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EPA (Eicosapentaenoic Acid) Deficiency

Macherel...
Macherel…EPA Rich!

What Is EPA?

[dropcap]E[/dropcap]PA (eicosapentaenoic acid) is an essential omega-3 fatty acid that is crucial for fetal brain and retina development and the child’s subsequent neurodevelopment among very many other activities in people of all ages.

Omega-3 fatty acids  are polyunsaturated long chain fatty acids which must be obtained from animal foods since they do not occur in plants.

In all ages, EPA is essential for normal brain function.

Q: Why is EPA essential to the way the brain works?

A: EPA helps nerve cells in the brain to communicate with each other.

In pregnancy, EPA may also play a role in determining the length of gestation and in preventing perinatal depression in the mother.1 and is essential for normal growth in children.

EPA is important building material for the eicosanoids, a large group of highly bioactive hormone-like substances including prostaglandins, leukotrienes, and thromboxanes that are involved in blood clotting, inflammation, and vasoconstriction. Its many important functions are described below.

What Is EPA Deficiency?

Sources:
  1. Coletta JM, Bell SJ, and Roman AS. Omega-3 Fatty Acids and Pregnancy. Rev Obstet Gynecol. 2010 Fall; 3(4): 163–171 [↩]

Low Plasma Proteins

Image of a protein molecule.
Image of a protein molecule.

What Are Low Plasma Proteins?

[dropcap]L[/dropcap]ow plasma proteins found in blood indicates an abnormal blood level.

Plasma proteins are any of the proteins that constitute about 6% to 7% of the blood plasma in the body. They include albumin, fibrinogen, prothrombin, and the gamma globulins. All plasma proteins except the gamma globulins are produced in the liver.1

Q: Which protein is most abundant in blood?

A: Of the dozens of plasma proteins, albumin makes up more than half. Albumin level is the most frequently tested in the presence of weight loss and other signs of poor nutrition. Albumin helps maintain water balance that affects osmotic pressure, increase blood viscosity, and helps maintain blood pressure.1

Other commonly tested blood proteins are globulins which make up about a third of plasma proteins. Lab reports show the ratio between albumin and globulin, as well as, their individual values. Fibrinogen, essential for clot formation, makes 7% of plasma proteins while regulatory proteins, which include enzymes and hormones, make up 1%.

What Are Low Plasma Proteins In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Mosby’s Medical Dictionary, 8th edition. © 2009, Elsevier. [↩] [↩]

Iron Deficiency

ferritinWhat Is Iron?

[dropcap]I[/dropcap]ron 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 Iron Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://ods.od.nih.gov/factsheets/Iron-HealthProfessional accessed 12/11/12 [↩]
  2. Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging. 2006 Sep-Oct; 10(5):377-85. [↩]

Potassium Deficiency

Luscious Figs For Potassium.
Luscious Figs For Potassium.

What Is Potassium?

[dropcap]P[/dropcap]otassium 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

What Is Potassium Deficiency In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Shin D, Joh HK, Kim KH, Park SM. Benefits of potassium intake on metabolic syndrome: The fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Atherosclerosis. 2013 Sep;230(1):80-5. doi: 10.1016/j.atherosclerosis.2013.06.025. [↩]

Homocysteine, Elevated Blood Level (Hyperhomocysteinemia)

A 3-D model of homocysteine.
A 3-D model of homocysteine.

What Is Elevated Homocysteine?

[dropcap]E[/dropcap]levated homocysteine in blood, called hyperhomocysteinemia, indicates an abnormal blood level of this transient amino acid.

Q: How does the level of homocysteine become abnormal?

A: In metabolism, homocysteine is briefly formed in the breakdown of the amino acid methionine. It is normally converted to cystathione and then to the amino acid cysteine by means of an enzyme that requires vitamin B6.

In the reverse, conversion of homocysteine to methionine requires an enzyme dependent on adequate folic acid and vitamin B12 levels.

Insufficient methionine levels and/or inefficiency in this process results in elevated homocysteine plasma levels that are toxic to blood vessels.

Folic acid, vitamin B12 and vitamin B6 are involved in the metabolic removal of homocysteine, but folic acid deficit occurs the most often.1

What Is Elevated Homocysteine In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Lim PO, Tzemos N, Farquharson CA, et al. Reversible hypertension following coeliac disease treatment: the role of moderate hyperhomocysteinaemia and vascular endothelial dysfunction. Journal of Human Hypertension. Jun 2002;16(6):411-5. [↩]

Zinc Deficiency

Oysters Have Mega Zinc!
Oysters Have Mega Zinc!

What Is Zinc?

[dropcap]Z[/dropcap]inc is an essential trace mineral that is involved in numerous aspects of cellular metabolism, being essential for activation of almost 200 enzymes that have vital roles in the body.

Q: What happens when enzymes do not get activated?

A: When enzymes do not get activated, they cannot perform their necessary functions which, in turn, damages health.

Zinc promotes healthy skin, hair, immunity, fertility, and growth.

A daily intake of zinc is required to maintain a steady state because the body has no specialized zinc storage system.1 Functions are more fully described below.

What Is Zinc Deficiency in Celiac Disease?

Sources:
  1. http://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/ [↩]

Hypocalcemia (Low Blood Calcium)

hypocalcemia celiac disease gluten symptomWhat Is Hypocalcemia?

[dropcap]H[/dropcap]ypocalcemia, or low plasma calcium, means the level of calcium in blood is too low to meet metabolic needs of the body for calcium.

Low blood calcium is characterized by bone and tooth demineralization (loss of calcium causing weak teeth and fragile bones), and these impaired functions: nerve conduction, muscle contraction, blood clotting, blood pressure regulation, glycogen to glucose conversion, many hormone actions, many enzyme activities, and acetylcholine production.

Q: Where is calcium found in the body?

A: Calcium is the most abundant mineral in the body, with 99% residing in bones and teeth where it constitutes 40% of skeletal bone weight along with 45% phosphorus. As a component of bone (hard tissue), calcium fulfills a structural role to maintain body size and act as attachments for musculoskeletal tissues. The remaining 1% of calcium is present in blood and soft tissues.

Calcium levels in the blood are maintained within very strict limits by dietary intake, hormonal regulation by the parathyroid gland and a rapidly exchangeable pool in bone tissue.

What Is Hypocalcemia In Celiac Disease and/or Gluten Sensitivity?

Hypoglycemia (Low Blood Sugar)

hypoglycemia symptom of celiac disease and glutenWhat Is Hypoglycemia?

Hypoglycemia means the level of glucose within cells is too low to meet metabolic needs of the body for this essential sugar.

Q: What are the metabolic needs for glucose?

A: Glucose is the most important simple sugar in human metabolism mainly because it is the primary source of energy for most cells of the body.

Energy contained in the glucose molecule is obtained by the body from its reaction with oxygen (oxidation). This oxidation reaction occurs in power producing mitochondria structures that are located within cells.1

Hypoglycemia is characterized by alterations in neurologic, metabolic and muscular functions:

  1. Neurologic function because brain tissue is particularly dependent on glucose for energy,
  2. Metabolic function of glucose-dependent tissues which include red blood cells, white blood cells, bone marrow, eye, inner heart of the kidney, and peripheral nerves because these tissues cannot metabolize fatty acids as an alternate source of energy, and
  3. Muscle function because muscle cells continually require glucose for energy production.

Glucose is made available to cells through the regulating action of insulin, a hormone produced by specialized cells located on the surface of the pancreas.

What Is Hypoglycemia In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://hyperphysics.phy-astr.gsu.edu/hbase/organic/sugar.html accessed 11 14 12 [↩]

Hypoprothrombinemia (Low Prothrombin Level)

bruiseWhat Is Hypoprothrombinemia?

[dropcap]H[/dropcap]ypoprothrombinemia is a deficiency of prothrombin (clotting factor II) in the blood that is characterized by impaired hemostasis in response to trauma or a laceration.

Q: What is hemostasis and how is it altered by a deficiency of prothrombin?

A: Hemostasis encompasses the tightly regulated processes of blood clotting, platelet activation, and blood vessel repair.1

Prothrombin is a protein clotting factor present in blood that is involved in the first part of hemostasis, which is blood clotting or coagulation. Vitamin K is required for prothrombin production.

When a laceration or wound is sustained, prothrombin is converted to the enzyme thrombin. Thrombin in turn acts on fibrinogen to convert it to fibrin which then forms the framework of a clot to stop bleeding. Deficiency of prothrombin prevents this series of events and bleeding is not properly stopped.

After the clotting process of hemostasis would come the second part, platelet activation. Eventually, coagulation and platelet activation are switched off by blood-borne inhibitors.

What Is Hypoprothrombinemia In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. Versteeg HH, Heemskerk JWM, Levi M,  Reitsma PH. New Fundamentals in Hemostasis. Physiological Reviews Published 1 January 2013Vol. 93no. 327-358DOI: 10.1152/physrev.00016.2011 [↩]

Neutropenia 

neutrophilWhat Is Neutropenia?

[dropcap]N[/dropcap]eutropenia  is a blood disorder characterized by presence of an abnormally low number of neutrophils.

Neutrophils are white blood cells (leukocytes) that serves as the primary defense against infections by destroying bacteria in the blood. 

Specfically, neutrophils are a type of granulocyte that contain granules filled with potent chemicals to break down the microbes they ingest. Some of these chemicals, such as histamine, also contribute to inflammation and allergy.

The process of eating and digesting microbes is called phagocytosis. Neutrophils are phagocytes.1

Q: How do neutrophils eat microbes?

A: Segmented neutrophils  are the mature phagocytes that migrate through tissues to destroy microbes and respond to inflammatory stimuli. Segmented neutrophils comprise 40-75 % of the peripheral leukocytes. They are usually 9 to 16 µm in diameter. The nuclear lobes, normally numbering from 2 to 5, may be spread out so that the connecting filaments are clearly visible, or the lobes may overlap or twist. The chromatin pattern is coarse and clumped. The cytoplasm is abundant with a few nonspecific granules and a full complement of rose-violet specific granules.1

What Is Neutropenia In Celiac Disease and/or Gluten Sensitivity?

Sources:
  1. http://www.wadsworth.org/chemheme/heme/microscope/seg.htm [↩] [↩]