This document discusses several essential trace minerals, including iron, zinc, and selenium. It provides information on their functions, dietary sources, deficiencies, and recommended intake levels. Specifically, it notes that trace minerals play important roles as enzyme cofactors and in various metabolic processes. Good dietary sources include meat, seafood, grains, fruits and vegetables. Deficiencies can result in conditions like anemia and impaired growth. Supplementation may be necessary in some cases to prevent deficiencies.

1. TRACE MINERALS OTHER THAN
FLUORIDES
DBA
Coojacinto
Lianza
Micu

2. Essential Trace
Minerals

3. Essential Trace Minerals
 Trace elements or micro-minerals
 Inorganic nutrients required by humans in very small
amountsfrom micrograms (o.oo1 mg) to no more
than a few mg - less than 100 mg/day
 Essential for humans with vital functions to avoid a
deficiency disease.
 Mn, Mo, Se, Cr, Co – human enzymatic actions
 Fe, I, Zn – recommended daily allowances
 Cu, F – estimated safe ranges and adequate intake

4. Trace Elements: Modes of Action
 Act as catalysts either as
 Metallo-enzymes
 the trace element is an integral part of the enzyme molecule
 Fe, Zn, Mo
 Cu – firmly bound and incorporated in the protein molecule of
the enzyme tyrosinase
 Metal-enzymes
 the metal ion is loosely associated with the enzymes
 Arginase
 Functions as constituents and activators of
hormones
 Iodine: found in thyroid hormones
 Chromium: insulin activator
 Cobalt: acts as a structural center of vit.B12

5. Dietary Sources & Classification
 Good sources
 Meat
 Fish
 Natural plant foods
 Grains
 Beans
 Fruits
 Vegetables
 Consumption of processed foods REDUCES the intake of
essential micronutrients, unless these foods are fortified to
conc’ns at least equal to those naturally occurring in the
product.
 2 categories:
1. Those that have well-defined human requirements – Fe, Zn, I,
Cu, F
2. Those that are integral constituents or activators of enzymes –
Mn, Mo, Se, Cr, Co

6. Iron

7. Iron
 One of the most important minerals in nutrition
 Involved in oxygen transport and cellular respiration
(in hemoglobin)
 Serves as an oxygen reserve in muscles metabolism
(in myoglobin)
 Total quantity ofironin the body averages about 4g,
consisting of two major fractions:
 70% essential body iron
 hemoglobin, myoglobin, and intracellular enzymes such as
cytochrome
 30% mobilizable iron reserves
 ferritin&hemosiderin

8. Physiological Functions
 Absorption
 Transport

9. Absorption
 Humans have difficulty in efficient iron absorption.
 Only 7-10% of iron in cereals and vegetables
 10-30% in animal protein and soybeans
 Iron is absorbed in the reduced ferrous state
(divalent) in the upper portion of the small intestine
 Ascorbic acid, citric acid, and amino acids
 convert the less absorbable ferric (trivalent) iron present
in foodsmore phosphoric absorbable ferrous form
 If phytates (a salt of phosphoric acid ester) present
in bran or food phosphates are ingested in excess,
the absorption of iron can be impaired.

10. Absorption
 The Ferrous iron is initially taken up by the brush border
of the intestinal wall, where it is passed into the intestinal
mucosal cells.
 In the mucosal cells, it can be either bound to:
 Transferrin
 an iron-binding protein for transport of iron in blood
 And absorbed into the bloodstream or combined with
another protein:
 Apoferritin
 This protein complex is known as ferritin (the storage
form of iron), which remains within the cells and is
released as needed.
 Control of iron absorption depends on the amount of iron
deposited as ferritin in the mucosal cells

11. Absorption
 2 most important factors determining the regulation
of iron absorption:
1. The state of iron stores in the body
2. The state of RBC formation in the bone marrow
 Absorption is increased in conditions that
decrease body iron
 during growth or pregnancy when new RBCs are being
produced
 during anemia resulting from hemorrhage

12. Transport
 Transferrin
 special carrier protein in the plasma designed for binding
and transporting iron.
 attach to the immature RBC and rapidly pass iron to
them.
 attaches to the liver cells and more slowly transfers iron to
them
 responsible for recycling iron and transporting it to the
bone marrow by production of new RBCs
 The normal plasma iron concentration= 100 µg per
100 mL
 The total iron-binding capacity (TIBC) of transferrin =
330 µg/per 100 L

13. Transport
 A drop in the saturation of transferrin below 10-15%
indicates iron deficiency anemia
 After 120 days, RBCs are destroyed by
reticuloendothelial cells (large phagocytic cell) and
the released iron is taken up by the transferrin
molecules.

14. Iron and Storage Overload
 Ferritin
 storage form of excess iron in the liver cells as when it is
deposited there among all cells of the body
 also found in the cells of spleen and bone marrow
 Hemosiderin
 an insoluble storage form of iron in the body as when the
amount of of iron in the liver, spleen, and bone marrow
EXCEEDS the capacity of the cells to form ferritin.
 Hemochromatosis
 occurs when there is excessive levels of hemosiderin or iron
overload.
 characterized by excess deposition of iron in the tissues,
especially in the liver, and by skin pigmentation

15. Iron and Storage Overload
 Common causes of Hemochromatosis:
1. Numerous transfusions in patients with hemolytic
anemia (separation of hemoglobin from red blood cells)
anemias
2. Excessive iron intake from food cooked in iron vessels
3. Drinking excessive amounts of cheap wines
4. Failure of the body to regulate absorption, as in
alcoholics on low-protein diets and in patients with
hereditary hemochromatosis

16. Recommended Dietary Allowances
 Iron intake usually tends to be inadequate in the infant
and child during the first 2 years.
 The recommended dietary allowance (RDA)=10-15
mg/day
 Males
 11-18 yrs. old: 18 mg daily
 19 and older: 10 mg daily
 Females
 At childbearing age: 18 mg daily
 After menopause: 10 mg
 The amount of iron expected from a normal diet is about
6 mg/1000 kcal
 Only 10% of iron from is food is absorbed, as this approx.
replaces the 1 mg/day lost physiologically in a normal
adult

17. Food Sources
 3 forms of iron in food
1. Heme
2. Nonheme
3. Additive iron
 Enriched white bread, rolls, and crackers are a
major source of iron.
 The amount of iron to be absorbed from the food
depends or on the bodily need for iron.
 The greater the need, the greater the absorption

18. Heme
 form of iron in hemoglobin and in myoglobin that is
absorbed intact
 found in organ meats (liver, heart, kidney, spleen),
red meats, veal, pork, poultry, fish, oysters, and
clams, but not milk or milk products
 About 40% of iron in meat and fish is heme iron
although only 1/3 can be absorbed by the body

19. Nonheme
 Accounts for the other 60% of iron in animal protein
and all the iron in molasses, fruits (figs, dates), green
veggies, dried beans, nuts, and grain products
(wheat germ)
 Only 2-10% can be absorbed by the body

20. Additive iron
 found in both enriched and fortified products

21. Iron Deficiency Anemia
 Occurs due to inadequate intake or excessive loss of
iron or both.
 Characterized by the production of small RBCs that
are deficient in hemoglobin.
 The most common type of nutritional anemia
 It leads to loss of efficiency and impaired general
health

22. Occurrences and Causes
 Occurs most frequently in infants and children due to
undergoing rapid growth and having rapid RBC
formation
 Occurs in pregnant women due to the increasing
demand of the growing fetus on the mother’s body
iron
 In adult males and postmenopausal women –
pathological blood loss
 In premenopausal women – menstruational blood
loss
 Bizarre food habits (avoidance of meat and
vegetables)
 Inadequate intake among the elderly due to poverty

23. Clinical Manifestations
 Slow development; takes for months or years
 Anemia
 Characterized by weakness, fatigue, pallor, and
numbness and tingling of the extremities
 Epithelial changes – early manifestations
 Nail changes; dullness, brittleness
 Fingernails may be flat instead of convex; spoon-shaped
appearance with longitudinal ridges (koilonychia)
 Hair growth may be altered
 Dysphagia (difficulty in swallowing) in severe cases

24. Clinical manifestations: oral area
 Glossitis
 Inflammation of the tongue
 Fissures (clefts or grooves) at the corners of the mouth
 The papillae of tongue are atrophied, giving a smooth,
shiny, red appearance to the tongue
 The clinical appearance of the tongue in iron deficiency
resembles that in vit.B complex deficiency
 Oral mucous membranes may be atrophied and ashen
gray
 More susceptible to carcinoma (cancer arising from
epithelial cells)
 Plummer-Vinson syndrome
 Combination of dysphagia, koilonychia, angular
stomatitis, and atrophic glossitis

25. THERAPY
 Administration of 200 mg of ferrous sulfate tablets 3x
a day (after each meal) as prescribed by a physician
 Treatment should be continued for approximately 2
months after the hemoglobin level has returned to
normal.

26. ZINC

27. Zinc
 Approx. 2-3 g of zinc in human body
 Is concentrated in the eyes, liver, bones, prostate,
prostatic secretions, and hair
 In blood, 85% in RBCs, but each WBC has about
25x than each RBC.

28. Functions
 An integral part of at least 70 enzymes that belong to
metallo-enzymes
 Active component of carbonic anhydrase
 Essential for the transport of CO2 to the lungs
 Other enzymes with zinc content
 Alcohol dehydrogenase
 Lactate dehydrogenase
 Activates enzymes (carboxypeptidase and
aminopeptidase) that function in the digestion of proteins
 Is part of alkaline phosphatase − bone metabolism
 Added to insulin to prolong the hypoglycemic effect
 It plays an essential role in RNA, DNA, and protein
synthesis

29. Functions
 Essential for wound healing, tissue growth, and
prevention of dwarfism, production of hormones.
 Zinc inadequacy may play an important role in
the reduced immune response in protein-calorie
malnutrition
 Used in the treatment of sickle-cell disease
 Assist in restoring a missing sense of taste in
some cases
 Important for thymic hormone activity since its
removal reduces hormone functions

30. Recommended Dietary Allowance
 RDI: 15 mg a day
 During pregnancy and lactation: 20-25 mg/day
 Infant at 6 mos. old: 3 mg/day
 6 mos.-1 yr.: 5 mg/day
 1-10 yrs.: 10 mg/day
*These are relatively high values when considered in
proportion to the amount of food eaten.

31. Food Sources
 Protein rich foods such as meat and fish
 Oysters and herring as highest zinc content per
ounce
 Milk --- total dietary zinc intake
**Grains contain dietary fiber and phytic acid, that
can bind zinc, inhibiting its absorption, but when
used in making bread with yeast, it inactivates
the phytates and the body now obtains more of
the zinc.

32. Deficiencies
 Causes
 Poor diet
 Excessive alcohol intake
 Liver disease
 Chronic kidney disease
 Genetic disorders
 Acrodermatitisenteropathica
 A sever gastrointestinal and cutaneous disease
 May intensify the anemia of sickle-cell disease

33. Deficiencies
 Clinical Manifestations
 Retardation of both growth and sexual development
 Poor appetite
 Slow healing of wounds
 Loss of sense of taste
 Progressive pustular dermatitis of the extremities, mouth, anus,
and genital areas
 Emotional irritability
 Tremors
 Loss of coordination
 In pregnancy
 Abnormal taste sensations
 Prolonged gestation
 Protracted labor
 Increased risks to the fetus

34. Supplementation
 Consuming excessive amounts of zinc may increase
the risk of cardiovascular disease due to:
 Low HDL
 High LDL
 Common zinc level in popular vitamin/mineral
preparations is 15 mg (safe)

35. Clinical Application
 Zinc sulfate supplements can decrease wound
healing time significantly
 Zinc peroxide powder when used topically on acute
gingival lesions in acute necrotizing gingivitis, the
soreness disappears soon enough and the mouth
restores to its normal healthy condition

36. SELENIUM

37. Selenium
 Essential component of the enzyme that catalyzes
oxidation of glutathione which protects red blood
cells through destruction of hydrogen peroxide
protecting hemoglobin from oxidative damage
 Extremely effective in reducing the prevalence of
keshan disease, which is characterized by
abnormalities in the heart muscle.
 Estimated safe and recommended daily intake of
selenium for adults is 0.05 to 0.2mg while for
infants, children and adolescents is somewhat less.

38. MOLYBDENUM

39. Molybdenum
 Part of the molecular structure of two enzymes:
Xanthineoxidase and Aldehydeoxidase,
Xanthineoxidase is responsible for the conversion of
xanthine to uric acid.
 Daily intake is 0.15 to 0.5mg

40. CHROMIUM

41. Chromium
 Trivalent chromium is the biologically active form of
chromium
 Required for the maintenance of normal glucose and
energy metabolism
 May act as cofactor in insulin and stimulates
synthesis of fatty acids and cholesterol in the liver
 Daily intake is 0.05 to 0.2mg

42. COPPER

43. Copper
 Functions :
1. Aids in synthesis of hemoglobin in the bone
marrow
2. Form and maintain compounds having enzymatic
activity
3. Influence the central nervous system physiology
4. Aids in formation of pigments
5. Component of enzyme necessary for the oxidation
of the amino acid tyrosine and vitamin C
6. May also have a role in the maintenance of the
myelin sheath around the nerve tissue

44. Copper
 Deficiency :
1. Copper deficiency seen in australian lambs called
“swayback disease” characterized by
demyelination and degeneration of motor nerves in
CNS, its prevented by giving copper supplements
to ewes(female sheep) during pregnancy.
2. Found by clinicians that combined administration of
copper and iron is more effective in treating
hypochromic anemia than the administration of iron
alone

45. Copper
 Effects of excess :
 Accumulation of excess copper in body tissues, probably
because of genetic absence of liver enzyme is called
Wilson’s disease, characterized by neurological
degeneration and cirrhotic liver changes.
 Reduction of dietary copper may be useful in treating this
disease.
 Also be arrested by giving chelating agents like
penicillamine to mobilize copper from tissues and promote
excretion in the urine.

46. Copper
 Excess copper concentrations found in human saliva
appear to inhibit acid production, although there is
nothing conclusive to this theory.
 Daily intake is 2 to 3mg

47. COBALT

48. Cobalt
 Part of the vitamin B₁₂ molecule
 May also be involved in the metabolism of sulfur
containing amino acids
 Inadequacies of cobalt will cause anemia
 Essential for adequate nutrition of sheep and cattle,
deficiency will cause extreme emaciation and
wasting.
 High dose of cobalt stimulates the bone marrow to
produce excessive numbers of red
cells(polycythemia) and higher than normal
hemoglobin level

49. MANGANESE

50. Manganese
 Functions :
1. needed for normal bone structure
2. For reproduction
3. Normal functioning of CNS
4. Important catalyst and component of many
enzymes in body, Enzymes involved in the
synthesis of carbohydrates, those necessary for
the protection of cells from high levels of oxygen
and enzymes necessary for mucopolysaccharide
synthesis

51. Manganese
 Effects of deficiency and excess :
1. Manganese deficiency produces skeletal
abnormalities in animals
2. Excesses can produce profound neurological
disturbances similar to those of Parkinson’s
disease

52. Manganese
 Average adult estimated safe and adequate daily
dietary intake appears to be between 2.5 to 5mg

53. IODINE

54. Iodine
 One of the first trace elements recognized essential
for normal health
 Integral part of the hormones thyroxine and
triiodothyronine, functions to maintain the control of
the energy metabolism of the body.
 Most important in synthesis of thyroid hormone is
the ability of the thyroid gland to trap and oxidize
iodine molecules into free iodine.

55. Effects of Imbalance

56. Hypothyroidism
 Goiter, Thyroid gland enlargement
 Develops swelling in the front of neck in the area of
hyoid bone
 Iodine deficiency
 Potassium iodide in small doses may completely
eliminate goiter
 Current level of enrichment furnishes 76 mg of iodine
per g of salt

57. Hypothyroidism
 Cretinism and Myxedema are pathological conditions
resulting from low thyroid activity
 Treatment is administration of thyroid hormone until
euthyroid(normal) state is achieved
 If it affects a fetus prior to birth, cretinism develops

58. Hyperthyroidism
 Excessive activity of thyroid gland brought by
deficiency of iodine producing an enlarged excretory
gland as a result of hyperplasia of the cells lining the
follicles along with increased colloidal material
 Produces hypermetabolic rate(increase pulse rate,
temperature and blood pressure, extreme
nervousness, irritability, increased sweating,
dyspnea, weight loss and tiredness)
 Patients with diffuse primary thyroid hyperplasia may
develop exopthalmos(abnormal protrusion of the
eyeball)

59. Oral Effects of Imbalance
 In severe hypothyroidism, jaws are small and rate of
tooth eruption is retarded
 Hyperthyroid patients conceivably develop caries
rapidly due to their increased need for calories and
possible use of excessive sugars

60. Effects on development of dental
caries

61. Mineral Elements That May Inhibit
or Promote Caries
 5 Categories of Elements accdg. to their Cariogenicity
(by Navia)
1. Caries-promoting: Selenium, Magnesium,
Cadmium, Platinum, Lead, Silicon
2. Mildly cariostatic: Molybdenum, Strontium, Calcium,
Boron, Lithium, Gold
3. With doubtful effect on caries: Beryllium, Cobalt,
Manganese, Tin, Zinc, Bromine, Iodine
4. Caries-inert: Barium, Aluminum, Nickel, Iron,
Palladium, Titanium
5. Strongly cariostatic: Fluorine, Phosphorus

62. Possible Mechanism of Trace
Elements Action on Dental Caries
 By altering the resistance of the tooth by
modifying the local environment at the plaque-
tooth enamel interface
 By altering the size of enamel crystals available
to acid exposure; influencing enamel solubility
 Smaller crystals have a greater surface area
(more exposed to acid solubility) than larger
crystals in enamel rods of similar size
 By influencing the microbial ecology of plaque to
either inhibit or promote the growth of caries-
producing bacteria