ESSENTIAL TRACE ELEMENTS

1. ESSENTIALTRACE
ELEMENTS
Prepared by
D.Mahendra,M.Pharm(PA&QA),.
Asst.Professor
NCOP-T7
1

2. Overview
• Introduction
• Classification
• Individual trace elements
• conclusion
2

3. Introduction
• Naturally occurring, homogeneous, inorganic
substance required in humans in amounts less
than 100 mg/day
• Minerals for 5% of our diet
3

4. Classificatio
n
4
• Essential trace elements
Iron, zinc, copper
Co, Cr, fluoride, iodide, Mn, Mo, & Se
• Probably essential trace elements
Ni, tin, vanadium, Si, Bo
• Non essential trace elements
Al, Au, Ba, Br, lead, silver, mercury, rubidium,
strontium, titanium, ziroconium,

5. Essential trace
elements
5
• Trace elements
Iron, zinc and copper
• Ultra trace elements
Manganese, selenium, cobalt, chromium,
fluoride, iodine, and molybdenum

6. Iro
n
6
• Most essential trace element
• Body content – 4-6g
Hb – 68%
ferritin – 13 %
haemosiderin – 12%
myoglobin – 3%
iron enzymes – 0.2%

7. • Iron dependent enzymes:
Cytochrome oxidase, xanthine oxidase and
peroxidase
• Body requirement
Daily requirement – 0.5 - 2 mg/day
3 - 5mg/day (pregnancy)
Daily excretion – 0.9mg/day
1.3mg/day (during menses)
7

8. • Dietary source:
Leafy greens, whole grains, beans , pulses, liver,
spleen, mollusks
•Iron is absorbed in ferrous
form, which is measurable
in blood as free iron
8

9. Transferri
n
• Transport protein
• Binds to two iron molecules
• Transports iron to various organs and
tissues
• S.Iron + total iron bound transferrin –
total iron in circulation
• Determination of transferrin gives TIBC
• Transferrin can be measured by
RIA, ELISA & chemiluminescence
9

10. Ferriti
n
10
• Protein having 24 subunits binds to 4000 iron
molecules
• Measurements used to assess iron stores in the
body
• ↑ferritin levels may be seen in hepatitis, cirrhosis,
hepatic carcinoma also in leukemia, NHL
•RIA, ELISA
chemiluminescence

11. 11

12. • Deficiency state:
asymptomatic
weakness, headache, irritability, and varying degrees
of fatigue and exercise intolerance.
Treatment:
3-6mg of elemental iron/kg/day
12

13. • Oral preparations of iron:
Ferrous sulphate
Ferrous fumerate
Ferrous gluconate
Ferrous succinate
Iron calcium complex
Ferric ammonium citrate
Adverse effects: epigastric pain, nausea, vomiting,
gastritis, metallic taste, constipation or diarrhea
Liquid prep- staining of teeth
13

14. • Parenteral preparations:
Iron dextran
Iron sorbitol citric acid complex
• Adverse effects:
Pain at injection site, pigmentation
Fever, headache, palpitations, anaphylaxis
14

15. Acute iron
poisoning
• 60mg/kg elemental iron
• Vomiting, abdominal pain, bloody diarrhea, shock,
dehydration, cyanosis, acidosis, coma
• Treatment:
• Gastric lavage with sodium bicarbonate solution
• Desferrioxamine 15 mg/kg per hour IV, ↑ to max
35 mg/kg per hour
•Correction of acidosis and shock
(if fails dialysis) 15

16. Zinc
16
• Second most abundant trace element
• Cofactor – DNA polymerase, alkaline
phosphatase, carboxypeptidase
Regulate- growth, immune system, collagen
synthesis, wound healing, bone metabolism,
reproduction, taste, smell & vision

17. • Reduce the time period of diarrhea
• High dose of zinc prevents dysmenorrhea
• Zinc required in producing testosterone
• For common cold
• In treatment of warts
17

18. • Body content 2.5g
60% in muscle, 30% in bone, 10% in body tissues
and organs
• Daily requirement: 3-14mg
• Diet rich in zinc: red meat, fish, sea food,
pumpkin, cashews, beans, dark chocolate
18

19. • Zinc deficiency:
Leukemia, cirrhosis, hepatitis, sickle cell anemia,
Malnutrition
Symptoms:
In children- growth retardation & skeletal
abnormalities
In adults- ↓smell & taste, ↓appetite, skin lesions,
and hair loss
19

20. Zinc deficiency is also associated with
• Acrodermatitis enteropathica
• Anorexia
• Esophageal squamous cell carcinoma
• Cognitive and motor impairement
• Diarrhea and pneumonia
Treatment:
• Zinc supplements 45 – 100mg/day
20

21. Copper
21
• 3rd most important trace element
• Diet rich in copper: red meat, shell fish, water
pumped through copper pipes
• Body content of copper is 80-120mg

22. • 40-60% absorbed in duodenum
• Transported through metallozymes eg ascorbic
acid
• 90% bound to ceruplasmin, 9% to albumin and
1% is free
• Body content of Cu is 80-120mg
22

23. Body functions:
• Erythropoiesis
• Nerve conduction and immune function
• Fertility and to maintain pregnancy
•Act as a catalyst for copper containing enzymes
Eg: tyrosinase, ascorbic acid
23

24. • Toxic – 5mg/kg
• Adequate – 34mcg/kg
• Deficient - <8.5mcg/kg
• RDA – 09 - 1.3mg/day
24

25. Deficiency symptoms:
• Fragile hair
• Depigmented skin
• Myeloneuropathy
• Edema
• Hepatosplenomegaly
• Osteoporosis
• Anemia, neutropenia
25

26. Menkes
disease
26
• Congenital X-linked genetic disorder
• Mutation in ATP7A gene
• Inactivating mutation in this gene causes Cu
deficiency

27. Wilsons
disease
27
• Autosomal recessive disorder
• Mutation in ATP7b gene
• Causes excessive accumulation of Cu
Clinical features:
• Diarrhea, vomiting
• Cardiac & renal failure
• Hepatic necrosis
• encephalopathy

28. Treatment:
• life long treatment
• Avoidance of high Cu diet
• In early stages Zn may be effective as it
competes with Cu for absorption
• Penicillamine
28

29. Chromiu
m
29
• In 1957, extracted from pork kidney and they
named it as “glucose tolerance factor” as it
corrected hyperglycaemia.
• Regulates plasma lipoprotein concentration and
reduces cholesterol and triglycerides.
• Found in – grains, cereals, fruits, processed meat

30. RDA : 20 – 35 mcg/ day
• In improving lean body mass
Deficiency:
• Limited to hospitalized patients on TPN
Toxicity :
• Lung Ca, Bronchogenic Ca in stainless steel
workers
• Dermatitis, skin ulcers
30

31. Fluorid
e
• Very important in preventing dental caries
• Promotes remineralization of decalcified enamel
•Available as tooth paste, solutions and gels
Excess cause flurosis
•Rx- tooth bleeching,
microabrasion,
replacement
31

32. Iodin
e
• Thyroid hormone synthesis and also have broad
spectrum germicidal action
• Iodine induced hyperthyroidism:
-In individuals of nodular goiter in endemic area
-thyrotoxicosis due to underlying areas of
autonomy (Jod Basedow phenomenon)
32

33. Iodine induced hypothyroidism:
• people at risk are- autoimmune thyroiditis,
Graves hyperthyroidism previously treated with
radioactive iodine
• Unusually sensitive to inhibitory effect due to
sustained activity on Na/I symporter
( Wolff Chaikoff effect ).
33

34. Iodine deficiency prophylaxis:
• Iodised salt
• Iodised oil
• Iodised water
• Iodine tablets or drops
• Biofortification of vegetables with iodine
• Also available as ointment, solution, mouth
gargles
34

35. Manganes
e
35
• Shown to be essential for normal growth and
development
• Role in human health unclear
• Dietary sources: meat, fish, poultry, dry fruits and
nuts

36. • Biological role: manganese superoxide dismutase
arginase, glutamate synthase & pyruvate
carboxylase
• Deficiency :
Experimental animals - ↓growth, ↓fertility, ataxia,
skeletal deformities, abnormal fat and CHO
metabolism
36

37. • Toxicity:
Neurotoxic- extrapyramidal parts affected
Headache
Hepatic dysfunction
• RDA – 2-11mg/day
37

38. Molybdenu
m
38
• Act as a catalyst for enzymes and helps facilitate
breakdown of certain amino acids
• Molybdenum in human tooth enamel may have a
role in lowering the risk of tooth decay.
• Deficiency – esophageal carcinoma
• RDA: 45mcg/day
pregnancy and lactation 50mcg/day

39. Seleniu
m
39
• Least abundant trace element
• Recommended intake for adults 50-200 μg/day
Functions in human body:
Selenium in Glutathione peroxidase (GTH-Px)-
important role immune system function, also plays a
crucial role in the control of oxygen metabolism.

40. Functions in human body:
40
• protects body from oxidative damage.
•Low GTH-Px in platelets leads to bleeding disorders
& edema due to damage to capillary membranes
• Protects phagocytes from destruction
• GTH-Px protects eye lens tissues and neurons from
damage

41. • Low Selenium leads to Keshan’s disease, which is a
type of cardiac myopathy discovered in china where
soil Selenium was absent.
Selenium deficiency occurs due to:
•Hemolytic anemia
•Clansman's thrombasthenia (platelet disorder)
•Gastrointestinal cancer
•Malnutrition
41

42. • Vanadium
• Control of sodium pump, inhibition of ATPase
• Tin
• Interaction with riboflavin metabolism
• Silicon
• Structural role in connective tissue, in metabolism
of osteogenic cells
• Nickel
• Component of enzyme urease 42

43. Boro
n
43
• Boron is a vital trace mineral that is required for the
normal growth and health of the body.
• apples, oranges, red grapes, kiwis, dates, as well as
certain vegetables, avocado, soybeans and nuts are
rich sources of boron

44. Health benefits:
• Prevents arthritis
• Used for body building
• Estrogen Production: Boron can improve the
production of estrogen in menopausal women
• Embryonic development: Boron appears to be
essential for reproduction and the development of
the fetus
• Proper cell membrane functions
• Lowers plasma lipid levels
44

45. Lithiu
m
45
• Discovered in 1817 as mood stabilizing agent
MOA:
• Inositol depletion theory
• Inhibition of NMDA receptor mediated signalling
• Inhibition of GSK3
• BDNF upregulation

46. Adverse effects:
• Nephrogenic diabetes insipidus
• Thyroid function abnormalities
• mental confusion
• hyperreflexia
• gross tremor
• dysarthria
• Seizures
• cardiac arrhythmias,
• hypotension, and
• albuminuria.
46

47. Uses
• BPD
• Mania
• Depression
• Cancer induced leukopenia & agranulocytosis
Preparation:
• Lithium carbonate 150/300/600mg
• Lithium citrate syrup 8mEq/5ml
47

48. Xenon
48
• A trace element in earths atmosphere
• Xenon is a medical gas capable of establishing
neuroprotection, inducing anesthesia and nuclear
medicine as a contrast agent
• Acts through NMDA receptor

49. THANK YOU