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Encyclopedia of Medicine, Apr 06, 2001 by Tom Brody
Selenium deficiency may occur in regions of the world where the soils are poor in selenium. Low-selenium soils can produce foods that are also low in selenium. Premature infants may also be at risk for selenium deficiency. Manganese deficiency is very rare. Experimental studies with humans fed a manganese deficient diet have revealed that the deficiency produces a scaly, red rash on the skin of the upper torso. Molybdenum deficiency has probably never occurred, but indirect evidence suggests that if molybdenum deficiency could occur, it would result in mental retardation and death.
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Sodium deficiency (hyponatremia) and water deficiency are the most serious and widespread deficiencies in the world. These deficiencies tend to arise from excessive losses from the body, as during prolonged and severe diarrhea or vomiting. Diarrheal diseases are a major world health problem, and are responsible for about a quarter of the 10 million infant deaths that occur each year. Nearly all of these deaths occur in impoverished parts of Africa and Asia, where they result from contamination of the water supply by animal and human feces.
The main concern in treating diarrheal diseases is dehydration, that is, the losses of sodium and water which deplete the fluids of the circulatory system (the heart, veins, arteries, and capillaries). Severe losses of the fluids of the circulatory system result in shock. Shock nearly always occurs when dehydration is severe enough to produce a 10% reduction in body weight. Shock, which is defined as inadequate supply of blood to the various tissues of the body, results in a lack of oxygen to all the cells of the body. Although diarrheal fluids contain a number of electrolytes, the main concern in avoiding shock is the replacement of sodium and water.
Sodium deficiency and potassium deficiency also frequently result during treatment with drugs called diuretics. Diuretics work because they cause loss of sodium from the body. These drugs are used to treat high blood pressure (hypertension), where the resulting decline in blood pressure reduces the risk for cardiovascular disease. However, diuretics can lead to sodium deficiency, resulting in low plasma sodium levels. A side effect of some diuretics is excessive loss of potassium, and low plasma potassium (hypokalemia) may result.
Iodine deficiency tends to occur in regions of the world where the soil is poor in iodine. Where soil used in agriculture is poor in iodine, the foods grown in the soil will also be low in iodine. An iodine intake of 0.10-0.15 mg/day is considered to be nutritionally adequate, while iodine deficiency occurs at below 0.05 mg/day. Goiter, an enlargement of the thyroid gland (located in the neck), results from iodine deficiency. Goiter continues to be a problem in eastern Europe, parts of India and South America, and in Southeast Asia. Goiter has been eradicated in the United States because of the fortification of foods with iodine. Iodine deficiency during pregnancy results in cretinism in the newborn. Cretinism involves mental retardation, a large tongue, and sometimes deafness, muteness, and lameness.
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