489. CALCIUM EXCESS IN OUR BODY

Side Effects of High Blood Calcium Levels

Bethany Fong, R.D.

Bethany Fong is a registered dietitian and chef from Honolulu. She has produced a variety of health education materials and worked in wellness industries such as clinical dietetics, food service management and public health.

Calcium is an essential mineral that supports bone formation, muscle contractions, release of hormones, and brain and nerve function. High blood calcium, also called hypercalcemia, can be caused by an overactive parathyroid gland, a gland that regulates blood calcium, which in severe cases may be removed. Other causes of high blood calcium include existing medical disorders, certain cancers and tumors, medications, and excessive use of vitamin D and calcium supplements. Hypercalcemia can affect many parts of the body. Treatment involves administering intravenous fluids and medications like calcitonin and bisphosphonates.

Abdominal Side Effects

        High blood calcium can cause

1.    nausea,

2.    vomiting,

3.    constipation and

4.    abdominal pain.

5.    Individuals may also experience a loss of appetite.

Kidney Side Effects

        The kidneys excrete water when blood calcium is high which can lead to dehydration, according to Merck Manuals.

        As a result individuals with hypercalcemia often experience increased thirst and frequent urination.

        Other side effects include flank pain and kidney stones.

Muscular and Skeletal Side Effects

        High blood calcium can lead to

1.    muscle atrophy,

2.    twitching,

3.    weakness and

4.    pain.

        In some cases hypercalcemia results from breakdown of bone and subsequent release of calcium into the blood stream. This can lead to bone pain, bowing of the shoulders, an increased risk of fractures, and curvature of the spine and height loss.

Psychological Side Effects

        Psychological side effects of high blood calcium include

1.    confusion,

2.    lethargy,

3.    fatigue,

4.    apathy,

5.    dementia,

6.    depression,

7.    irritability and

8.    memory loss.

In severe cases coma and death can ensue.

488. IRON EXCESS IN OUR BODY

IRON EXCESS

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What are the symptoms and signs of hemochromatosis?

Patients with early hemochromatosis have no symptoms and are unaware of their condition. The disease may then be discovered when elevated iron blood levels are noted by routine blood testing. In men, symptoms may not appear until 40-50 years of age. Iron deposits in the skin cause darkening of the skin. Since females lose iron through menstrual blood loss, they develop organ damage from iron accumulation 15 to 20 years later than men on average.
Iron deposits in the pituitary gland and testicles cause shrinkage of the testicles and impotence. Iron deposits in the pancreas cause a decrease in insulin production resulting in diabetes mellitus (please read the Diabetes Mellitus article). Iron deposits in the heart muscle can cause heart failure as well as abnormal heart rhythms. Iron accumulation in the liver causes scarring of the liver (cirrhosis) and an increased risk of developing liver cancer. For further information on the consequences of cirrhosis, please read the Cirrhosis article.

How is hemochromatosis diagnosed?

Most patients with hemochromatosis are diagnosed early and have no symptoms. Their hemochromatosis is discovered when elevated levels of iron in the blood are found as part of routine blood testing; or when blood iron levels are measured as in screening studies in family members of patients with hereditary hemochromatosis. Some patients are diagnosed as having hemochromatosis when their doctors perform blood iron levels as part of the evaluation for abnormal elevations in blood levels of liver enzymes AST and ALT.
Blood iron tests
There are several blood tests that reflect the amount of iron in the body;

1.      ferritin level,

2.      iron level, t

3.      otal iron binding capacity (TIBC), and

4.      transferrin saturation.

Ferritin is a blood protein whose levels correlate with the amount of iron stored in the body. Blood ferritin levels usually are low in patients with iron deficiency anemia, and are high in patients with hemochromatosis and other conditions that cause an increase in body iron levels. Since ferritin also can be elevated in certain infections such as viral hepatitis and other inflammatory conditions in the body, an elevated ferritin level alone is not sufficient to accurately diagnose hemochromatosis.
Serum iron, TIBC, and transferrin saturation are often performed together. Serum iron is the measure of the amount of iron in serum (the liquid portion of the blood). TIBC is a measure of the total amount of iron that can be carried in serum by transferrin, a protein that carries iron in serum from one part of the body to another. Transferrin saturation is a number calculated by dividing serum iron by TIBC—it is a number that reflects what percentage of the transferrin that is being used to transport iron. In healthy individuals the transferrin saturation is between 20 and 50 percent. In patients with iron deficiency anemia, the serum iron and transferrin saturation are abnormally low; and in patients with hereditary hemochromatosis the serum iron and transferrin saturation are abnormally high.
Since serum iron can be elevated by eating and can fluctuate during the day, serum iron measurements should be done fasting, usually in the morning before breakfast.

Liver biopsy
The most accurate test for diagnosing hemochromatosis is measurement of the iron content of liver tissue obtained by a biopsy. A liver biopsy involves the removal of a sample of liver tissue for analysis and is usually performed with a needle under local anesthesia. After numbing the skin and the underlying tissues, the doctor inserts the needle into the liver through the right lower rib cage, sometimes under ultrasound guidance. The tissue obtained by the needle is studied under a microscope for signs of active liver disease, fibrosis and cirrhosis (permanent scarring), and iron content (usually significantly elevated in hemochromatosis).
The liver biopsy also has prognostic value because it determines whether the patient already has irreversible advanced cirrhosis. Patients with hemochromatosis but an otherwise normal liver biopsy have longevity similar to other healthy adults if adequately treated, while patients with cirrhosis as a result of hemochromatosis have significantly reduced longevity. Furthermore, the risks of cirrhotic patients developing liver cancer (hepatocellular carcinoma) are substantially higher than normal subjects even with adequate treatment of the iron overload with phlebotomy (see below).

An algorithm for diagnosing hereditary hemochromatosis is as follows:

1. Adults suspected of having hereditary hemochromatosis (for example, adult, first-degree relatives of a patient with hereditary hemochromatosis) are subjected to measurements of fasting serum iron, TIBC, transferrin saturation and ferritin.

2. Patients with elevated serum iron, ferritin, and transferrin saturation of greater than 45% are subjected to genetic testing

3. Patients with transferrin saturation greater than 45% who are C282Y homozygotes have hemochromatosis and, therefore, should be treated with therapeutic phlebotomy (see below).

Who should undergo liver biopsy?
Not all patients with hemochromatosis need to undergo liver biopsy. The purpose of liver biopsy is to identify those patients with cirrhosis and to exclude other possible liver diseases. (Patients with hemochromatosis and cirrhosis are at increased risk of complications, especially liver cancer.)
Young patients (<40 years of age) who are C282Y homozygotes with normal liver blood levels and serum ferritin levels <1000 ng/ml have a very low risk of having cirrhosis of the liver. Therefore, these patients can be treated with therapeutic phlebotomy without a liver biopsy. Their prognosis is excellent with adequate treatment.
Older patients (>40 years of age) who have serum ferritin levels >1000 ng/ml, and have abnormally elevated liver blood levels may already have developed cirrhosis. Doctors may recommend liver biopsies in these patients provided that it is safe for them to undergo liver biopsy.

487. Mineral Uses in the Body

Mineral Uses in the Body

The three main functions of minerals are: components of the skeleton, helping to create the framework of the body, as soluble salts which help control the makeup of body fluids, and as essential supports to the action of many enzymes and other proteins.
Minerals are the inorganic substance that occurs naturally in rocks and in the ground and has its own characteristic appearance and chemical composition.
There are many different types of minerals such as calcium, magnesium, potassium, selenium, and zinc.
Calcium
Calcium is a major mineral essential for healthy and strong bones and teeth. It is also ensures the proper functioning of muscles and nerves and even helps your blood clot. It is of very much importance for the growing children.
The sources of calcium are milk, cheese, eggs, dairy products, fruits, green vegetables, almonds, seaweeds (such as kelp, wakame and hijiki), nuts, beans and pulses, breads and fish.
The deficiency of calcium can affect bone and teeth formation, while its excess can lead to kidney stones.
Magnesium
Magnesium is an important mineral that helps the body to maintain muscles, nerves, and bones. It is also used in heart rhythm, energy metabolism and protein synthesis.
The major sources of magnesium are spinach, nuts, seeds, whole grains, water, fruits and vegetables.

The deficiency of magnesium can cause

1.      sensitiveness to noise,

2.      nervousness,

3.      irritability,

4.      mental depression,

5.      confusion,

6.      twitching,

7.      trembling,

8.      apprehension,

9.      insomnia,

10.  muscle weakness and

11.  cramps in the

a.       toes,

b.      feet,

c.       legs, or

d.      fingers.

Potassium
Potassium is a mineral that serves as an electrolyte and is involved in the balance of fluid within the body. It is important in controlling the activity of the heart, muscles, nervous system and just about every cell in the body. It regulates the water balance and acid-base balance in the blood and tissues. Our bodies contain more than twice as much potassium as sodium (typically nine ounces versus four ounces).
The major sources of potassium are bananas and orange juice. Some other sources include breads, cereals and other grain products.
The deficiency of potassium can cause your muscles not to work properly and you will feel weak. The excess of potassium can cause an irregular heart beat.
Selenium
Selenium is an essential mineral that functions largely in the form of proteins, called seleno-proteins, which act as enzymes and help prevent damage to cells in the body by oxidants in the environment or those produced by normal metabolism.
The sources of selenium are seafood, some meats (such as kidney and liver), and some grains and seeds.
The deficiency of selenium causes “Keshan” disease, a fatal form of cardiomyopathy (heart muscle disease).
While its excess can cause

1.      reversible balding and

2.      brittle nails,

3.      give a garlic odor to the breath, and

4.      cause intestinal distress,

5.      weakness and

6.      slowed mental functioning.

Zinc
Zinc is an essential mineral which is involved in the manufacture of protein and in cell division. It is also a constituent of insulin, and is concerned with the sense of smell.
The sources of zinc are eggs, cereal grains, meat, liver, seafood and nuts.

The deficiency of zinc can cause

1.      short stature,

2.      anemia,

3.      increased pigmentation of skin,

4.      enlarged liver and

5.      enlarged  spleen (hepatosplenomegaly),

6.      impaired gonadal function,

7.      impaired wound healing, and

8.      immune deficiency.

The excess of zinc can cause gastrointestinal irritation (upset stomach) and cause copper deficiency.

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