Regulation of Calcium Homeostasis

Calcium Turnover

--- Content provided by‍ FirstRanker.com ---

Calcium Balance

? Calcium Intake = Calcium output

? Negative calcium balance: Output >

--- Content provided by‍ FirstRanker.com ---

intake

?Negative Ca2+ balance leads to

--- Content provided by FirstRanker.com ---

osteoporosis

? Positive calcium balance: Intake >

output

--- Content provided by​ FirstRanker.com ---

?Positive Ca balance occurs during

growth

--- Content provided by FirstRanker.com ---

Calcium Balance


Exercise and Calcium

--- Content provided by‌ FirstRanker.com ---

? Normal bone function

requires weight-bearing

exercise

--- Content provided by⁠ FirstRanker.com ---

? Total bed-rest causes bone

loss and negative calcium

--- Content provided by‌ FirstRanker.com ---

balance.

Calcium Homeostasis

--- Content provided by FirstRanker.com ---

Calcium and the Cel

? Translocation across the plasma membrane

? Translocation across the ER and mitochondrion;

--- Content provided by‍ FirstRanker.com ---

Ca2+ ATPase in ER and plasma membrane


Regulation of

--- Content provided by⁠ FirstRanker.com ---

Calcium

Homeostasis

--- Content provided by‍ FirstRanker.com ---

Calcium Homeostasis

kidney

bone

--- Content provided by FirstRanker.com ---

calcium deposition

Blood

--- Content provided by‍ FirstRanker.com ---

Ca++

calcium resorption

1000 g Ca++

--- Content provided by‍ FirstRanker.com ---

stored in bone

Ca++ absorbed

--- Content provided by‌ FirstRanker.com ---

Ca++

into blood

lost in urine

--- Content provided by​ FirstRanker.com ---

Calcium in

the diet

--- Content provided by‌ FirstRanker.com ---

calcium lost in feces

smal intestine

--- Content provided by‌ FirstRanker.com ---

Calcium Homeostasis

storage

--- Content provided by‌ FirstRanker.com ---

kidney

bone

--- Content provided by⁠ FirstRanker.com ---

calcium deposition

Blood

Ca++

--- Content provided by‍ FirstRanker.com ---

calcium resorption

1000 g Ca++

--- Content provided by​ FirstRanker.com ---

stored in bone

intake

Ca++ absorbed

--- Content provided by​ FirstRanker.com ---

Ca++

into blood

--- Content provided by FirstRanker.com ---

excretion

lost in urine

Calcium in

--- Content provided by‌ FirstRanker.com ---

the diet

calcium lost in feces

--- Content provided by⁠ FirstRanker.com ---

smal intestine

Calcium Homeostasis

kidney

--- Content provided by‍ FirstRanker.com ---

bone

calcium deposition

--- Content provided by FirstRanker.com ---

Blood

Ca++

calcium resorption

--- Content provided by‍ FirstRanker.com ---

Ca++ absorbed

Ca++

--- Content provided by FirstRanker.com ---

into blood

lost in urine

Calcium in

--- Content provided by FirstRanker.com ---

the diet

calcium lost in feces

--- Content provided by‌ FirstRanker.com ---

smal intestine

--- Content provided by⁠ FirstRanker.com ---

Calcium Homeostasis

kidney

bone

--- Content provided by FirstRanker.com ---

1,25 Vit. D3 (+)

Parathormone (+)

--- Content provided by‌ FirstRanker.com ---

Calcitonin (-)

Blood

resorption

--- Content provided by FirstRanker.com ---

Ca++

deposition

--- Content provided by​ FirstRanker.com ---

PTH

Ca++

Ca++

--- Content provided by⁠ FirstRanker.com ---

1,25 Vit D3

Ca++

--- Content provided by FirstRanker.com ---

Ca++

smal intestine

1,25 Vitamin D3

--- Content provided by​ FirstRanker.com ---

UV

Cholesterol precursor 7-dehydrocholesterol

--- Content provided by FirstRanker.com ---

Vitamin D3

25 Vitamin D3

1,25 Vitamin D3

--- Content provided by‍ FirstRanker.com ---

Low plasma Ca++ increase kidney enzymes
Excretion Of Calcium

Excretion of Ca

--- Content provided by‍ FirstRanker.com ---

? Mostly through the intestine.
? Partly through the kidney.
Calcium Excretion

--- Content provided by​ FirstRanker.com ---

qIn feces: 80%
qIn urine: 20%

?Unabsorbed dietary

--- Content provided by FirstRanker.com ---

Calcium is mostly

excreted out through

feces.

--- Content provided by⁠ FirstRanker.com ---

?Excretion of Ca into the

feces is a continuous

process

--- Content provided by FirstRanker.com ---

?This is increased in

vitamin D deficiency

--- Content provided by​ FirstRanker.com ---

When Wil Calcium Excreted In Urine?
? The renal threshold for

Calcium is 10 mg%.

--- Content provided by‍ FirstRanker.com ---

? When blood Calcium crosses

more than 10 mg% it is

excreted in Urine.

--- Content provided by​ FirstRanker.com ---

Excretion of Calcium

under influence of PTH.
?The excretion of Calcium

--- Content provided by FirstRanker.com ---

and Phosphorous is

reciprocal y regulated.

--- Content provided by⁠ FirstRanker.com ---

?If Phosphorous excretion

is increased Calcium

excretion is decreased.

--- Content provided by​ FirstRanker.com ---

? Conditions Increasing

Excretion Calcium

--- Content provided by​ FirstRanker.com ---

- Low Parathyroid hormone

(PTH)

- High extracellular fluid volume

--- Content provided by‍ FirstRanker.com ---

- High blood pressure

- Low plasma Phosphate

--- Content provided by FirstRanker.com ---

- Metabolic Alkalosis
? Excretion Of Calcium Is

decreased by:

--- Content provided by​ FirstRanker.com ---

- High Parathyroid hormone

- Low extracellular fluid volume

- Low blood pressure

--- Content provided by⁠ FirstRanker.com ---

- High plasma phosphate

- Metabolic acidosis

--- Content provided by​ FirstRanker.com ---

- Low Vitamin D3

Clinical Significance Of Calcium
Disorders Associated

--- Content provided by⁠ FirstRanker.com ---

To

Calcium Metabolism

Defect In Fol owing Factors

--- Content provided by​ FirstRanker.com ---

Leads to Calcium Related Disorders

? Dietary Intake Of Calcium
? Role of PTH , Calcitriol and

--- Content provided by‍ FirstRanker.com ---

Calcitonin

? Status of Parathyroid , Thyroid

--- Content provided by‍ FirstRanker.com ---

, Liver and Kidney
Investigations To Diagnose

Calcium Related Disorders

--- Content provided by FirstRanker.com ---

? Serum Ca and Pi levels
? PTH
? Vit D ( 1,25 Dihydroxy levels)
? Mg
? Urinary Ca/ Cr ratio

--- Content provided by FirstRanker.com ---

Disorders Of Calcium

Metabolism

--- Content provided by‌ FirstRanker.com ---

Hypercalcemia

And

Hypocalcaemia

--- Content provided by​ FirstRanker.com ---

Hypercalcemia

?Hypercalcemia is the

condition where there is

--- Content provided by‌ FirstRanker.com ---

?Persistent high levels of

blood Calcium above 11

--- Content provided by FirstRanker.com ---

mg%.

Conditions Leading To Hypercalcemia

? Excessive intake of Calcium

--- Content provided by​ FirstRanker.com ---

? Hyperparathyroidism-

Increased PTH

? Parathyroid Adenoma

--- Content provided by​ FirstRanker.com ---

? Hypervitaminosis D
? Pagets Disease
(Increased Release From Bones)
? Addisons Disease
(Decreased Excretion Of Calcium)

--- Content provided by‌ FirstRanker.com ---

? Bone Tumors
(Leak of Calcium From Bones)
? Multiple Myeloma-Leukemia ,

Polycythemia

--- Content provided by⁠ FirstRanker.com ---

? Milk Alkali Syndrome( Calcium+Alkali)

?Excessive use of

--- Content provided by FirstRanker.com ---

antacids with phosphate

-binding

?Prolonged immobility

--- Content provided by‌ FirstRanker.com ---

?Thiazide diuretics

?Thyrotoxicosis
Hypercalcemia Signs and Symptoms

--- Content provided by‍ FirstRanker.com ---

?Muscle weakness
?Personality changes
?Nausea and Vomiting
?Polyuria

--- Content provided by‍ FirstRanker.com ---

?Extreme thirst

? Anorexia
? Constipation
? Pathological fractures

--- Content provided by​ FirstRanker.com ---

? Calcifications in the skin and

Cornea

? Cardiac arrest(prolonged Systole)

--- Content provided by⁠ FirstRanker.com ---

Clinical manifestations of Hypercalciemia

--- Content provided by​ FirstRanker.com ---

Osteodystrophy (Recklinhauzen disease)

Cystosis swel ing in the distal

--- Content provided by​ FirstRanker.com ---

ends of both fibula bones

Mechanism

Hyperparatireosis ? increasing of in blood ? waste of from bones by

--- Content provided by⁠ FirstRanker.com ---

resorbtion ? osteoporosis ? overgrowth of connective tissue (but isn't

deposited) - osteofibrosis

--- Content provided by⁠ FirstRanker.com ---

Hypocalcemia

? Hypocalcemia is the condition

where there is persistent low levels

--- Content provided by‌ FirstRanker.com ---

of blood Calcium below 9 mg %.

? Hypocalcemia is more dangerous

--- Content provided by​ FirstRanker.com ---

and life threatening if not

corrected and managed timely.
Conditions Causing Hypocalcemia

--- Content provided by‍ FirstRanker.com ---

? Malnutrition and

Malabsorption

? Diarrhea

--- Content provided by‍ FirstRanker.com ---

? Acute Pancreatitis
? Hypoparathyroidism
? Hypovitaminosis D

? Rickets

--- Content provided by⁠ FirstRanker.com ---

? Osteomalacia
? Renal Rickets (Deficiency of 1

Hydroxylase)

--- Content provided by⁠ FirstRanker.com ---

? Fanconis Syndrome
? Hypoalbuminemia( Decreases

Protein bound Calcium)
? Chronic kidney failure

--- Content provided by FirstRanker.com ---

? Low blood magnesium level

(in cases with severe

alcoholism)

--- Content provided by FirstRanker.com ---

? Diet high in Phytate

Hypocalcaemia ? Clinical Features

--- Content provided by⁠ FirstRanker.com ---

? Neuromuscular excitability

? Paraesthesia (tingling

sensation) around mouth,

--- Content provided by​ FirstRanker.com ---

fingers and toes

? Tetany

--- Content provided by FirstRanker.com ---

? Muscle cramps, Carpopedal

spasms

? Seizures ? focal or generalised

--- Content provided by‌ FirstRanker.com ---

? Laryngospasm, Stridor and

apneas (neonates)

--- Content provided by‍ FirstRanker.com ---

? Cardiac Rhythm disturbances

(prolonged QT interval)

? Chvostek's and Trousseau's

--- Content provided by​ FirstRanker.com ---

signs ? latent hypocalcemia

Calcium Deficiency Manifestations

--- Content provided by‌ FirstRanker.com ---

Calcium Deficiencies

? Tetany
? Rickets

--- Content provided by⁠ FirstRanker.com ---

?In growing children's

? Osteomalacia (Osteoporosis)

--- Content provided by FirstRanker.com ---

?In adult animals

Tetany

? Tetany is the manifestations

--- Content provided by‍ FirstRanker.com ---

caused due to hypocalcemia.

? Serum Calcium below 7 mg %

--- Content provided by​ FirstRanker.com ---

causes Tetany.
? Tetany is a life threatening

condition.

--- Content provided by‌ FirstRanker.com ---

? Tetany may be suffered in

persons whom

?Parathyroid gland is surgical y

--- Content provided by⁠ FirstRanker.com ---

removed

?Parathyroid dysfunction due to

--- Content provided by‍ FirstRanker.com ---

auto immune disorder.

? Low Calcium levels directly

affects neuromuscular

--- Content provided by‌ FirstRanker.com ---

activity.

? Leads to increased

--- Content provided by​ FirstRanker.com ---

neuromuscular irritability

of muscles.
?Twitching and spasm

--- Content provided by FirstRanker.com ---

of muscles of

face,hand,feet neck

?Carpopedal and

--- Content provided by‍ FirstRanker.com ---

Laryngeal and Stridor

Spasm.

--- Content provided by​ FirstRanker.com ---

Clinical Sign Of Tetany
? Chvostek's Sign (Tapping over

facial nerve causes facial

--- Content provided by⁠ FirstRanker.com ---

contraction)

? Trousseaus Sign (Inflation of

BP Cuff for 3 minutes causes

--- Content provided by‌ FirstRanker.com ---

Carpopedal spasm).

ECG Changes In Tetany

--- Content provided by​ FirstRanker.com ---

?Increased Q-T interval

in ECG.
? Low blood Calcium
? Increased Phosphate in

--- Content provided by‍ FirstRanker.com ---

blood

? Low urine Calcium and

--- Content provided by​ FirstRanker.com ---

Phosphorous

Treatment Of Tetany

?Intravenous

--- Content provided by⁠ FirstRanker.com ---

infusions of Calcium

salts.

--- Content provided by​ FirstRanker.com ---

--- Content provided by​ FirstRanker.com ---

Clinical manifestations of Hypocalcaemia

Tetany

The process of tetany potentiation

--- Content provided by‌ FirstRanker.com ---

at the motor neurons and interneuron of spinal cord violate

Conduction of impulses at reflex arch become easier

--- Content provided by⁠ FirstRanker.com ---

Activate a reflex muscles contraction on mechanical and other stimuli

Spasm of larynx, bronchus

Coronarospasm (cardiotetanus)

--- Content provided by⁠ FirstRanker.com ---

Cramps

--- Content provided by FirstRanker.com ---

asphyxia



angina

--- Content provided by‍ FirstRanker.com ---

death

Stop of heart

--- Content provided by‌ FirstRanker.com ---

Calcium Deficiencies -Rickets

?weakness and deformity of the bones that occurs from
vitamin D deficiency or dietary deficiency of Ca and P in
a growing person or animal.

--- Content provided by⁠ FirstRanker.com ---

--- Content provided by‌ FirstRanker.com ---

Clinical manif

e st

--- Content provided by⁠ FirstRanker.com ---

a

ti

o

--- Content provided by​ FirstRanker.com ---

n s

of

--- Content provided by⁠ FirstRanker.com ---

Hy

pocalcaemia

Ricket

--- Content provided by FirstRanker.com ---

Calcium and Osteoporosis

? Around age 40,

--- Content provided by‍ FirstRanker.com ---

bone breakdown

exceeds

formation.

--- Content provided by FirstRanker.com ---

? By age 65, some

women have

--- Content provided by⁠ FirstRanker.com ---

lost 50% of bone

mass.

--- Content provided by‍ FirstRanker.com ---

Calcium Deficiencies -Osteoporosis

?progressive loss of bone density, thinning of bone tissue
and increased vulnerability to fractures in the elderly
people of both sexes.

--- Content provided by‍ FirstRanker.com ---

Calcium and Osteoporosis

? Bone growth is greatest during "linear growth"

--- Content provided by‍ FirstRanker.com ---

? Peaks out at around age 30

How does Osteoporosis Look?
Effect Of pH On

--- Content provided by‌ FirstRanker.com ---

Extracellular Calcium

? Binding of Calcium to Albumin
is pH dependent

--- Content provided by‍ FirstRanker.com ---

? Acute alkalosis increases

calcium binding to protein and

--- Content provided by‌ FirstRanker.com ---

decreases ionized calcium

? Patients who develop Acute

Respiratory Alkalosis

--- Content provided by‌ FirstRanker.com ---

? Have increased neural excitability

and are prone to seizures

--- Content provided by⁠ FirstRanker.com ---

? This is due to:

? Low ionized calcium in the

extracel ular fluid

--- Content provided by⁠ FirstRanker.com ---

?Increased permeability to Sodium

ions
Prevention is the Key

--- Content provided by⁠ FirstRanker.com ---

? Maintain adequate Calcium

and Vitamin D intake--

--- Content provided by​ FirstRanker.com ---

? Perform weight-bearing

exercise

? Take Estrogen supplements?

--- Content provided by FirstRanker.com ---

Treatment of Hypocalcaemia

Severe Symptomatic:

--- Content provided by​ FirstRanker.com ---

?IV 10% Calcium Gluconate @ 0.11 mmol/kg

(0.5 mls/kg ? max 20 mls) over 10 minutes

?Continuous IV infusion of Calcium Gluconate

--- Content provided by FirstRanker.com ---

@ 0.1 mmol/kg (Max 8.8 mmols) over 24

hours

--- Content provided by‍ FirstRanker.com ---

Severe Asymptomatic:

Oral Calcium Supplements @ 0.2 mmol/kg

(Max 10 mmols or 400 mg Ca) 4 x a day

--- Content provided by⁠ FirstRanker.com ---

Calcium Toxicity

? Calcium deposition in soft tissue

? Impaired kidney function

--- Content provided by‌ FirstRanker.com ---

? Interference of other nutrient

absorption

--- Content provided by‍ FirstRanker.com ---

?Iron & zinc

? Toxicity ? Hypercalcemia

(normal y does not to

--- Content provided by‍ FirstRanker.com ---

occur)

? Hyperparathyroidism,

--- Content provided by‍ FirstRanker.com ---

vitamin D intoxication,

cancer are few causes.

--- Content provided by‌ FirstRanker.com ---

Toxicity Of Calcium

? MAS (Milk Alkali Syndrome)
- Rare and potentially life threatening

--- Content provided by⁠ FirstRanker.com ---

condition in individuals consuming large

quantities of calcium and alkali

- Characterized by renal impairment,

--- Content provided by⁠ FirstRanker.com ---

alkalosis and Hypercalcemia: cause

progressive depression of the nervous

--- Content provided by​ FirstRanker.com ---

system

Metabolic calcinosis ( )

Pathogenesis unknown

--- Content provided by⁠ FirstRanker.com ---

Limestone deposits in skin, tendons, fascias, muscles, along nerves and vessels

--- Content provided by‌ FirstRanker.com ---

Dystrophic static calcinosis (petrification)

--- Content provided by‌ FirstRanker.com ---

It arises in necrotic and dystrophic tissues - tuberculosis center , infarctions,

dead fetus, chronic focus of inflamations (lungs and heart like an armor ),

focuses of atherosclerosis, scar tissue

--- Content provided by‍ FirstRanker.com ---

Mechanism: alkalinity conditions ? increased absorption from blood ?

The increased activity of phosphatases, which prodused from necrotic cel s ? formation of

--- Content provided by FirstRanker.com ---

insoluble salts of

Metastasic calcinosis

Calcinosis of aortic valve

--- Content provided by‌ FirstRanker.com ---

Phosphorous

Metabolism

Phosphorous

--- Content provided by​ FirstRanker.com ---

? Phosphorous is a

Macromineral /Chief/Principle

--- Content provided by‌ FirstRanker.com ---

Element of human body.

? It is a second most abundant

Mineral of human body.

--- Content provided by FirstRanker.com ---

Daily Requirement/RDA of

Phosphorous

? The dietary Ca:P ratio ideal y

--- Content provided by⁠ FirstRanker.com ---

should be 1:1 for optimal

absorption and functions.

--- Content provided by FirstRanker.com ---

? Thus the requirement of

dietary Phosphorous is more

or less same as that of

--- Content provided by‍ FirstRanker.com ---

Calcium.

?Adults= 800 mg/day
?Growing Children=1000

--- Content provided by‌ FirstRanker.com ---

mg/day
Dietary Sources Of Phosphorous

? Milk and Milk Products

--- Content provided by FirstRanker.com ---

? Cereals
? Egg
? Meat
? Green Leafy Vegetables ,

--- Content provided by FirstRanker.com ---

Cabbage , Cauliflower

Absorption Of Dietary Phosphorous

? Absorption of Phosphorous is

--- Content provided by‌ FirstRanker.com ---

along with Calcium.

? Hence factors promoting and

--- Content provided by​ FirstRanker.com ---

inhibiting Calcium absorption

are likely with Phosphorous.
? The Calcium and Phosphorous

--- Content provided by FirstRanker.com ---

ratio in diet affects absorption

and excretion of Phosphorous.

? If any one of this is excess in

--- Content provided by⁠ FirstRanker.com ---

diet the excretion of the other

is increased.

--- Content provided by‌ FirstRanker.com ---

Body Distribution Of Phosphorous

? Total content of

Phosphorous in an adult

--- Content provided by FirstRanker.com ---

body is 1 Kg.

? Phosphorous is present in

--- Content provided by FirstRanker.com ---

each and every cell of

body cell.
? 80 % of Phosphorous is present in

--- Content provided by‌ FirstRanker.com ---

bones and teeth along with

Calcium as Hydroxyapatite

crystals.

--- Content provided by‍ FirstRanker.com ---

? 10% of Phosphorous is present in

Muscles and blood associated to

--- Content provided by⁠ FirstRanker.com ---

Proteins, Lipids and Carbohydrate

moieties.

?10 % of Phosphorous is

--- Content provided by‍ FirstRanker.com ---

component of various

Phosphorylated

--- Content provided by⁠ FirstRanker.com ---

biomolecules.
Phosphorous In Blood

? In blood Phosphorous is

--- Content provided by FirstRanker.com ---

present in following forms:

? Free/Ionized Phosphorous:

40%

--- Content provided by‌ FirstRanker.com ---

?H2PO4-
?HPO4- -

? Bound/Complex forms of

--- Content provided by‍ FirstRanker.com ---

Phosphorous:

? Phosphorous bound and present

--- Content provided by‍ FirstRanker.com ---

as organic forms- Non diffusible

form.

? Phosphorous bound to other

--- Content provided by FirstRanker.com ---

Cations /Inorganic salt : Calcium

Phosphate
? Total Phosphorous levels in

--- Content provided by⁠ FirstRanker.com ---

Whole blood= 40 mg%

? Serum Inorganic

--- Content provided by FirstRanker.com ---

Phosphorous

? Adults= 2-4 mg%
? Children's= 4- 6 mg%

--- Content provided by‍ FirstRanker.com ---

? Fasting levels of serum inorganic

Phosphorous are higher than post

prandial values.

--- Content provided by‍ FirstRanker.com ---

? Since after meals the inorganic

Phosphorous from blood are drawn into

--- Content provided by​ FirstRanker.com ---

cells

? Where it is utilized for phosphorylation

of Glucose , Fructose and Galactose

--- Content provided by​ FirstRanker.com ---

during metabolism.
? After a rich Carbohydrate diet

there decreases serum inorganic

--- Content provided by⁠ FirstRanker.com ---

Phosphorous levels.

? In Diabetes mel itus the levels of

--- Content provided by FirstRanker.com ---

serum inorganic Phosphorous get

increased due to low utilization

within cells.

--- Content provided by FirstRanker.com ---

Functions Of Phosphorous

--- Content provided by⁠ FirstRanker.com ---

? Phosphorous along with Calcium has

important role in bone mineralization

and bone development.

--- Content provided by‌ FirstRanker.com ---

? Phosphorous and Calcium are

components of Hydroxyapatite crystals

--- Content provided by‍ FirstRanker.com ---

of bone inorganic matrix.
? Phosphorous is important

component during biosynthesis of

--- Content provided by‍ FirstRanker.com ---

certain Phosphorylated

biomolecules viz:

?Phospholipids

--- Content provided by FirstRanker.com ---

?Nucleotides- Components of DNA

and RNA

?Phosphoproteins

--- Content provided by‌ FirstRanker.com ---

? Phosphorylation reactions of

metabolism and forming Esters ex

--- Content provided by FirstRanker.com ---

Glucose-6-PO4,Fru-6-PO4 etc

? High energy phosphorylated

compounds.

--- Content provided by⁠ FirstRanker.com ---

?Creatine Phosphate ATP,GTP ,CTP

,UTP.

--- Content provided by⁠ FirstRanker.com ---

? Nucleotide Coenzymes

:NAD+,NADP,FAD,PLP
? Phosphorous is a component of

--- Content provided by‍ FirstRanker.com ---

Phosphate Buffer system which

participate in Acid Base Balance.

?KH2PO4/K2HPO4

--- Content provided by⁠ FirstRanker.com ---

? Phosphorous is involved in

phosphorylation of certain

--- Content provided by⁠ FirstRanker.com ---

enzymes and bringing covalent

modification.

Excretion Of Phosphorous

--- Content provided by⁠ FirstRanker.com ---

? About 500 mg of

Phosphorous is excreted

--- Content provided by⁠ FirstRanker.com ---

through urine per day.

? Renal threshold for

Phosphorous is 2 mg%.

--- Content provided by‌ FirstRanker.com ---

? PTH hormone stimulates

the excretion of

Phosphorous

--- Content provided by FirstRanker.com ---

? By inhibiting tubular renal

reabsorption of

--- Content provided by‌ FirstRanker.com ---

Phosphorous.

? Thus there is inverse relationship

of PTH activity and serum

--- Content provided by​ FirstRanker.com ---

Phosphorous levels.

? Hyperparathyroidism decreases

--- Content provided by​ FirstRanker.com ---

serum inorganic Phosphorous

levels.
? Excretion of Phosphorous

--- Content provided by​ FirstRanker.com ---

and Calcium is reciprocal y

regulated.

? When Phosphorous is

--- Content provided by FirstRanker.com ---

excreted Calcium is retained

and vice a versa.

--- Content provided by⁠ FirstRanker.com ---

Disorders Associated To Phosphorous
Hyperphosphatemia

?Hyperphosphatemia is

--- Content provided by‍ FirstRanker.com ---

abnormal y persistent

high levels

?Of serum Inorganic

--- Content provided by‍ FirstRanker.com ---

Phosphorous above the

normal range.

--- Content provided by‌ FirstRanker.com ---

Conditions Causing

Hyperphosphatemia

? Increased dietary intake of Phosphorous

--- Content provided by​ FirstRanker.com ---

? Hypoparathyroidism
(Decreased PTH decreased excretion)
? Hypervitaminosis D
(Increased Calcitriol increased absorption)
? Bone Tumors

--- Content provided by FirstRanker.com ---

(More turn over of Phosphorous)
? Diabetes mel itus
(Decreased utilization)
? Renal Failure
? Chronic Nephritis

--- Content provided by‍ FirstRanker.com ---

? Intake of Steroids
(Decreased excretion)

Hypophosphatemia

--- Content provided by‍ FirstRanker.com ---

?Hypophosphatemia is

abnormal y persistent low

levels

--- Content provided by‌ FirstRanker.com ---

?Of serum Inorganic

Phosphorous below the

--- Content provided by‍ FirstRanker.com ---

normal range.
Conditions Of Hypophosphatemia

? Starvation and Malabsorption Syndrome
? Hyperparathyroidism

--- Content provided by‍ FirstRanker.com ---

? Hypovitaminosis D
? Rickets
? Osteomalacia
? Rich Carbohydrate diet
? Intake of antacids, contraceptives and

--- Content provided by​ FirstRanker.com ---

Diuretics

Sulfur Metabolism
Sulfur

--- Content provided by⁠ FirstRanker.com ---

?Sulfur is an essential

Macromineral.

--- Content provided by‍ FirstRanker.com ---

?Third most abundant

Mineral of human

body.

--- Content provided by‍ FirstRanker.com ---

RDA of Dietary Sulfur

?No specific dietary

--- Content provided by‍ FirstRanker.com ---

requirement for Sulfur.

?Sulfur as free element

cannot be utilized.

--- Content provided by⁠ FirstRanker.com ---

? Sulfur is mainly associated to Sulfur

containing compounds viz:

?Sulfated Amino acids and Proteins

--- Content provided by​ FirstRanker.com ---

?Sulfolipids
?Mucopolysaccharides (Sulfated)
?Sulfated Vitamin B complex

members: Thiamine, Pantothenic

--- Content provided by‌ FirstRanker.com ---

acid, Biotin and Lipoic acids

? Proteins contains about 1%

--- Content provided by FirstRanker.com ---

Sulfur by weight.

? The ingestion of dietary

Proteins rich in Sulfur

--- Content provided by‌ FirstRanker.com ---

containing amino acids is

sufficient source of Sulfur.
Dietary Sources Of Sulfur

--- Content provided by⁠ FirstRanker.com ---

? Dietary sources of Sulfated Proteins:

? Egg

--- Content provided by FirstRanker.com ---

? Fish

? Meat

? Liver

--- Content provided by‌ FirstRanker.com ---

? Legumes

? Cereals

--- Content provided by FirstRanker.com ---

Dietary Absorption

?The sulfated Amino

acids are absorbed

--- Content provided by‍ FirstRanker.com ---

from intestine

?Through active

--- Content provided by​ FirstRanker.com ---

transport mechanism.
Body Distribution Of Sulfur

? The total content of Sulfur in an

--- Content provided by FirstRanker.com ---

adult body is 150-200 gm.

? Very smal amount of inorganic

Sulphate occurs in tissues and body

--- Content provided by FirstRanker.com ---

fluids.

? Sulfur levels in blood=0.1-1 mg%

--- Content provided by⁠ FirstRanker.com ---

Functions Of Sulfur
? Sulfur in the body is present in organic

form as various biomolecules carrying

--- Content provided by⁠ FirstRanker.com ---

following functions:

? Sulfated Proteins ,Enzymes containing

Sulfur containing amino acids possess ?

--- Content provided by‌ FirstRanker.com ---

SH groups serves as functional parts.

? The SH groups are responsible for

--- Content provided by​ FirstRanker.com ---

forming S-S bonds in the structures.

Sulfated Compounds Of Human Body

? Immunoglobulins

--- Content provided by⁠ FirstRanker.com ---

? Keratin of Nail and Hair
? Glutathione Peroxidase
? FAS Complex
? Coenzymes-TPP , Biotin ,CoA
PAPS

--- Content provided by FirstRanker.com ---

?Phospho Adenosine

Phospho Sulfate(PAPS) is

--- Content provided by‌ FirstRanker.com ---

an active Sulfate

?PAPS is a conjugating

agent involved in:

--- Content provided by⁠ FirstRanker.com ---

? Detoxification process
? In Conjugation reaction
? By Sulfuration
? Substances like Phenol , Indole , Skatole

--- Content provided by⁠ FirstRanker.com ---

and Steroids are detoxified by

Sulfuration Conjugation reaction

--- Content provided by​ FirstRanker.com ---

? To form Organic Sulfates like Etheral

Sulfates: Indoxyl Sulfate, Skatoxyl

Sulfate to get excreted in urine.

--- Content provided by‍ FirstRanker.com ---

? PAPS is also used during

biosynthesis of

--- Content provided by⁠ FirstRanker.com ---

Glycosaminoglycans/MPS:

?Heparin

?Chondritin Sulfate

--- Content provided by‌ FirstRanker.com ---

?Dermatan Sulfate

? Keratan Sulfate
? SAM activated Methionine a

--- Content provided by‌ FirstRanker.com ---

Sulfated Amino acid

? Is an active donor of Methyl

--- Content provided by⁠ FirstRanker.com ---

groups

? SAM is actively involved in

Transmethylation reactions.

--- Content provided by FirstRanker.com ---

? Iron Sulfur Proteins are

components of ETC

--- Content provided by‍ FirstRanker.com ---

(Respiratory Chain).
Excretion Of Sulfur

?The Sulfur from different

--- Content provided by‍ FirstRanker.com ---

sulfated compounds is

oxidized in Liver and

excreted through Urine.

--- Content provided by FirstRanker.com ---

?Urine excretes both

inorganic and organic

--- Content provided by‍ FirstRanker.com ---

forms of Sulfur.

?In the form of

Thiocynates and Sulfur

--- Content provided by‌ FirstRanker.com ---

containing amino acid.
Forms Of Sulfur Excreted

? Inorganic Sulfate = 80%.

--- Content provided by‍ FirstRanker.com ---

? Organic Sulfate/Etheral

Sulfate-10 %

? Unoxidized Sulfur =10%

--- Content provided by‌ FirstRanker.com ---

Magnesium Metabolism
Magnesium

? Magnesium (Mg) is a

--- Content provided by‌ FirstRanker.com ---

Macromineral of human body

? It is the fourth most abundant

--- Content provided by FirstRanker.com ---

mineral and important Cation

of human body.

Daily Requirement/RDA of Magnesium

--- Content provided by⁠ FirstRanker.com ---

?Adults = 300-400 mg/day

?High doses of Mg above

--- Content provided by⁠ FirstRanker.com ---

600mg/day oral y causes

diarrhea.
Dietary Sources Of Magnesium

--- Content provided by‍ FirstRanker.com ---

? Cereals
? Nuts, Beans , Almonds
? Meat, Milk
? Green Leafy Vegetables (Chlorophyll-

--- Content provided by‌ FirstRanker.com ---

Mg)

? Cabbage, Cauliflower
? Fruits

--- Content provided by‍ FirstRanker.com ---

Absorption of Mg

? About 50-80 % of dietary

Magnesium is absorbed by

--- Content provided by‍ FirstRanker.com ---

intestinal mucosal cel s.

? Through a specific carrier

--- Content provided by⁠ FirstRanker.com ---

system.
Factors affecting Mg Absorption

Factors promoting Mg absorption:

--- Content provided by FirstRanker.com ---

?PTH
?Calcitriol
Factors inhibiting Mg absorption:

?High Calcium and

--- Content provided by FirstRanker.com ---

Phosphorous in diet

?Phytates
?Fatty acids

--- Content provided by‌ FirstRanker.com ---

?Alcohol consumption

Body Distribution Of Magnesium

? The content of Mg in an adult

--- Content provided by‍ FirstRanker.com ---

body is 20 gm.

? 70 % of Mg is in bones along

--- Content provided by⁠ FirstRanker.com ---

with Ca and P

? 30 % of Mg is in soft tissues

and body fluids.

--- Content provided by​ FirstRanker.com ---

Blood Magnesium Levels

?Free/Ionized form of Mg

-60%

--- Content provided by‍ FirstRanker.com ---

?Mg bound to Proteins-

30%

--- Content provided by‌ FirstRanker.com ---

?Salts of Mg-10%

Normal range of

Serum Magnesium-2

--- Content provided by​ FirstRanker.com ---

-3 mg%
Functions Of Magnesium

? Magnesium along with

--- Content provided by FirstRanker.com ---

Calcium and Phosphorous.

? Is a component of inorganic

--- Content provided by‌ FirstRanker.com ---

matrix of Bones and Enamel

of teeth

?Ionized form of

--- Content provided by⁠ FirstRanker.com ---

Magnesium has role

in neuro muscular

--- Content provided by⁠ FirstRanker.com ---

function.
? Mg++ is inorganic cofactor of

Enzyme Kinases:

--- Content provided by FirstRanker.com ---

?Hexokinase

?PFK

?PK

--- Content provided by FirstRanker.com ---

?Glucokinase

?Mg has role in

--- Content provided by FirstRanker.com ---

sensitizing Insulin

?Which Promotes

Glucose uptake by

--- Content provided by‍ FirstRanker.com ---

cel s.
? Mg is a component of

Chlorophyl pigments of

--- Content provided by‍ FirstRanker.com ---

plants.

? Hence green leafy

--- Content provided by‌ FirstRanker.com ---

vegetables are good

sources of Mg.

Disorders Associated To Magnesium

--- Content provided by‍ FirstRanker.com ---

Hypomagnesemia

? Hypomagnesemia low levels of

Mg(< 2mg%) leads to :

--- Content provided by⁠ FirstRanker.com ---

? Neuromuscular irritability
? The manifestations are managed

by oral dosage of Mg +2

--- Content provided by‍ FirstRanker.com ---

Hypomagnesemia Conditions

? Starvation and Malnutrition

--- Content provided by‍ FirstRanker.com ---

? Malabsorption

? Chronic Alcoholism

? Liver Cirrhosis

--- Content provided by⁠ FirstRanker.com ---

? Uncontrolled Diabetes mellitus(Osmotic

diuresis)

--- Content provided by​ FirstRanker.com ---

? Hyperthyroididsm

? Rickets
Hypermagnesemia

--- Content provided by⁠ FirstRanker.com ---

? Hypermagnesemia is

increased levels of serum Mg.

? Hypermagnesemia depresses

--- Content provided by​ FirstRanker.com ---

nerve conduction.

Hypermagnesemia Conditions

--- Content provided by FirstRanker.com ---

?Hypothyroidism
?Advanced Renal

Failure (Less

--- Content provided by‌ FirstRanker.com ---

excretion)
Sodium Metabolism

Sodium

--- Content provided by​ FirstRanker.com ---

? Sodium is an essential

Macromineral

? Sodium serves as a body

--- Content provided by FirstRanker.com ---

Electrolyte.

? Sodium (Na +) is the chief

--- Content provided by‍ FirstRanker.com ---

Cation of ECF.
RDA Of Sodium

? Sodium is taken through diet in

--- Content provided by‌ FirstRanker.com ---

the form of NaCl.

? 5-10 gm of NaCl per day

provide the required amount

--- Content provided by FirstRanker.com ---

of Na.

? 10 gm of NaCl contains 4 gm

--- Content provided by FirstRanker.com ---

of Na.

Remember

? Hypertensive patients

--- Content provided by​ FirstRanker.com ---

/Patients having history of

Hypertension should limit

--- Content provided by‌ FirstRanker.com ---

their intake of NaCl.

? For them RDA is 1 gm

NaCl/day.

--- Content provided by⁠ FirstRanker.com ---

Dietary Sources of Na

? Common Salt (NaCl)
? Bread
? Whole grains

--- Content provided by FirstRanker.com ---

? Nuts
? Eggs
? Milk
? Green Leafy Vegetables

--- Content provided by‍ FirstRanker.com ---

Absorption Of Sodium

? Sodium is readily absorbed from

GIT.

--- Content provided by​ FirstRanker.com ---

? Less than 2 % is normal y

excreted through feces.

--- Content provided by‌ FirstRanker.com ---

? However in diarrhea large

quantities of Na is lost through

feces.

--- Content provided by​ FirstRanker.com ---

Body Distribution Of Sodium

? 50% of Sodium is in bones
? 40 % of Sodium is in ECF
? 10% of Na is in Soft tissues.

--- Content provided by⁠ FirstRanker.com ---

?Na + is estimated by

Electrolyte Analyzers

--- Content provided by‌ FirstRanker.com ---

?Normally in Serum Na + -

136-146 mEq/L.

?Na + in ICF is 35 mEq/L

--- Content provided by‍ FirstRanker.com ---

Biomedical Functions Of Na

?Na+ along with other

electrolytes in ECF

--- Content provided by FirstRanker.com ---

exerts osmotic pressure

and maintains fluid

--- Content provided by‌ FirstRanker.com ---

balance.

?Na+ has role in

neuromuscular

--- Content provided by​ FirstRanker.com ---

function.
?Na is a component of

ECF buffer system

--- Content provided by FirstRanker.com ---

plays role in acid base

balance.

--- Content provided by⁠ FirstRanker.com ---

? Na+ is involved in Sodium

dependent active transport

mechanism

--- Content provided by FirstRanker.com ---

? For Glucose , Galactose and

Amino acids absorption from GIT

--- Content provided by‍ FirstRanker.com ---

lumen into the intestinal mucosal

cells.
? Sodium has role in

--- Content provided by​ FirstRanker.com ---

maintenance of cel

permeability.

? Sodium initiates and maintains

--- Content provided by‍ FirstRanker.com ---

heart beat .

? Hence high Sodium content in

--- Content provided by‌ FirstRanker.com ---

hypertensives aggravate the

condition of BP.

Excretion Of Sodium

--- Content provided by​ FirstRanker.com ---

? Sodium absorbed from GIT after its

functional role it is excreted out

--- Content provided by​ FirstRanker.com ---

through Urine.

? Sodium metabolism is influenced by

Aldosterone a Mineralocorticoids.

--- Content provided by‍ FirstRanker.com ---

?Aldosterone act to:

?Increase renal

reabsorption of Na from

--- Content provided by FirstRanker.com ---

ultrafiltrate.

?Retain blood Sodium.

--- Content provided by​ FirstRanker.com ---

?Decrease Na excretion.

? In Adrenocortical

insufficiency there is

--- Content provided by‍ FirstRanker.com ---

decreased Aldosterone


? Which decreases renal

--- Content provided by⁠ FirstRanker.com ---

reabsorption of Na leading

to Hyponatremia.
?Na is alternatively

--- Content provided by‍ FirstRanker.com ---

excreted out through

Skin sweating.

--- Content provided by​ FirstRanker.com ---

Disorders Of Sodium Metabolism
Hypernatremia

?Sodium levels

--- Content provided by FirstRanker.com ---

above 150 mEq/L in

ECF is termed as

Hypernatremia.

--- Content provided by‌ FirstRanker.com ---

Conditions Causing Hypernatremia

? Parenteral Therapy (IV infusion) with

--- Content provided by FirstRanker.com ---

Saline Solution.

? High intake of Salt without

corresponding in take of Water

--- Content provided by FirstRanker.com ---

? Hyperaldosteronism (Increased renal

reabsorption of Na)
? Cushing's Syndrome (Hyper

--- Content provided by‌ FirstRanker.com ---

Adrenal Cortex Activity)

? Osmotic diuresis
? Decreased ADH secretion

--- Content provided by FirstRanker.com ---

(Causes Hemoconcentration)

Hyponatremia

--- Content provided by‌ FirstRanker.com ---

? Hyponatremia is decreased

levels of blood Na .

? Low Sodium levels is an

--- Content provided by⁠ FirstRanker.com ---

emergency critical condition

which has to be managed at

--- Content provided by FirstRanker.com ---

earliest.
Conditions Causing Hyponatremia

? Diarrhea
? Excessive Sweating

--- Content provided by FirstRanker.com ---

? Nephrotic Syndrome
? Addison's Disease (Decreased

Na+ renal reabsorption)

--- Content provided by​ FirstRanker.com ---

? Malnutrition

Potassium Metabolism
Potassium

--- Content provided by‌ FirstRanker.com ---

?Potassium (K) is a

Macromineral and a body

Electrolyte.

--- Content provided by‍ FirstRanker.com ---

?K+ is a chief cation of ICF.

RDA and Dietary Sources Of

--- Content provided by⁠ FirstRanker.com ---

Potassium

? 3-4 gm/day is the RDA for Potassium.
Dietary Rich Sources Of K+

--- Content provided by⁠ FirstRanker.com ---

? Fruits: Banana ,Oranges

,Pineapple

? Tender Coconut water

--- Content provided by​ FirstRanker.com ---

? Potatoes
? Beans
? Chicken,Liver

Absorption Of Potassium

--- Content provided by⁠ FirstRanker.com ---

? 90% of K is efficiently

absorbed from GIT and very

--- Content provided by‍ FirstRanker.com ---

little is lost through feces.

? During diarrhea there is

significant loss of K+ ions out

--- Content provided by FirstRanker.com ---

from the body.
Blood Levels Of Potassium

? Whole blood contains K+ level

--- Content provided by⁠ FirstRanker.com ---

upto = 50 mEq/L

? K+ is the chief Cation of ICF
? The serum /plasma K+ is 3.5-

--- Content provided by⁠ FirstRanker.com ---

5.0mEq/L

Biochemical Functions Of Potassium

--- Content provided by‍ FirstRanker.com ---

? Potassium along with other

blood Electrolytes

? Exerts Osmotic pressure and

--- Content provided by‌ FirstRanker.com ---

maintains fluid balance in

E.C.F and I.C.F.
?K+ has role in

--- Content provided by‍ FirstRanker.com ---

neuromuscular function.

?K+ of E.C.F influences

--- Content provided by‍ FirstRanker.com ---

Cardiac muscle activity.

?K+ is component of

I.C.F buffer system

--- Content provided by​ FirstRanker.com ---

?Plays important role

in acid base balance.
?K+ is cofactor for

--- Content provided by FirstRanker.com ---

Enzyme Pyruvate

Kinase of Glycolysis.

--- Content provided by FirstRanker.com ---

? K+ of I.C.F is necessary for

proper Protein biosynthesis

by Ribosomes.

--- Content provided by FirstRanker.com ---

Excretion Of Potassium

Excretion of Na+ and K+ are

reciprocal y regulated.

--- Content provided by‍ FirstRanker.com ---

? If Na+ is excreted K+ is

retained vice a versa.

--- Content provided by⁠ FirstRanker.com ---

?Aldosterone increases K+

excretion .

?Aldosterone inhibits

--- Content provided by FirstRanker.com ---

tubular renal reabsorption

of K+ and promotes its

--- Content provided by‌ FirstRanker.com ---

excretion.
? Thus in Adrenal Cortex

insufficiency decreased

--- Content provided by⁠ FirstRanker.com ---

Aldosterone levels .

? Decreased K+ excretion and

leads to Hyperkalemia.

--- Content provided by FirstRanker.com ---

Disorders Of K + Metabolism
Hyperkalemia

?Hyperkalemia is

--- Content provided by FirstRanker.com ---

increased K+ levels

more than 5 mEq/L .

--- Content provided by⁠ FirstRanker.com ---

Hyperkalemia Conditions

? Dehydration Conditions
? Violent Muscular Activity
? Intravascular Hemolysis

--- Content provided by FirstRanker.com ---

? Addisons Disease (Adrenal Cortex

Insufficiency)

? Acidosis

--- Content provided by​ FirstRanker.com ---

? Renal Failure (Decreased Excretion)
Hypokalemia

?Hypokalemia is

--- Content provided by FirstRanker.com ---

decreased K+ levels

more than 3 mEq/L .

Hypokalemia Conditions

--- Content provided by‌ FirstRanker.com ---

? Starvation

? Insulin Therapy

--- Content provided by​ FirstRanker.com ---

? Cushing's Syndrome

(Increased Adrenal Cortex Activity)

? Alkalosis

--- Content provided by​ FirstRanker.com ---

Chloride Metabolism

? Chloride is a Macromineral

and an Electrolyte of

--- Content provided by‍ FirstRanker.com ---

human body.

? Chloride is negatively

--- Content provided by‍ FirstRanker.com ---

charged anion liberated

from NaCl.
The metabolism

--- Content provided by‍ FirstRanker.com ---

of Na+ and Cl-

goes paral el

RDA OF Chloride

--- Content provided by⁠ FirstRanker.com ---

?The daily requirement

of Chloride is in the

--- Content provided by FirstRanker.com ---

form of NaCl is 5-10

gm/day.
Dietary Sources

--- Content provided by​ FirstRanker.com ---

? Common Salt (NaCl)
? Whole grains
? Green Leafy Vegetables.
? Eggs
? Milk

--- Content provided by FirstRanker.com ---

? Chlorinated Water

Absorption Of Chloride

?Dietary Chloride is

--- Content provided by FirstRanker.com ---

almost total y absorbed

from the GIT.
Blood And CSF Chloride

--- Content provided by‍ FirstRanker.com ---

? Serum Chloride Levels= 95-105 mEq/L
? CSF Chloride Levels= 125- 130 mEq/L

? C.S.F Chloride is higher than serum

--- Content provided by‌ FirstRanker.com ---

Chloride

? Since in CSF the concentration of

--- Content provided by​ FirstRanker.com ---

Proteins is very low as compared to

Serum Protein Levels.

? The higher CSF Chloride maintains

--- Content provided by FirstRanker.com ---

the osmotic pressure and Donan

Membrane Equilibrium.
Functions Of Chlorides

--- Content provided by‌ FirstRanker.com ---

? Chloride is an anion, serves as

an electrolyte of body

--- Content provided by‍ FirstRanker.com ---

? It maintains osmotic pressure

along with other Electrolyte and

regulate water balance.

--- Content provided by FirstRanker.com ---

?Chloride has role in

Acid Base Balance

--- Content provided by⁠ FirstRanker.com ---

by Chloride Shift

related to RBC's.
?Cl- is essential for

--- Content provided by⁠ FirstRanker.com ---

production of gastric

HCl for digestion

process.

--- Content provided by‌ FirstRanker.com ---

?Enzyme Amylase

requires Chloride as

--- Content provided by‍ FirstRanker.com ---

cofactor.
Excretion Of Chloride

?The excretion of Cl- and

--- Content provided by​ FirstRanker.com ---

Na+ is paral el.

?The renal threshold for

Cl- is about 110 mEq/L

--- Content provided by‌ FirstRanker.com ---

?The retention of Na+ wil

retain Cl- in the body.

--- Content provided by‍ FirstRanker.com ---

?Aldosterone has

influence on Na +

retention which retains

--- Content provided by‍ FirstRanker.com ---

Cl-
Disorders Of Chloride Metabolism

? The Chloride and Sodium ions goes

--- Content provided by⁠ FirstRanker.com ---

simultaneously.

? Conditions increasing Sodium also

--- Content provided by‍ FirstRanker.com ---

increases Chloride and vice versa.

? Chloride and Sodium has direct

relationship.

--- Content provided by​ FirstRanker.com ---

? The Chloride(Cl-) and Bicarbonate

(HCO3-) ions have inverse

--- Content provided by FirstRanker.com ---

relationship.

? In Acidosis there is decreased

HCO3- and increased Cl-

--- Content provided by‍ FirstRanker.com ---

? In Alkalosis there is increased

HCO3- and decreased Cl-
Hyperchloremia

--- Content provided by‌ FirstRanker.com ---

? Hyperchloremia is increased

Chlorides in serum.

--- Content provided by FirstRanker.com ---

? Excess intake of salt with

insufficient of water.

? Parenteral infusion of Saline (I.V

--- Content provided by‍ FirstRanker.com ---

infusion)

? Dehydration without loss of

--- Content provided by​ FirstRanker.com ---

Salts.

? Cushings Syndrome( Retention

of Na+ and Cl-)

--- Content provided by‍ FirstRanker.com ---

? Acidosis increases Cl-
? Nephritis (Decreased excretion

of Cl- by kidneys

--- Content provided by FirstRanker.com ---

Hypochloremia

? Hypochloremia is decreased

Chlorides in serum

--- Content provided by⁠ FirstRanker.com ---

? Less Intake of Salt
? Severe vomiting and

Diarrhoea (Loss of Salt)

--- Content provided by‌ FirstRanker.com ---

?Congestive Cardiac Failure

(Sweating looses Salt)

--- Content provided by FirstRanker.com ---

?Addisons Disease
(Decreased Renal

Reabsorption)
?Alkalosis (Increases HCO3-

--- Content provided by‍ FirstRanker.com ---

Decreases Cl-)

?Kidney Dysfunction where

--- Content provided by⁠ FirstRanker.com ---

there is no renal

reabsorption of Cl-

Study Of

--- Content provided by FirstRanker.com ---

Trace Elements
Iron Metabolism

Iron

--- Content provided by FirstRanker.com ---

? Iron is an essential trace

element of human body.

--- Content provided by‌ FirstRanker.com ---

? It is an important component

of many essential vital

biomolecules vital for human

--- Content provided by‌ FirstRanker.com ---

body.


RDA of Dietary Iron

--- Content provided by‍ FirstRanker.com ---

?Adult Man =10 mg/day
?Menstruating Women =

18mg/day

--- Content provided by‌ FirstRanker.com ---

?Pregnant and Lactating

Women= 40 mg/day

--- Content provided by‌ FirstRanker.com ---

Dietary Type Of Iron
Two Types of Iron in Food

vHeme Iron

--- Content provided by​ FirstRanker.com ---

v Derived from the Hemoproteins

viz Hemoglobin and Myoglobin

vPresent in Animal Foods

--- Content provided by‌ FirstRanker.com ---

vMeat ,Liver tissue

vPlant foods do not contain any

--- Content provided by​ FirstRanker.com ---

Heme Iron .


vNon-Heme Iron

--- Content provided by⁠ FirstRanker.com ---

v Derived mainly from Plant

foods

vCereals ,Legumes, Nuts, Dates

--- Content provided by​ FirstRanker.com ---

Fruits and vegetables.

vThe Iron in Meat is

--- Content provided by​ FirstRanker.com ---

approximately

v 40% Heme Iron
v 60% Non-Heme Iron
Dietary Sources Of Iron

--- Content provided by⁠ FirstRanker.com ---

? Rich Sources Of Iron-

? Organ Meat Like Liver ,Heart Kidney

--- Content provided by‍ FirstRanker.com ---

and Jaggery.

? Good Sources of Iron-

? Dates, Nuts, Green Leafy Vegetables,

--- Content provided by‍ FirstRanker.com ---

Pulses, Cereals, Apples and Spinach.

? Poor Sources

--- Content provided by‍ FirstRanker.com ---

? -Milk , Wheat and Polished Rice.

IRON IN VEGETABLES

VEGETABLES

--- Content provided by⁠ FirstRanker.com ---

IRON IN /mg

Mushroom, pleurote

--- Content provided by⁠ FirstRanker.com ---

1.74

Potatoes

0.76

--- Content provided by FirstRanker.com ---

Cabbage, Collards

0.19

--- Content provided by‌ FirstRanker.com ---

Cabbage, Green

0.59

Roasted Pumpkin and Squash Seeds

--- Content provided by​ FirstRanker.com ---

15

Spinach

--- Content provided by‌ FirstRanker.com ---

2.71

Sesame Butter(Tahim) and Seeds

14.8

--- Content provided by‌ FirstRanker.com ---

Sundried Tomatoes

9.1

--- Content provided by​ FirstRanker.com ---

Dried Apricot

2.2

Lentils

--- Content provided by​ FirstRanker.com ---

6.20
IRON IN FRUITS

FRUITS

--- Content provided by FirstRanker.com ---

IRON IN/mg

Apples, without skin

--- Content provided by⁠ FirstRanker.com ---

0.07

Blackberries

0.57

--- Content provided by FirstRanker.com ---

Dates

1.15

--- Content provided by‌ FirstRanker.com ---

Pears, without skin

0.25

Pineapple

--- Content provided by​ FirstRanker.com ---

0.37

Raspberries

--- Content provided by‍ FirstRanker.com ---

0.57

IRON IN GRAINS

GRAINS

--- Content provided by⁠ FirstRanker.com ---

SERVING

IRON IN /mg

--- Content provided by FirstRanker.com ---

Wheat Flour, White Cake,

1 cup

10.03

--- Content provided by FirstRanker.com ---

Enriched
Wheat, Soft White

1 cup

--- Content provided by⁠ FirstRanker.com ---

9.02

Wheat, Hard White

--- Content provided by​ FirstRanker.com ---

1 cup

8.76

Sorghum

--- Content provided by FirstRanker.com ---

1 cup

8.45

--- Content provided by​ FirstRanker.com ---

Corn flour, Masa, Enriched 1 cup

8.22

White

--- Content provided by⁠ FirstRanker.com ---

Corn flour, Masa, Enriched 1 cup

8.22

Yellow

--- Content provided by​ FirstRanker.com ---

Millet

1 cup

6.02

--- Content provided by FirstRanker.com ---

Oats

1 cup

--- Content provided by​ FirstRanker.com ---

7.36

Quinoa

1 cup

--- Content provided by​ FirstRanker.com ---

2.36

Rice Bran, crude

--- Content provided by‌ FirstRanker.com ---

1 cup

21.88
HEME IRON RICH FOODS

--- Content provided by‌ FirstRanker.com ---

Meat

IRON IN/mg

Beef Lean Chuck

--- Content provided by‍ FirstRanker.com ---

2.9mg

Turkey Meat(Dark)

--- Content provided by‍ FirstRanker.com ---

2.3mg

Chicken Leg(Roasted)

1.3mg

--- Content provided by⁠ FirstRanker.com ---

Tuna(Bluefin)

1.3mg

--- Content provided by‌ FirstRanker.com ---

Halibut

1.3mg

Pork Chops(Loin)

--- Content provided by FirstRanker.com ---

1mg

White Tuna

--- Content provided by‌ FirstRanker.com ---

0.9mg

Shrimp(Prawns/Camarones)

1mg

--- Content provided by‌ FirstRanker.com ---

Liver

30.5mg

--- Content provided by⁠ FirstRanker.com ---

Clams, Oysters and Mussels

28mg

Absorption Of Dietary Iron

--- Content provided by⁠ FirstRanker.com ---

?Only 10% of Dietary Iron is

absorbed (1-2 mg/day).
? The site of absorption is:

--- Content provided by‍ FirstRanker.com ---

? Duodenum and Jejunum

of GIT by active transport

process.

--- Content provided by‌ FirstRanker.com ---

The Absorption of Iron is

Regulated at GIT level
? The absorption of Iron is

--- Content provided by FirstRanker.com ---

proportionately increased

where Iron stores are depleted.

--- Content provided by⁠ FirstRanker.com ---

?In growing Children's
?In Iron Deficiency Anemia

HEME IRON Absorption

--- Content provided by‍ FirstRanker.com ---

v Heme Iron is well absorbed and relatively

unaffected by other factors .

--- Content provided by​ FirstRanker.com ---

v It is influenced to some extent by the

body's Iron stores.

--- Content provided by⁠ FirstRanker.com ---

vThe average absorption of Heme Iron in

meat is about 25%.
NON-HEME IRON Absorption

--- Content provided by‌ FirstRanker.com ---

v Non Heme Iron is not so well

absorbed as Heme Iron

vIt is affected by both the Iron

--- Content provided by‍ FirstRanker.com ---

status of an individual

v Components in foods eaten at

--- Content provided by​ FirstRanker.com ---

the same time.

v Absorption of non-Heme Iron can vary :
v1% in an individual with replete stores
v20% in an individual with depleted Iron

--- Content provided by‍ FirstRanker.com ---

stores .

v Generally Non-Heme Iron absorption

--- Content provided by‍ FirstRanker.com ---

is less than 5%.
? Dietary Iron is mostly found in

Ferric form associated with

--- Content provided by‌ FirstRanker.com ---

food Proteins and organic

acids.

? Gastric HCl releases Ferric form

--- Content provided by‌ FirstRanker.com ---

of Iron in the GIT lumen.

? Ferric form of Iron (Fe+3) is

--- Content provided by​ FirstRanker.com ---

unabsorbable form of Iron.

? Ferric form is transformed to Ferrous

form of Iron at GIT in presence of

--- Content provided by FirstRanker.com ---

Vitamin C (Ascorbic acid).

Fe+3 Fe+2

--- Content provided by‍ FirstRanker.com ---

Vitamin C

Glutathione-SH
?Thus Ascorbic acid

--- Content provided by​ FirstRanker.com ---

transform non absorbable

Ferric form of Iron to

absorbable Ferrous form

--- Content provided by FirstRanker.com ---

?Vitamin C is the most potent

enhancer Iron absorption.

--- Content provided by​ FirstRanker.com ---

Factors Affecting Iron Absorption
Iron Absorption Promoting Factor

? Gastric acidity- HCl facilitates in

--- Content provided by‌ FirstRanker.com ---

releasing the dietary bound form

of Iron to free form.

? Vitamin C, Glutathione ?Cys ?SH

--- Content provided by⁠ FirstRanker.com ---

help in reduction of Ferric to

Ferrous in GIT and make it

--- Content provided by FirstRanker.com ---

absorbable.

? Gastroferrin a Glycoprotein

of gastric juice facilitates

--- Content provided by‍ FirstRanker.com ---

the uptake of Fe+2 Iron from

Duodenum and Jejunum.
?Dietary items promotes

--- Content provided by‌ FirstRanker.com ---

and facilitates Iron

absorption.

--- Content provided by​ FirstRanker.com ---

?Smal peptides
?Amino acids and
?Low phosphate

Factors Inhibiting Iron Absorption

--- Content provided by‌ FirstRanker.com ---

? Alkalinity
? Phytates and Oxalates
? Long free Fatty acids (In Steatorrhoea)
? Dietary fibers

--- Content provided by​ FirstRanker.com ---

? High concentration of dietary

Calcium and Phosphorous inhibits

--- Content provided by‍ FirstRanker.com ---

Iron absorption.

? Low Copper and high lead in body

affects Iron metabolism.

--- Content provided by‌ FirstRanker.com ---

Mineral Interactions

Zn

--- Content provided by‌ FirstRanker.com ---

(

Cu

-)

--- Content provided by‌ FirstRanker.com ---

(+)

Fe

--- Content provided by FirstRanker.com ---

(-)

Mn
? Tea and Eggs decrease Iron

--- Content provided by‌ FirstRanker.com ---

absorption to some extent.

? Iron absorption is severely

impaired in patients who has

--- Content provided by‍ FirstRanker.com ---

undergone partial or total

surgical removal of Stomach

--- Content provided by‌ FirstRanker.com ---

/Intestine.
? Absorption of Non-Heme iron (plant sources) increased

by:

--- Content provided by‌ FirstRanker.com ---

? Vitamin C

? Meat in diet (MFP factor)

? Citric acid and lactic acid from foods

--- Content provided by​ FirstRanker.com ---

? HCl in the stomach

? Sugars

--- Content provided by‌ FirstRanker.com ---

? Absorption is decreased by:

? Phytates and fibers (grain products)

? Polyphenols (tea, coffee)

--- Content provided by​ FirstRanker.com ---

? Oxalates

? Calcium and phosphorus in milk

--- Content provided by‍ FirstRanker.com ---

? Tannic acid

? Other minerals (calcium, zinc)

Uniqueness Of Iron

--- Content provided by FirstRanker.com ---

? Iron is one way element

? Iron once absorbed and enter in

--- Content provided by‍ FirstRanker.com ---

body not excreted out through

Urine.

? Iron is not excessively absorbed

--- Content provided by⁠ FirstRanker.com ---

and then get excreted in urine

? Hence Iron is little absorbed and

--- Content provided by FirstRanker.com ---

little/no loss.
Regulation Of Iron Metabolism In GIT

Remembering

--- Content provided by FirstRanker.com ---

?Iron is not excessively

absorbed from GIT

?Iron is not excreted out

--- Content provided by‌ FirstRanker.com ---

through Urine.
? Regulation of Iron

metabolism takes place at

--- Content provided by‍ FirstRanker.com ---

GIT level

? By Intestinal Mucosal block

--- Content provided by⁠ FirstRanker.com ---

/Mucosal block theory of

Iron absorption.

Mucosal Block Theory

--- Content provided by​ FirstRanker.com ---

Of

Iron Absorption
? For Iron absorption at GIT

--- Content provided by‍ FirstRanker.com ---

level Garnick Proposed

Mucosal block theory

--- Content provided by‍ FirstRanker.com ---

?Mucosal block theory

explains the regulation

of the bodies Iron

--- Content provided by​ FirstRanker.com ---

content within normal

state
?Ferrous (Fe+2) form of Iron

--- Content provided by‌ FirstRanker.com ---

from the intestinal lumen

is absorbed

--- Content provided by⁠ FirstRanker.com ---

?Made its entry into

intestinal mucosal cells

through receptor mediated

--- Content provided by FirstRanker.com ---

uptake.

?Inside the cytosol of

--- Content provided by‌ FirstRanker.com ---

Intestinal mucosal cel s,

Intestinal Iron Carrier

(I.I.C) bind with

--- Content provided by​ FirstRanker.com ---

absorbed Fe+2 form of

Iron.
? Fe+2 form of Iron in intestinal

--- Content provided by FirstRanker.com ---

mucosal cel s is then oxidized

to Fe+3 by Ferroxidase I

--- Content provided by​ FirstRanker.com ---

activity .

? This Ferric form of Iron is

temporarily stored as Ferritin

--- Content provided by​ FirstRanker.com ---

form, in intestinal mucosal

cel s.

--- Content provided by⁠ FirstRanker.com ---

? The Iron absorption from

GIT lumen is regulated by:

?The saturation of I C (Carrier

--- Content provided by⁠ FirstRanker.com ---

Iron Pool) and

?Adequate mucosal Ferritin

--- Content provided by‌ FirstRanker.com ---

content.
? As per the bodies requirement

the temporarily stored Iron as

--- Content provided by⁠ FirstRanker.com ---

Ferritin is released in Ferrous

form by Ferroreductase

activity.

--- Content provided by​ FirstRanker.com ---

? The Ferrous form of Iron from

intestinal mucosal cel s is then

--- Content provided by​ FirstRanker.com ---

diffused in blood.

? Ferrous form Fe+2 form of Iron

diffused in blood circulation is

--- Content provided by‍ FirstRanker.com ---

transformed to Ferric Fe+3 form

in blood circulation

--- Content provided by‍ FirstRanker.com ---

? By Ferroxidase II activity of

Ceruloplasmin (A Copper containing

Protein) .

--- Content provided by​ FirstRanker.com ---

Effect of Iron Status on Iron Absorption

--- Content provided by‌ FirstRanker.com ---

HEME IRON UPTAKE

HEME IRON

HEME IRON

--- Content provided by‌ FirstRanker.com ---

TRANSPORT

ENDOCYTOSIS

--- Content provided by‍ FirstRanker.com ---

FERROUS IRON

LIBERATED WITH IN ENDOSOME
NON-HEME IRON UPTAKE

--- Content provided by​ FirstRanker.com ---

FERRIC IRON

REDUCED BY

ASCORBIC

--- Content provided by⁠ FirstRanker.com ---

ACID

INCLUDE

--- Content provided by‌ FirstRanker.com ---

DUODENAL

FERROUS IRON

CYTOCHROME

--- Content provided by​ FirstRanker.com ---

B

TRANSFERRIN

--- Content provided by⁠ FirstRanker.com ---

FERROPORTIN

HEPHAESTIN

VITAMIN C IMPROVE

--- Content provided by‌ FirstRanker.com ---

NON-HAEM IRON

ABSORPTION

--- Content provided by FirstRanker.com ---

IRON ABSORPTION IN HUMAN BODY
Iron Absorption

Transport Of Iron In Blood

--- Content provided by‌ FirstRanker.com ---

Transport Of Iron

? Transport of Iron through

blood is accomplished

--- Content provided by⁠ FirstRanker.com ---

? With the help of a specific

Iron Transport Protein

--- Content provided by​ FirstRanker.com ---

Transferrin.

? Transferrin is chemically a

Glycoprotein with mol.weight

--- Content provided by⁠ FirstRanker.com ---

90,000 daltons.

Transferrin is a beta Globulin

--- Content provided by⁠ FirstRanker.com ---

plasma Protein.


Iron Transported By Transferrin

--- Content provided by FirstRanker.com ---

? Apo transferrin is a Protein, not

bound with Iron.

? Apo transferrin binds with two

--- Content provided by⁠ FirstRanker.com ---

atoms of Fe+3 form of Iron and get

transformed to

--- Content provided by‌ FirstRanker.com ---

Transferrin/Siderophil in .

Transferrin

? Transports Iron in the blood

--- Content provided by FirstRanker.com ---

? Contains only 2 atoms of Iron in Ferric state

? Transferrin is the only source of Iron for

--- Content provided by FirstRanker.com ---

Hemoglobin

? Transferrin saturation is clinical y useful

for Iron metabolism studies

--- Content provided by⁠ FirstRanker.com ---

Total Iron Binding

Capacity

(TIBC)

--- Content provided by⁠ FirstRanker.com ---

? The plasma Transferrin

concentration is 250 mg%

--- Content provided by⁠ FirstRanker.com ---

? Transferrin can bind 400 g

of Iron/dl of plasma.

? This is known as Total Iron

--- Content provided by​ FirstRanker.com ---

Binding Capacity Of Iron

(TIBC).

--- Content provided by​ FirstRanker.com ---

? Transferrin Saturation:

? Normal about 30-50 %

--- Content provided by​ FirstRanker.com ---

? Transferrin saturation under 15 %=

Iron deficiency
?TIBC is reduced in

--- Content provided by‌ FirstRanker.com ---

patients suffering from

Iron Deficiency Anemia

and Liver Diseases.

--- Content provided by‌ FirstRanker.com ---

?High concentration

of TIBC is noted in

--- Content provided by​ FirstRanker.com ---

Iron toxicity.
Iron Uptake By Cel s

? The Cells of various tissues

--- Content provided by​ FirstRanker.com ---

have specific receptors for

Transferrin.

? An Iron Transferrin Receptor

--- Content provided by‍ FirstRanker.com ---

Complex is formed and Iron is

internalized within the cel s.

--- Content provided by⁠ FirstRanker.com ---

?Transferrin receptors

are richly present on:

?Liver

--- Content provided by‌ FirstRanker.com ---

?Spleen

?Bone Marrow

--- Content provided by​ FirstRanker.com ---

? Pancreas


Iron Circulation, Uptake Into Cel s, &

--- Content provided by FirstRanker.com ---

Storage

? Transferrin

?Delivers Iron to body cells through

--- Content provided by‌ FirstRanker.com ---

?Transferrin Receptors
Storage Of Iron As Ferritin

? Iron is normal y stored in Liver,

--- Content provided by‌ FirstRanker.com ---

Spleen and Bone marrow

? Iron is temporarily stored in the

form of Ferritin til it get

--- Content provided by​ FirstRanker.com ---

utilized.

? Apoferritin is a Glycoprotein of

--- Content provided by FirstRanker.com ---

500,000 daltons mol.wt

? Apoferritin is not bound to Iron.

--- Content provided by FirstRanker.com ---

?An Apoferritin can bind

with 4,000 atoms of

--- Content provided by‌ FirstRanker.com ---

Ferric form of Iron and

form Ferritin.

? Ferritin protein consists of

--- Content provided by‍ FirstRanker.com ---

24 subunits

? Ferritin stores are approx.

--- Content provided by​ FirstRanker.com ---

25% of Iron on weight

basis.

--- Content provided by‌ FirstRanker.com ---

? Inside the Ferritin shel , Iron

ions form crystal ites

together with phosphate and

--- Content provided by‌ FirstRanker.com ---

hydroxide ions.

Ferritin:

--- Content provided by‍ FirstRanker.com ---

Iron Storage protein

In men, Ferritin contains up to

1 gram of Iron

--- Content provided by⁠ FirstRanker.com ---

? Ferritin levels reflects the amount of

BODY IRON STORES

? Men: 20-275 g/litre

--- Content provided by​ FirstRanker.com ---

? Women: 15-200 g/litre

? 15 g/ litre and less: insufficient Iron

--- Content provided by FirstRanker.com ---

stores

Hemosiderin

? Hemosiderin is Iron complex

--- Content provided by‌ FirstRanker.com ---

Proteins

? Found in tissues in Iron toxic

--- Content provided by FirstRanker.com ---

conditions.

? Hemosiderin is Ferritin with

partial y stripped shel .

--- Content provided by‍ FirstRanker.com ---

? Hemosiderin contains Ferric form

of Iron stored around 35% on

weight basis.

--- Content provided by⁠ FirstRanker.com ---

? Hemosiderin is rather insoluble

form and mobilization of Iron is

--- Content provided by‌ FirstRanker.com ---

much slower from Hemosiderin

than Ferritin.

Body Distribution Of Iron

--- Content provided by‌ FirstRanker.com ---

Body Distribution Of Iron

? Total Iron content of an

adult body varies and

--- Content provided by‍ FirstRanker.com ---

ranges from 2-5 grams.

? About 70% of Iron is present in

--- Content provided by‌ FirstRanker.com ---

RBC's associated to Hemoglobin

? 5% of Iron is present in Muscles

associated to Myoglobin.

--- Content provided by FirstRanker.com ---

? Remaining 25 % in other cel s

associated to Heme and non

--- Content provided by​ FirstRanker.com ---

Heme compounds.
Role Of Iron In Human Body

Functions Of Iron

--- Content provided by‍ FirstRanker.com ---

?Iron is an essential trace

element

?Iron is utilized for the

--- Content provided by⁠ FirstRanker.com ---

biosynthesis of various

Iron containing functional

--- Content provided by‍ FirstRanker.com ---

biomolecules.
? Iron is a component of Prosthetic group

Heme which in turn forms various

--- Content provided by​ FirstRanker.com ---

Hemoproteins:

?Hemoglobin
?Myoglobin
?Cytochromes

--- Content provided by‍ FirstRanker.com ---

?Glutathione Peroxidase
?Catalase
?Xanthine Oxidase
?Tryptophan Pyrrolase

--- Content provided by FirstRanker.com ---

?Iron Involved In

Oxygen Transport &

Storage:

--- Content provided by‍ FirstRanker.com ---

?Hemoglobin

?Myoglobin
?Iron Involved In Electron

--- Content provided by FirstRanker.com ---

Transport & Energy

Metabolism(ATP)

--- Content provided by‌ FirstRanker.com ---

?Cytochromes

?Fe-S proteins

?Iron In Drug Detoxification:

--- Content provided by‍ FirstRanker.com ---

?Cytochrome P450
? Substrate Oxidation & Reduction

? Iron dependent Enzyme-

--- Content provided by‍ FirstRanker.com ---

?Ribonucleotide reductase

?Amino acid Oxidases

--- Content provided by‌ FirstRanker.com ---

?Fatty acid Desaturases

?Nitric oxide Synthetase

?Peroxidases

--- Content provided by​ FirstRanker.com ---

? Iron serve as an inorganic cofactor

for fol owing Enzymes:

--- Content provided by‍ FirstRanker.com ---

?NADH Dehydrogenase-FeS Proteins
?Succinate Dehydrogenase-Iron

Sulfur Proteins

--- Content provided by‌ FirstRanker.com ---

?Aconitase
?Cytochrome Oxidase
?Acyl-CoA Dehydrogenase
?NADH Reductase
Iron Content in Hemoproteins

--- Content provided by⁠ FirstRanker.com ---

? Hemoglobin: more than one half of total body iron

(2.5 grams)

--- Content provided by​ FirstRanker.com ---

? Myoglobin: about 0.3 grams Fe, muscle oxygen

storage protein

? Cytochromes of the mitochondrial respiratory chain

--- Content provided by‍ FirstRanker.com ---

(100 mg of iron)

? Cytochrome P450: most abundant Hemoprotein of

--- Content provided by‍ FirstRanker.com ---

the liver (about 1 mg) detoxifies foreign compounds



Function

--- Content provided by‌ FirstRanker.com ---

Flavoproteins

Heme

--- Content provided by⁠ FirstRanker.com ---

2Fe-2S

Other Nzms

Flavoproteins

--- Content provided by‍ FirstRanker.com ---

4Fe-4S

Nzms

--- Content provided by⁠ FirstRanker.com ---

Transferrin

Fe-sulfur

Iron

--- Content provided by​ FirstRanker.com ---

&

Nzms

--- Content provided by‌ FirstRanker.com ---

Activated

Others

Nzms

--- Content provided by FirstRanker.com ---

Other Fe

Fe-Containing

--- Content provided by​ FirstRanker.com ---

Other Fe

Proteins

Proteins

--- Content provided by​ FirstRanker.com ---

Nzms

Ferritin

--- Content provided by⁠ FirstRanker.com ---

&

Other Nzms

Hemosiderin

--- Content provided by⁠ FirstRanker.com ---

Hemeproteins

Hemoglobin

--- Content provided by⁠ FirstRanker.com ---

Myoglobin

Cytochromes

Other Nzms

--- Content provided by‌ FirstRanker.com ---

Non - Heme Iron Proteins Of

Body

? Ferritin - Iron storage

--- Content provided by​ FirstRanker.com ---

protein

? Transferrin: Iron transport

--- Content provided by FirstRanker.com ---

protein

Excretion Of Iron
Conservation Of Iron In Human Body

--- Content provided by‍ FirstRanker.com ---

OR

Iron Is One Way Element

? Iron is a rare element

--- Content provided by⁠ FirstRanker.com ---

? It is produced and present in

deep core of Earth surface .

? Since it contains comparatively

--- Content provided by​ FirstRanker.com ---

little Iron, hence Iron is

considered as very precious

--- Content provided by​ FirstRanker.com ---

element for biological system.
? The dietary Iron has to face

many interferences in GIT

--- Content provided by​ FirstRanker.com ---

with many factors.

? Only 1-2 % of dietary Iron

succeed to get absorbed

--- Content provided by‌ FirstRanker.com ---

inside the intestinal mucosal

cells.

--- Content provided by‍ FirstRanker.com ---

Note

?Iron absorption and

release in blood stream

--- Content provided by​ FirstRanker.com ---

is regulated by Hepcidin

to maintain the body

--- Content provided by‌ FirstRanker.com ---

Iron stores.
?Iron is conserved

recycled and

--- Content provided by FirstRanker.com ---

reutilized within the

body cel s.

? Iron is said to be one way element

--- Content provided by FirstRanker.com ---

since

?The dietary absorbed Iron at GIT

--- Content provided by FirstRanker.com ---

level(approx 10%) once entered in

the body

?Iron is stored and functionally

--- Content provided by​ FirstRanker.com ---

reutilized.

?Almost no Iron is excreted out

--- Content provided by‌ FirstRanker.com ---

through urine.
? The Hemoglobin (Hb) and Heme (Iron

containing compounds)released from

--- Content provided by FirstRanker.com ---

lysed RBC's get bound to

?Haptoglobin (Hp)
?Hemopexin respectively.

--- Content provided by‍ FirstRanker.com ---

? Which prevent Iron excretion

through Urine.

? Hb-Hp complex and Heme-

--- Content provided by‌ FirstRanker.com ---

Hemopexin complex prevents

the excretion of Iron through

--- Content provided by​ FirstRanker.com ---

Urine and conserve the Iron

within body.

? Iron is restored as Ferritin and

--- Content provided by FirstRanker.com ---

reutilized.
?To prevent Iron overload

and toxicity in the body.

--- Content provided by‌ FirstRanker.com ---

?Only 10 % absorbed Iron at

GIT is recycled, reutilized

--- Content provided by‌ FirstRanker.com ---

and conserved

Remember

? Iron absorption is regulated at GIT

--- Content provided by⁠ FirstRanker.com ---

level depending upon:

? Bodies demand and requirement

--- Content provided by⁠ FirstRanker.com ---

of body cel s

? Since Iron is not excreted through

Urine

--- Content provided by‍ FirstRanker.com ---

? There is no excess absorption of

Iron at GIT level
?Generally Body Iron

--- Content provided by​ FirstRanker.com ---

stores are greater in

men than in women

--- Content provided by⁠ FirstRanker.com ---

Routes Of Iron Loss

? Physiologically during

Menstruation Iron is lost

--- Content provided by‍ FirstRanker.com ---

(1mg/day).
? During Parturition Iron loss is

1gm/pregnancy

--- Content provided by‌ FirstRanker.com ---

? Loss of Iron in males is less than

0.5 mg/day.

--- Content provided by⁠ FirstRanker.com ---

Only 1 mg of Iron is lost daily from the body

(about 0.025% of total body iron)

--- Content provided by‍ FirstRanker.com ---

Nonspecific pathways

(sloughing of dead cells, iron excretion in bile)

In women, additional 30 mg of iron is lost monthly

--- Content provided by​ FirstRanker.com ---

by menstruation

(about 1% of total body iron)

--- Content provided by‌ FirstRanker.com ---

Loss of Iron is more from a Women's body than

Men's body.

? Feces contains unabsorbed Iron and

--- Content provided by⁠ FirstRanker.com ---

Iron lost due to desquamation of

intestinal cells (about 30%).

--- Content provided by​ FirstRanker.com ---

? The upper layers of skin cel s

contain Iron which are being lost and

becomes another source of Iron loss.

--- Content provided by FirstRanker.com ---

Pathological Loss Of Iron

? Excess of blood loss in cases

of Hemorrhage due to

--- Content provided by⁠ FirstRanker.com ---

accidents

? Hemorrhoids is another

--- Content provided by‍ FirstRanker.com ---

major source of Iron loss.


Iron Recycling

--- Content provided by FirstRanker.com ---

Copyright 2005 Wadsworth Group, a division of Thomson Learning

Disorders Of Iron Metabolism
Disorders Due To Iron Deficiency

--- Content provided by⁠ FirstRanker.com ---

Iron Deficiency Anemia (IDA)

?Iron Deficiency Anemia is

most common

--- Content provided by FirstRanker.com ---

?Nutritional deficiency

disease of world

--- Content provided by‍ FirstRanker.com ---

population.
Prevalence Of IDA

? 30 % of World population is anemic due

--- Content provided by FirstRanker.com ---

to IDA

? 70% of Indian population is suffering

from IDA.

--- Content provided by‌ FirstRanker.com ---

? 85% of pregnant women suffer from

IDA.

--- Content provided by‍ FirstRanker.com ---

? 15% of maternal deaths are attributed

due to IDA.

Six Causes Of IDA

--- Content provided by FirstRanker.com ---

1. Malabsorption Syndrome:

? Gastrectomy
? Achlorhydria

--- Content provided by⁠ FirstRanker.com ---

? Vitamin C deficiency

2. Nutritional deficiency of Iron:

?Poverty

--- Content provided by‍ FirstRanker.com ---

?Ignorance
?Faulty food habits
3. Chronic loss of blood

?Hook worm Infections (0.3 ml/day/hookworm)

--- Content provided by‌ FirstRanker.com ---

?Bleeding Hemorrhoids (Piles)
?Peptic Ulcers
?Uterine Hemorrhage

4. Repeated Pregnancies ( 1gm/delivery)

--- Content provided by‌ FirstRanker.com ---

5. Nephrosis -Kidney dysfunction

leads to loss of Haptoglobin,

--- Content provided by‌ FirstRanker.com ---

Hemopexin ,Transferrin loss through

Urine.
6. Copper and Ceruloplasmin

--- Content provided by⁠ FirstRanker.com ---

deficiency: Affects Iron transport and

Heme biosynthesis .
Consequences and Manifestations Of

--- Content provided by​ FirstRanker.com ---

IDA

?Iron deficiency Anemia is

characterized by:

--- Content provided by‌ FirstRanker.com ---

?Microcytic Hypochromic

Anemia

--- Content provided by⁠ FirstRanker.com ---

?Hb less than 10 gm%
? Low Iron content in human body Lowers:

?Hb levels which in turn

--- Content provided by‍ FirstRanker.com ---

? Decreases low Oxygen supply to tissues and

cells.

?Cytochrome function in ETC

--- Content provided by​ FirstRanker.com ---

?ATP production
?Cel activity

Manifestations Of IDA

--- Content provided by​ FirstRanker.com ---

? Apathy (Uninterested in Surroundings)
? Sluggishness ,Fatigue
? Impaired attention
? Irritability
? Poor Memory

--- Content provided by​ FirstRanker.com ---

? Palpitation
Diagnosis Of IDA

?Hb Concentration
?Peripheral Smear (PS) of

--- Content provided by FirstRanker.com ---

blood

?Serum Iron Levels
?TIBC Levels

--- Content provided by FirstRanker.com ---

Other Parameters: Measuring Iron Status

? Serum Ferritin

--- Content provided by⁠ FirstRanker.com ---

? Hematocrit

? Ceruloplasmin levels

? Vitamin C

--- Content provided by FirstRanker.com ---

Treatment Of IDA

? Dietary Sources Containing Rich

Concentration Of Iron

--- Content provided by‌ FirstRanker.com ---

? Vitamin C Supplementation

? Oral Iron Supplementation

--- Content provided by​ FirstRanker.com ---

Iron Toxicity Disorders
Hemosiderosis Iron Toxic Condition

Hemosiderosis

--- Content provided by FirstRanker.com ---

? Hemosiderosis is Iron overload

condition

? Where there is increased Iron

--- Content provided by‍ FirstRanker.com ---

Stores as Hemosiderin

? In Liver, Spleen, Bone marrow

--- Content provided by FirstRanker.com ---

etc without associated tissue

injury and cel ular dysfunction.
? Hemosiderosis is an initial

--- Content provided by​ FirstRanker.com ---

Stage of Iron overload.

? Hemosiderin are golden

brown granules

--- Content provided by​ FirstRanker.com ---

Causes of Hemosiderosis

? Prolonged Parenteral Iron

--- Content provided by FirstRanker.com ---

supplements

? Repeated Blood

Transfusions

--- Content provided by‍ FirstRanker.com ---

? Hemosiderosis occurs during treatment

of Hemophilia and Beta Thalassemia

? Since these patients receive repeated

--- Content provided by⁠ FirstRanker.com ---

blood transfusions.

? GIT level of regulation is bypassed in

--- Content provided by​ FirstRanker.com ---

the parenteral infusion of blood.

Types Of Hemosiderosis
Primary Hemosiderosis

--- Content provided by​ FirstRanker.com ---

? Genetic cause due to presence of

abnormal gene on short arm of 6th

Chromosome.

--- Content provided by​ FirstRanker.com ---

? In these cases Iron absorption is

increased at GIT level and

--- Content provided by‌ FirstRanker.com ---

? Transferrin levels in serum are

elevated.

Acquired Hemosiderosis/

--- Content provided by⁠ FirstRanker.com ---

Nutritional Siderosis /

Bantus Siderosis
? Bantus are tribal people of

--- Content provided by​ FirstRanker.com ---

Africa.

? Who cooked their food in Iron

--- Content provided by​ FirstRanker.com ---

pots.

? Staple food of them contained

low Phosphate and High Iron

--- Content provided by FirstRanker.com ---

content.

?The Iron absorption is

--- Content provided by‌ FirstRanker.com ---

high in the Bantus

?Gradually leading to

Hemosiderosis termed

--- Content provided by‌ FirstRanker.com ---

as Nutritional/Bantus

Siderosis
Hemochromatosis

--- Content provided by‍ FirstRanker.com ---

What Is Hemochromatosis?

?Hemochromatosis is much

--- Content provided by‍ FirstRanker.com ---

more severe condition of

Iron overload.
? Deposition of large concentrations of

--- Content provided by‌ FirstRanker.com ---

Hemosiderin

? In functional stores of organs causing

dysfunction and injury to these

--- Content provided by​ FirstRanker.com ---

organs.

? In Hemochromatosis

--- Content provided by​ FirstRanker.com ---

Hemosiderin is spil ed out of

tissues and found in blood

circulation.

--- Content provided by​ FirstRanker.com ---

? Thus there is Hemosiderin,

also deposited under skin.
Consequences And Clinical

--- Content provided by FirstRanker.com ---

Manifestations Of Hemochromatosis

Iron Poisoning

--- Content provided by⁠ FirstRanker.com ---

? Acute or over dosage of Iron may lead to Iron

poisoning this manifests with:

? Vomiting

--- Content provided by‌ FirstRanker.com ---

? Nausea

? Diarrhea

--- Content provided by‍ FirstRanker.com ---

? Hematemesis (Blood Vomits)

? Liver Damage

? Organ Dysfunctions

--- Content provided by‍ FirstRanker.com ---

? Coma
? Liver Cirrhosis
? Pancreatic Damage-Diabetes mel itus
? Skin Pigmentation-Bronze Diabetes

--- Content provided by FirstRanker.com ---

? Hypothyroidism
? Arthritis
? Arrhythmia
? Heart failure

--- Content provided by⁠ FirstRanker.com ---

? Severe Hemochromatosis leading

to organ dysfunctions lead to

death.

--- Content provided by⁠ FirstRanker.com ---

? 90% of affected individuals are

Males.
Organ systems susceptible to

--- Content provided by‍ FirstRanker.com ---

Iron overload

Clinical sequelae of Iron overload

--- Content provided by​ FirstRanker.com ---

Pituitary Impaired growth, infertility
Thyroid

Hypothyroidism

--- Content provided by​ FirstRanker.com ---

Heart Cardiomyopathy, cardiac
Liver Hepatic cirrhosis
Pancreas Diabetes mellitus
Gonads Hypogonadism

--- Content provided by‍ FirstRanker.com ---

?Liver is the principal site for

iron storage and has the

largest capacity for excess

--- Content provided by‌ FirstRanker.com ---

Iron storage.

?When the Liver capacity is

--- Content provided by​ FirstRanker.com ---

exceeded, Iron is deposited in

other organs.
?In patients with -Thalassemia,

--- Content provided by FirstRanker.com ---

Iron loading of the anterior

pituitary

?Is primarily responsible for

--- Content provided by​ FirstRanker.com ---

disrupted sexual maturation.

? Hemochromatosis also

--- Content provided by‍ FirstRanker.com ---

leads to Growth failure

due to :

?Growth hormone

--- Content provided by​ FirstRanker.com ---

deficiency

?Defective synthesis of

--- Content provided by‍ FirstRanker.com ---

Insulin-like growth factor
Hepcidin And Its Role

Discovery of HEPCIDIN (2000)

--- Content provided by‍ FirstRanker.com ---

Hepcidin: "Iron Regulatory Hormone"
What Is Hepcidin?

?Hepcidin is a natural protein

--- Content provided by‍ FirstRanker.com ---

hormone of human body

?Encoded by the HAMP gene.

vHepcidin is 25 amino-acid peptide

--- Content provided by​ FirstRanker.com ---

hormone.

vHepcidin is synthesized by

--- Content provided by​ FirstRanker.com ---

Hepatocytes.

vIt is then transported in the blood

stream for its function.

--- Content provided by‌ FirstRanker.com ---

vHepcidin regulates Iron absorption in

blood.

--- Content provided by​ FirstRanker.com ---

Hepcidin blocks Iron Export from:

MACROPHAGES

--- Content provided by‍ FirstRanker.com ---

And

ENTEROCYTES IN THE SMALL INTESTINE

? Hepcidin is the principal

--- Content provided by⁠ FirstRanker.com ---

regulator of systemic/blood

Iron homeostasis
? Hepcidin blocks Iron

--- Content provided by FirstRanker.com ---

export from Macrophages

and Enterocytes into

--- Content provided by FirstRanker.com ---

blood circulation.

? Hepcidin Reduces

--- Content provided by‌ FirstRanker.com ---

? Dietary Iron absorption by reducing Iron

transport across the gut mucosa

--- Content provided by‌ FirstRanker.com ---

(enterocytes)

? Iron exit from Macrophages the main site of

Iron storage

--- Content provided by​ FirstRanker.com ---

? Iron exit from the Liver
Specific Action Of Hepcidin

? Hepcidin inhibits iron transport by binding

--- Content provided by FirstRanker.com ---

to the Iron export channel Ferroportin

? Which is located on the basolateral surface

--- Content provided by​ FirstRanker.com ---

of

?Gut Enterocytes
?Plasma membrane of Reticuloendothelial cells

--- Content provided by⁠ FirstRanker.com ---

Macrophages

? Hepcidin controls Blood Iron

concentration

--- Content provided by⁠ FirstRanker.com ---

? Tissue distribution of Iron by:

?Inhibiting intestinal Iron

--- Content provided by‍ FirstRanker.com ---

absorption

?Iron recycling by macrophages

?Iron mobilization from hepatic

--- Content provided by‌ FirstRanker.com ---

stores.
HEPCIDIN In Inflammation

? In states of inflammation

--- Content provided by‍ FirstRanker.com ---

the Hepcidin level is abnormal y high.

? In inflammation serum Iron fal s down
? Due to Iron trapping within

--- Content provided by⁠ FirstRanker.com ---

Macrophages and Liver cel s

? Decreased Gut iron absorption.

--- Content provided by​ FirstRanker.com ---

? Hepcidin elevated during infections and

inflammation,

? Causing a decrease in serum Iron levels

--- Content provided by⁠ FirstRanker.com ---

? Contribute to the development of

anemia of inflammation

? Probably as a host defense mechanism

--- Content provided by‌ FirstRanker.com ---

to limit the availability of Iron to

invading microorganisms.
Regulation Of Hepcidin Synthesis

--- Content provided by‍ FirstRanker.com ---

Hepcidin is released from the Liver

according to body Iron status:

--- Content provided by‍ FirstRanker.com ---

? Iron overload increases

Hepcidin expression

--- Content provided by‍ FirstRanker.com ---

? Iron deficiency decreases

Hepcidin expression

? Due to mutations in the Hepcidin

--- Content provided by​ FirstRanker.com ---

gene itself or due to mutations in

the regulators of Hepcidin

--- Content provided by FirstRanker.com ---

synthesis.

? Hepcidin defects appears to be the

ultimate cause of most forms of

--- Content provided by​ FirstRanker.com ---

Hemochromatosis.

--- Content provided by⁠ FirstRanker.com ---

Iodine Metabolism

Iodine

? Iodine is an essential trace

--- Content provided by​ FirstRanker.com ---

element

? Iodine is very vital for

--- Content provided by​ FirstRanker.com ---

normal health , growth and

reproduction of human

body.

--- Content provided by⁠ FirstRanker.com ---

RDA For Iodine

? For Adults ? 100- 150 g/day

? Pregnant Women-200 g/day

--- Content provided by‌ FirstRanker.com ---

Dietary Sources

? Iodized Salt
? Sea Foods

--- Content provided by‌ FirstRanker.com ---

? Fruits Vegetables grown on sea

beds

? Onions

--- Content provided by‌ FirstRanker.com ---

? Drinking Water
Absorption Of Iodine

? Absorption of Iodine is

--- Content provided by‌ FirstRanker.com ---

mainly from smal intestine.

? Smal amounts of Iodine

are absorbed through Skin

--- Content provided by‍ FirstRanker.com ---

and Lungs.

Body Distribution Of Iodine

--- Content provided by FirstRanker.com ---

? Total body content of Iodine= 25-30

mg.

? 80 % of Iodine is taken up by

--- Content provided by⁠ FirstRanker.com ---

Thyroid gland.

? Skin and Skeleton contains small

--- Content provided by‍ FirstRanker.com ---

amount of Iodine.

? Blood levels of Iodine- 5-10g%
Functions Of Iodine

--- Content provided by⁠ FirstRanker.com ---

? Iodine is mainly taken up

by Thyroid gland.

? Iodine is utilized for the

--- Content provided by‌ FirstRanker.com ---

biosynthesis of Thyroid

Hormones .

--- Content provided by‍ FirstRanker.com ---

? The Iodine is activated and

added to Tyrosine residues of

Thyroglobulin Protein

--- Content provided by⁠ FirstRanker.com ---

? To form MIT and DIT which in

turn forms T3 and T4.
? Iodine metabolism requires

--- Content provided by‌ FirstRanker.com ---

Selenium.

? T4 is transformed to T3 in

--- Content provided by FirstRanker.com ---

presence of Se containing

Enzyme DeIodinase.

Functions Of Thyroid Hormones

--- Content provided by FirstRanker.com ---

? Thyroid Hormones Regulate

Basal Metabolism

--- Content provided by⁠ FirstRanker.com ---

? Thus Iodine regulate

Carbohydrates, Lipids and

Protein Metabolism

--- Content provided by‌ FirstRanker.com ---

? Iodine develops Brain

? Regulate Body Temperature

Excretion Of Iodine

--- Content provided by FirstRanker.com ---

? Nearly 70-80% of Iodine is excreted

through Urine.

--- Content provided by‌ FirstRanker.com ---

? Small amount of Iodine may get

excreted through Bile ,Skin and

Saliva.

--- Content provided by‌ FirstRanker.com ---

? Milk of lactating women contains

some Iodine.
Disorders Of Iodine Deficiency

--- Content provided by‌ FirstRanker.com ---

?Iodine is general y scarce in

soil of Mountanious

--- Content provided by‍ FirstRanker.com ---

regions.

?Upper regions of

mountains contain less

--- Content provided by FirstRanker.com ---

Iodine such areas are called

as Goiterous belt.
? Deficiency of Iodine to an

--- Content provided by​ FirstRanker.com ---

adult human body causes

Goiter.

--- Content provided by FirstRanker.com ---

? Deficiency of Iodine in

Children leads to Cretinism,

? Severe Iodine deficiency in

--- Content provided by‌ FirstRanker.com ---

pregnant mothers leads to

?Intrauterine hypothyroidism

--- Content provided by FirstRanker.com ---

resulting in Cretinism.

? The condition is characterized

by mental retardation ,slow

--- Content provided by​ FirstRanker.com ---

body development-Dwarfism,

Characteristic facial Structure.

--- Content provided by FirstRanker.com ---

Endemic Goitre

? Severe Iodine deficiency in

--- Content provided by⁠ FirstRanker.com ---

adults leads to Endemic Goitre.

? Goitre is a condition of enlarged

Thyroid gland

--- Content provided by‍ FirstRanker.com ---

? With decreased Thyroid

hormone production due to

--- Content provided by⁠ FirstRanker.com ---

Iodine deficiency.
? In Goitre enlargement of

Thyroid gland

--- Content provided by​ FirstRanker.com ---

? Due to proliferation of Thyroid

epithelial cells.

? Enlarged Thyroid gland in Iodine

--- Content provided by‌ FirstRanker.com ---

deficient state is significant

? To extract Iodine from blood

--- Content provided by‌ FirstRanker.com ---

more efficiently.

Types of Goitre

?Simple Goitre

--- Content provided by FirstRanker.com ---

?Toxic Goitre
? A simple goiter can occur without a

known reason.

--- Content provided by‌ FirstRanker.com ---

? In this person thyroid gland is not able

to make enough thyroid hormone to

meet the body's needs.

--- Content provided by⁠ FirstRanker.com ---

? This can be due to a lack of iodine in a

person's diet.

--- Content provided by FirstRanker.com ---

? To make up for the shortage of thyroid

hormone, the thyroid gland grows

larger.

--- Content provided by​ FirstRanker.com ---

?Simple goiters

may occur in people

--- Content provided by⁠ FirstRanker.com ---

?Who live in

areas where the soil

and water do not have

--- Content provided by​ FirstRanker.com ---

enough Iodine.
? Toxic Nodular Goiter is an

enlarged thyroid gland that has

--- Content provided by‍ FirstRanker.com ---

a small, rounded growth or

many growths cal ed nodules.

--- Content provided by⁠ FirstRanker.com ---

? One or more of these nodules

produce too much thyroid

hormone.

--- Content provided by⁠ FirstRanker.com ---

Goitrogens

? These are compounds

--- Content provided by FirstRanker.com ---

present in food stuffs

? Which prevent utilization of

Iodine

--- Content provided by‌ FirstRanker.com ---

? Goitrogens leads to Iodine

deficient disorder Goiter.
?Cabbage and Tapioca

--- Content provided by⁠ FirstRanker.com ---

contain Thiocyanate

?This inhibits uptake of

--- Content provided by FirstRanker.com ---

Iodine by Thyroid

gland.

? Mustard seed contain

--- Content provided by‍ FirstRanker.com ---

Thiourea

? Which inhibit Iodination of

--- Content provided by‍ FirstRanker.com ---

Thyroglobulin during T3

and T4 hormone synthesis.
Copper Metabolism

--- Content provided by FirstRanker.com ---

Copper

? Copper is an essential trace

element

--- Content provided by FirstRanker.com ---

? Required for varied

functions of human body

--- Content provided by​ FirstRanker.com ---

keeping it vital and active.
RDA Of Copper

?Adults 2-3 mg/day
?Infants and Childrens-

--- Content provided by FirstRanker.com ---

0.5-2 mg/day

Dietary Sources Of Copper

--- Content provided by‌ FirstRanker.com ---

? Organ Meat
? Liver
? Kidney
? Eggs
? Cereals

--- Content provided by​ FirstRanker.com ---

? Nuts
? Green Leafy Vegetables.
Absorption Of Copper

? About 10% of dietary Copper is

--- Content provided by⁠ FirstRanker.com ---

absorbed mainly by Duodenum.

? Metal othionein facilitates

--- Content provided by‍ FirstRanker.com ---

Copper absorption by mucosal

cel s.

?Phytate ,Zinc,

--- Content provided by FirstRanker.com ---

Molybdenum (Mo+2)

decreases Copper

--- Content provided by‍ FirstRanker.com ---

uptake into intestinal

mucosal cells.
Body Distribution Of Copper

--- Content provided by​ FirstRanker.com ---

? Total body content of Copper

is 100 mg distributed in

different organs.

--- Content provided by‍ FirstRanker.com ---

? The Copper concentration of

Plasma=100-200g%.

--- Content provided by‌ FirstRanker.com ---

? 95% of Copper in blood is

tightly bound to a Copper

containing Protein

--- Content provided by‌ FirstRanker.com ---

Ceruloplasmin.

? 1 molecule of

--- Content provided by‌ FirstRanker.com ---

Ceruloplasmin contains 8

atoms of Copper.
Functional Role Of Copper

--- Content provided by⁠ FirstRanker.com ---

Enzymes and Proteins Containing Cu

?Copper is an essential

constituent of several

--- Content provided by‍ FirstRanker.com ---

Enzyme and Proteins.
Cu- Containing Enzymes

?Cytochrome Oxidase

--- Content provided by FirstRanker.com ---

(In E.T.C)

?Catalase (H2O2

--- Content provided by‍ FirstRanker.com ---

Detoxification)

? Tyrosinase (Melanin Biosynthesis)
? Super oxide Dismutase ( SOD) an

--- Content provided by FirstRanker.com ---

Antioxidant.

? ALA Synthase (Heme Biosynthesis)
? Ascorbic acid Oxidase
? Monoamine Oxidase

--- Content provided by FirstRanker.com ---

? Phenol Oxidase
? Lysyl Oxidase( Col agen Synthesis)
? Since Cu containing Lysyl

Oxidase Enzyme is involved

--- Content provided by​ FirstRanker.com ---

cross linking of Col agen Fibers

of bone

--- Content provided by‍ FirstRanker.com ---

? Copper has indirect role bone

development.

Copper Containing Proteins

--- Content provided by FirstRanker.com ---

? Ceruloplasmin (Ferroxidase I Activity)
? Storage form of Copper
(Liver RBCs and Brain Cel s)

--- Content provided by​ FirstRanker.com ---

?Hepatocuperin
?Hemocuperin
?Cerebrocuperin
Role Of Copper In Iron Metabolism

--- Content provided by FirstRanker.com ---

Ceruloplasmin

? Ceruloplasmin is a Copper containing

Glycoprotein.

--- Content provided by​ FirstRanker.com ---

? Ceruloplasmin is blue colored.

? Ceruloplasmin contains both Cuprous

--- Content provided by FirstRanker.com ---

and Cupric forms of Copper in its

structure.
Remember

--- Content provided by FirstRanker.com ---

?Ceruloplasmin is not

Copper transport

Protein.

--- Content provided by FirstRanker.com ---

? Normal Concentration of

Ceruloplasmin -25-50mg%.

--- Content provided by​ FirstRanker.com ---

? 5% of Copper in blood is

loosely bound to Protein

Albumin.

--- Content provided by‌ FirstRanker.com ---

? Function of Ceruloplasmin in

blood is Ferroxidase I activity.

? Ceruloplasmin converts Ferrous

--- Content provided by​ FirstRanker.com ---

to Ferric in blood and added to

Apotransferin for its transport.

--- Content provided by‍ FirstRanker.com ---

? Thus Copper has role in Iron

metabolism.

? Copper deficiency affects the function

--- Content provided by‍ FirstRanker.com ---

of Ceruloplasmin
? Low Ceruloplasmin levels affects

Iron Metabolism:

--- Content provided by‍ FirstRanker.com ---

?Transport of Iron
?Storage of Iron
?Utilization of Iron
?Heme Biosynthesis

--- Content provided by⁠ FirstRanker.com ---

? Copper helps in

maintaining Myelin

--- Content provided by⁠ FirstRanker.com ---

Sheaths of Nerve Fibers

? Role in development of

Nervous system

--- Content provided by​ FirstRanker.com ---

? Recently found out Copper

helps to protect the Heart

? By increasing HDL activity

--- Content provided by⁠ FirstRanker.com ---

(Scavenging Action-Reverse

Transport Of Cholesterol)

--- Content provided by⁠ FirstRanker.com ---

? Reduces risk of

Atherosclerosis.

?Copper is necessary for

--- Content provided by⁠ FirstRanker.com ---

the biosynthesis of:

?Phospholipids
?Melanin ?Skin and hair

--- Content provided by FirstRanker.com ---

pigment
Excretion Of Copper

? Normal y 85-99 % of

--- Content provided by FirstRanker.com ---

ingested Copper is excreted

through feces via bile

--- Content provided by​ FirstRanker.com ---

? Remaining 1-15% may get

excreted through Urine.

Disorders Associated To Copper

--- Content provided by‌ FirstRanker.com ---

Metabolism
Deficiency Of Copper

?Deficiency of Copper

--- Content provided by​ FirstRanker.com ---

consequently lowers:

?Saturation of Transferrin

--- Content provided by‌ FirstRanker.com ---

?Ferritin Levels

?Hb concentration

?Oxygen supply to tissues

--- Content provided by⁠ FirstRanker.com ---

?ATP production in body
Deficiency Of Copper

? Deficiency of Copper in body directly and

--- Content provided by‍ FirstRanker.com ---

indirectly affects:

?Iron Metabolism

--- Content provided by⁠ FirstRanker.com ---

?Heme Biosynthesis

?Leads to Iron deficiency Anemia

?Melanin Biosynthesis

--- Content provided by‌ FirstRanker.com ---

?Collagen Biosynthesis

Copper Deficiency Manifestations

--- Content provided by⁠ FirstRanker.com ---

?Bone disorders

?Thin Cortices
?Deficient Trabeculae
?Wide Epiphyses

--- Content provided by‍ FirstRanker.com ---

?Weakness ,Weight Loss
?Atropy of Myocardium
?Demyelination
?Non Coordinated

--- Content provided by‌ FirstRanker.com ---

movements

Menkes Disease

Kinky /Steel Hair Syndrome

--- Content provided by⁠ FirstRanker.com ---

A Copper Deficiency Disorder
?Menkes Disease is

associated to Copper

--- Content provided by FirstRanker.com ---

Metabolism.

?It is inherited X linked

--- Content provided by‍ FirstRanker.com ---

disorder affects male

only.

Biochemical Defects

--- Content provided by​ FirstRanker.com ---

? Defects in intestinal

Copper absorption.

--- Content provided by‍ FirstRanker.com ---

? Leads to Copper deficiency

in human body.
? Due to absence of Copper

--- Content provided by⁠ FirstRanker.com ---

binding ATPase

? Defective Transport of Copper

across the Serosa of mucosal

--- Content provided by FirstRanker.com ---

cel membrane.

?In Menkes Disease

--- Content provided by⁠ FirstRanker.com ---

the serum and Urine

Copper levels are

markedly decreased.

--- Content provided by⁠ FirstRanker.com ---

? Copper deficiency affects the

Melanin biosynthesis.

? Causes hypopigmentation of Skin

--- Content provided by FirstRanker.com ---

and hair

? Leads to greying of hair
? Flag type of hair growth (alternate

--- Content provided by FirstRanker.com ---

grey and white patches on hair)

Clinical Manifestations Of Cu

--- Content provided by‍ FirstRanker.com ---

Deficiency

? Iron Deficiency Anemia
? Depigmentation of hair
? Mental Retardation

--- Content provided by‌ FirstRanker.com ---

? Abnormal Bone formation
? Susceptible to Infections.
Copper Toxicity Disorder

--- Content provided by‌ FirstRanker.com ---

Wilsons Disease

Hepatolenticular Degeneration

--- Content provided by‌ FirstRanker.com ---

Wilsons Disease

?Wilsons Disease is an

inherited disorder

--- Content provided by FirstRanker.com ---

associated to Copper

metabolism.
Inheritance

--- Content provided by​ FirstRanker.com ---

?Wilsons Disease is

inherited as

--- Content provided by‌ FirstRanker.com ---

Autosomal Recessive.

Incidence

?Incidence of

--- Content provided by​ FirstRanker.com ---

Wilsons Disease is

1 in 50,000 of live

--- Content provided by‍ FirstRanker.com ---

births.
Biochemical Defect

? Gene present on Chromosome 13

--- Content provided by​ FirstRanker.com ---

? Encoding for Copper binding ATPase

/ATP 7B Gene in cel s is defective

? Which affects the normal excretion of

--- Content provided by‌ FirstRanker.com ---

Copper, through bile out from Liver

cel s.

--- Content provided by​ FirstRanker.com ---

? Copper is not excreted through bile.

? In Wilson disease, the Copper

builds up in toxic levels in Liver,

--- Content provided by‌ FirstRanker.com ---

? Liver releases the copper directly

into blood stream.
?In Wilsons disease due to

--- Content provided by FirstRanker.com ---

high toxic levels of Copper

in Liver

--- Content provided by​ FirstRanker.com ---

?There occurs defect in

incorporation of Copper

into Apoceruloplasmin to

--- Content provided by‌ FirstRanker.com ---

form Ceruloplasmin.

? Thus in Wilsons disease the Copper

--- Content provided by​ FirstRanker.com ---

atoms are underutilized

? Not incorporated into

Apoceruloplasmin to form

--- Content provided by‍ FirstRanker.com ---

Ceruloplasmin.

? Wilsons disease has low Ceruloplasmin

--- Content provided by​ FirstRanker.com ---

levels in blood which affects its

Ferroxidase activity.
? In Wisons disease due to low

--- Content provided by⁠ FirstRanker.com ---

Ferroxidase activity of

Ceruloplasmin

--- Content provided by FirstRanker.com ---

? The Iron transport and Storage is

indirectly affected.

? In Wilsons disease the unutilized

--- Content provided by⁠ FirstRanker.com ---

Copper liberated out from

damaged hepatocytes

--- Content provided by‍ FirstRanker.com ---

? Copper is markedly excreted out

through Urine.
Clinical Manifestations

--- Content provided by​ FirstRanker.com ---

? Due to retention of Copper in

functional organs like Liver

,Brain ,Kidneys and Eyes.

--- Content provided by‌ FirstRanker.com ---

? In Wilsons disease following

manifestations are noted.

--- Content provided by​ FirstRanker.com ---

? Accumulation of toxic levels of

Copper in hepatocytes

? Leads to hepatocel ular

--- Content provided by FirstRanker.com ---

degeneration and Liver Cirrhosis.
? In Wilsons disease Copper is also

deposited in brain basal ganglia

--- Content provided by​ FirstRanker.com ---

? Leads to lenticular degeneration

and neurological symptoms.

--- Content provided by‌ FirstRanker.com ---

? Copper deposits in Kidneys
? Leads to defect in renal tubular

reabsorption leading to

--- Content provided by‍ FirstRanker.com ---

Aminoaciduria.


? Copper deposition in

--- Content provided by⁠ FirstRanker.com ---

Descemets membrane of the

eyes ,around cornea.

? Causes a golden brown ,yellow

--- Content provided by⁠ FirstRanker.com ---

or green ring round the Cornea

termed as Kayser Fleischer

--- Content provided by‌ FirstRanker.com ---

Ring.
Wilsons Disease Treatment

? Penicil amine injection

--- Content provided by‍ FirstRanker.com ---

Chelates the Copper

? Remove the Copper

deposited in tissues and

--- Content provided by⁠ FirstRanker.com ---

excreted out.

? Sometimes Zinc is used

--- Content provided by‌ FirstRanker.com ---

therapeutical y in Wilsons

disease

? As Zn decreases Copper

--- Content provided by FirstRanker.com ---

absorption.
Copper Toxicity Manifestations

? Diarrhea

--- Content provided by FirstRanker.com ---

? Blue-Green Discoloration of Saliva
? Hemolysis
? Hemoglobinuria
? Renal Failure
? Proteinuria

--- Content provided by‌ FirstRanker.com ---

Zinc Metabolism
Zinc

?Zinc is an important trace

--- Content provided by‍ FirstRanker.com ---

element of human body.

?Zinc is mainly intracellular

--- Content provided by‌ FirstRanker.com ---

element.

RDA of Zinc

?Adults= 10-15 mg/day

--- Content provided by​ FirstRanker.com ---

?Pregnant and Lactating

Women=25 mg/day
Dietary Sources Of Zinc

--- Content provided by​ FirstRanker.com ---

? Meat
? Fish
? Eggs
? Milk

--- Content provided by⁠ FirstRanker.com ---

? Legumes
? Pulses
? Spinach
? Lettuce
? Yeast Cells

--- Content provided by‌ FirstRanker.com ---

? Beans
? Nuts

Absorption Of Zinc

--- Content provided by‍ FirstRanker.com ---

? Only smal percentage of

dietary Zinc is absorbed

? From duodenal and ileal

--- Content provided by FirstRanker.com ---

part of smal intestine.
? Zn absorption is facilitated

by

--- Content provided by⁠ FirstRanker.com ---

? A low molecular weight Zinc

binding factor produced and

--- Content provided by​ FirstRanker.com ---

secreted by Pancreas.

?Zn absorption is

interfered with

--- Content provided by FirstRanker.com ---

?High amounts of dietary

Ca, P and Phytates.
Body Distribution Of Zinc

--- Content provided by‍ FirstRanker.com ---

? The total content of Zinc in adult human

body is 1.5 -2 gm.

--- Content provided by‌ FirstRanker.com ---

? high concentrations of Zinc in Prostate

and Skin (80-100 mg/100 gm).

? Bones and teeth contains moderate

--- Content provided by⁠ FirstRanker.com ---

amounts of Zinc.

? Very low content in Brain and Lungs.

--- Content provided by FirstRanker.com ---

Zinc In Blood

?Blood Zinc Levels 120-

140 g/100ml

--- Content provided by‌ FirstRanker.com ---

?Zinc is associated with

Albumin in blood.
Biochemical Functions Of Zinc

--- Content provided by FirstRanker.com ---

? Zinc serves as inorganic

cofactor for certain Enzymes

--- Content provided by⁠ FirstRanker.com ---

? Zinc containing Enzymes:

?Alcohol Dehydrogenase
?Alkaline Phosphatase

--- Content provided by​ FirstRanker.com ---

?ALA Dehydratase
? Carbonic Anhydrase
? Carboxy Peptidase
? Super Oxide Dismutase-Zn
? LDH

--- Content provided by‍ FirstRanker.com ---

? DNA and RNA Polymerase

?Zinc is required for the

storage and secretion of

--- Content provided by FirstRanker.com ---

Insulin hormone

?From the Beta cells of

--- Content provided by⁠ FirstRanker.com ---

Islets of Langerhans of

Pancreas.
?Zinc has role in wound

--- Content provided by‍ FirstRanker.com ---

healing by promoting

epithelialization.

?The Salivary taste Protein

--- Content provided by‍ FirstRanker.com ---

"Gustin " contains Zn.

? Zinc has role in growth and

--- Content provided by‌ FirstRanker.com ---

reproduction of human beings.

? Zinc binds to regulatory Proteins

of DNA and

--- Content provided by​ FirstRanker.com ---

? Involve in the control of

Transcription (Zinc Finger Motif).

--- Content provided by‌ FirstRanker.com ---

? Zinc helps in biosynthesis of

Retinol binding Protein.

--- Content provided by FirstRanker.com ---

? Thus Zinc is necessary to

maintain normal levels of

--- Content provided by FirstRanker.com ---

Retinol(Vitamin A) in blood.

Excretion Of Zinc

? A normal healthy body looses 9

--- Content provided by⁠ FirstRanker.com ---

mg of Zinc through Feces and 0.5

mg through Urine.

--- Content provided by‍ FirstRanker.com ---

? Trace amount of Zn is lost in

sweat.

? 0.5 mg of Zn is retained in the

--- Content provided by FirstRanker.com ---

body.
Disorders And Manifestations Of Zinc

Zinc Deficiency Manifestations

--- Content provided by‌ FirstRanker.com ---

?Poor Wound Healing
?Lesions of Skin
?Hyperkeratosis
?Dermatitis

--- Content provided by⁠ FirstRanker.com ---

? Alopecia
? Impaired Spermatogenesis
? Impaired Macrophage

Function

--- Content provided by⁠ FirstRanker.com ---

? Depression ,Dementia and

Other Neuropsychiatric

--- Content provided by‌ FirstRanker.com ---

Complications.

Achrodermatitis Enteropathica

?This is a rare inherited

--- Content provided by​ FirstRanker.com ---

disorder of Zn

metabolism.

--- Content provided by‌ FirstRanker.com ---

?It is a autosomal

recessive disorder.
Biochemical Defect

--- Content provided by FirstRanker.com ---

?Defect In Zinc

absorption from GIT

?Leads to Zinc

--- Content provided by⁠ FirstRanker.com ---

deficiency in human

body.

--- Content provided by‍ FirstRanker.com ---

Clinical Manifestations

? Achrodermatitis-

Inflammation around mouth

--- Content provided by‌ FirstRanker.com ---

,nose, fingers

(Dermatological Disorder)

--- Content provided by⁠ FirstRanker.com ---

? GIT disturbances-Diarrhea
? Neuropsychiatric features
?Ophthalmological

dysfunctions

--- Content provided by FirstRanker.com ---

?Growth Retardation.
?Hypogonadism
?Alopecia

--- Content provided by​ FirstRanker.com ---

Secondary Causes Of Zinc Deficiency

?Chronic Alcoholism
?Uncontrolled Diabetes

--- Content provided by​ FirstRanker.com ---

mellitus.
Zinc Toxicity

?Zinc Toxicity is manifested
?When dosage of Zn is more

--- Content provided by​ FirstRanker.com ---

than 1000 mg/day.

Causes Of Zinc Toxicity

--- Content provided by‍ FirstRanker.com ---

? Zinc toxicity is commonly noted

in Welders who may inhale

fumes of Zinc Oxide.

--- Content provided by‌ FirstRanker.com ---

? Many Rat poisons contain Zn

compounds ,ingestion of it leads

--- Content provided by⁠ FirstRanker.com ---

to Zn toxicity.
Manifestations Of Zn Toxicity

? Chronic toxicity of Zn produces

--- Content provided by‍ FirstRanker.com ---

Gastric Ulcer

? Pancreatitis
? Nausea ,Vomiting
? Pulmonary Fibrosis

--- Content provided by⁠ FirstRanker.com ---

Acute Zinc Manifestations

? Fever
? Excessive Salivation

--- Content provided by‌ FirstRanker.com ---

? Headache
? Anemia
? Leukocytosis
Therapeutic Value Of Zinc

--- Content provided by​ FirstRanker.com ---

? Recent evidences has proved Zinc

therapy may reduces

Atherosclerosis.

--- Content provided by​ FirstRanker.com ---

? Administration of 3.4 mg of

elemental Zn /day has

--- Content provided by⁠ FirstRanker.com ---

Significantly reduced serum LDL

Cholesterol.

? Prevents Aortic wal

--- Content provided by‌ FirstRanker.com ---

Cholesterol deposition

? Prevent Platelet adhesion
? Increased Fibrinolytic

--- Content provided by‍ FirstRanker.com ---

activity.
?Acute fal in Zinc is noted

on 3rd or 4th day of

--- Content provided by​ FirstRanker.com ---

Myocardial Infarction.

Fluorine Metabolism
Fluorine

--- Content provided by⁠ FirstRanker.com ---

?Fluorine is a trace

element

--- Content provided by​ FirstRanker.com ---

?important in preventing

tooth caries and decay.

RDA Of Fluorine

--- Content provided by​ FirstRanker.com ---

? Safe limit of Fluorine is

1ppm/day

--- Content provided by‍ FirstRanker.com ---

? 1ppm= 1mg/10,000 ml
Dietary Sources Of Fluoride

? Drinking Water is the main

--- Content provided by​ FirstRanker.com ---

source

? Fluoride Tooth paste
? Tea
? Fishes

--- Content provided by‍ FirstRanker.com ---

? Jawar

Absorption Of Fluoride

?The dietary soluble

--- Content provided by‌ FirstRanker.com ---

forms of Fluorides are

absorbed by

--- Content provided by‍ FirstRanker.com ---

?Simple diffusion from

intestine.
Body Distribution OF Fluoride

--- Content provided by‍ FirstRanker.com ---

? Fluoride in body is mainly

present in bones and teeth.

? The blood contains ionized

--- Content provided by FirstRanker.com ---

form of Fluoride=10-20 g%.

Biochemical Functions Of Fluoride

--- Content provided by​ FirstRanker.com ---

? Fluorine in trace amounts help

in teeth development and

prevent dental caries

--- Content provided by​ FirstRanker.com ---

? By hardening of dental enamel

and maintaining Fluoroapetite

--- Content provided by⁠ FirstRanker.com ---

(Calcium Fluoride).
? Fluoroapetite makes:

?Tooth surface strong
?More resistant to plaque

--- Content provided by⁠ FirstRanker.com ---

?No bacterial attack
?Prevention of tooth decay

?Fluorine has role in

--- Content provided by​ FirstRanker.com ---

bone development

?Which Prevent old age

Osteoporosis.

--- Content provided by FirstRanker.com ---

? Fluoride is an inhibitor of

Enzyme Enolase of Glycolysis

(Antiglycolytic agent)

--- Content provided by​ FirstRanker.com ---

? Sodium Fluoride is content of

sugar bulb/grey vacutainer

--- Content provided by‍ FirstRanker.com ---

? Used for blood col ection for

Glucose estimation.

Excretion Of Fluoride

--- Content provided by FirstRanker.com ---

?Fluorides are

mainly excreted

--- Content provided by‌ FirstRanker.com ---

through Urine.

?

u

--- Content provided by​ FirstRanker.com ---

Disorders Of Fluorine Metabolism

Deficiency Of Fluorine

? Intake of Fluorine less than 0.5

--- Content provided by‍ FirstRanker.com ---

ppm in Children

? May lead to Fluorine deficiency
? Fluorine deficiency directly

--- Content provided by‍ FirstRanker.com ---

affects the health of teeth and

bones.
? In Fluorine deficient persons.

--- Content provided by⁠ FirstRanker.com ---

the Fluorapatite is not formed

and maintained on the enamel

--- Content provided by FirstRanker.com ---

of teeth

? These teeth are susceptible to

acid produced by bacterial

--- Content provided by‍ FirstRanker.com ---

action on foods.

? In cases of low Fluoroapatite

--- Content provided by FirstRanker.com ---

?Enamel is removed by acid
?Dentine pulp is exposed
?Leads to plaque formation
?Inflammation , tooth

--- Content provided by⁠ FirstRanker.com ---

ache/decay
Toxicity Of Fluorine/ Fluorosis

?Intake of Fluorine

--- Content provided by⁠ FirstRanker.com ---

more than 5ppm/day

causes Fluorosis.

?The manifestations

--- Content provided by⁠ FirstRanker.com ---

of Fluorosis are

more severe than

--- Content provided by⁠ FirstRanker.com ---

Fluorine deficiency.
Causes Of Fluorine Toxicity

? Drinking Fluoridinated

--- Content provided by FirstRanker.com ---

Water

? Excessive use of Fluoride

Tooth paste

--- Content provided by⁠ FirstRanker.com ---

? Eating Jawar

Clinical Manifestations Of Fluorosis

--- Content provided by⁠ FirstRanker.com ---

? Fluorosis cause GIT upset

?Gastroenteritis
?Loss of Appetite
?Loss of Weight

--- Content provided by‌ FirstRanker.com ---

? Dental Fluorosis leads to:

?Mottling of Teeth Enamel

--- Content provided by FirstRanker.com ---

?Stratification and

Discoloration of Teeth

(Brown/Yel ow Patches on Teeth).

--- Content provided by⁠ FirstRanker.com ---

?Fluoride levels more than

20 ppm is very toxic

--- Content provided by​ FirstRanker.com ---

?Leads to advanced

skeletal Fluorosis /Genu

--- Content provided by FirstRanker.com ---

valgum.
? Characteristic features of Skeletal

Fluorosis are:

--- Content provided by⁠ FirstRanker.com ---

?Alternate areas of

Osteoporosis and

Osteosclerosis with brittle

--- Content provided by‌ FirstRanker.com ---

bones.

?Bone density is

--- Content provided by FirstRanker.com ---

increased due to

? Fluoride deposition in

bones of limbs ,pelvis

--- Content provided by‌ FirstRanker.com ---

and spine.


?Individuals are crippled

--- Content provided by​ FirstRanker.com ---

and has stiff joints

?They are unable to

--- Content provided by FirstRanker.com ---

perform their daily

routines.

--- Content provided by‍ FirstRanker.com ---

Prevention Of Fluorosis

? By checking the Fluoride levels

of drinking water of deep bore

--- Content provided by FirstRanker.com ---

wel s

? Reducing drinking water

--- Content provided by‌ FirstRanker.com ---

containing excess levels of

Fluoride.
? Avoid use of tooth paste which

--- Content provided by‌ FirstRanker.com ---

are excessively fluoridinated.

? Restricting intake of excess

Jawar.

--- Content provided by​ FirstRanker.com ---

? Supplementation of Vitamin C.

Metabolism Of

--- Content provided by⁠ FirstRanker.com ---

Manganese

(Mn)
Manganese

--- Content provided by⁠ FirstRanker.com ---

? Manganese (Mn) is a trace

element

? Mainly found in the Nucleus

--- Content provided by⁠ FirstRanker.com ---

? In association with Nucleic

acids.

--- Content provided by⁠ FirstRanker.com ---

RDA For Mn

?Adults- 2- 9 mg/day
Dietary Sources Of Mn

--- Content provided by‌ FirstRanker.com ---

? Tea is a rich source of Mn.
? Other sources are

Cereals,Nuts,Leafy Vegetables

--- Content provided by‌ FirstRanker.com ---

and Fruits.

? Liver an Kidney are animal

food sources of Mn.

--- Content provided by​ FirstRanker.com ---

.

? About 3-4% of dietary Mn is

--- Content provided by‍ FirstRanker.com ---

normal y absorbed in Intestine.

? Dietary Calcium , Phosphorous

and Iron may inhibit Mn

--- Content provided by​ FirstRanker.com ---

absorption.
Body Distribution Of Mn

? The total body content of Mn is

--- Content provided by​ FirstRanker.com ---

about 15 mg

? Liver and Kidney are rich in Mn.
? The blood Mn levels 4-20 g%.

--- Content provided by⁠ FirstRanker.com ---

?Transmagnin a Beta 1

Globulin protein.

--- Content provided by‌ FirstRanker.com ---

?Transports Mn in blood
Biochemical Functions Of Mn

? Mn is associated with

--- Content provided by‍ FirstRanker.com ---

enzyme RNA Polymerase in

nucleus and helps in

transcription process.

--- Content provided by‍ FirstRanker.com ---

? Mn serves as cofactor for

fol owing Enzymes:

?Arginase (Urea Cycle)

--- Content provided by​ FirstRanker.com ---

?Pyruvate Carboxylase (Pyr to OAA)
?IDH (TCA Cycle)

?SOD-Mn (Mitochondrial)
?Peptidase

--- Content provided by⁠ FirstRanker.com ---

?Succinate

Dehydrogenase
? Mn is associated with SOD

--- Content provided by​ FirstRanker.com ---

Antioxidant activity

? Thus Mn has an antioxidant

function and prevent Lipid

--- Content provided by⁠ FirstRanker.com ---

peroxidation

? Mn plays important role in

--- Content provided by​ FirstRanker.com ---

Glycoprotein and Mucoprotein

biosynthesis.

? Mn is necessary for Cholesterol

--- Content provided by‌ FirstRanker.com ---

and Hemoglobin biosynthesis.
? Mn is also required for the

Bone formation and normal

--- Content provided by​ FirstRanker.com ---

function of nervous system.

Excretion Of Mn

--- Content provided by​ FirstRanker.com ---

?Mn is excreted through

bile and Pancreatic

juice.

--- Content provided by FirstRanker.com ---

Deficiency Of Mn

? Growth retardation
? Skeletal Deformities (Defective

--- Content provided by⁠ FirstRanker.com ---

Chondritin SO4)

? Increased ALP levels
? Functional activity of Beta cells to

--- Content provided by⁠ FirstRanker.com ---

produce Insulin diminished

? Severe deficiency may lead to sterility.

Manifestations Of Mn Toxicity

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? Mn toxicity leads to

Psychotic and Parkinsonism

--- Content provided by‌ FirstRanker.com ---

like symptoms.
Molybdenum

Metabolism

--- Content provided by FirstRanker.com ---

Molybdenum

? Molybdenum Trace

element

--- Content provided by FirstRanker.com ---

? Dietary requirement of Mo

in Adults is 0.5 mg/day

--- Content provided by​ FirstRanker.com ---

? For Children 0.3 mg/day
Dietary Sources OF Mo

?Cereals and Legumes

--- Content provided by‌ FirstRanker.com ---

are rich sources of Mo.

?Liver is also rich in Mo.

Absorption Of Mo

--- Content provided by​ FirstRanker.com ---

? Mo is absorbed from the intestine.

? Higher levels of Mo in food wil

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impair the absorption of Copper.
Body Distribution Of Mo

? The content of Mo in human

--- Content provided by‍ FirstRanker.com ---

body is very little .

? It is mainly present in bones to

smal er extent in Liver and

--- Content provided by FirstRanker.com ---

Kidneys.

Biochemical Functions

--- Content provided by​ FirstRanker.com ---

? Mo is constituent of the Enzymes.

?Xanthine Oxidase
(Purine Catabolism)
?Sulfite Oxidase

--- Content provided by​ FirstRanker.com ---

?Aldehyde Oxidase
?Mo in Enzymatic reactions

participates

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?Internal electron transfer

during oxido reduction.

Excretion Of Mo

--- Content provided by‍ FirstRanker.com ---

? Mo is mainly excreted through

urine to smal extent through

--- Content provided by⁠ FirstRanker.com ---

feces via bile.
Disorders Of Mo

? Deficiency of Mo causes

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decreased Xanthine oxidase

activity

? Which increases Xanthinuric

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acid and decreases Uric acid

excretion

--- Content provided by​ FirstRanker.com ---

? Molybdenosis is a rare

disorder caused by excessive

intake of Mo.

--- Content provided by⁠ FirstRanker.com ---

? It manifests as impairment in

growth, diarrhea and

--- Content provided by⁠ FirstRanker.com ---

Anemia

? Excess Mo affects intestinal

Copper absorption.

--- Content provided by​ FirstRanker.com ---

Selenium Metabolism

Selenium

? Selenium is a trace element

--- Content provided by⁠ FirstRanker.com ---

associated to antioxidant

activity.

--- Content provided by‌ FirstRanker.com ---

? RDA of Selenium in adults is

50-200g/day
Dietary Sources Of Selenium

--- Content provided by FirstRanker.com ---

? Rich sources of Selenium are organ

meat like Liver and Kidney.

? Sea Foods

--- Content provided by​ FirstRanker.com ---

? Food crops grown in Selenium rich

soil

? Soil of Punjab and Haryana is rich

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in Selenium content.

Absorption Of Selenium

--- Content provided by FirstRanker.com ---

? Selenium is mainly absorbed

from Duodenum.

? Selenium is transported

--- Content provided by FirstRanker.com ---

bound to Plasma Proteins.
Body Distribution Of Selenium

? Selenium is widely distributed

--- Content provided by⁠ FirstRanker.com ---

in all tissues .

? Highest concentrations of

--- Content provided by​ FirstRanker.com ---

Selenium are found in Kidney

,Liver and Finger nails.

? Low concentration of Se is

--- Content provided by FirstRanker.com ---

found in Muscles , Bones

,Blood and Adipose tissues.

--- Content provided by FirstRanker.com ---

? Blood levels of Selenium are

0.05 to 0.34 g/ml
Biological Forms Of Selenium

--- Content provided by‌ FirstRanker.com ---

? The termination codon UGA is

responsible for the direct insertion

of Seleno-Cystine

--- Content provided by‍ FirstRanker.com ---

? In Selenium containing Enzymes

during Protein biosynthesis.

--- Content provided by​ FirstRanker.com ---

? Thus Seleno-Cysteine may be

considered as the 21 st amino acid.

? Biological forms of Selenium

--- Content provided by‍ FirstRanker.com ---

are analogues of S containing

amino acids viz

--- Content provided by​ FirstRanker.com ---

?Selenomethionine
?Selenocysteine
?SelenoCystine
Biochemical Functions Of

--- Content provided by​ FirstRanker.com ---

Selenium (Se)

? Selenium along with vitamin E

has potent antioxidant function.

--- Content provided by​ FirstRanker.com ---

? Selenium has sparing effect on

Vitamin E

--- Content provided by​ FirstRanker.com ---

? Selenium reduces Vitamin E

requirement in the body.
?Selenium as

--- Content provided by​ FirstRanker.com ---

Selenocysteine is an

essential component of

enzyme Glutathione

--- Content provided by FirstRanker.com ---

Peroxidase

? Se containing Glutathione

--- Content provided by⁠ FirstRanker.com ---

Peroxidase detoxifies toxic free

radical H2O2 within cells.

? Thus this detoxification of H2O2

--- Content provided by​ FirstRanker.com ---

protects the cel s against the

damage caused by H2O2.
? Selenium also interacts with free

--- Content provided by​ FirstRanker.com ---

radicals including Superoxide

radicals.

--- Content provided by FirstRanker.com ---

? Se protects the cel s from Lipid

peroxidation of biological

membranes

--- Content provided by FirstRanker.com ---

? This maintains structural integrity

of the biomembranes

--- Content provided by FirstRanker.com ---

?Selenium prevents :

?Intracel ular

hemolysis

--- Content provided by‍ FirstRanker.com ---

?Hepatic necrosis and

muscular dystrophy.
? Selenium has anticancer role

--- Content provided by⁠ FirstRanker.com ---

? Since it protects the body from

the action of chemical

--- Content provided by FirstRanker.com ---

Carcinogens on DNA and

prevent from mutations.

? 5'-Deiodinase enzyme is another Se

--- Content provided by​ FirstRanker.com ---

containing enzyme which has its role

in T3 Hormone biosynthesis.

--- Content provided by⁠ FirstRanker.com ---

( T4 to T3 transformation).

? Selenium is necessary for normal

development of Spermatozoa.

--- Content provided by FirstRanker.com ---

?Selenium has affinity for

Hg+2 and Cd ions

?It interacts with them and

--- Content provided by‍ FirstRanker.com ---

?protect the body from

toxic action of heavy

metals atoms.

--- Content provided by‌ FirstRanker.com ---

Excretion Of Selenium

? Main route of Selenium

--- Content provided by‍ FirstRanker.com ---

excretion is through Urine

? Very smal amount of Se

excreted through feces and

--- Content provided by​ FirstRanker.com ---

expired air.
Disorders Associated

To

--- Content provided by‍ FirstRanker.com ---

Selenium Metabolism

Selenium Deficiency Disorders
Keshans Disease/ Cardiomyopathy

--- Content provided by‌ FirstRanker.com ---

? This Selenium deficiency disorder

was first reported in ?Keshan a

--- Content provided by‌ FirstRanker.com ---

country of North Eastern China.

? Mostly Childrens and Womens were

affected due to low dietary intake of

--- Content provided by⁠ FirstRanker.com ---

Selenium.

Clinical Manifestations

--- Content provided by‍ FirstRanker.com ---

? Acute or Chronic Cardiac

enlargement

? Arrhythmia

--- Content provided by​ FirstRanker.com ---

? E.C.G Changes

? Cardiomyopathy ( Multifocal

--- Content provided by‌ FirstRanker.com ---

Myocardial Necrosis)
Treatment

? Supplementation of Sodium

--- Content provided by‍ FirstRanker.com ---

Selenite

? Is highly effective in

Prophylaxis /prevention and

--- Content provided by⁠ FirstRanker.com ---

treatment of Keshans

disease.

--- Content provided by⁠ FirstRanker.com ---

Kashin Beck Disease (Osteoarthritis)

?Selenium Deficiency

affects mostly children's

--- Content provided by⁠ FirstRanker.com ---

of age between 5 to 13

years.
Clinical manifestations

--- Content provided by‍ FirstRanker.com ---

? Severe enlargement and

dysfunctions of the joints.

--- Content provided by‌ FirstRanker.com ---

? Shortens fingers and long

bones.

? Growth retardation

--- Content provided by​ FirstRanker.com ---

? Degenerative Osteoarthritis

Treatment

?Supplementing 20

--- Content provided by​ FirstRanker.com ---

to 120 g/day of

Selenium.
Selenium Toxicity Disorders

--- Content provided by​ FirstRanker.com ---

Selenosis

?Toxic doses (900

--- Content provided by⁠ FirstRanker.com ---

g/day) of Selenium

may lead to Selenosis .

? Early hal mark of Selenium

--- Content provided by​ FirstRanker.com ---

toxicity is garlicky odor in

breath.

--- Content provided by⁠ FirstRanker.com ---

? Due to exhalation of

Dimethyl Selenide.
Causes of Selenosis

--- Content provided by​ FirstRanker.com ---

?Workers working in

electronic ,glass and

paint industries suffer

--- Content provided by⁠ FirstRanker.com ---

from Selenosis.

Manifestations Of Selenosis

--- Content provided by‌ FirstRanker.com ---

? Chronic Dermatitis
? Loss of hair
? Brittle nails
? Diarrhea
? Weight loss

--- Content provided by FirstRanker.com ---

Cobalt Metabolism

Cobalt

? Cobalt is the metal atom

--- Content provided by FirstRanker.com ---

an essential trace element.

? Cobalt forms an integral

--- Content provided by‍ FirstRanker.com ---

parts of Vitamin B12.


?Cobalt is a component of

--- Content provided by‌ FirstRanker.com ---

Corrin ring system.

?Corrin Ring is an internal

component of

--- Content provided by‌ FirstRanker.com ---

Cyanocobalamin/Vitamin

B12
RDA Of Cobalt

--- Content provided by‌ FirstRanker.com ---

? The daily requirement of

Cobalt is 5 to 8 g/day.

--- Content provided by‌ FirstRanker.com ---

Dietary Sources Of Cobalt

? Cobalt is mainly present in

animal food sources

--- Content provided by‍ FirstRanker.com ---

? Co not present in vegetables.
Absorption Of Cobalt

?70-80% of the dietary

--- Content provided by⁠ FirstRanker.com ---

Cobalt is readily absorbed

from the intestine.

--- Content provided by‌ FirstRanker.com ---

Body Distribution Of Cobalt

? Cobalt is mainly stored in

Liver cells.

--- Content provided by⁠ FirstRanker.com ---

? Trace amount is present in

other tissues.
Biochemical Functions

--- Content provided by​ FirstRanker.com ---

? Cobalt is the component of Corrin

Ring System of Vitamin B 12/

--- Content provided by FirstRanker.com ---

Cyanocobalamin.

? In human body Cyanocobalamin is

transformed to Adenosyl

--- Content provided by‍ FirstRanker.com ---

Cobalamin which has Coenzyme

role.
? Vitamin B 12 is used in

--- Content provided by FirstRanker.com ---

DNA multiplication.

? Cyanocobalamin has role in

--- Content provided by‍ FirstRanker.com ---

normal functioning of

the Brain and Nervous

system.

--- Content provided by‍ FirstRanker.com ---

? Cobalt is required to maintain

normal bone marrow

--- Content provided by⁠ FirstRanker.com ---

function. Blood formation

? Help in maturation of RBC's

by synthesis of Erythropoietin

--- Content provided by‍ FirstRanker.com ---

hormone.
? Cobalt serve as cofactor for

enzyme Glycyl-Glycine

--- Content provided by‍ FirstRanker.com ---

Dipeptidase of intestinal

juice.

--- Content provided by FirstRanker.com ---

Excretion Of Cobalt

?65% of ingested

Cobalt is excreted

--- Content provided by​ FirstRanker.com ---

almost through Urine.
Disorders Of Cobalt Metabolism

? Cobalt deficiency in humans is a

--- Content provided by‌ FirstRanker.com ---

rare deficiency of Vitamin B12 leads

to Macrocytic Anemia.

--- Content provided by⁠ FirstRanker.com ---

? Cobalt toxicity results in

overproduction of R.B.Cs causing

--- Content provided by​ FirstRanker.com ---

Polycythemia.

Chromium Metabolism
?Traces of Chromium

--- Content provided by‌ FirstRanker.com ---

plays important role in

Carbohydrate ,Lipid and

Protein Metabolism.

--- Content provided by‍ FirstRanker.com ---

RDA Of Chromium

?10 -100 g/day is RDA

--- Content provided by⁠ FirstRanker.com ---

of Chromium for an

Adult body.
Dietary Sources Of Cr

--- Content provided by‌ FirstRanker.com ---

? Yeast
? Cheese
? Grains
? Cereals
? Meat

--- Content provided by FirstRanker.com ---

? Food cooked in Steel vessels

increases Chromium contents of

food .

--- Content provided by⁠ FirstRanker.com ---

Absorption

?Chromium is mainly

--- Content provided by‌ FirstRanker.com ---

absorbed from smal

intestine.

?It is transported through

--- Content provided by⁠ FirstRanker.com ---

Transferrin.
Body Distribution Of Chromium

? Human body contains about 6mg

--- Content provided by FirstRanker.com ---

of Chromium mainly resides in

Mitochondria, Microsomes and

--- Content provided by​ FirstRanker.com ---

Cytosol of Liver cells.

? Blood levels of Chromium 20 g %

Biochemical Functions Of Chromium

--- Content provided by⁠ FirstRanker.com ---

? Role of Cr in Carbohydrate

Metabolism:

--- Content provided by‌ FirstRanker.com ---

? Trivalent Cr is known as Glucose

Tolerance Factor

? Since Cr along with Insulin promotes

--- Content provided by​ FirstRanker.com ---

the uptake and utilization of Glucose

by cel s (Cr alone is ineffective).

--- Content provided by‌ FirstRanker.com ---

? Thus Cr is true promoter of Insulin.
? Role of Cr In Lipid

Metabolism:

--- Content provided by FirstRanker.com ---

? Chromium lowers the Serum

Cholesterol levels

? Decreases and prevents

--- Content provided by‌ FirstRanker.com ---

atheromatous plaque

formation in aorta.

--- Content provided by⁠ FirstRanker.com ---

?Role of Cr in Protein

metabolism:

?Cr participates in the

--- Content provided by⁠ FirstRanker.com ---

transport of amino acids

into the cells of Liver

--- Content provided by​ FirstRanker.com ---

and Heart.
Chromium Related Disorders

? Deficiency of Cr causes

--- Content provided by‌ FirstRanker.com ---

disturbances in

Carbohydrates ,Lipid and

Protein metabolism

--- Content provided by‌ FirstRanker.com ---

? Causes impaired Glucose

tolerance.

--- Content provided by⁠ FirstRanker.com ---

Chromium Toxicity:

? Hexavalent Cr is more

toxic than Trivalent Cr.

--- Content provided by​ FirstRanker.com ---

? Cr toxicity increases lung

cancer ,Liver and Kidney

--- Content provided by‌ FirstRanker.com ---

damage.
List Of Minerals With

Antioxidant Activity

--- Content provided by‍ FirstRanker.com ---

?Selenium
?Copper
?Zinc
?Manganese

--- Content provided by‍ FirstRanker.com ---

List Of Minerals

With Neuro Muscular Activity

? Calcium

--- Content provided by​ FirstRanker.com ---

? Sodium
? Potassium
? Chloride
List OF Minerals

--- Content provided by‍ FirstRanker.com ---

With Bone Involvement

? Calcium

? Phosphorous

--- Content provided by FirstRanker.com ---

? Magnesium

? Copper

--- Content provided by FirstRanker.com ---

? Fluorine

Elements of Human Body

--- Content provided by FirstRanker.com ---

Questions
Long Essays

? Q.1.Enumerate the Principle

--- Content provided by‌ FirstRanker.com ---

elements of our body? Describe the

calcium metabolism with respect to

dietary rich sources, RDA, factors

--- Content provided by‌ FirstRanker.com ---

affecting its absorption, distribution,

functional role, excretion & disorders

--- Content provided by⁠ FirstRanker.com ---

associated with it.

? Q.2.Describe the Phosphorous

metabolism in details with

--- Content provided by FirstRanker.com ---

respect to dietary sources,

RDA, absorption, functions &

--- Content provided by FirstRanker.com ---

disorders associated with it.
? Q.3.Enumerate the body

electrolytes. Describe the role

--- Content provided by‍ FirstRanker.com ---

of Na, K & Cl in the body.

? Q.4.Name the trace elements

in the body. Describe in details

--- Content provided by​ FirstRanker.com ---

of Iron metabolism.

? Q.5.Describe the role of trace

--- Content provided by⁠ FirstRanker.com ---

elements in the body with

respect to Cu, I2, Fl, Mn, Se,

Zn & Mo.

--- Content provided by⁠ FirstRanker.com ---

? Q.6.Describe the Magnesium

metabolism in details.

--- Content provided by FirstRanker.com ---

? Short Notes

?Factors affecting calcium absorption.

?Homeostasis of calcium/Regulation of

--- Content provided by‌ FirstRanker.com ---

serum calcium.

?Condition of Hypercalcemia &

--- Content provided by‌ FirstRanker.com ---

Hypocalcemia.

?Role of Calcitriol in calcium

metabolism.

--- Content provided by FirstRanker.com ---

?Tetany.

?Transferrin & Ferritin/Transport &

--- Content provided by FirstRanker.com ---

storage of Iron.

?Mucosal Block Theory/Absorption

of Iron.

--- Content provided by FirstRanker.com ---

?Differences between Ferritin and

Hemosiderin.

--- Content provided by‍ FirstRanker.com ---

?Nutritional Hemosiderosis/Bantu's

Siderosis.
?Hemochromatosis/Bronz

--- Content provided by⁠ FirstRanker.com ---

e Diabetes.

?Iron deficiency Anemia-

cause & clinical

--- Content provided by​ FirstRanker.com ---

manifestations.

?Wilson's disease

--- Content provided by‌ FirstRanker.com ---

?Menke's disease.

?Goiter

?Flurosis/Genu Valgum

--- Content provided by‌ FirstRanker.com ---

?Selenosis/Selenium Toxicity

?Deficiency of Zinc

--- Content provided by‌ FirstRanker.com ---

?Conditions of Hypernatremia &

Hyponatremia.

?Causes of Hyperkalemia &

--- Content provided by‍ FirstRanker.com ---

Hypokalemia


?Clinical significance of Phosphorous.

--- Content provided by⁠ FirstRanker.com ---

?Give the list of Zn, Mg, Cu, Se, Cl, Mo

requiring enzymes of human body.

?Role of Ceruloplasmin.

--- Content provided by⁠ FirstRanker.com ---

?Keshan's disease
?Justify Iron is one-way element.
?How serum electrolytes are estimated?

What are its normal values present in

--- Content provided by FirstRanker.com ---

blood.

Thank you