Monica Adhikari
Sr Dietician, Great Ormond Street Hospital, London
First Created: 09/15/2014  Last Updated: 09/15/2014

Patient Education

Just as vitamins are necessary for maintaining various body functions, similarly, minreals and trace elements are required in small amounts for growth and maintenance of health. Various minerals that are required in human body are:

  • Calcium
  • Carbon
  • Chromium
  • Cobalt
  • Copper
  • Fluorine
  • Iodine
  • Iron
  • Magnesium
  • Manganese
  • Molybdenum
  • Selenium
  • Silicon
  • Sodium
  • Phosphorus
  • Potassium
  • Zinc

Each trace element leads to poisoning if the dose exceeds and leads to the deficiency if the intake is less than the requirement. These trace elements are also known as micronutrients. The most important ones are discussed here.


Zinc deficiency was first described in the Middle East. Zinc deficiency is commonly seen in conditions such as chronic diarrhea, nephrotic syndrome, cirrhosis, with chelators as in Thalassemia, patients on total parenteral nutrition (TPN), burns, and hemolytic anemia. Zinc deficiency can also occur due to eating a predominantly cereal diet or when body requirements are increased as in pregnant women. Zinc in the body can decrease in patients eating mud and clay (pica).

Clinical features of zinc deficiency:

Early features of zinc deficiency include loss of appetite, impaired taste, and poor healing of wounds. It can also lead to anemia, night blindness, enlargement of the liver, loss of hair, and tendency towards infection due to impaired immunity. In older boys, impotency may be seen. Zinc deficiency in pregnant women can lead to growth retardation in the baby.

The classical presentation of zinc deficiency is "acrodermatitis enteropathica". This is a genetic disease due to failure to absorb zinc from the intestines. It leads to loss of hair, poor appetite, diarrhea, and typical skin ulcerations over the buttocks and genitals.


can be established by measuring zinc levels in blood and urine.


Patients with zinc deficiency should eat a diet rich in zinc such as meat, eggs, nuts, cheese, and grains. Zinc can also be applied as a cream over ulcers, wounds, burns, and pimples to fasten healing. Zinc can be given in the dose of 20-40 mg/day for the treatment of acrodermatitis enteropathica. Zinc is also recommended in the treatment of persistent diarrhea and Wilson's disease (a genetic problem that leads to the accumulation of copper in the liver and brain. Zinc helps to excrete this extra copper in the urine).

Zinc toxicity:

Zinc toxicity can lead to nausea, vomiting, diarrhea, anemia, and neurological problems. It occurs due to food cooked in galvanized utensils.

Recommended Daily Allowance (RDA)

  • 0-1 year - 5 mg
  • 1-10 years - 10 mg
  • >10 years - 15 mg


Copper is a part of several enzymes in the body. It is an antioxidant and plays an important part in the utilization of iron and the formation of red blood cells. Copper deficiency is extremely rare and may occur in formula-fed premature babies. Copper deficiency leads to anemia, recurrent diarrhea, and bone problems. Copper deficiency can also occur in a genetic disease such as Menke's disease (leads to hair and brain involvement).

Excess of copper in the body can occur when milk boiled and stored in brass utensils is consumed. It leads to a liver problem such as Indian Childhood Cirrhosis (ICC). Copper excess can also occur in a genetic disorder - Wilson's disease (characterized by the liver, eye, and brain problems). The diagnosis of copper deficiency can be established by measuring blood copper levels. Copper excess can be determined by measuring the copper content in the organ that is involved.

Sources of Copper:

Oysters, fish, whole grains, nuts, legumes, milk boiled and stored in brass utensils.

Recommended Daily Allowance (RDA):

0.05 - 0.1 mg/kg.


Magnesium is a part of bone and teeth and helps to maintain the normal function of muscles and nerves. It has been used in the treatment of asthma and persistent pulmonary hypertension (PPHN) in newborns. The deficiency of magnesium leads to the spasm of the muscles (tetany). Deficiency can occur in malnutrition, diabetes, chronic kidney disease, and in patients with pancreatic problems. Magnesium deficiency can be diagnosed by measuring the magnesium levels in the blood.

Magnesium excess can occur in newborns born to mothers who had received magnesium in pregnancy.


Cereals, legumes, nuts, milk, meat.

Recommended Daily Allowance:

40-340 mg.


It is part of the enzyme system of the body. Deficiency of selenium leads to heart (cardiomyopathy) and muscle involvement (myopathy). It is particularly seen in Keshan province in China where the soil is deficient in selenium. Excess of selenium causes alopecia, abnormal nails, garlic odor to the breath, and fatigue.

Sources of selenium:

Vegetables, meat, water.

Recommended Daily Allowance (RDA)

<6 months of age - 10 µg

6-12 months of age - 15 µg

1-6 years of age - 20 µg

7-10 years of age - 30 µg

>11 years of age - 50-75 µg

Other Minerals

Minerals are needed for the growth and maintenance of body structures. They also help to maintain digestive juices and the fluids found in and around cells.

The minerals the body needs in large amounts include calcium, chlorine, magnesium, phosphorus, potassium, sodium, and sulfur.

Other minerals, called trace elements, are needed in much smaller amounts. Trace elements include iron, copper, fluorine, iodine, selenium, zinc, chromium, cobalt, manganese, and molybdenum.

Health benefits
Best sources
Is vital for building strong bones and teeth. The time to build strong bones is during childhood and teen years.
Important for muscle function.
Weak bones are susceptible to condition called osteoporosis, which causes bones to break easily
Paneer (cottage cheese)
The kidneys help to control calcium levels. Healthy kidneys can increase calcium excretion almost fivefold to maintain normal concentrations in the body. Hypercalcemia can occur when the concentration of calcium overwhelms the ability of the kidneys to maintain balance.
Helps red blood cells carry oxygen to all parts of the body.
Helps in energy production.
Symptoms of iron deficiency anemia include weakness and fatigue, lightheadedness and shortness of breath.
Red meat
Leafy vegetables
Some of the cereals and flours are fortified with iron.
Signs of iron overload may be seen after as few as 10 red blood cell transfusions, making iron overload a common secondary disease among transfusion-dependent patients.
A patient with chronic severe anemia's caused by thalassemia ,sickle cell disease , and myelodysplastic syndromes are at greatest risk.
Helps muscles and nerves to function, steadies the heart rhythm and keeps bones strong.
It also helps the body to create energy and make protein
Whole grains
Leafy vegetables
Common conditions such as mitral valve prolapse,migraines, attention deficit disorder, fibromyalgia,asthma and allergies have all been linked to a Mg deficiency
Not known.
Helps in healthy bones and teeth.
It also helps body to make energy.
It is apart of every cell membrane, every cell in the body needs phosphorous to function normally.
is found in most foods but the best sources are dairy products,
Meat, Fish
Symptoms varying from painful bones, irregular breathing, fatigue, anxiety, numbness, skin sensitivity and changes in body weight.
A ratio of 2:1 in the diet between phosphorus and calcium can cause low blood calcium levels.
Ingesting dosages of phosphorus exceeding 3 to 4 grams may be harmful as it can interfere with calcium absorption, such as the high level in fizzy soda drinks.
Helps in muscles and nervous system function.
It also helps the body to maintain the balance of water in the blood and body tissues.
Potatoes (with skin)
Leafy vegetables
Citrus Fruitse.g. oranges,lemon.
Dried fruits
The kidneys excrete any excesses, but deficiencies are seldom found in people on normal diets, although most people could look at increasing their potassium intake. A deficiency may result in fatigue, cramping legs, muscle weakness, slow reflexes,acne, dry skin, mood changes, and irregular heartbeat.
Excessive potassium can be toxic and will affect your heart, but is mainly a problem when you suffer from a problem such as kidney failure.
Important for strong immunity.
Wound healing. (tissue repair and growth), Essential for cell reproduction, normalgrowth and developmentin children.
Dried beans
There is a shortage of zinc in many people's diet, since zinc is destroyed in the milling process and is also lost in cooking. A deficiency will result in an under-performing immune system, open to infections,allergies, night blindness, loss of smell, falling hair, white spots under finger nails, skin problems, sleep disturbances etc.
Larger amounts may result in nausea,diarrhea, dizziness, drowsiness and hallucinations.
Essential for maintaining normal blood pressure and balance of body fluids and for transmitting nerve signals
Table salt, vegetables
animal foods
some bottled waters
A deficiency is rare, but can easily happen with diarrhea, vomiting or excessive sweating, and a shortage may lead to nausea, dizziness, poor concentration and muscle weakness.
Excessive sodium may cause high blood pressure, which may lead to a host of health problems. Excessive long-term use of sodium may also cause a loss of calcium from your body.

The best way to get the vitamins and minerals you need is by eating a varied, balanced diet, rich in fruits, vegetables, and whole grains.

Minerals Minerals https://www.pediatriconcall.com/show_article/default.aspx?main_cat=nutrition&sub_cat=minerals&url=minerals-patient-education 2014-09-15
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