Mineral Deficiencies

Multiple elevated cytokines are likely responsible for the commonly observed reduction in serum mineral concentrations. This is known as part of the cytokine-mediated inflammatory response. In addition, in patients with injury, infection, or cancer, the reduced mineral content may also occur secondary to poor oral intake, increased requirements, and excessive urinary and stool losses.

Magnesium Total body stores are 2028 g of magnesium. Communications with several experts on magnesium and current work on the antiarrhythmic actions of magnesium suggest a that the commonly used normal values for serum magnesium levels should be increased from 1.7-2.3 mg/dl to 2.0-2.6 mg/dl. Large losses can occur in conditions such as diarrhea, in which the stool may have up to 12 meq of magnesium per liter and the urine may have up to 25 meq per day. Large urinary losses can occur in cancer patients given aminoglycides, diuretics, and ketoconazole. Furthermore, large losses can occur in some of the intestinal fluids (Table 3) in cancer and other operative patients who develop GI fistulas.

Zinc Total body stores are only 2 or 3 g of zinc. Zinc concentration in the blood decreases as an early response to cytokines. This is commonly seen in many different types of injury as well as in cancer patients. There are minor tissue stores of zinc in skin, bone, and intestine. Zinc is redistributed to liver, bone marrow, thymus, and the site of injury or inflammation. This redistribution is mediated by IL-1 and the other cytokines secreted from macrophages. In hospitalized cancer patients, a reduced serum zinc concentration (<70 mg/dl) is not uncommon. The administration of approximately 50 mg of zinc per day is associated with a normalization of the zinc level after 3 weeks of feeding. Fifteen percent of healthy elderly have been found to have reduced serum zinc levels (<67mg/dl). The replacement of a multivitamin with 14 mg of zinc per day for 1 year resulted in a significant reduction in the number of days associated with infection-related illnesses (48 ± 7 to 23 ± 5 days per year). This vitamin and mineral supplementation improved the lymphocyte response to phytohemagglutin and the natural killer cell activity. There was no change in the placebo-treated group. Zinc supplementation in hospitalized patients may help with normal immune response for minor infection and wound healing. Zinc is needed for cell mitosis and cell proliferation. It has also been demonstrated to improve wound healing in patients provided 600 mg of zinc sulfate (136 mg of elemental zinc) orally per day who had a serum zinc level on admission of less than 100 mg/dl. In this double-blind study, the healing rate increased more than twofold in those randomized to receive zinc supplementation. In addition, large losses of zinc can occur via intestinal losses (Table 3). It is important to note that intestinal fluids can contain up to 17 mg of zinc per liter, so the replacement rate of zinc should take into account the abnormal sources of zinc loss as well as the routine nutritional requirements.

Copper Total body stores are very small at 60-80 mg. Serum copper status is normal or increased compared to that of serum zinc, and cytokines are also believed to be responsible for these changes. The benefits of or rational for these increased concentrations are not known.

Iron Total body stores are 3.5-4.5 g of iron. An increase in cytokines also contributes to the observed decrease in serum iron concentration. This is a mediated response to cancer, injury, or infection. The exact mechanism is not known, but iron is stored in Kupffer cells of the liver until the injury wanes. This is probably a beneficial effect

Table 3 Electrolyte contents of body fluids

Body fluid Electrolyte and mineral concentration (meq/l)

Table 3 Electrolyte contents of body fluids

Body fluid Electrolyte and mineral concentration (meq/l)

Sodium

Potassium

Chloride

Bicarbonate

Magnesium

Zinc (mg)

Bile

145

5

100

15-60

1-2

Colonic fluids

50

30-70

15-40

30

6-12

17

Diarrheal fluids

50

35

40

45

1-13

17

Duodenum

130

5-10

90

10

1-2

12

Ileal fluids

140

10-20

100

20-30

6-12

17

Pancreatatic juice

140

5

75

70-115

0.5

Saliva

10

20-30

15

50

0.6

Stomach fluids

100

10

120

0

0.9

Urine

60-120

30-70

60-120

5

0.1-0.5

Urine post Lasix

15x normal

2x normal

20 x normal

since many microbes use iron as a source of energy. Iron administration should be restricted in patients who have a serious infection because it has been shown to cause harm with fungal, parasitic, malarial, or other types of low-grade or quiescent infections.

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment