Trace elements

A naturally occurring, homogeneous, inorganic, substance required in humans in small

amounts less than 100 mg/day. Trace elements are vital for human body to maintain normal yet
complex physiological functions related to body’s growth & development. They also balance
toxicity levels. They are called trace elements because of their body concentration, which is few
milligrams per kg or less. The daily requirement of dietary trace elements is few milligrams.
They are also known as micronutrients.
Trace elements have several important roles in human bodies, some are essential for
enzymes reactions where they attract and facilitate conversion of substrate molecules to specific
end products. Moreover, some of them donate or accept electrons in redox reactions that are of
primary importance in the generation and utilization of metabolic energy. Some of them have
structural roles and responsible for the stability of important biological molecules. Furthermore,
some trace elements have important actions throughout biological processes, for example, iron
(Fe) which can bind, transport, and release oxygen in the body [2,3]. In fact, although the trace
elements are essential components of biological activities, the excessive levels of these elements
can be toxic for the body health and may lead to many fatal diseases, such as cancers.

Classification
These are categorized as: Essential, probably essential or non-essential. This is based upon their
biological effect, diseases that occur due to their deficiency and toxicity due to overdose.
Essential Trace Elements:
Iron, zinc, copper, cobalt, chromium, fluorine, iodine, manganese, molybdenum and selenium.
Probably essential: nickel, tin, vanadium, silicon, boron.
Non-essential:
Aluminum, arsenic, barium, bismuth, bromine, cadmium, germanium, gold, lead, lithium,
mercury, rubidium, silver, strontium, titanium and zirconium is all found in plant and animal
tissue.
Essential Trace Elements are again divided into two sub-groups
Trace Elements:
Iron, Zinc and Copper.
Ultra Trace-Elements: Manganese, Selenium, Cobalt, Chromium, Fluorine, Iodine and
Molybdenum.

Trace Elements:
IRON (Fe)
Significance of iron: One of the most essential trace elements Body content is 4-6g and is found
in the following forms; Hemoglobin 68%, Ferritin 13%, Haemosiderin 12%, Myoglobin 3%
,Iron enzymes 0.2%, Other iron compounds 3.6%,
Iron dependent enzymes (enzymes that require iron as cofactor): Cytochrome oxidase,
Xanthine oxidase and peroxidase, Catalase.
Body requirement & iron conservation:
Daily requirements: 10 mg/day (adult) 18 mg/day (pregnant) Daily excretion: 0.9 mg/day
(adult) 1.3 mg/day (during menstruation in females) Iron loss also increases during bleeding and
hemorrhage • Dietary Source: Liver, kidneys, heart and spleen, egg yolk, fish and oyster.
Body conserves iron very well. Only ~1.3 mg/day is absorbed from digested food however the
absorption increases during growth and pregnancy. In case of iron deficiency the iron absorption
from food increases to 4 mg/day. Iron is absorbed in Ferrous (Fe2+) form, which is measurable
in blood as free iron. The Fe contained in hemoglobin is also responsible for the red color of
blood.
Iron deficiency disorders
In the case that the body supply of available Fe is too low, this lead to a condition known as Fe
deficiency. Fe deficiency is the most common nutritional deficiency in the world. People with Fe
deficiency cannot produce an adequate amount of hemoglobin to meet their body’s oxygen
transport needs. When the deficiency becomes severe, the condition is diagnosed as Fe-
deficiency anemia. The WHO estimates that approximately half of the 1.62 billion cases of
anemia worldwide are due to Fe deficiency.
Zinc
Zn is an essential trace element that functions as a cofactor for certain enzymes involved in
metabolism and cell growth, it is found in nearly 300 specific enzymes. As a component of many
enzymes, Zn is involved in the metabolism of proteins, carbohydrates, lipids, and energy. Zn is
vital for the healthy working of many of the body’s systems; it plays an essential role in
numerous biochemical pathways. It is particularly important for healthy skin and is essential for
a healthy immune system and resistance to infection. Zn plays a crucial role in growth and cell
division where it is required for protein and DNA synthesis, in insulin activity, in the metabolism
of the ovaries and testes, and in liver function.
Body content is 2.5g and is distributed as 60% in muscle, 30% in bone and remaining 10% in
other body tissues and organs.
Daily requirement is 3-14mg, age and sex dependant (infants and children require as little as 3-
5mg where as adult males require more than adult females however during lactation demand in
females increases to 14mg/day)
Diet rich in zinc includes: red meat, fish and sea food – 20-30% of the dietary zinc is absorbed
mainly by small intestine. – Post absorption it’s found in the blood bound to erythrocytes (75-
80%), the rest is complexed with albumin, transferring and immunoglobulin’s – Zinc is mainly
excreted through GIT in the stool and to a lesser extent in urine Zn toxicity occurs due to:
Excessive ingestion of Zn. Some toxic compounds such as ZnCl2 if ingested may cause
generalized necrosis, burns and ulcers if applied excessively on skin. This compound is found
mostly in deodorants prolonged exposure to industrial compounds such as ZnO may lead to
pneumonitis and sometimes even cancers Zinc levels will decrease substantially in: leukemia,
liver cirrhosis, hepatitis, sickle cell anemia, Infection, pernicious anemia and malnutrition.
Common symptoms of zinc deficiency that must be noted include:
In children: growth retardation and skeletal abnormalities are typical symptoms in which zinc
deficiency should be considered.
In adults: reduced sense of taste and smell, loss of appetite, development of abnormal skin
lesions and excessive hair loss.
Zn toxicity occurs due to: Excessive ingestion of Zn. Some toxic compounds such as ZnCl2 if
ingested may cause generalized necrosis, burns and ulcers if applied excessively on skin. This
compound is found mostly in deodorants prolonged exposure to industrial compounds such as
ZnO may lead to pneumonitis and sometimes even cancers.
Copper (Cu)
Cu is an essential trace element in plants and animals. The human body only contains about 150
mg of this vital mineral. The daily dietary requirement is between 2-6mg which is mainly
obtained from red meat, cocoa, shell-fish, water pumped through copper pipes and chocolates. –
Typically 40-60% copper is absorbed by the duodenum and is transported via metalloenzymes
e.g. ascorbic acid oxidase. – In plasma 90% is bound to a conjugated metalloenzyme known as
ceruloplasmin, 9% is bound to carrier proteins such as albumin and only 1% is free Cu²+. – Body
content of copper is 80-120mg.

Body functions: - Copper is involved in the process of erythropoiesis, erythrocyte function and
regulates erythrocyte survival - Copper is critical for energy production in the cells. It is also
involved in nerve conduction, connective tissue, the cardiovascular system and the immune
system. - Copper is closely related to estrogen metabolism, and is required for women's fertility
and to maintain pregnancy. - Copper stimulates production of the neurotransmitters epinephrine,
norepinephrine and dopamine. - Acts as a catalyst for copper-containing enzymes such as;
ceruloplasmin, ascorbic acid, dopamine-β- hydroxylase, cytochrome oxidase and tyrosinase.
Clinical significance: Hypocuperaemia is associated with − Anemia in infants − Malnutrition in
infants − Menkes’ kinky-hair syndrome….genetic disorder where copper absorption leads to a
brain disease which then cause characteristic wiry-steel hair.
Clinical significance: Hypocuperaemia is associated with − Anemia in infants − Malnutrition in
infants − Menkes’ kinky-hair syndrome….genetic disorder where copper absorption leads to a
brain disease which then cause characteristic wiry-steel hair.
− Nephrosis − Hypoproteinemia. Hypercuperaemia is associated with: − Pregnancy − Estrogen
therapy − Thelassemia and anemia − Leukemia and Lymphoma particularly Hodgkin’s disease −
Rheumatoid arthritis Copper toxicity may occur due to ingestion of excess copper or as a result
of environmental exposure and this is characterize by increased tissue and serum levels Wilson’s
disease: – Autosomal recessive genetic disorder with onset in the 2nd or 3rd decade – Onset in
children aged 4-5yrs is also reported but rarely – Serum ceruloplasmin and serum copper is low –
Increased urine and tissue copper due to excessive deposition of copper in tissues particularly in
the hepatocytes and basal ganglia of the brain leading to their steady degeneration. Symptoms: -
In the CNS: Tremor, in-coordination, ataxia, rigidity, dysphagia - In the liver: Jaundice,
weakness, partial hypertension, cirrhosis, anorexia.
Ultra Trace-Elements:
Manganese (Mn)
Mn is a trace mineral that is present in tiny amounts in the body. It is one of the most important
nutrients for human health. The average human body contains about 12 mg of Mn. About 43% of
it is found in the skeletal system, with the rest occurring in soft tissues including liver, pancreas,
kidneys, brain, and central nervous system.
Important role in regulating metabolic processes which mainly include lipid and carbohydrate
metabolism, bone and tissue formation, skeletal growth and reproduction. Over 50 Manganese
dependent enzymes have been identified and these include: catalase, peroxidase, super oxide
dimutase, 5’ nucleotidase, R Nase and glucosyl- and glactosyl-transferase. Average daily intake
is 20 μg/day however daily body requirement is 2-5 μg/day. Manganese is absorbed via small
intestine in similar process as iron. Beta-microglobulins carry Manganese to mitochondrial rich
organs such as liver, pancreas, kidney and pituitary gland. Major excretion is through bile and
pancreas into GIT.
Deficiency disorder.
Deficiency of Manganese is rare however its etiology is not well known • Several defects have
yet been associated with it; such as hair color and growth alterations, loss of weight, inhibition of
vit-K dependant clotting and altered cholesterol transport and utilization • Manganese toxicity
occurs due to inhalation of manganese dust, where minors are known to suffer from headaches,
sterility, loss of appetite and speech difficulties. Excessive manganese have also been associated
with psychological and neurological disturbances • Manganese is normally NOT tested in routine
diagnostic laboratories, however it’s known to increase in case of myocardial infarction.
Reduced levels have been observed in children suffering from epilepsy and other convulsive
disorders.
Cobalt (Co)
Co is an essential trace element for the human body, where it is a key constituent of cobalamin
(the scientific name of vitamin B12). It also has a substantial role in the formation of amino acids
and neurotransmitters. Human body can get Co ions through several pathways: With food, by the
respiratory system, by the skin, and as a component of biomaterials. The cobalt ions enter the
body through any of the above routes and bind with proteins within the bloodstream and get
transported with blood to be deposited in tissues and cells.
The largest source of exposure to cobalt for the general population is the food supply. The
estimated intake from food is 5-40 µg/day, most of which is inorganic cobalt. Green vegetables
and fresh cereals are the richest sources of cobalt, whereas dairy products, refined cereals, and
sugar contain the least cobalt. Inorganic forms of cobalt are toxic to the human body, and the
longer they stay in the body, the more the detrimental effects they cause in cells. It has been
found that the cobalt deficiency is associated with disturbances in vitamin B12 synthesis. It
might cause anemia and hypothyroidism, as well as increase the risk of developmental
abnormalities and failure in infants. The excess level of this metal in the human body might
cause hypothyroidism and overproduction of erythrocytes, fibrosis in lungs and asthma.
Chromium (Cr)
Cr is a trace element that humans require in trace amounts. It is found primarily in two forms:
Trivalent (chromium III), which is biologically active and found in food and hexavalent
(chromium VI), a toxic form that results from industrial pollution. Adequate intakes of
chromium are 35 mg/day for adult males and 25 mg/day for adult females. Cr is widely
distributed in the food supply, but most foods provide only small amounts of it. It is found in egg
yolks, whole-grain products, high-bran breakfast cereals, coffee, nuts, green beans, broccoli,
meat, and brewer’s yeast. It has been found that chromium produces significant increases in
enzyme activity and serves an important function in carbohydrate metabolism, stimulation of
fatty acid and cholesterol synthesis from acetate in the liver, and improved sugar metabolism
through the activation of insulin. In addition, it has been found that chromium renders the body’s
tissues more sensitive to insulin. It is a critical cofactor in the action of insulin.
Deficiency disorder
chromium deficiency is associated with glucose intolerance and insulin resistance in patients on
long-term parenteral nutrition. Furthermore, it has been reported that chromium deficiency may
be the reason to an increase in hematological parameters (hemoglobin, hematocrit, erythrocytes,
leukocytes, and mean erythrocyte volume).
Iodine
Thyroid hormone synthesis and also have broad spectrum germicidal action.
Iodine induced hyperthyroidism: In individuals of nodular goiter in endemic area -
thyrotoxicosis due to underlying areas of autonomy (Jod Basedow phenomenon).
Iodine induced hypothyroidism: people at risk are- autoimmune thyroiditis, Graves
hyperthyroidism previously treated with radioactive iodine.Unusually sensitive to inhibitory
effect due to sustained activity on Na/I symporter ( Wolff Chaikoff effect ).
Iodine deficiency prophylaxis: Iodised salt. Iodised oil. Iodised water. Iodine tablets or drops.
Biofortification of vegetables with iodine • Also available as ointment, solution, mouth gargles.
Fluoride
Very important in preventing dental caries. Promotes remineralization of decalcified enamel.
Available as tooth paste, solutions and gels Excess cause flurosis. tooth bleeching.
Molybdenum
Act as a catalyst for enzymes and helps facilitate breakdown of certain amino acids Molybdenum
in human tooth enamel may have a role in lowering the risk of tooth decay. Deficiency –
esophageal carcinoma.