Phosphorus is a chemical element with symbol P and atomic number 15. Inorganic phosphorus is required for all known forms of life, playing a major role in biological molecules such as DNA and RNA where it forms part of the structural framework of these molecules. Living cells also use phosphate to transport cellular energy in the form of adenosine triphosphate (ATP). Nearly every cellular process that uses energy obtains it in the form of ATP. ATP is also important for phosphorylation, a key regulatory event in cells. Phospholipids are the main structural components of all cellular membranes. Calcium phosphate salts assist in stiffening bones. Living cells are defined by a membrane that separates it from its surroundings. Biological membranes are made from a phospholipid matrix and proteins, typically in the form of a bilayer. Phospholipids are derived from glycerol, such that two of the glycerol hydroxyl (OH) protons have been replaced with fatty acids as an ester, and the third hydroxyl proton has been replaced with phosphate bonded to another alcohol. An average adult human contains about 0.7 kg of phosphorus, about 85–90% of which is present in bones and teeth in the form of apatite, and the remainder in soft tissues and extracellular fluids (~1%). The phosphorus content increases from about 0.5 weight% in infancy to 0.65–1.1 weight% in adults. Average phosphorus concentration in the blood is about 0.4 g/L, about 70% of that is organic and 30% inorganic phosphates. A well-fed adult in the industrialized world consumes and excretes about 1–3 grams of phosphorus per day, with consumption in the form of inorganic phosphate and phosphorus-containing biomolecules such as nucleic acids and phospholipids; and excretion almost exclusively in the form of phosphate ions. Only about 0.1% of body phosphate circulates in the blood, and this amount reflects the amount of phosphate available to soft tissue cells. In medicine, low-phosphate syndromes are caused by malnutrition, by failure to absorb phosphate, and by metabolic syndromes that draw phosphate from the blood (such as re-feeding after malnutrition) or pass too much of it into the urine. The main food sources for phosphorus are foods containing protein, although proteins do not contain phosphorus. For example, milk, meat, and soya typically also have phosphorus. As a rule, if one holds a meal plan providing sufficient amount of protein and calcium then the amount of phosphorus is also likely sufficient.
Calcium is a chemical element with symbol Ca and atomic number 20. Calcium is essential for living organisms, in particular in cell physiology, where movement of the calcium ion Ca2+ into and out of the cytoplasm functions as a signal for many cellular processes. As a major material used in mineralization of bone, teeth and shells, calcium is the most abundant metal by mass in many animals. Calcium is an important component of a healthy diet and a mineral necessary for life. pproximately 99 percent of the body’s calcium is stored in the bones and teeth. The rest of the calcium in the body has other important uses, such as some exocytosis, especially neurotransmitter release, and muscle contraction. In the electrical conduction system of the heart, calcium replaces sodium as the mineral that depolarizes the cell, proliferating the action potential. In cardiac muscle, sodium influx commences an action potential, but during potassium efflux, the cardiac myocyte experiences calcium influx, prolonging the action potential and creating a plateau phase of dynamic equilibrium. Long-term calcium deficiency can lead to rickets and poor blood clotting and in case of a menopausal woman, it can lead to osteoporosis, in which the bone deteriorates and there is an increased risk of fractures. While a lifelong deficit can affect bone and tooth formation, over-retention can cause hypercalcemia (elevated levels of calcium in the blood), impaired kidney function and decreased absorption of other minerals. Calcium supplements are used to prevent and to treat calcium deficiencies. Office of Dietary Supplements (National Institutes of Health) recommends that no more than 600 mg of supplement should be taken at a time because the percent of calcium absorbed decreases as the amount of calcium in the supplement increases. It is therefore recommended to spread doses throughout the day. Recommended daily calcium intake for adults ranges from 1000 to 1300 mg. Calcium supplements may have side effects such as bloating and constipation in some people. It is suggested that taking the supplements with food may aid in nullifying these side effects.
Potassium is a chemical element with symbol K (derived from Neo-Latin kalium) and atomic number 19. Potassium is the eighth or ninth most common element by mass (0.2%) in the human body, so that a 60 kg adult contains a total of about 120 g of potassium. The body has about as much potassium as sulfur and chlorine, and only the major minerals calcium and phosphorus are more abundant.Potassium cations are important in neuron (brain and nerve) function, and in influencing osmotic balance between cells and the interstitial fluid, with their distribution mediated in all animals (but not in all plants) by the so-called Na+/K+-ATPase pump. This ion pump uses ATP to pump three sodium ions out of the cell and two potassium ions into the cell, thus creating an electrochemical gradient over the cell membrane. In addition, the highly selective potassium ion channels (which are tetramers) are crucial for the hyperpolarization, in for example neurons, after an action potential is fired. Potassium is also important in preventing muscle contraction and the sending of all nerve impulses in animals through action potentials. By nature of their electrostatic and chemical properties, K+ ions are larger than Na+ ions, and ion channels and pumps in cell membranes can distinguish between the two types of ions, actively pumping or passively allowing one of the two ions to pass, while blocking the other. Potassium is an essential macromineral in human nutrition; it is the major cation (positive ion) inside animal cells, and it is thus important in maintaining fluid and electrolyte balance in the body. Sodium makes up most of the cations of blood plasma at a reference range of about 145 mmol/L (3.345 g)(1 mmol/L = 1mEq/L), and potassium makes up most of the cell fluid cations at about 150 mmol/L (4.8 g). Plasma is filtered through the glomerulus of the kidneys in enormous amounts, about 180 liters per day. Thus 602 g of sodium and 33 g of potassium are filtered each day. All but the 1–10 g of sodium and the 1–4 g of potassium likely to be in the diet must be reabsorbed. Supplements of potassium in medicine are most widely used in conjunction with loop diuretics and thiazides, classes of diuretics that rid the body of sodium and water, but have the side-effect of also causing potassium loss in urine. A variety of medical and non-medical supplements are available. Potassium salts such as potassium chloride may be dissolved in water, but the salty/bitter taste of high concentrations of potassium ion make palatable high concentration liquid supplements difficult to formulate. Typical medical supplemental doses range from 10 mmol (400 mg, about equal to a cup of milk or 6 US fl oz (180 ml). of orange juice) to 20 mmol (800 mg) per dose. Potassium salts are also available in tablets or capsules, which for therapeutic purposes are formulated to allow potassium to leach slowly out of a matrix, as very high concentrations of potassium ion (which might occur next to a solid tablet of potassium chloride) can kill tissue, and cause injury to the gastric or intestinal mucosa. For this reason, non-prescription supplement potassium pills are limited by law in the US to only 99 mg of potassium. Individuals suffering from kidney diseases may suffer adverse health effects from consuming large quantities of dietary potassium. End stage renal failure patients undergoing therapy by renal dialysis must observe strict dietary limits on potassium intake, as the kidneys control potassium excretion, and buildup of blood concentrations of potassium (hyperkalemia) may trigger fatal cardiac arrhythmia.
Magnesium is a chemical element with symbol Mg and atomic number 12. Because of the important interaction between phosphate and magnesium ions, magnesium ions are essential to the basic nucleic acid chemistry of life, and thus are essential to all cells of all known living organisms. Over 300 enzymes require the presence of magnesium ions for their catalytic action, including all enzymes utilizing or synthesizing ATP, or those that use other nucleotides to synthesize DNA and RNA. ATP exists in cells normally as a chelate of ATP and a magnesium ion. Magnesium is a vital component of a healthy human diet. Human magnesium deficiency (including conditions that show few overt symptoms) is relatively rare although only 32% of people in the United States meet the RDA-DRI; low levels of magnesium in the body have been associated with the development of a number of human illnesses such as asthma, diabetes, and osteoporosis. Taken in the proper amount, magnesium plays a role in preventing both stroke and heart attack. The symptoms of people with fibromyalgia, migraines, and premenstrual syndrome are less severe, and magnesium can shorten the length of the migraine symptoms. Adult human bodies contain about 24 grams of magnesium, with 60% in the skeleton, 39% intracellular (20% in skeletal muscle), and 1% extracellular. Serum levels are typically 0.7–1.0 mmol/L or 1.8–2.4 mEq/L. Serum magnesium levels may appear normal even in cases of underlying intracellular deficiency, although no known mechanism maintains a homeostatic level in the blood other than renal excretion of high blood levels. Intracellular magnesium is correlated with intracellular potassium. Magnesium is absorbed in the gastrointestinal tract, with more absorbed when status is lower. Magnesium competes with calcium in the human body, in this way it actually keeps calcium in check. However, this can cause a calcium deficiency if calcium levels are already low. Low and high protein intake inhibit magnesium absorption, and other factors such as phosphate, phytate, and fat affect absorption. Excess dietary magnesium is excreted in feces, urine, and sweat. Magnesium status may be assessed roughly through serum and erythrocyte Mg concentrations and urinary and fecal excretion, but intravenous magnesium loading tests are likely the most accurate and practical in most people. In these tests, magnesium is injected intravenously; a retention of 20% or more indicates deficiency. Other nutrient deficiencies are identified through biomarkers, but none are established for magnesium. Excess magnesium in the blood is freely filtered at the kidneys, and for this reason it is difficult to overdose on magnesium from dietary sources alone. With supplements, overdose is possible, in particular in people with poor renal function; occasionally, with use of high cathartic doses of magnesium salts, severe hypermagnesemia has been reported to occur even without renal dysfunction. Alcoholism can produce a magnesium deficiency, which is reversible by oral or parenteral administration, depending on the degree of deficiency.