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Nutritional Elements Deficiency Sources Toxicity Treatment and Absorption in Human Body

Posted By HealthcareOnTime Posted on 2021-09-20
Nutritional Elements Deficiency Sources Toxicity Treatment and Absorption in Human Body

Boron

- Abundance On Earth-0.00086% In Human Body-0.00003% Boron is a soft, brown element found in small amounts in the human body. Trace minerals occur in the soil, in foods and in our body at much lower levels than the macro minerals, so they become more easily depleted.

Absorption in the Body Boron as borate is readily, and almost completely absorbed from the human gut and appears rapidly in the blood and body tissues. Unlike soft tissues and blood, bone takes up boron selectively four times higher than its levels in blood serum. Boron also remains for a longer duration in the bone before its elimination. It is predominantly excreted in the urine as borate.

Deficiency Boron deficiency is much more common than its toxicity. When its deficiencies occur, important metabolic functions like blood sugar regulation or specific substances and enzymes in the body do not work properly. Boron deficiency has not been observed definitively in human populations. However, it has been suggested that boron deficiency could be a contributing factor to Kashin-Beck Disease (KBD), a musculoskeletal deficiency which may cause severe joint deformity. Short periods of restricted boron intake may affect brain function and cognitive performance in healthy humans.

Dietary Sources Per day body need: 1-13 mg Boron is predominantly found in nuts, legumes, fresh fruits and green vegetables; cider and beer are rich in boron while meat, fish and dairy products are poor sources. It is present in a number of multi-vitamin and mineral food supplements.

Sources of Exposure Occupational exposure to Boron occurs in various industries like borate mines, processing plants, glass manufacturing plants, e-learning products manufacturing plants, as well as fertilizers, pesticides and cosmetic industries. Toxicity may also occur due to overdose of Boron supplements. Many athletes may choose to take boron supplements as it increases testosterone levels and thus builds body muscle mass.

Toxicity Boron is not a particularly toxic element, however, accidental exposure to acute, lethal dose of boric acid can cause irritability, seizures and gastrointestinal disturbances, as boric acid is not metabolised in body. There have also been reports of inflammation, congestion, oedema, exfoliative dermatitis, exfoliation of the mucosa and findings of cloudy swelling and granular degeneration of renal tubular cells.

Indicators of chronic excessive boron intake are not well defined. However, elevated blood boron and urinary excretion of boron are indicators of acute and possibly chronic excessive intake of boron in humans.

Treatment Treatment for toxicity involves identifying the source of the toxicity and removing the patient from the source of exposure. Boron toxicity can be avoided in most patients with a few precautions. In patients on oral contraceptives or hormone replacement therapy, boron should not be consumed as a supplement because it may lead to increased estrogen levels. It should also be avoided in patients with impaired renal function as it is primarily excreted via the kidneys. Boron overdose has rarely resulted in death so removing the source of the exposure and providing treatment could aid in relieving many symptoms of boron toxicity.

Global Statistics A small study of Russian male workers exposed for 10 or more years to high levels of vapours and aerosols of boron salts (22-80 mg/m) involved in borax mining and the production of borates and boric acid suggested low sperm count, reduced sperm motility, changes in seminal fluid composition and decreased sexual function.

Chromium

- Abundance In Human Body-0.00002% On Earth-0.014% Chromium is a mineral that humans require in trace amounts. It is an essential mineral which enhances the action of insulin to regulate blood sugar levels in the body. Insulin is a hormone that our body uses to change sugar, starches and other food into energy needed for daily life. It also slows the loss of calcium, so it may help prevent bone loss in women during menopause.

Absorption in the Body Absorption of chromium from the intestinal tract is low, ranging from less than 0.4% to 2.5% of the amount consumed and the unabsorbed part is excreted in feces. Enhancing the mineral's absorption are vitamin C (found in fruits, vegetables and their juices) and vitamin B or niacin (found in meats, poultry, fish, and grain products). Absorbed chromium is stored in the liver, spleen, soft tissue and bone.

Deficiency The body's chromium content may be reduced under several conditions. Diets high in simple sugars can increase chromium excretion in the urine. Infection, acute exercise, pregnancy, lactation and stressful states (such as physical trauma) increase chromium losses and can lead to deficiency, especially if chromium intakes are already low. Deficiency of chromium can result in diabetes and atherosclerosis. Low chromium levels may cause high cholesterol levels which in turn increase the risk for Coronary Artery Disease (CAD).

Dietary Sources Per day body need: 24.5-37 ug Broccoli, potato, grape juice, orange, bran cereals as well as meat like beef, turkey, oyster, and egg are relatively good sources of Chromium.

Sources of Exposure Chromium has been reported in areas near landfills, hazardous waste disposal sites, chromate industries and highways. It enters in different compartments of environment (air, water and soil) through dye and pigment manufacturing, alloys manufacturing, electroplating industries, etc.

Toxicity Chromium usually occurs in an industrial environment where concentrations in the air are high or contact with the skin is frequent. Trivalent chromium has a low toxicity, hence deleterious effects of excessive intake of this form of chromium does not occur readily. Hexavalent chromium is much more toxic than the trivalent form; oral administration of 50 pg/g in diet has been found to induce growth of depression, together with liver and kidneys damage.

Treatment As our body normally removes chromium rapidly, the exposure should be stopped immediately in order to remove the toxic effects. Thereafter, the symptoms can be managed. However, acute chromium poisoning may result in death as there is no proven antidote. In these cases, supportive measures may include mechanical ventilation, cardiovascular support and monitoring of kidney and liver function.

Global Statistics The carcinogenicity of chromate dust has been known for a long time; in 1890 as publication first described the elevated cancer risk in workers in a chromate dye industry. In some parts of Russia pentavalent chromium was reported as one of the causes of premature dementia.

Cobalt

Abundance In Human Body-0.000004% On Earth-0.003% Cobalt is another essential mineral needed in very small amounts in the diet. It is an integral part of vitamin B12, or cobalamin, which supports red blood cell production and the formation of myelin nerve coverings. Some healthcare organisations do not consider cobalt to be essential as a separate nutrient since it is needed primarily as part of vitamin B which is itself essential. Cobalt, as part of vitamin B is used to prevent anemia, particularly pernicious anemia; vitamin B is also beneficial in some cases of fatigue, digestive disorders and neuro-muscular problems.

Absorption in the Body Cobalt, as part of vitamin B, is not easily absorbed from the digestive tract. The normal level of cobalt in body is 80-300 ug. It is stored in the red blood cells and the plasma, as well as in the liver, kidney, spleen, and pancreas.

Deficiency Deficiency of cobalt is not really a concern if we get enough vitamin B12. Vegetarians need to be more concerned than others about getting enough cobalt and vitamin B. The soil is becoming deficient in cobalt, further reducing the already low levels found in plant foods. As cobalt deficiency leads to decreased availability of vitamin B, there is an increase in many symptoms and problems related to vitamin B deficiency, particularly pernicious anemia and nerve damage.

Dietary Sources Per day body need: 0.12 ug Meat, liver, kidney, clam, oyster and milk contain some amount of cobalt. Sea foods contain cobalt, but land vegetables have very little amounts; some cobalt is available in legumes, spinach, cabbage, lettuce, beet greens and fig.

Sources of Exposure Accidental exposure could occur in industries like ceramic industry, glass industry, magnet manufacturing company, industry of hard metal or fritted metals. The grinding of surgical and dental prostheses (alloy with nickel, chromium and molybdenum) can involve exposure to cobalt as well as the polishing of diamonds using discs made up of microdiamonds whose binding agent is cobalt. It is present in trace amounts in some cements as well.

Toxicity Toxicity can occur from excess inorganic cobalt found as a food contaminant. Cobalt causes cardiomyopathy and congestive heart failure. Increased intake may affect the thyroid or cause overproduction of Red blood cells, thickened blood and increased activity in the bone marrow.

Treatment - Treatment for skin contact Since rashes are rarely serious, very little will be done for the same. The area may be washed and a skin cream may be prescribed.

- Treatment for lung involvement Breathing problem will be treated based on symptoms. Breathing treatments and medications to treat swelling and inflammation in lungs may be prescribed. X-rays may be taken.

- Treatment for swallowed cobalt In the rare cases where large levels of cobalt is detected in blood, hemodialysis is performed and medications (antidotes) to reserve the effects of the poison may be given.

Global Statistics in the 1960s, some breweries added cobalt to beer to stabilize the foam. Some people who drank large quantities of the beer experienced nausea, vomiting and serious effects on the heart.

Copper

- Abundance On Earth-0.0068% In Human Body-0.70% copper is required in the formation of hemoglobin, red blood cells and for healthy bones. It helps with the formation of elastin as well as collagen, making it necessary for wound healing. It works closely with iron for these functions.

It is a vital component of a number of essential enzymes. It is essential for energy production, connective tissue formation, iron metabolism, melanin formation and it also has an antioxidant function. It is also necessary for manufacture of the neurotransmitter noradrenaline as well as for the pigmentation of hair.

Absorption in the Body Copper absorption may be decreased by excess dietary iron or zinc. Conversely, too much copper may cause an iron deficiency. Copper may be absorbed by both the stomach and small intestinal mucosa, with most absorbed by the small intestine. Copper is found in the blood bound to proteins.

Deficiency Severe copper deficiency is relatively uncommon, yet approximately 25% of the population may be at a risk of copper deficiency. Copper deficiency has been shown to cause anemia and a drop of HDL (High Density Lipoprotein) cholesterol or the "good" cholesterol. Other symptoms of copper deficiency include diarrhea and stunned growth; some studies have found that patients with mental and emotional problems also have low levels of copper.

Dietary Sources Per day body need: 0.6-0.7 mg Large amounts of copper can be found in seafood, especially oyster and other shellfish. Nuts, dried legumes, whole grain products, potato, prune, chocolate and liver also contain copper. One can also obtain significant amounts of copper through their drinking water.

Sources of Exposure The most common sources of poisonous copper include blue vitriol, copper sulphate and verdigris. Physical contact with large quantities of copper is an occupational hazard in various metal work and construction jobs. Common sources of accidental exposure include aquarium products, fungicides and insecticides.

Toxicity Although small amount of copper is essential, excess amount can be toxic. Too much copper can lead to variety of conditions, including hemolytic anemia, emotional problems, behavioural disorders, mood swings, Depression, liver damage and also damage to the central nervous system. Using oral contraceptives and smoking (tobacco) may also lead to a rise in the amount of copper found in the blood and may cause hypertension.

Treatment The main thing to do is increase Zinc and magnesium levels to calm the mind and nervous system. Ingesting activated charcoal is also effective in treating copper poisoning. Prolonged exposure may require dialysis. Treatment involves milk diet with drugs for the pain and diarrhea.

Global Statistics Chronic copper toxicity include Indian childhood cirrhosis and Tyrolean infantile cirrhosis; these cases are related to high exposure to copper due to animal milk stored or heated in copper or copper alloy containers.

lodine

- Abundance On Earth-0.000049% In Human Body-0.00002% lodine is an essential element that enables the thyroid gland to produce thyroid hormones. Three iodine atoms are added to the tyrosine residue to make T3 (triiodothyronine) and four for T4 (thyroxine)-the two key hormones produced by the thyroid gland. Hence, iodine is essential for the production of these two hormones of the master gland of metabolism, which in turn regulates the conversion of fat to energy, stabilizing our body weight as well as controlling our cholesterol levels.

These hormones produced from iodine are also needed to help form our bones as well as to keep our skin, nails, hair and teeth in prime condition.

Absorption in the Body lodine, upon absorption in the bloodstream is concentrated within the thyroid gland by an active transport system called the "lodine Pump". In the thyroid, iodine is oxidized to iodide by the enzyme iodine peroxidase. In this form, iodine is incorporated into tyrosine residues of the protein thyroglobulin, whereupon it forms the active hormones thyroxine (T4) and triiodothyronine (T3).

Deficiency 18 million children per year are born with impaired mental abilities because of iodine deficiencies. Nearly two billion individuals have insufficient iodine in their diets, including one third of all school aged children. Populations with chronic iodine deficiency showed a reduction in their Intelligence Quotient (IQ) of 12.5 to 13.5 points.

A severe iodine deficiency can cause hypothyroidism and even developmental brain disorders and severe goiter. Less severe iodine deficiency is linked to hypothyroidism, thyroid enlargement (goiter) and hyperthyroidism. It can also lead to cretinism, the most serious form of mental retardation and associated physical disabilities.

Dietary Sources Per day body need: 100-150 ug Some good sources of iodine are egg, seafood, iodized salt, iodine-containing herb like kelp.

Sources of Exposure Accidental or deliberate ingestion or medical procedures such as wound irrigation could be the possible sources of exposure. Food sources of iodine that have caused adverse effects include naturally occurring iodine in water supplies and seaweed, and ground beef containing thyroid issue. Other food sources are foods to which iodine was added as part of a supplementation program (e.g. iodized water, bread or salt) and milk.

Toxicity Excess dietary iodine is on the rise and has many nutritionists concerned. Excessive intake of iodine may result in a condition known as iodine goiter. This type of goiter is characterized by an enlargement of the thyroid gland and might be erroneously diagnosed as goiter resulting from insufficient iodine intake. Research indicates that excess iodine may initially induce acne -like skin lesions or worsen pre-existing acne and can result in the inhibition of thyroid hormones synthesis, with the effects being most pronounced in patients with hyperthyroidism.

Treatment Life supportive procedures and symptomatic/specific treatment; support cardiovascular and respiratory functions. Oxygen with assisted ventilation may be needed. Treatment is given for an anaphylactic type reaction. Dialysis is reported to be effective in an early phase, Saline diuresis is useful, if renal function is adequate.

Global Statistics Endemic goiter is currently more common in developing countries and typically occurs in mountainous areas such as the Andes, Himalayas and the mountain chain extending through Southeast Asia and Oceania.

Iron

- Abundance On Earth-6.3% In Human Body- < 0.05% The main role of iron in the body is in the red blood cells. Here it combines with a protein to form a substance called hemoglobin. When we breathe in, oxygen in our lungs is attracted to the iron in hemoglobin and combines with it to form oxyhemoglobin. This is transported around the body by the red blood cells and oxygen is released whenever it is needed to allow the conversion of carbohydrates (sugars) into energy. This is why blood in the arteries is bright red, whereas blood in the veins (which return blood to the heart and lungs for a further dose of oxygen) is darker in color.

Absorption in the Body Like most mineral nutrients, the majority of the iron absorbed from digested food sources or supplements is absorbed in the small intestine, specifically to duodenum. Iron enters the stomach where it is exposed to stomach acid and changes into a form that allows it to be easily absorbed. From there it enters the mucosal sites of the duodenum (the first section of the small intestine) where most of the iron absorption takes place.

Deficiency Iron deficiency is a condition resulting from too little iron in the body. Iron deficiency is the most common nutritional deficiency and the leading cause of anemia. Too little iron in the blood can lead to paleness, tiredness and lethargy, making it harder to concentrate, and affecting our performance at school or work. Resistance to illness, such as infections, coughs and cold, is also weaker.

A spoon shaped appearance of the fingernails (Koilonychia) may occur in iron deficiency and soreness of the corners of the mouth and tongue may be present.

Dietary Sources Per day body need: 8-27mg Lean red meat, other meats (chicken, poultry, pork) and fish are good sources of easy-to-absorb iron. Tofu, iron fortified breakfast cereal, cooked bean, spinach, broccoli, chickpea, red kidney bean, date and lentils are good sources of iron.

Sources of Exposure Cookware, iron pipes, drinking water in iron rich soil areas, occupational exposure in welders, sheet metal workers, machinists, plumbers, auto mechanics, steel workers and other workers exposed to iron and steel can absorb large quantities of iron through contact. Long term consumption of iron supplements, if selfprescribed, can cause iron overload.

Toxicity Having too much iron in the blood is also possible, but is much less common. It can be caused by taking iron supplements when not needed, a high alcohol intake, hepatitis or haemochromatosis. Sickle cell disease, thalassemia, enzyme deficiency diseases such as pyruvate kinase, glucose 6 phosphate dehydrogenase (G6PD) can also cause iron toxicity. Numerous blood transfusions and excessive iron therapy can also result in toxicity.

Treatment Several methods are used for congenital haemochromatosis. Phlebotomy or bleeding, is still used. Desferrioxamine-B is a chelating agent that is occasionally used to enhance urinary excretion of iron.

Global Statistics In Kerala, iron toxicity problems were reported since early 1930s in Kuttanad. This acute problem of iron toxicity is present in around 80,000 hectares of soil in Kuttanad.

Manganese

- Abundance On Earth-0.11% | In Human Body-0.00002% The adult human body contains about 10 to 20 mg of manganese. Most of this is concentrated in the pancreas, bone, liver and kidneys. It acts as a catalyst and cofactor in many enzymatic processes involved in the synthesis of fatty acids and cholesterol. It is also an essential cofactor of important enzymes active in the mitochondria and in the synthesis of glycoproteins, which coat body cells and protect against invading viruses. Mucopolysaccharide is an important constituent in both skeletal and cartilage structural matrix. Because of its role in mucopolysaccharide synthesis, manganese is important in skeletal and connective tissue development.

Absorption and Excretion Manganese metabolism is similar to that of iron. It is absorbed in the small intestine and while the absorption process is slow, the total absorption rate is exceptionally high- about 40%. Excess manganese is excreted in bile and pancreatic secretion. Only a small amount is excreted in urine.

Deficiency Manganese deficiency is associated with nausea, vomiting, poor glucose tolerance (high blood sugar levels), skin rash, loss of hair colour, excessive bone loss, low cholesterol levels, dizziness, hearing loss, and compromised function of the reproductive system. Severe manganese deficiency in infants can cause paralysis, convulsions, blindness and deafness. Manganese activates several enzyme systems and supports the utilization of vitamin C, vitamin E, choline and other B-vitamins. Inadequate choline utilization reduces the acetylcholine synthesis, causing conditions such as myasthenia gravis (loss of muscle strength).

Dietary Sources Per day body need: 2-5 mg Excellent food sources of manganese include mustard greens, raspberry, pineapple, strawberry, spinach, garlic, summer squash, grape, brown rice, maple syrup, clove, cinnamon, black pepper and turmeric. Very good sources of manganese include tofu, broccoli, beet, whole wheat, cucumber, peanut, banana, carrot, cashew, bell pepper and onion

Sources of Exposure The primary anthropogenic sources of manganese in ambient air include emission of manganese from industrial sources such as ferroalloy production plants, iron and steel foundries, power plants and coke ovens. High levels and chronic exposure to manganese could be through drinking water. Higher inhalation exposures may be experienced in occupational settings such as manganese mines, foundries, smelters and battery manufacturing facilities.

Toxicity Ingestion of large amounts of manganese may result in elevated concentrations of manganese in the liver, but there are no ill effects overall. Ingestion of potassium permanganate can result in acute poisoning, with symptoms of capillary damage, jaundice, and tissue damage in the gastric mucosa of the intestine. Excessive inhalation of manganese dust has resulted in manganese poisoning, with symptoms such as involuntary laughing, impotence, blurred speech, mask-like facial expression, hand tremors and spastic gait. This poisoning has been noticed and documented primarily in manganese ore miners.

Treatment Para-aminosalicylic acid, an FDA-approved drug used in the treatment of Tuberculosis, has been used successfully in the treatment of severe manganese (Mn)-induced Parkinsonism in humans. When high levels of manganese export results in instances of manganism or manganese poisoning, chelation therapy is often used. Chelation therapy works by intravenously administering EDTA and the drug will travel through the body gathering the manganese and carries it through the bloodstream where it will later be washed out in the urine.

Global Statistics John Couper was the first to report neurological effects associated with exposure to Mn in the scientific literature in 1837, when he described muscle weakness, limb tremor, whispering speech, salivation and a bent posture in five men working in a Manganese ore crushing plant in France. He called this collection of symptoms 'manganese crusher's disease', which was later recognized as 'manganism'.

Molybdenum

- Abundance On Earth-0.00011% In Human Body-0.000007% Molybdenum is found in several tissues of the human body and is required for the activity of some enzymes that are involved in catabolism of purines and the sulfur amino acids. As a dietary mineral, molybdenum is part of sulfite oxidase. Sulfite oxidase breaks down sulfites that are present in many chemically preserved foods as well as specific food proteins. Break down of sulfites results in reduction of toxic build-up and promotes overall healthy body function.

Some of the primary functions include promoting healthy and regulated cell functions as well as aiding in nitrogen metabolism. Molybdenum has been shown to help fight cancer-causing nitrosamines and even assist in preventing cavities. The most commonly associated function of molybdenum is its role in the production of uric acid.

Absorption in the Body The body absorbs molybdenum quickly in the stomach and in the small intestine. The mechanism of absorption is uncertain. Following absorption, molybdenum is transported by the blood to the liver and to the other tissues of the body. In the molybdate form, it is carried in the blood bound to a alpha-macroglobulin and by adsorption of red blood cell. The liver and kidneys store the highest amounts of molybdenum

Deficiency A deficiency of molybdenum in our diets can cause mouth and gum disorders and cancer. A diet high in refined and processed foods can lead to a deficiency of molybdenum, resulting in anemia (lack of oxygen in blood) and loss of appetite and weight. In a rare inherited metabolic disorder, molybdenum deficiency is associated with genetic deficiency of the molybdenum pterin cofactors. Neurological disorders, abnormal urinary metabolites, dislocated ocular lenses and failure to thrive are observed. The disorder is fatal by the age of 2-3 years.

Dietary Sources Per day body need: 45ug Peas, beans, lentils, cereal products, almond, leafy vegetables, chestnut, peanut, cashew, soybean, yogurt, cottage cheese, egg, tomato and low-fat milk are good sources of molybdenum. Sources of Exposure Exposure commonly occurs during the liberation of dust from mining and the processing of ore, from the grinding of metals or alloys, from oxyacetylene cutting and from dust from its various compounds.

Toxicity Food or water must contain more than 100 mg/kg to produce signs of toxicity, which include diarrhea, anemia and high levels of uric acid in the blood. Elevated uric acid levels , which are associated with the onset of gout, are hypothesized to be caused by stimulation of xanthine oxidase by high molybdenum intake. Occupational exposure by inhalation of molybdenum containing dusts has been associated with pneumoconiosis.

Treatment Persons exposed to hazardous concentrations of molybdenum should be removed from further exposure. Treatment is symptomatic and no specific therapy is available for removal molybdenum tissues . Treatment of joint complaints is supportive.

Global Statistics In Russia, 503 workers in a powder metallurgy plant were exposed to dusts containing molybdenum. The inspiratory, expiratory and vital capacities were determined. All the three capacities were observed to be reduced in 17.8% of molybdenum workers, 12.9% of sulphuric acid workers and 7.2% of sintered carbide workers. A pathological ratio of expiratory and inspiratory capacities, which may be an indication of bronchospasm, was encountered with a comparatively greater frequency among molybdenum workers than among those working in other departments. The nature of the molybdenum to which the workers were exposed was not clear but was probably molybdenum trioxide fume and molybdenum metal powder.

Nickel

- Abundance On Earth-0.0089% | In Human Body-0.00002% Nickel plays a major role in helping the body absorb the iron it needs. Additionally, nickel prevents conditions such as anemia and helps in building strong skeletal frames by strengthening bones.

It is also present in DNA and RNA which means it is found in every cell of the human body. It assists in breaking down glucose, helps in creating energy for daily use and even contributes to the production of certain enzymes that initiate important chemical reactions such as the development of nucleic acids.

Absorption in the Body The absorption of nickel is affected by the presence of certain foods and substances including milk, coffee, tea, orange juice and ascorbic acid. Nickel is transported in blood bound primarily to albumin. Although most tissues and organs do not significantly accumulate nickel, in humans the thyroid and adrenal glands have relatively high nickel concentrations (132 to 141 vg/kg dry weight). Most organs contain less than 50 ug of nickel/kg dry weight.

Because of the poor absorption of nickel, the majority of ingested nickel is excreted in the feces. The majority of absorbed nickel is excreted in the urine with minor amounts excreted in sweat and bile.

Deficiency Nickel deficiencies are rare, but when they do occur, they can be extremely serious. Those with a higher risk of developing a nickel deficiency are people who are suffering from kidney problems, cirrhosis of the liver or have vitamin B6 deficiency. Symptoms can range from urinary tract infections to severe allergic reactions, most often seen in the form of skin rashes.

In very severe cases, those who suffer from a nickel deficiency may experience paralysis alongside inflammation of the liver and lungs.

Dietary Sources Per day body need: <200 ug Nuts, dried beans, peas, grains, fruits, vegetables, shellfish, leguminous seeds, egg and milk are good sources of nickel.

Sources of Exposure Natural sources of atmospheric nickel include dusts from volcanic emissions and the weathering of rocks and soils. Natural sources of aqueous nickel are derived from biological cycles and solubilization of nickel compounds from soil. Anthropogenic sources include emissions from fossil fuel consumption, industrial production as well as use and disposal of nickel, and alloy compounds. The consumption of nickel-containing products leads to environmental pollution by nickel. Occupational exposure to nickel occurs predominantly in mining, alloy production, electroplating and welding.

Toxicity The ingestion of high doses of soluble nickel salts cause nausea, abdominal pain, diarrhea, vomiting and shortness of breath. In persons with hypersensitivity to nickel, oral exposure has been reported to result in contact dermatitis-like symptoms.

Treatment Patients in the moderate and severe categories of acute Ni(CO), poisoning should be treated immediately with a chelating drug, sodium Diethyldithiocarbamate (DDC). The beneficial effect of DDC in acute Ni(CO), poisoning has been attributed to diminution of the pulmonary nickel burden. Hemodialysis would be the therapy of choice for patients with acute Ni" poisoning, if renal function fails, or if cardiotoxicity and neurotoxicity become life-threatening. Chelation with DDC is not recommended in severe Ni** toxicity because DDC enhances the cerebral uptake of Ni'. Immediate supportive treatment should also be included.

Global Statistics An investigation of respiratory tract cancers in former workers at a Canadian nickel sinter plant demonstrated that the excess risk of death from cancers of the lung or nasal cavities continued for as long as 30-40 years after leaving the sinter plant; this reflects long-term persistence of carcinogenic nickel compounds in the respiratory tract mucosa.

Selenium

- Abundance On Earth- 5 x 10 % | In Human Body-0.00002% Selenium is an essential trace mineral in the human body. This nutrient is an important part of antioxidant enzymes that protect cells against the effects of free radicals that are produced during normal oxygen metabolism. The body has developed defenses such as antioxidants to control levels of free radicals because they can damage cells and contribute to the development of some chronic diseases. It is also essential for normal functioning of the immune system and thyroid gland.

Absorption in the Body Absorption of selenium occurs mainly at the lower end of the small intestine. All forms of selenium, organic as well as inorganic are readily absorbed. Ingested selenium is transported in the blood from the intestine to the liver. There, it is reduced to selenide before being transported into the blood. The highest levels of selenium are deposited in red blood cells, liver, spleen, heart, nails and tooth enamel.

Deficiency Selenium deficiency is most commonly seen in parts of China where the selenium content in the soil is low. The cereals grown on this soil contain lower amount of selenium, therefore selenium intake is very low. Selenium deficiency is linked to Keshan disease. Signs of Keshan disease are an enlarged heart and poor heart function. It also affects thyroid function because selenium is essential for the synthesis of active thyroid hormones.

Selenium deficiency has been seen in people who rely on Total Parental Nutrition (TPN) as their source of nutrition. TPN is a method of feeding nutrients through an intravenous line to people whose digestive system do not function. Severe gastrointestinal disorders may decrease the absorption of selenium, resulting in selenium depletion or deficiency.

Dietary Sources Per day body need: 50-200 ug Cereals and cereal products, meat, egg, fish, pulses, dairy products, fruits and vegetables, shellfish, crab, kidney, liver and brazil nut are the dietary sources.

Sources of Exposure Selenium poisoning is not reported frequently in humans apart from incidents that include industrial accidents, accidental ingestion, suicide or attempted murder.

Toxicity Taking too much selenium can result in a condition called selenosis, which is characterized by hair loss, nausea, irritability and fatigue. This is rare in the developed world. There is no clearly defined syndrome of selenium toxicity. Long term ingestion of high amounts may cause problems with tooth enamel and strength, as higher selenium level seem to increase tooth decay. Some subtle symptoms that have been experienced include a garlic odour, metallic taste or dizziness. Acute selenium poisoning can lead to fever, anorexia, gastrointestinal symptoms, liver and kidney impairment and even death, if the levels are high enough.

Treatment Although the treatment of selenium poisoning is not reviewed here, several points are worth emphasizing
1) The most important aspects of treatment are supportive care and the prevention of further exposure.
2) Chelation is not recommended since animal studies suggest it may increase toxicity.
3) Emesis is not recommended, particularly if a caustic compound such as selenite is involved.

Global Statistics Periodic outbreaks of selenosis have occurred in regions of China where high concentrations of selenium are found in the soil. Selenium toxicity is rare in the US, with the few reported cases being associated with accidental exposure.

Fatty Acid Oxidation Profile (19)
- Tetradecanoylcarnitine (C14)
- Palmitoylcarnitine (C16)
- Carnitine (CO)
- Glutaryl-/OH Decanoylcarnitine (CSDC)
- Tetradecenoylcarnitine (C14:1)
- OH Hexadecenoylcarnitine (C16:1-OH)
- OH Palmitoylcarnitine (C16-OH)
- Linoleylcarnitine (C18:2)
- Oleylcarnitine (C18:1)
- OH Oleylcarnitine (C18:1-OH)
- OH Stearylcarnitine (C18-OH)
- Hexanoylcamitine (C6)
- Octanoylcarnitine (C8)
- Decenoylcarnitine (C10:1)
- Decanoylcarnitine (C10)
- OH Butyrylcarnitine (C4-OH)
- Butyryl-/Isobutyrylcarnitine (C4)
- Dodecanoylcarnitine (C12)
- Stearylcarnitine (C18)

Organic Acid Profile (7)
- Glutaryl-/OH Decanoylcarnitine (CSDC)
- Methylglutarylcarnitine (C6DC)
- Butyryl-/Isobutyrylcarnitine (C4)
- Isovaleryl-/2-Methylbutyrylcarnitine (C5)
- OH Butyrylcarnitine (C4-OH)
- Propionylcarnitine (C3)
- Tiglylcarnitine (C5:1)

Amino Acid Profile (9) - Arginine
-Methionine
-Phenylalanine
-Leucine/Isoleucine -Valine
-Phenylalanine
-Tyrosine
-Argininosuccinic acid
-Citrulline

Biochemical Profile (7)
- 17-hydroxyprogesterone (17-OHP)
- Immunoreactive Trypsinogen (IRT)
- Total Galactose
- Thyroid Stimulating Hormone (TSH)
- Biotinidase
- Phenylalanine
- Glucose-6-Phosphate Dehydrogenase (G6PD)

Hemoglobinopathy Profile (6)
- Hemoglobin A2
- Hemoglobin AD
- Hemoglobin F
- Hemoglobin Variant S
- Hemoglobin Variant D
- Hemoglobin Variant C

Silicon

- Abundance On Earth-27% In Human Body-0.001% Silicon is vital for healthy bone cartilage, organ and connective tissues (artery walls, aorta, trachea, tendons and ligaments) and for fine-looking skin, hair and nails. In the human body, the amount of silicon available is 7g but this amount decreases with age.

It is a calcium re-organizer. It shapes the calcification process and the rate at which calcium is lodged in bone. Silicon might also be of value in the reduction of cholesterol and fats in blood.

It is a necessary element for the process of the construction of antigens and antibodies. Additionally, it stimulates cell metabolism and cell formation, has moderate disinfecting properties and is an antiinflammatory agent. It also protects against toxic aluminum

Absorption in the Body There are many different forms of dietary silicon, all with different absorptions. Silicic acid is the bio available form, especially as monosilicic and disilicic acid. It is easily absorbed from the gastrointestinal tract (50%. 80%). The average absorption of daily silicon intake is less than 50%. The absorption is facilitated by small pores known as aquaporins in intracellular membranes which facilitate the transport of water and silicic acid. Another possibility for silicon uptake by the body is transdermal absorption.

Deficiency Deficiency induces defective connective tissue and bone formation, poorly made articulations and atypical bone development. Arterial disease may develop as a consequence of silicon inadequacy. On the other hand silicon is plentiful (upto 14 times) in the arterial blood vessels in individuals who have no cardiovascular disease. Brittle nails, thin hair, loss of elasticity of the skin, osteopenia are the symptoms of silicon deficiency.

Dietary Sources Per day body need: 13-62 mg High levels of silicon are found in foods derived from plants, particularly grains such as oats, beans, peas, root vegetables, beet, fruits (especially dried), barley or rice. Silicon levels in foods from animal source like sea food is relatively low.

Toxicity Limited data is available on the oral toxicity of silicon in humans and no acute or chronic toxicity data have been identified. The occurrence of silica stones has been reported in patients undergoing antacid therapy with magnesium trisilicate. If inhaled at high concentrations for prolonged time, certain forms of silica can cause silicosis. Silica particles are inhaled into the alveoli of the lung, causing tissue damage that ultimately results in fibrosis which reduces the efficiency of the lungs and results in shortness of breath.

Treatment Individuals exposed to silica who have a positive tuberculin test but negative sputum, having airway obstruction should be treated as for chronic airway obstruction. Some authorities recommend lifelong treatment because the function of alveolar macrophages may be permanently compromised by silica. Patients with silicosis and active pulmonary TB require extension of standard multidrug therapy by at least 3 to 6 months.

Global Statistics At the turn of 20h century in Vermont, USA, introduction of pneumatic tools to the granite cutting industry was followed by a dramatic rise in death rate from silicosis.

Vanadium

- Abundance In Human Body-0.0000002% On Earth-0.019% The mineral vanadium is essential in human nutrition; this nutrient is considered to be an ultra-trace mineral in human body. It inhibits cholesterol formation in the blood vessels and is believed to be involved in energy production. A cofactor of vanadium enzymes accelerate chemical reactions in the body that participates in blood sugar and fat metabolism, thereby helping to build bones and teeth.

Absorption in the Body The absorption is low, about 5-10% of total ingested. Most of it is eliminated in the feces and urine. In humans, vanadium is mainly stored in fats.

Deficiency Low levels of vanadium have not been clearly shown in humans, though there is a suspicion that deficiency can increase susceptibility to heart disease and cancer or may even lead to elevated cholesterol and triglyceride levels.

Dietary Sources Per day body need: 10ug Fat, oil, fresh fruit and vegetable contain the lowest levels of vanadium, whereas whole grain, seafood, meat and dairy product contain more (0.005-0.03 mg/kg). A few foods including spinach, parsley, mushroom and oyster contain relatively high amounts (0.10 mg/kg). It is present in a number of multi-vitamin/mineral dietary supplements at levels of approximately 0.025 mg per day. There are no licensed medicines containing this nutrient.

Toxicity The toxicity of vanadium compounds increases as valency increases, V being the most toxic. In humans, exposure by inhalation causes diverse toxic effects on the respiratory, digestive and central nervous systems, kidney and skin. There are very few reported cases of vanadium toxicity in humans, when it is consumed orally. Supplementation with vanadyl compounds at oral doses of 50-125 mg/day causes cramps, loose stools and green tongue in major cases, whereas fatigue and lethargy are observed in rare cases.

Treatment Treatment is based on the symptoms. Oxygen and bronchodilators are known to provide effective treatment while chelating treatment has not proved to be effective.

Global Statistics There are very few reported cases of toxicity caused by vanadium toxicity, in human.

Zinc

- Abundance On Earth-0.0078% In Human Body-0.003% zinc is necessary for the action of various important enzymes like carbonic dehydrogenase, carboxypeptidase and alcohol dehydrogenase. It is required for protein, DNA and RNA synthesis in body cells. Also, it accelerates the process of wound healing. The highest concentration is observed in the liver, pancreas, kidneys and brain.

Absorption Absorption of zinc salts from food is approximately 2040%, higher being in fish and meat, and lower absorption from cereals as phytate content impairs absorption. The absorption of zinc salts depends on their solubility. Zinc is poorly absorbed from the intestine and most of it is excreted in feces. A small amount of zinc is also excreted through urine. A high calcium and phytate intake interferes with the absorption of zinc.

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Deficiency The deficiency of zinc among human beings is rare. Reports suggest that cirrhosis of liver, pernicious anemia and myocardial infarction occur due to low zinc levels in the blood. Certain cases of growth failure (dwarfism) and hypogonadism are also associated with zinc deficiency.

Deficiency of zinc includes poor prenatal development and growth, mental retardation, impaired nerve conduction and nerve damage, reproductive failure, dermatitis, hair loss, diarrhea, loss of appetite, taste and smell, anemia, susceptibility to infections, delayed wound healing and muscular degeneration.

Dietary Sources Per day body need: 2-13mg Zinc is widely distributed in both animal and vegetable foods. Animal sources of zinc are egg, crab, shellfish, meat (beef, pork, chicken, turkey), oyster, milk and milk products (yogurt, cheese). Vegetarian diets are generally low in their zinc content. Zinc is present in legumes (beans, chickpea), nuts (cashew, almond, peanut) and seeds (wheat, sesame, celery, poppy, sunflower, pumpkin, mustard).

Toxicity The symptoms of acute zinc salt toxicity include abdominal pain, nausea and vomiting. Other reported effects include lethargy, dizziness, aches and pains, convulsions, difficulty in breathing, fainting or change in level of consciousness, fever and chills, inability to urinate, metallic taste, seizures, shock and jaundice.

Treatment Calcium disodium-Ethylene-Diaminetetra Acetic acid (EDTA) and dimercaprol have been successful in lowering serum zinc levels. Zinc-induced copper deficiency requires discontinuation of supplemental zinc and therapy with oral or intravenous copper, if necessary.

Global Statistics Recent population level analyses from food balance sheets have estimated that 21% of the world's population is at risk for zinc deficiency. World Health Organisation (WHO) has identified zinc deficiency as a major risk to child health and they have linked it to morbidity from diarrhea (10%), lower respiratory tract infections (6%) and malaria (18%) accounting for 0.8 million child deaths per year.

 

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