Minerals and Transition Metals in Nutrition
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Questions and Answers

How long does it generally take to raise hemoglobin levels after starting oral iron treatment?

  • 1-2 weeks
  • Over 6 months
  • 2-3 months
  • 4-6 weeks (correct)

    • Intravenous iron treatments take less time to correct anemia than oral iron treatments.

    True

    What are some common gastrointestinal side effects of oral iron supplementation?

    Bloating, upset stomach, pain, constipation

    Oral iron takes ______ to build up sufficient iron stores in the body.

    <p>2-3 months</p> Signup and view all the answers

    Which of the following is a study finding regarding intravenous iron vs. oral iron?

    <p>Intravenous iron results in higher cord blood ferritin.</p> Signup and view all the answers

    Higher doses of iron always result in fewer side effects compared to lower doses.

    <p>False</p> Signup and view all the answers

    What adverse effect is associated with ferric carboxymaltose?

    <p>Hypophosphatemia</p> Signup and view all the answers

    A patient experiencing reaction during intravenous iron treatment may have a ______ reaction.

    <p>Fishbane</p> Signup and view all the answers

    Match the following iron treatment methods with their characteristics:

    <p>Oral Iron = Takes 4-6 weeks to raise hemoglobin IV Iron = May cause hypophosphatemia Higher Dose Iron = Same hemoglobin increase with more side effects Lower Dose Iron = Fewer side effects with same hemoglobin increase</p> Signup and view all the answers

    What is the recommended time frame for administering IV iron before elective surgery?

    <p>2-4 weeks</p> Signup and view all the answers

    Which type of calcium preparation has the highest elemental calcium content?

    <p>Calcium carbonate</p> Signup and view all the answers

    Zinc is not involved in redox reactions due to having a full valence shell of electrons.

    <p>True</p> Signup and view all the answers

    What can inhibit the absorption of zinc?

    <p>Phytates and calcium</p> Signup and view all the answers

    Calcium is primarily stored in the ________ and ________.

    <p>bone, teeth</p> Signup and view all the answers

    Match the minerals with their key functions:

    <p>Calcium = Bone and teeth formation Zinc = Component of transcription factors Manganese = Redox reactions and enzyme function Magnesium = Muscle function and energy production</p> Signup and view all the answers

    Which enzyme is NOT associated with manganese?

    <p>Carbonic anhydrase</p> Signup and view all the answers

    Phytic acid has no effect on calcium absorption in the intestinal lumen.

    <p>False</p> Signup and view all the answers

    Which amino acid mutation in zinc fingers leads to rickets?

    <p>Single amino acid mutation in the Zn fingers of the 1,25(OH)2-D3 receptor</p> Signup and view all the answers

    The cytosolic superoxide dismutase is one of the ________ that contains zinc.

    <p>metalloenzymes</p> Signup and view all the answers

    Zinc is commonly found in which type of foods?

    <p>Animal-source foods</p> Signup and view all the answers

    What type of iron is absorbed 100%?

    <p>Heme iron polypeptide</p> Signup and view all the answers

    Non-heme iron is primarily found in meat and poultry.

    <p>False</p> Signup and view all the answers

    Name two proteins that are associated with iron-based functions.

    <p>Hemoglobin and myoglobin</p> Signup and view all the answers

    Free transition metals are vulnerable to nonspecific oxidation due to their extremely low levels in __________.

    <p>cells</p> Signup and view all the answers

    Match the following iron preparations with their elemental iron content:

    <p>Ferrous fumarate = 105 mg Ferrous gluconate = 30 mg Heme iron polypeptide = 10.5 mg Ferrous sulfate = 74 mg</p> Signup and view all the answers

    Which of the following statements about iron absorption is true?

    <p>Heme iron is absorbed more efficiently than non-heme iron.</p> Signup and view all the answers

    Iron Dextran can be administered in a single infusion of up to 1000 mg.

    <p>True</p> Signup and view all the answers

    What is the purpose of heme iron in myeloperoxidase?

    <p>To catalyze the condensation of H2O2 with Cl- ions to generate HOCl.</p> Signup and view all the answers

    Iron atoms cycle between ferrous (Fe+2) and ferric (Fe+3) states in the __________.

    <p>electron transport chain</p> Signup and view all the answers

    Which of the following foods is a good source of heme iron?

    <p>Seafood</p> Signup and view all the answers

    Which of the following foods is a source of non-heme iron?

    <p>Spinach</p> Signup and view all the answers

    Heme iron is absorbed less effectively than non-heme iron.

    <p>False</p> Signup and view all the answers

    What is the role of myeloperoxidase in relation to iron?

    <p>It uses heme iron to catalyze the condensation of H2O2 with Cl- ions.</p> Signup and view all the answers

    Iron atoms cycle between ______ and ______ states in the electron transport chain.

    <p>ferrous, ferric</p> Signup and view all the answers

    Which of the following is true about intravenous iron preparations?

    <p>Iron Dextran can be given in one maximum dose of 1000 mg.</p> Signup and view all the answers

    Free transition metals have high levels in cells.

    <p>False</p> Signup and view all the answers

    What is the main advantage of using heme iron as an iron supplement?

    <p>It is absorbed 100% and doesn't leave any unabsorbed iron.</p> Signup and view all the answers

    Daily intake of iron must be balanced with ______ to prevent deficiency.

    <p>absorption</p> Signup and view all the answers

    Which type of calcium preparation contains the highest percentage of elemental calcium?

    <p>Calcium carbonate</p> Signup and view all the answers

    Phytic acid in cereals enhances the absorption of calcium in the intestinal lumen.

    <p>False</p> Signup and view all the answers

    Name one enzyme associated with manganese.

    <p>Isocitrate dehydrogenase</p> Signup and view all the answers

    Zinc is a key component of ________ that play a role in gene expression.

    <p>transcription factors</p> Signup and view all the answers

    Match the following minerals with their key characteristics:

    <p>Calcium = Regulates extracellular concentration Manganese = Involved in redox reactions Zinc = Contains zinc fingers Magnesium = Cofactor for many enzymes</p> Signup and view all the answers

    Which of the following foods is likely to be the best source of zinc?

    <p>Chicken breast</p> Signup and view all the answers

    Zinc can undergo various oxidation states like manganese due to its electronic configuration.

    <p>False</p> Signup and view all the answers

    What effect does protein have on zinc absorption?

    <p>Enhances absorption</p> Signup and view all the answers

    A deficiency in zinc can lead to a clinical syndrome known as ________.

    <p>rickets</p> Signup and view all the answers

    What element cycles between +2 and +3 oxidation states during its biological functions?

    <p>Manganese</p> Signup and view all the answers

    What is the preferred method for increasing hemoglobin with fewer side effects?

    <p>Lower dose of oral iron</p> Signup and view all the answers

    It takes longer to build up iron stores with oral iron than to raise hemoglobin levels.

    <p>True</p> Signup and view all the answers

    What is a common gastrointestinal side effect of oral iron supplementation?

    <p>constipation</p> Signup and view all the answers

    Intravenous iron should be given ______ weeks before elective surgery.

    <p>2-4</p> Signup and view all the answers

    Match the type of iron treatment with its effect:

    <p>Oral Iron = Takes 4-6 weeks to raise hemoglobin Intravenous Iron = Delivers higher cord blood ferritin Higher Dose Oral Iron = More side effects Low Dose Oral Iron = Fewer side effects</p> Signup and view all the answers

    Which of the following is a major adverse effect associated with ferric carboxymaltose?

    <p>Hypophosphatemia</p> Signup and view all the answers

    Iron overdose is a risk with both oral and IV iron supplementation.

    <p>True</p> Signup and view all the answers

    How long does it typically take for oral iron to raise hemoglobin?

    <p>4-6 weeks</p> Signup and view all the answers

    A reaction during intravenous iron treatment may be due to a __________ allergy.

    <p>pseudo</p> Signup and view all the answers

    Which of the following may lead to a higher cord blood ferritin level?

    <p>Intravenous iron (ferumoxytol)</p> Signup and view all the answers

    Which food source is classified as non-heme iron?

    <p>Spinach</p> Signup and view all the answers

    Heme iron is absorbed with 100% efficiency.

    <p>True</p> Signup and view all the answers

    What enzyme utilizes heme iron to produce hypochlorous acid?

    <p>Myeloperoxidase</p> Signup and view all the answers

    The interaction of iron with the porphyrin ring in hemoglobin protects Fe+2 from oxidation to Fe+3, which forms __________.

    <p>methemoglobin</p> Signup and view all the answers

    Match the following iron preparations with their absorbed iron percentage:

    <p>Ferrous fumarate = 33% Ferrous gluconate = 12% Ferrous sulfate = 20% Heme iron polypeptide = 100%</p> Signup and view all the answers

    What is the role of iron in the electron transport chain?

    <p>Cycles between ferrous and ferric states</p> Signup and view all the answers

    Iron dextran must always be administered in single doses of 100 mg.

    <p>False</p> Signup and view all the answers

    Name one advantage of using heme iron supplements over non-heme iron supplements.

    <p>Higher absorption efficiency</p> Signup and view all the answers

    Which transition metal is particularly important for protecting cells against oxidation?

    <p>Iron</p> Signup and view all the answers

    Which type of calcium preparation has the lowest percentage of elemental calcium?

    <p>Calcium gluconate</p> Signup and view all the answers

    Zinc is involved in redox reactions due to its valence shell configuration.

    <p>False</p> Signup and view all the answers

    Which mineral is primarily stored in bones, teeth, and cartilage?

    <p>Calcium</p> Signup and view all the answers

    Manganese is crucial for enzymes involved in _____ metabolism.

    <p>nitrogen</p> Signup and view all the answers

    Match the following minerals with their key properties:

    <p>Calcium = Majority found in bone and teeth Zinc = Component of metalloproteins with zinc fingers Manganese = Involved in redox reactions Potassium = Regulates fluid balance</p> Signup and view all the answers

    Which enzyme is associated with manganese metabolism?

    <p>Pyruvate carboxylase</p> Signup and view all the answers

    Which method is recommended for preoperative iron supplementation before elective surgery?

    <p>Intravenous iron 2-4 weeks before surgery</p> Signup and view all the answers

    Oral iron can effectively raise hemoglobin levels in 2-4 weeks.

    <p>False</p> Signup and view all the answers

    What is one of the gastrointestinal side effects of oral iron supplementation?

    <p>Constipation</p> Signup and view all the answers

    Name a type of food that is high in zinc content.

    <p>Animal-source foods</p> Signup and view all the answers

    The human body contains approximately _____ zinc-containing metalloproteins.

    <p>3000</p> Signup and view all the answers

    To build up iron stores, oral iron takes ______ months.

    <p>2-3</p> Signup and view all the answers

    Match the type of iron treatment with the appropriate characteristic:

    <p>Oral iron = Takes 4-6 weeks to raise hemoglobin Intravenous iron = Recommended for rapid correction of anemia Ferric carboxymaltose = May cause hypophosphatemia Ferumoxytol = Used in pregnant women with anemia</p> Signup and view all the answers

    What is a potential adverse effect of intravenous iron administration?

    <p>Fishbane reaction</p> Signup and view all the answers

    Higher doses of oral iron always result in better absorption compared to lower doses.

    <p>False</p> Signup and view all the answers

    How long does it take for oral iron to raise hemoglobin levels?

    <p>4-6 weeks</p> Signup and view all the answers

    Oral iron tablets can continue to be taken after receiving ______ iron infusions.

    <p>intravenous</p> Signup and view all the answers

    Match each iron treatment type with its corresponding key feature:

    <p>Ferrous sulfate = Lower gastric irritation Ferric carboxymaltose = Single dose infusion Intravenous iron = Rapid increase in iron levels Oral iron = Longer time to correct anemia</p> Signup and view all the answers

    Study Notes

    Minerals

    • Minerals are involved in various bodily functions, including structural support, membrane function, enzyme activity, hormone regulation, and more.
    • Some minerals are known to be essential for proper bodily functions, but their precise roles are still unknown.
    • Other minerals contribute to the body's systems, but their essentiality is not yet established.
    • Many minerals can be toxic when present in excess amounts.
    • Different minerals are found in various foods and their absorption efficiency varies depending on the form in which they are ingested.
    • Specific minerals like calcium, magnesium, and phosphates are crucial for structure and function.
    • Minerals like sodium and potassium are involved in membrane activity.
    • Calcium, magnesium, phosphate, sodium, potassium, cobalt, copper, iron, molybdenum, selenium, zinc, calcium, chromium, iodine, magnesium, manganese, sodium, potassium, silicon, vanadium, nickel, tin, fluoride, lithium, aluminum, arsenic, antimony, boron, bromine, cadmium, cesium, germanium, lead, mercury, silver, strontium are some examples of the types of minerals.

    Nutritionally Essential Transition Metals

    • Some transition metals are essential for human health and are classified by their toxicity levels (nontoxic, low, medium to high).
    • The classification is based on existing research.
    • Examples include aluminum, manganese, calcium, bismuth, molybdenum, iron, cobalt, copper, and zinc.
    • Transition metals like iron, cobalt, copper, and zinc play critical roles, and their specific roles are further detailed in later sections.

    General Features of Transition Metals

    • Transition metals are associated with proteins through amino acid side chains containing O2, N, and S atoms.
    • These elements are commonly found with porphyrins, corrins, and pterins.
    • Transition metals play a role in protecting against oxidation, suppressing reactive oxygen species (ROS) production, and enhancing solubility.
    • Their levels are typically low within cells, as they are vulnerable to non-specific oxidation.

    Importance of Iron-Protein Interactions

    • Hemoglobin and myoglobin employ porphyrin rings and histidyl residues to protect iron from oxidative states and maintain their functional properties.
    • Iron atoms contained within heme groups of cytochromes and Fe-S clusters cycle between ferrous and ferric states in the electron transport chain.
    • Myeloperoxidase uses heme iron to catalyze the condensation of hydrogen peroxide (H2O2) and chloride (Cl-) ions to produce hypochlorous acid (HOCl), which can be important in cellular processes.
    • DNA replication and repair enzymes utilize Fe-S clusters.
    • Iron is used in various enzymatic functions.

    Food Sources of Iron

    • Heme iron is found in meat, poultry, and seafood.
    • Non-heme iron is commonly found in whole grains, nuts, seeds, and animal products that consume plant matter.
    • Fortified foods are also a potential source of iron.

    Oral Iron Supplements

    • Different oral iron preparations have varying quantities of iron per tablet and differ in their absorption rates.
    • The absorption rate can be lower than 100% for most oral supplements not made from heme iron (typically <100%).
    • Absorption rates are influenced by the chemical form of the iron and other factors.
    • Studies show different iron compounds have varying absorption percentages. Examples include preparations like ferrous fumarate, ferrous gluconate, and various forms of ferrous sulfate.

    Intravenous Iron Preparations

    • Intravenous (IV) iron preparations include iron dextran, iron sucrose, and ferric carboxymaltose, each with different recommended doses and infusion times.
    • IV iron administration is sometimes preferable to oral iron for patients with specific needs.

    Iron Dosing

    • Daily iron intake versus intermittent intake can have different impacts on ferritin and hemoglobin levels.
    • A once-daily iron intake plan may be superior to twice-daily regimens for some applications, based on research.
    • Lower iron doses may avoid negative side effects of higher doses without compromising efficacy.
    • Dosing strategies should be tailored to individual needs.

    Iron Absorption

    • Iron from food can be absorbed as either heme or non-heme iron, with different absorption mechanisms.
    • Iron is taken up by epithelial cells and absorbed following an intricate process leading to distribution in the body.
    • Absorption is inhibited by phytates and calcium.
    • Hepcidin, ferroportin, and other factors are involved in this process.

    Correcting Anemia

    • Oral iron supplements require 4-6 weeks to elevate hemoglobin levels and 2-3 months to fully replenish iron stores.
    • Side effects of oral iron supplements may include digestive issues.
    • Preoperative IV iron administration might be necessary depending on specific circumstances and patient risks.
    • Some side effects may occur with IV iron treatments, such as fishbane reactions.

    Practical Questions

    • Patients may continue to take oral iron medications after IV iron infusions, but it's important to consult a medical professional for advice based on individual needs.
    • Iron overdose is a potential risk when considering iron intake.

    Calcium

    • Calcium is predominantly found in bones, teeth, and cartilage.
    • Extracellular calcium levels are tightly regulated to prevent toxicity.
    • Phytic acid in certain foods can bind calcium and reduce its absorption.
    • Negative side effects such as constipation and bloating can occur.
    • The role of calcium in bone and teeth development and maintenance is significant.

    Calcium Supplements

    • Different calcium preparations have varying percentages of elemental calcium.
    • Calcium carbonate is a common and inexpensive preparation.

    Manganese

    • Manganese-containing enzymes are primarily located within mitochondria.
    • Manganese enzymes are involved in different metabolic processes including carbohydrate metabolism, nitrogen metabolism, and more.
    • Manganese acts in redox reactions cycling between +2 and +3 oxidation states.
    • Manganese plays a critical role in enzyme functionality and metabolic processes. Manganese is a component of important enzymes.

    Zinc

    • Zinc is abundant in animal-sourced foods.
    • Zinc absorption may be hindered by phytates and calcium in the diet.
    • Zinc is vital for various protein functions, and is crucial for the production of certain proteins and DNA-RNA activity. Zinc is a component of a large number of enzymes.

    Cobalt

    • Cobalt is a crucial component of Vitamin B12 which facilitates one-carbon transfer in reactions.
    • Cobalt is also seen in related compounds (corrinoids).
    • Different metabolic pathways associated with cobalt are involved in various processes.
    • Cobalt is essential in the function of Vitamin B12 and subsequent metabolic pathways. Cobalt plays a crucial role in B12 synthesis and cellular metabolism.

    Copper

    • Copper is essential for various enzymes.
    • Copper is crucial for crosslinking proteins like collagen and elastin.
    • Absorption of copper may decrease due to other ions such as zinc, potentially leading to lethal anemia.
    • Excessive zinc intake impacts copper absorption and has serious consequences.
    • Copper is essential for various enzymatic reactions including collagen and elastin formation. Copper can be affected by zinc levels.

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