What Is Irritable Bowel Syndrome? I rritable bowel syndrome (IBS) is a motility disorder without anatomic cause involving the entire gastrointestinal tract that is characterized by these four features: 1) Abdominal pain usually relieved by…
Osteoporosis is a metabolic bone disorder characterized by diminished bone mass (density) with normal cell appearance but fragile bone strength that prediposes to broken bones, and with high bone turnover.
This condition usually goes undetected until late when loss of height or a bone fracture occurs. In fact, each year 1.5 million fractures mainly of the hip, spine and wrist are attributed to osteoporosis. Compression fractures of vertebrae bones are the most common, accounting for 700,000 cases.
Bone is composed of specialized connective tissue called osseous tissue. Osseous tissue is made up of living bone cells (osteocytes) that are embedded in a hard matrix (framework) of calcified substance.
Bone matrix contains collagen fibers and the minerals calcium phosphate and calcium carbonate, which provide strength to bone. The copper enzyme, lysyl oxidase, is involved in the cross-linking of collagen in forming the framework for depositing calcium and other minerals to build and repair bone.
Q: How do osteocytes function in bone?
A: Osteocytes maintain the health of bone by their metabolic activity in regulating normal bone turnover. Bone turnover is the breaking down and removal of old or damaged bone and rebuilding or remodeling of healthy bone that is ongoing throughout life. The bone formation process takes about 3 months to complete.
Osteoporosis develops from failure of the body to maintain health and to provide bone tissue with adequate nutrition for proper function. Risk factors that can be modified include: low calcium intake, sedentary lifestyle, smoking, drinking alcohol excessively, eating a diet with excessive caffeine, protein, and phosphate, and taking certain medications over a long time such as steroids, thyroid preparations, the anti-convulsive drug phenytoin, aspirin, antacids, anticoagulants, some diuretics, and some chemotherapeutic drugs. See below for a fuller description.
In addition to celiac disease, osteoporosis is associated with advancing age, family history, nulliparity (no pregnancies) and post-menopause in females, certain disorders such as hyperthyroidism, hypogonadism, inflammatory bowel disease like Crohn’s disease, multiple myeloma, anorexia nervosa, and Cushing’s disease.
Bone strength is easily measured by testing bone mineral density (BMD). BMD is evaluated by DEXA scan (dual-energy X-ray absorptiometry). DEXA at the femoral neck and lumbar spine is considered the gold standard to confirm the diagnosis of osteoporosis. Results are expressed as T and Z scores. T scores compare the result with a 20 to 40 year old helathy person while Z scores compare the result with persons in the same age group. Both are measured in standard deviations (SD).
According to WHO criteria (World Health Organization), a T-score of -1 SD or greater denotes normal bone, a T-score between −1 to −2.5 SD denotes osteopenia, and a T-score of −2.5 or more denotes osteoporosis.1
Treatment is aimed to preserve and increase bone density, minimize symptoms for better quality of life and reduce risk of bone fractures.
The cumulative effects of gluten-induced inflammation, treatment delay, and malabsorption result in lower bone density and bone fragility.2
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What Is Hypomagnesemia?Hypomagnesemia means the level of magnesium in the bloodstream is too low to meet metabolic needs of the body for this mineral.
Q: What are the metabolic needs of the body for magnesium?
A: The metabolic needs of the body for magnesium are numerous which gives rise to very many distressing symptoms when this mineral is deficient.
A major function of magnesium is to stabilize the structure of an enzyme called adenosine triphosphate (ATP) within cells for the production of energy. In the brain, magnesium plays important roles in all the major metabolisms such as oxidation-reduction and regulation of ions (charged minerals).1
U rticaria is an immune based skin disorder characterized by multiple eruptions of well-demarcated edematous, intensely pruritic (itchy) plaques that may be small or reach the diameter of many centimeters with surrounding erythema (redness) each lasting less than 24 hours.1
Q: What is the immune reaction in hives?
A: Hives form when, in response to histamine, blood plasma leaks out of small blood vessels in the skin. Histamine is a chemical released from specialized cells along the skin’s blood vessels. Allergic reactions, chemicals in certain foods, insect stings, sunlight exposure, or medications can all cause histamine release.2
In many patients, in spite of extensive investigations, the cause remains elusive. The term idiopathic is often used to denote this category. Now it is known that autoimmunity is the cause of chronic urticaria in 50% of cases.
Treatment is generally started with nonsedating antihistamine in the daytime and sedating antihistamine in the night.3
What Is Zincemia?Zincemia means the zinc level in blood plasma is too low to meet metabolic needs of the body for this mineral.
Q: How important is a normal blood level of zinc?
A: A low blood level of zinc is characterized by widespread alterations in energy metabolism, growth, hemoglobin, carbon dioxide transport, hormone activity, insulin storage, many enzyme activities, prostaglandin function, collagen production, male fertility, protein synthesis, and vitamin A metabolism.
Copper is an essential trace element that is required for a number of enzymes which are necessary for normal metabolic function.
In the body almost all the copper is present as a component of copper proteins which are produced and controlled by the liver.
Q: How does the liver control copper?
A: The liver maintains proper copper balance by binding free copper to proteins and by excreting excess copper as part of bile that is then emptied into the intestinal tract and excreted in stool.
Metabolic balance studies have demonstrated that daily copper losses are approximately 1.3 mg/day.1
Among its specific functions listed below, copper is essential for energy production, blood and nerve functions, blood components, immunity, and collagen tissue. The copper enzyme, lysyl oxidase, is involved in the cross-linking of collagen in forming the framework for depositing calcium and other minerals to build and repair bone.
Animal studies suggest that adequate copper levels during pregnancy are critical to development of higher brain function in the offspring.2
Chromium is a mineral that the body absolutely requires in trace amounts for normal metabolism, meaning the physical and chemical processes by which energy is produced and used.
Chromium is especially involved in the use of glucose sugar and lipids such as cholesterol and the effectiveness of insulin hormone.
Q: How is chromium involved in the use of glucose?
A: Very small amounts of chromium are required to enable insulin to move glucose from the bloodstream into cells for use as energy.
Insulin is a hormone that controls the use and storage of glucose in two ways: 1) lowers a rise of glucose in blood after meals by moving it out of the bloodstream into body cells, especially muscle cells and 2) limits the release of glucose from the liver between meals. Insulin is produced by beta cells on the surface of the pancreas.
To date, the molecular mechanism by which chromium affects glucose and lipid metabolism is still unclear.1
What Is Iron?Iron is an essential mineral that is required for normal body function.
Almost two-thirds of iron in the body is found in hemoglobin, the protein in red blood cells that carries oxygen to tissues. Smaller amounts of iron are found in myoglobin, a protein that helps supply oxygen to muscle, and in enzymes that assist biochemical reactions.
Iron is also found in proteins that store iron for future needs and that transport iron in blood.
Q: How are iron stores regulated?
A:Iron stores are regulated by intestinal iron absorption.1That is, whenever iron is needed, more iron is absorbed than when iron is sufficient. This mechanism prevents excess iron in the body which is harmful.
In the brain, iron is necessary to ensure oxygenation and to produce energy in the cerebral parenchyma (via cytochrome oxid. ase), and for the synthesis of neurotransmitters and myelin.
Iron concentrations in the umbilical artery are critical during the development of the fetus, and in relation with the IQ in the child.2
What Is Phosphorus?Phosphorus is an essential mineral present in every cell of the body mostly in the form of phosphate.
About 85% of phosphorus is present in bone making up a major component of bone formation. As a component of calcium phosphate, phosphorus constitutes 45% of skeletal bone weight while calcium constitutes 40% to support the body.1.
Phosphorus is required for normal tooth development. Inadequate phosphorus in early childhood development makes for defective tooth enamel in permanent teeth.
Phosphorus is crucial for the production of ATP (adenosine triphosphate), a molecule within cells that the body uses to store energy, and is required for production of phosphocreatine to power muscles. Functions are more fully described below.
One gram of protein in food provides approximately 15 mg of phosphorus. In an adult, the body content of phosphorus ia about 700 grams.
Potassium is a mineral that is crucial for life being essential for every cell, especially nerve and muscle function.
Most potassium is intracellular, meaning it is found within cells while sodium, its opposing mineral (both electrolytes), is found in the fluid surrounding cells.
In muscle contraction, exchange of potassium and sodium takes place so that potassium moves out of muscle cells and sodium moves into them.
With muscle relaxation, potassium moves back into the cells and sodium moves out. Functions are described below.
Importantly, a recent study investigating the association between the metabolic syndrome and potassium intake in the general population found a significant inverse association between potassium intake and metabolic syndrome in adults. That is, the lower the potassium intake, the greater the odds of developing metabolic syndrome. After adjusting for various lifestyle and dietary confounders, subjects in the highest quartile of potassium intake had 39% lower odds for metabolic syndrome compared to those in the lowest quartile. This association was consistent for both sexes. Among the components of metabolic syndrome, potassium intake was inversely related to abdominal obesity and fasting hyperglycemia in multivariate analysis.1