Module 7 - Mineral Balance
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What is the big idea for Mineral Balance?
Calcium is a game of cofactors:
- - Systemic pH
- - Hormonal Function
- - Hydration - Water & Electrolytes
- - Other Minerals
- - Vitamins
- - (Essential) Fatty Acids
- - Digestion
Almost everyone gets enough calcium. They are missing the cofactors that allow the body to absorb/use it.
What roles do minerals play in the body (know at least four for the test)?
- Act as cofactors for enzyme reactions
- Maintain pH balance in the body
- Facilitate the transfer of nutrients across cell membranes
- Maintain proper nerve conduction
- Contract and relax muscles
- Regulate tissue growth
- Provide structural and functional support
What is the significance of bone remodeling in calcium homeostasis?
Bone plays a key role in the body’s calcium homeostasis. Calcium is only made available for other tissues when bone is broken down during remodeling. E.g., bone remodeling makes calcium ions available to the blood when blood pH needs to be raised.
What are the 7 cofactors required for proper absorption and use of calcium within the body?
The 7 major cofactors that impact the absorption and use of calcium within the body are:
Systemic pH. Bone is a major buffer of calcium and calcium is a major buffer of blood pH; when blood becomes too acidic, it pulls calcium from the tissues; when blood becomes too alkaline, calcium separates out of solutions; if the excess calcium is deposited in inappropriate tissues, it can cause problems.
Hormonal Function. Parathyroid hormone, Calcitonin, Sex hormones all inhibit or promote osteoblastic/clastic activity. Aldosterone controls sodium/potassium homeostasis, which impacts calcium.
Hydration (Water & Electrolytes). Ensures blood is fluid enough to efficiently transport calcium throughout the body to other tissues; balanced electrolytes (electrically charged ions of calcium, sodium, potassium , chloride, bicarbonate) ensure appropriate transfer of calcium in and out of cells.
Other Minerals. Calcium must be in balance with the other macrominerals; potassium and the trace elements manganese, boron, copper, and zinc are also important for proper use of calcium.
Vitamins. Vitamin D works with PTH to increase the level of calcium in blood serum; increases absorption through the gastrointestinal tract; pulls calcium from the bones/tissues; decreases loss in the urine/feces.
Fatty Acids. Necessary for transport of calcium across the cell membrane; increase the calcium levels in tissues.
Digestion. Minerals must be ingested (i.e., the body can't make them); calcium is only absorbed in an acid environment & requires robust HCl.
Describe Lowenberg's Test (FE for Mineral Balance).
First, ask the client if they have any contraindications: Phlebitis, edema, thrombosis, vascular or any other circulation problems in the legs.
With elderly or frail clients, do not inflate above 180mm.
With the client sitting on the edge of the table place the BP cuff around the largest portion of the calf of the leg. Instruct the client to advise you when they feel the steady ONSET of a cramp. Inflate the BP cuff slowly with a smooth needle. Once the client’s threshold is reached, deflate the cuff quickly.
Wait 30 seconds (so that blood can profuse the tissue) and repeat the test
on the same leg. You are attempting to reach 240 without cramping.
- 150mm = Very Deficient
- <200 = Deficient
- >200 = Sufficient;
- >240 = Optimal
NOTE: Clients who are hyperadrenic/fast oxidizers/highly sympathetic can skew this test.
Describe the Iodine Skin Test (FE for Mineral Status).
- Always ask the client if they are sensitive to iodine or if they have any thyroid conditions before you begin.
- Apply 2-3” square patch of brown 2% iodine tincture to forearm, abdomen or thigh (thin skinned areas).
- Instruct client to watch patch over the next 24 hours and make note of the time (in hours) when the patch faded.
- Advise okay to bathe but not to soak or scrub and to be certain to check before bed.
Describe the Zinc Status Test (FE for Mineral Status).
Client should not have had anything to eat or drink (except water) within 30 minutes. Explain to the client that they will swish 1 TBS liquid zinc around in their mouth for up to 30 seconds and to let you know immediately when it tastes like something other than water by shaking their head. With the zinc in client's mouth, practitioner should read the list of taste sensations slowly to pace with 30 second timing.
- 1. Strong unpleasant taste
- 2. Definite taste that gets stronger
- 3. No immediate taste but slightly minerally, dry or furry
- 4. No specific taste after 30 seconds
- 5. Sweet taste after 30 seconds.
- EXCELLENT: A strong and unpleasant taste is noted immediately. Client normally grimaces.
- FAIR: a definite, though not strongly unpleasant taste is noted almost immediately and tends to intensify with time.
- POOR: No immediate taste is noted, but develops in 10-15 seconds variously described as:"dry," "minerally," "furry," or "sweet."
- DEFICIENT: No specific taste or sensation is noted, even after the solution has been held in the mouth for up to 30 seconds. "Tastes like water."
- EXTREMELY DEFICIENT: Tastes sweet when held in the mouth for up to 30 seconds.
Describe the Iron Deficiency Test (FE for Mineral Status).
- Hold the client's hand palm up. Place your fingers across the clients fingers at the second knuckle and exert light pressure, bending the fingers away from the palm and towards the floor.
- Observe the creases and lines in the fingers and palm.
- If the lines brighten and redden there is no deficiency. If the lines do not brighten and stay pale this indicates a deficiency. (+/-)
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