Mineral deficiency

Last updated
Mineral deficiency
Specialty Endocrinology   OOjs UI icon edit-ltr-progressive.svg

Mineral deficiency is a lack of the dietary minerals, the micronutrients that are needed for an organism's proper health. [1] The cause may be a poor diet, impaired uptake of the minerals that are consumed, or a dysfunction in the organism's use of the mineral after it is absorbed. These deficiencies can result in many disorders including anemia and goitre. Examples of mineral deficiency include, zinc deficiency, iron deficiency, and magnesium deficiency.

Contents

Individual deficiency

MineralSymptoms & DiagnosisInformation
Calcium deficiency Asymptomatic or, in severe cases, can have dramatic symptoms and be life-threatening. Symptoms of include numbness in fingers and toes, muscle cramps, irritability, impaired mental capacity and muscle twitching. [2] Vitamin D related hypocalcemia may be associated with a lack of vitamin D in the diet, a lack of sufficient UV exposure, or disturbances in renal function. Low vitamin D in the body can lead to a lack of calcium absorption and secondary hyperparathyroidism (hypocalcemia and raised parathyroid hormone). [2] Parathyroid related or vitamin D related.
Chromium deficiency Severely impaired glucose tolerance, weight loss, peripheral neuropathy and confusion. [3] [4] The authorities in the European Union do not recognize chromium as an essential nutrient, [5] those in the United States do, and identify an adequate intake for adults as between 25 and 45 μg/day, depending on age and sex. [4] Dietary supplements containing chromium are widely available in the United States, with claims for benefits for fasting plasma glucose, hemoglobin A1C and weight loss. Reviews report the changes as modest, and without scientific consensus that the changes have a clinically relevant impact. [6] [7]
Copper deficiency Neurological problems including myelopathy, peripheral neuropathy, and optic neuropathy. Blood symptoms of anemia and neutropenia. [8] Copper deficiency can manifest in parallel with vitamin B12 and other nutritional deficiencies. [9] The most common cause of copper deficiency is a remote gastrointestinal surgery, such as gastric bypass surgery, due to malabsorption of copper, or zinc toxicity.
Fluorine deficiency Increased dental caries and possibly osteoporosis Fluorine is not considered to be an essential nutrient, but the importance of fluorides for preventing tooth decay is well-recognized, [10] although the effect is predominantly topical. [11]
iron deficiency fatigue, dizziness/lightheadedness, pallor, hair loss, twitches, irritability, weakness, pica, brittle or grooved nails, hair thinning, pagophagia, restless legs syndrome [12] Iron deficiency may be caused by blood loss, inadequate intake, medications interfering with absorption, mechanical hemolysis from athletics, malabsorption syndromes, inflammation, and parasitic infections. In a 2014 U.S. government consumption survey and reported that for men and women ages 20 and older the average iron intakes were, respectively, 16.6 and 12.6 mg/day. [13]
Iodine deficiency Goiter, congenital iodine deficiency syndrome, and fibrocystic breast changes In areas where there is little iodine in the diet, typically remote inland areas where no marine foods are eaten, iodine deficiency is common. It is also common in mountainous regions of the world where food is grown in iodine-poor soil. Prevention includes adding small amounts of iodine to table salt, a product known as iodized salt . Iodine compounds have also been added to other foodstuffs, such as flour, water and milk, in areas of deficiency. [14]
Manganese deficiency Skeletal deformation and inhibits the production of collagen in wound healing. [15] Manganese is a vital element of nutrition in very small quantities (adult male daily intake 2.3 milligrams).
Magnesium deficiency Tiredness, generalized weakness, muscle cramps, abnormal heart rhythms, increased irritability of the nervous system with tremors, paresthesias, palpitations, low potassium levels in the blood, hypoparathyroidism which might result in low calcium levels in the blood, chondrocalcinosis, spasticity and tetany, migraines, epileptic seizures, [16] The diagnosis is typically based on finding low blood magnesium levels (hypomagnesemia). [17] basal ganglia calcifications [18] and in extreme and prolonged cases coma, intellectual disability or death. [19] Magnesium plays an important role in carbohydrate metabolism and its deficiency may worsen insulin resistance, a condition that often precedes diabetes, or may be a consequence of insulin resistance. [20] Normal magnesium levels are between 0.6 and 1.1 mmol/L (1.46–2.68 mg/dL) with levels less than 0.6 mmol/L (1.46 mg/dL) defining hypomagnesemia. [21] Specific electrocardiogram (ECG) changes may be seen. [21] Causes include low dietary intake, alcoholism, diarrhea, increased urinary loss, poor absorption from the intestines, and diabetes mellitus. [22] [23] [24] A number of medications may also cause low magnesium, including proton pump inhibitors (PPIs) and furosemide. [25]
Molybdenum deficiency High blood methionine, low blood uric acid, and low urinary uric acid and sulfate concentrations.The amount of molybdenum required is relatively small, and molybdenum deficiency usually does not occur in natural settings. [26]
Potassium deficiency Mild low potassium does not typically cause symptoms. [27] Symptoms may include feeling tired, leg cramps, weakness, and constipation. [21] Low potassium also increases the risk of an abnormal heart rhythm, which is often too slow and can cause cardiac arrest. [21] [27] Causes of potassium deficiencyinclude vomiting, diarrhea, medications like furosemide and steroids, dialysis, diabetes insipidus, hyperaldosteronism, hypomagnesemia, and not enough intake in the diet. [21] Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels below 3.5 mmol/L defined as hypokalemia. [21] [28] It is classified as severe when levels are less than 2.5 mmol/L. [21] Low levels may also be suspected based on an electrocardiogram (ECG). [21] Hyperkalemia is a high level of potassium in the blood serum. [21]
Selenium deficiency Significant negative results, [29] affecting the health of the heart, Keshan disease and the nervous system; contributing to depression, anxiety, and dementia; and interfering with reproduction and gestation.People dependent on food grown from selenium-deficient soil may be at risk for deficiency. [30]
Sodium deficiency Mild symptoms include a decreased ability to think, headaches, nausea, and poor balance. [31] [32] Severe symptoms include confusion, seizures, and coma. [31] [33] [34] The causes of hyponatremia are typically classified by a person's body fluid status into low volume, normal volume, or high volume. [35] Low volume hyponatremia can occur from diarrhea, vomiting, diuretics, and sweating. [35] Normal volume hyponatremia is divided into cases with dilute urine and concentrated urine. [35] Cases in which the urine is dilute include adrenal insufficiency, hypothyroidism, and drinking too much water or too much beer. [35] Cases in which the urine is concentrated include syndrome of inappropriate antidiuretic hormone secretion (SIADH). [35] High volume hyponatremia can occur from heart failure, liver failure, and kidney failure. [35] Conditions that can lead to falsely low sodium measurements include high blood protein levels such as in multiple myeloma, high blood fat levels, and high blood sugar. [36] [37]
Zinc deficiency Common symptoms include increased rates of diarrhea. Zinc deficiency affects the skin and gastrointestinal tract; brain and central nervous system, immune, skeletal, and reproductive systems.Zinc deficiency in humans is caused by reduced dietary intake, inadequate absorption, increased loss, or increased body system use. The most common cause is reduced dietary intake. In the U.S., the Recommended Dietary Allowance (RDA) is 8 mg/day for women and 11 mg/day for men. [38]

See also

Related Research Articles

<span class="mw-page-title-main">Osteoporosis</span> Skeletal disorder

Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to more porous bone, and consequent increase in fracture risk.

A nutrient is a substance used by an organism to survive, grow and reproduce. The requirement for dietary nutrient intake applies to animals, plants, fungi and protists. Nutrients can be incorporated into cells for metabolic purposes or excreted by cells to create non-cellular structures such as hair, scales, feathers, or exoskeletons. Some nutrients can be metabolically converted into smaller molecules in the process of releasing energy such as for carbohydrates, lipids, proteins and fermentation products leading to end-products of water and carbon dioxide. All organisms require water. Essential nutrients for animals are the energy sources, some of the amino acids that are combined to create proteins, a subset of fatty acids, vitamins and certain minerals. Plants require more diverse minerals absorbed through roots, plus carbon dioxide and oxygen absorbed through leaves. Fungi live on dead or living organic matter and meet nutrient needs from their host.

Vitamin deficiency is the condition of a long-term lack of a vitamin. When caused by not enough vitamin intake it is classified as a primary deficiency, whereas when due to an underlying disorder such as malabsorption it is called a secondary deficiency. An underlying disorder can have 2 main causes:

<span class="mw-page-title-main">Mineral (nutrient)</span> Chemical element required as an essential nutrient by organisms to perform life functions

In the context of nutrition, a mineral is a chemical element. Some "minerals" are essential for life, but most are not. Minerals are one of the four groups of essential nutrients; the others are vitamins, essential fatty acids, and essential amino acids. The five major minerals in the human body are calcium, phosphorus, potassium, sodium, and magnesium. The remaining elements are called "trace elements". The generally accepted trace elements are iron, chlorine, cobalt, copper, zinc, manganese, molybdenum, iodine, and selenium; there is some evidence that there may be more.

<span class="mw-page-title-main">Hypocalcemia</span> Low calcium levels in ones blood serum

Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum. The normal range of blood calcium is typically between 2.1–2.6 mmol/L, while levels less than 2.1 mmol/L are defined as hypocalcemic. Mildly low levels that develop slowly often have no symptoms. Otherwise symptoms may include numbness, muscle spasms, seizures, confusion, or in extreme cases cardiac arrest.

<span class="mw-page-title-main">Electrolyte imbalance</span> Abnormality in the concentration of electrolytes in the body

Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the body. They help to regulate heart and neurological function, fluid balance, oxygen delivery, acid–base balance and much more. Electrolyte imbalances can develop by consuming too little or too much electrolyte as well as excreting too little or too much electrolyte. Examples of electrolytes include calcium, chloride, magnesium, phosphate, potassium, and sodium.

<span class="mw-page-title-main">Hypokalemia</span> Medical condition with insufficient potassium

Hypokalemia is a low level of potassium (K+) in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abnormal heart rhythm, which is often too slow and can cause cardiac arrest.

Hypermagnesemia is an electrolyte disorder in which there is a high level of magnesium in the blood. Symptoms include weakness, confusion, decreased breathing rate, and decreased reflexes. Hypermagnesemia can greatly increase the chances of adverse cardiovascular events. Complications may include low blood pressure and cardiac arrest.

<span class="mw-page-title-main">Chlortalidone</span> Thiazide-like diuretic drug

Chlortalidone, also known as chlorthalidone, is a thiazide-like diuretic drug used to treat high blood pressure, swelling, diabetes insipidus, and renal tubular acidosis. Because chlortalidone is effective in most patients with high blood pressure, it is considered a preferred initial treatment. It is also used to prevent calcium-based kidney stones. It is taken by mouth. Effects generally begin within three hours and last for up to three days. Long-term treatment with chlortalidone is more effective than hydrochlorothiazide for prevention of heart attack or stroke.

Chromium deficiency is described as the consequence of an insufficient dietary intake of the mineral chromium. Chromium was first proposed as an essential element for normal glucose metabolism in 1959, but its biological function has not been identified. Cases of deficiency were described in people who received all of their nutrition intravenously for long periods of time.

Magnesium deficiency is an electrolyte disturbance in which there is a low level of magnesium in the body. Symptoms include tremor, poor coordination, muscle spasms, loss of appetite, personality changes, and nystagmus. Complications may include seizures or cardiac arrest such as from torsade de pointes. Those with low magnesium often have low potassium.

Manganese deficiency in humans results in a number of medical problems. Manganese is a vital element of nutrition in very small quantities. However poisoning may occur when greater amounts are ingested.

<span class="mw-page-title-main">TRPM7</span> Protein-coding gene in the species Homo sapiens

Transient receptor potential cation channel, subfamily M, member 7, also known as TRPM7, is a human gene encoding a protein of the same name.

<span class="mw-page-title-main">CYP2R1</span> Mammalian protein found in Homo sapiens

CYP2R1 is cytochrome P450 2R1, an enzyme which is the principal vitamin D 25-hydroxylase. In humans it is encoded by the CYP2R1 gene located on chromosome 11p15.2. It is expressed in the endoplasmic reticulum in liver, where it performs the first step in the activation of vitamin D by catalyzing the formation of 25-hydroxyvitamin D.

<span class="mw-page-title-main">Manganese in biology</span> Use of manganese by organisms

Manganese is an essential biological element in all organisms. It is used in many enzymes and proteins. It is essential in plants.

<span class="mw-page-title-main">Vitamin D deficiency</span> Human disorder

Vitamin D deficiency or hypovitaminosis D is a vitamin D level that is below normal. It most commonly occurs in people when they have inadequate exposure to sunlight, particularly sunlight with adequate ultraviolet B rays (UVB). Vitamin D deficiency can also be caused by inadequate nutritional intake of vitamin D; disorders that limit vitamin D absorption; and disorders that impair the conversion of vitamin D to active metabolites, including certain liver, kidney, and hereditary disorders. Deficiency impairs bone mineralization, leading to bone-softening diseases, such as rickets in children. It can also worsen osteomalacia and osteoporosis in adults, increasing the risk of bone fractures. Muscle weakness is also a common symptom of vitamin D deficiency, further increasing the risk of fall and bone fractures in adults. Vitamin D deficiency is associated with the development of schizophrenia.

<span class="mw-page-title-main">Nutritional neuroscience</span> Scientific discipline

Nutritional neuroscience is the scientific discipline that studies the effects various components of the diet such as minerals, vitamins, protein, carbohydrates, fats, dietary supplements, synthetic hormones, and food additives have on neurochemistry, neurobiology, behavior, and cognition.

<span class="mw-page-title-main">Copper in biology</span>

Copper is an essential trace element that is vital to the health of all living things. In humans, copper is essential to the proper functioning of organs and metabolic processes. Also, in humans, copper helps maintain the nervous system, immune system, brain development, and activates genes, as well as assisting in the production of connective tissues, blood vessels, and energy. The human body has complex homeostatic mechanisms which attempt to ensure a constant supply of available copper, while eliminating excess copper whenever this occurs. However, like all essential elements and nutrients, too much or too little nutritional ingestion of copper can result in a corresponding condition of copper excess or deficiency in the body, each of which has its own unique set of adverse health effects.

Relatively speaking, the brain consumes an immense amount of energy in comparison to the rest of the body. The mechanisms involved in the transfer of energy from foods to neurons are likely to be fundamental to the control of brain function. Human bodily processes, including the brain, all require both macronutrients, as well as micronutrients.

<span class="mw-page-title-main">Calcium channel blocker toxicity</span> Medical condition

Calcium channel blocker toxicity is the taking of too much of the medications known as calcium channel blockers (CCBs), either by accident or on purpose. This often causes a slow heart rate and low blood pressure. This can progress to the heart stopping altogether. Some CCBs can also cause a fast heart rate as a result of the low blood pressure. Other symptoms may include nausea, vomiting, sleepiness, and shortness of breath. Symptoms usually occur in the first six hours but with some forms of the medication may not start until 24 after hours.

References

  1. ↑ "Introduction: Mineral Deficiency and Toxicity: Merck Manual Professional" . Retrieved 2008-11-29.
  2. 1 2 Murphy, E; Williams (2009). "Hypocalcemia". Medicine. 37 (9): 465–468. doi:10.1016/j.mpmed.2009.06.003.
  3. ↑ Freund, Herbert; Atamian, Susan; Fischer, Josef E. (February 1979). "Chromium deficiency during total parenteral nutrition". JAMA. 241 (5): 496–498. doi:10.1001/jama.1979.03290310036012. PMID   104057.
  4. 1 2 "Chromium". NCBI Bookshelf. 2022-03-15. Retrieved 2022-03-15.
  5. ↑ "Overview on Dietary Reference Values for the EU population as derived by the EFSA Panel on Dietetic Products, Nutrition and Allergies" (PDF). 2017.
  6. ↑ Costello, Rebecca B.; Dwyer, Johanna T.; Bailey, Regan L. (2022-01-27). "Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness". Nutrition Reviews. 74 (7): 455–468. doi:10.1093/nutrit/nuw011. PMC   5009459 . PMID   27261273.
  7. ↑ Onakpoya I, Posadzki P, Ernst E (2013). "Chromium supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials". Obes Rev. 14 (6): 496–507. doi:10.1111/obr.12026. PMID   23495911. S2CID   21832321.
  8. ↑ Scheiber, Ivo; Dringen, Ralf; Mercer, Julian F. B. (2013). "Chapter 11. Copper: Effects of Deficiency and Overload". In Astrid Sigel, Helmut Sigel and Roland K. O. Sigel (ed.). Interrelations between Essential Metal Ions and Human Diseases. Metal Ions in Life Sciences. Vol. 13. Springer. pp. 359–387. doi:10.1007/978-94-007-7500-8_11. ISBN   978-94-007-7499-5. PMID   24470097.
  9. ↑ Halfdanarson, Thorvardur R.; Kumar, Neeraj; Li, Chin-Yang; Phyliky, Robert L.; Hogan, William J. (2008-02-13). "Hematological manifestations of copper deficiency: a retrospective review". European Journal of Haematology. 80 (6). Wiley: 523–531. doi:10.1111/j.1600-0609.2008.01050.x. ISSN   0902-4441. PMID   18284630. S2CID   38534852.
  10. ↑ Olivares M, Uauy R (2004). "Essential nutrients in drinking-water (Draft)" (PDF). WHO. Archived from the original (PDF) on 2012-10-19. Retrieved 2008-12-30.
  11. ↑ Pizzo G, Piscopo MR, Pizzo I, Giuliana G (September 2007). "Community water fluoridation and caries prevention: a critical review". Clin Oral Investig. 11 (3): 189–93. doi:10.1007/s00784-007-0111-6. PMID   17333303. S2CID   13189520.
  12. ↑ Rangarajan S, D'Souza GA (April 2007). "Restless legs syndrome in Indian patients having iron deficiency anemia in a tertiary care hospital". Sleep Medicine. 8 (3): 247–51. doi:10.1016/j.sleep.2006.10.004. PMID   17368978.
  13. ↑ "What We Eat In America, NHANES 2013–2014" (PDF). National Health and Nutrition Examination Survey (NHANES). US Department of Agriculture, Agricultural Research Service.
  14. ↑ Creswell J. Eastman; Michael Zimmermann (12 February 2014). "The Iodine Deficiency Disorders". Thyroid Disease Manager. Retrieved 2016-12-11.
  15. ↑ Keen, C.L.; Zidenberg-Cherr, S. (1996). "Manganese". In Ziegler, E.E.; Filer, L.J. (eds.). Present Knowledge in Nutrition (7th ed.). ILSI Press. pp. 334–343. ISBN   9780944398722.
  16. ↑ Yuen, Alan W.C.; Sander, Josemir W. (2012-06-01). "Can magnesium supplementation reduce seizures in people with epilepsy? A hypothesis". Epilepsy Research. 100 (1–2): 152–156. doi:10.1016/j.eplepsyres.2012.02.004. ISSN   0920-1211. PMID   22406257. S2CID   23147775.
  17. ↑ Goldman, Lee; Schafer, Andrew I. (2015). Goldman-Cecil Medicine E-Book. Elsevier Health Sciences. p. 775. ISBN   9780323322850.
  18. ↑ "Basal Ganglia Calcification with Hypomagnesemia". www.japi.org. Retrieved 2021-06-03.
  19. ↑ Viering, Daan H. H. M.; Baaij, Jeroen H. F. de; Walsh, Stephen B.; Kleta, Robert; Bockenhauer, Detlef (2016-05-27). "Genetic causes of hypomagnesemia, a clinical overview". Pediatric Nephrology. 32 (7): 1123–1135. doi:10.1007/s00467-016-3416-3. ISSN   0931-041X. PMC   5440500 . PMID   27234911.
  20. ↑ Kobrin, SM; Goldfarb, S (Nov 1990). "Magnesium deficiency". Seminars in Nephrology. 10 (6): 525–35. PMID   2255809.
  21. 1 2 3 4 5 6 7 8 9 Soar, J; Perkins, GD; Abbas, G; Alfonzo, A; Barelli, A; Bierens, JJ; Brugger, H; Deakin, CD; Dunning, J; Georgiou, M; Handley, AJ; Lockey, DJ; Paal, P; Sandroni, C; Thies, KC; Zideman, DA; Nolan, JP (October 2010). "European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution". Resuscitation. 81 (10): 1400–33. doi:10.1016/j.resuscitation.2010.08.015. PMID   20956045.
  22. ↑ Soar, J; Perkins, GD; Abbas, G; Alfonzo, A; Barelli, A; Bierens, JJ; Brugger, H; Deakin, CD; Dunning, J; Georgiou, M; Handley, AJ; Lockey, DJ; Paal, P; Sandroni, C; Thies, KC; Zideman, DA; Nolan, JP (October 2010). "European Resuscitation Council Guidelines for Resuscitation 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution". Resuscitation. 81 (10): 1400–33. doi:10.1016/j.resuscitation.2010.08.015. PMID   20956045.
  23. ↑ de Baaij JH, Hoenderop JG, Bindels RJ (January 2015). "Magnesium in man: implications for health and disease". Physiol. Rev. 95 (1): 1–46. CiteSeerX   10.1.1.668.9777 . doi:10.1152/physrev.00012.2014. PMID   25540137. S2CID   4999601.
  24. ↑ Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH (January 2016). "Hypomagnesemia in Type 2 Diabetes: A Vicious Circle?". Diabetes. 65 (1): 3–13. doi: 10.2337/db15-1028 . PMID   26696633.
  25. ↑ III, James L. Lewis (2021-09-29). "Hypomagnesemia - Endocrine and Metabolic Disorders". Merck Manuals Professional Edition (in German). Retrieved 2022-03-15.
  26. ↑ "Molybdenum". Linus Pauling Institute. Oregon State University. Retrieved 2008-11-29.
  27. 1 2 Zieg, J; Gonsorcikova, L; Landau, D (July 2016). "Current views on the diagnosis and management of hypokalaemia in children". Acta Paediatrica. 105 (7): 762–72. doi:10.1111/apa.13398. PMID   26972906. S2CID   19579505.
  28. ↑ Pathy, M.S. John (2006). "Appendix 1: Conversion of SI Units to Standard Units". Principles and Practice of Geriatric Medicine. Vol. 2 (4. ed.). Chichester: Wiley. p. Appendix. doi:10.1002/047009057X.app01. ISBN   9780470090558.
  29. ↑ Kieliszek, Marek (3 April 2019). "Selenium–Fascinating Microelement, Properties and Sources in Food". Molecules. 24 (7): 1298. doi: 10.3390/molecules24071298 . PMC   6480557 . PMID   30987088.
  30. ↑ Jones, Gerrad D.; Droz, Boris; Greve, Peter; Gottschalk, Pia; Poffet, Deyan; McGrath, Steve P.; Seneviratne, Sonia I.; Smith, Pete; Winkel, Lenny H. E. (2017-03-14). "Selenium deficiency risk predicted to increase under future climate change". Proceedings of the National Academy of Sciences. 114 (11): 2848–2853. doi: 10.1073/pnas.1611576114 . ISSN   0027-8424. PMC   5358348 . PMID   28223487.
  31. 1 2 Babar, S. (October 2013). "SIADH Associated With Ciprofloxacin" (PDF). The Annals of Pharmacotherapy. 47 (10): 1359–63. doi:10.1177/1060028013502457. ISSN   1060-0280. PMID   24259701. S2CID   36759747. Archived from the original (PDF) on May 1, 2015. Retrieved November 18, 2013.
  32. ↑ Henry, DA (4 August 2015). "In The Clinic: Hyponatremia". Annals of Internal Medicine. 163 (3): ITC1–19. doi:10.7326/aitc201508040. PMID   26237763. S2CID   12434550.
  33. ↑ Williams, DM; Gallagher, M; Handley, J; Stephens, JW (July 2016). "The clinical management of hyponatraemia". Postgraduate Medical Journal. 92 (1089): 407–11. doi: 10.1136/postgradmedj-2015-133740 . PMID   27044859.
  34. ↑ Ball, S; De Groot, LJ; Beck-Peccoz, P; Chrousos, G; Dungan, K; Grossman, A; Hershman, JM; Koch, C; McLachlan, R; New, M; Rebar, R; Singer, F; Vinik, A; Weickert, MO (2000). "Hyponatremia". Endotext. PMID   25905359. Accessed 1 August 2016.
  35. 1 2 3 4 5 6 Lee, JJ; Kilonzo, K; Nistico, A; Yeates, K (13 May 2014). "Management of hyponatremia". CMAJ: Canadian Medical Association Journal. 186 (8): E281–86. doi:10.1503/cmaj.120887. PMC   4016091 . PMID   24344146.
  36. ↑ Filippatos, TD; Liamis, G; Christopoulou, F; Elisaf, MS (April 2016). "Ten common pitfalls in the evaluation of patients with hyponatremia". European Journal of Internal Medicine. 29: 22–25. doi: 10.1016/j.ejim.2015.11.022 . PMID   26706473.
  37. ↑ Marx, John; Walls, Ron; Hockberger, Robert (2013). Rosen's Emergency Medicine – Concepts and Clinical Practice (8 ed.). Elsevier Health Sciences. pp. 1639–42. ISBN   978-1455749874. Archived from the original on 2016-08-15.
  38. ↑ "Zinc" Archived 19 September 2017 at the Wayback Machine , pp. 442–501 in Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press. 2001.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.