Mineral deficiency is a reduced level of any of the
essential to human health. An abnormally low mineral concentration is
usually defined as a level that may impair a function dependent on that
Minerals are essential nutrients for every living cell in the human body.
Defined in the study of human
as all the inorganic elements or molecules required for life, minerals
assist in body functions such as producing energy, growing, and healing.
Minerals are required for fluid balance, blood and bone development,
maintaining a healthy nervous system, and regulating muscles, including
heart muscles. Minerals, like
, function as coenzymes. They participate in all enzyme reactions in the
body and help in the assimilation and use of vitamins and other nutrients.
Minerals occur either as bulk minerals (macrominerals) or trace minerals
(microminerals). The body needs more bulk minerals than it does trace
minerals, although both are essential for health. Minerals are consumed in
food from plants and plant-eating animals. These sources of minerals
develop in a sequence that takes millions of years, beginning with rock
formation, the breakdown of rocks into mineral salts, and the assimilation
of these salts into soil that nourishes edible plants.
Recommended daily allowances exist for a number of minerals, such as
calcium. However, minimum daily requirements for some minerals such as
boron, chromium, and molybdenum, do not exist. The essential bulk minerals
Trace minerals essential for human health include:
Trace and bulk minerals are stored in muscles and bones and delivered to
tissue cells through blood circulation. They work together synergistically
and must be chemically balanced in the body; if one is deficient or out of
balance, it can affect all the others, often resulting in illness. If
zinc, for example, is present at high levels, calcium levels will be
reduced because the two minerals compete for absorption. Similarly, too
much calcium will deplete magnesium, and so on. Deficiency in one nutrient
occurs less often than deficiency in several nutrients. A child suffering
will likely be deficient in a variety of nutrients. Deficiencies in one
nutrient do occur, however, such as in populations living in iodine-poor
regions, and in iron deficient persons who lose excess iron by abnormal
bleeding. All uncorrected mineral deficiencies can affect body functions,
produce symptoms, and result in illness.
Statistics are not available for most individual mineral deficiencies,
most likely because such deficiencies are rare in the United States.
Surveys of lower-income families in the United States reveal that about 6
percent of infants are anemic, indicating a possible deficiency of iron in
the diet (all
are not iron-deficiency related).
Diarrheal diseases and related sodium and potassium deficiencies are
responsible for about two million infant deaths each year worldwide. Few
of these deaths occur in the United States.
Causes and symptoms
Calcium and phosphorus are plentiful in foods, and dietary deficiencies
are rare. Vitamin D deficiency impairs the absorption of dietary calcium
and can provoke calcium deficiency (hypocalcemia) even when adequate
calcium is consumed. Vitamin D deficiency can be found among young infants
and the elderly who may be shielded from sunshine for prolonged periods.
As women age, reductions in the hormone estrogen can affect the rate of
calcium loss. Significant depletion of calcium stores can lead to
osteoporosis. Deficiency of calcium or imbalances with phosphorus and
magnesium can produce muscle cramping and digestive problems. Symptoms of
calcium deficiency include joint
, brittle nails, eczema,
, insomnia, high blood pressure, nervousness, and
. Calcium deficiency can also contribute to cognitive problems (confusion,
inattention, learning, and memory), convulsions, depression, and
hyperactivity. Phosphorus deficiency can produce
Deficiency or imbalance in sodium and potassium does not usually result
from a lack of these minerals in the diet, but from imbalances in body
fluids. This can be caused by excessive losses of body fluid (dehydration)
from severe diarrhea or vomiting; laxative abuse; or during treatment of
heart disease or high blood pressure (hypertension) with diuretic drugs,
which are used to reduce fluid overload. Sodium and potassium imbalances
can cause cardiac arrhythmias and shock (a reduced flow of blood and
oxygen to tissues throughout the body). Although diarrheal fluids deplete
a number of electrolytes (sodium, potassium, chloride, calcium,
phosphorus, and magnesium), the main concern in avoiding shock is
replacing sodium and water. Potassium deficiency alone can also affect
Dietary magnesium deficiency is rare because the mineral is found in
nearly all foods, but it can occur through poor diet or in malnutrition,
or result from excessive losses due to severe diarrhea or vomiting.
Symptoms of magnesium deficiency include faulty transmission of nerve and
muscle impulses, irritability, nervousness, and
. Confusion, poor digestion, rapid or irregular heartbeat (arrhythmia),
and seizures can also result. Magnesium deficiency is associated with
, chronic fatigue syndrome, chronic pain, depression, insomnia,
irritable bowel syndrome
, and lung conditions.
Boron deficiency is rare, although reduced levels do occur with aging and
with reduced levels of vitamin D. Because boron is involved in the
absorption of calcium, the only symptom may be reduced levels of calcium
or the inability to absorb supplemental calcium.
Many Americans are deficient in dietary chromium, which can be associated
with poor regulation of insulin and related imbalances in glucose (either
). Symptoms include fatigue, anxiety, poor protein metabolism, and glucose
intolerance (as in diabetes). In adults, chromium deficiency can be a sign
of coronary artery disease.
Copper is obtained through a balanced diet and deficiency is rare. Signs
of copper deficiency may include anemia, diarrhea, weakness, poor
respiratory function, baldness, skin sores, and increased lipid (fat)
levels in the blood. Severe alterations in copper metabolism are seen in
two rare genetic diseases: Wilson disease and Menkes' disease,
which occur in about one in 100,000 births. Both diseases involve
mutations in copper transport proteins, special channels that allow copper
ions to pass through cell membranes. Menkes' disease, called the
"kinky hair disease," results in tangled, grayish, steely,
or kinky hair and chubby, rosy cheeks. Untreated Menkes' disease is
and death before three years of age. Wilson disease involves decreases in
copper in blood cells, the liver and brain; and increases in copper
(copper toxicosis) in the cells of the intestines and kidneys. It results
in degenerative changes in the brain, liver disease, and hemolytic anemia.
Children older than five years who have any form of liver disease are
often evaluated for serum and cellular copper levels to determine if
Wilson disease is present.
Germanium deficiency is rare; in fact, there is no established deficiency
Iodine deficiency occurs when soil is iodine-poor and foods grown in the
soil are correspondingly low in iodine. An iodine intake of
0.10–0.15 mg/day is considered to be nutritionally adequate. Iodine
deficiency occurs when intake is below 0.05 mg/day. Goiter, an enlargement
of the thyroid gland in the neck, results from iodine deficiency. Although
goiter continues to be a problem in other parts of the world, it no longer
occurs in the United States because of the fortification of foods with
iodine. Iodine deficiency during pregnancy can result in cretinism in
newborns, involving mental retardation and a large tongue.
Iron deficiency occurs most often because of poor iron intake and poor
absorption. In children, iron deficiency is due to periods of dietary
deficiency and heavy demands for iron during rapid growth. Human milk and
cow's milk both contain low levels of iron; however, the iron in
human milk is in a highly absorbable form. Infants are at risk for
acquiring iron deficiency because their rapid rate of growth needs a
corresponding increased supply of dietary iron, for use in making blood
and muscles. Cow's milk formula is fortified with iron. Human milk
is a better source of iron than cow's milk, since about half of the
iron in human breast milk is absorbed by the infant's digestive
tract. In contrast, only 10 percent of the iron in cow's milk is
absorbed by the infant. Toddlers who drink excessive whole cow's
milk are at risk for iron deficiency. Iron deficiency can also be caused
by excess phosphorus in the diet, chronic intestinal bleeding, poor
digestion and absorption, prolonged illness, ulcers, and the use of
antacids. In women and teenage girls, blood loss through
can result in iron deficiency. Symptoms of iron deficiency include anemia
and resulting fatigue and weakness, especially during physical exertion.
Fragile bones, brittle hair and nails, hair loss, spoon-shaped fingernails
or ridges from the base of the nails to the ends, difficulty swallowing,
nervousness, paleness, and lagging mental responses are also possible iron
Deficiency of manganese is very rare. Experimental studies of individuals
fed a manganese deficient diet have revealed that the deficiency produces
a scaly, red rash on the skin of the upper torso.
Selenium deficiency may occur in premature infants who naturally tend to
have about one-third the selenium levels of full-term infants. It is not
known if these lower levels result in adverse consequences. Selenium
deficiency occurs in regions of the world containing low-selenium soils,
including parts of China, New Zealand, and Finland. In Keshan Province,
China, a condition (Keshan disease) occurs that results in deterioration
of regions of the heart and the development of fibers in these areas.
Keshan disease, which may be fatal, is thought to result from a
combination of selenium deficiency and a virus.
Zinc deficiency can be caused by diarrhea, liver and kidney disease,
, diabetes, malabsorption, and overconsumption of fiber. Symptoms of zinc
, recurrent colds and flu, loss of senses of taste and smell, poor night
vision, slow growth, lack of sexual maturation, lack of pubic hair, and
small stature. Studies have shown that signs of zinc deficiency are
detectable after two to five weeks of consuming a zinc-free diet. Signs
include a rash on the face, groin, hands and feet, and diarrhea.
Administering zinc will correct these symptoms.
Mineral deficiencies present with a wide variety of symptoms. Parents
should observe children closely and report any unusual symptoms to the
pediatrician, such as tiredness, weakness, depression or anxiety,
irritability, nervousness, skin irritations, dehydration from vomiting or
diarrhea, and slow growth or development of skills. Other than providing
regular vitamin supplements and a balanced diet to prevent deficiencies,
parents should not attempt to diagnose and treat deficiencies on their
Individual minerals can be measured in blood serum, red blood cells,
tissue cells, or urine, to estimate available levels and determine normal
or abnormal status. Since each mineral performs strikingly different
functions, tests to confirm deficiency are markedly different from each
other. Testing can range from simple to extensive. Physicians will
consider the possible consequences of each type of deficiency and evaluate
the function of organ systems affected by the particular mineral.
In addition to determining serum calcium, phosphorus, and vitamin D
levels, the diagnosis of calcium and phosphorus deficiency may involve
of the skeleton.
Diagnosing iron deficiency will require measuring iron levels and
investigating anemia by performing blood tests such as a complete blood
count (CBC) to determine the number of red blood cells, hemoglobin level,
red cell volume, and cell maturity (morphology). A stair-stepping test may
be used to evaluate stamina, but a blood test is required to diagnose iron
Diagnosing low levels or imbalances of the electrolytes sodium, potassium,
calcium, magnesium, or phosphate involves measuring the serum levels of
each. Measurement determines the circulating blood level at the time blood
was drawn. Laboratory values of sodium and potassium, which are present
within cells and in the fluid between cells, can change rapidly depending
on the individual's overall condition. They may be measured
repeatedly to determine a trend and to monitor correction of the
deficiency or imbalance after diagnosis.
Normal serum magnesium levels are 1.2–2.0 mE/l, while levels in
deficiency (hypomagnesemia) are below 0.8 mE/l. Because calcium and
magnesium must remain balanced, magnesium levels below 0.5 mE/l can
provoke a decline in serum calcium levels. Hypomagnesemia can also result
in low serum potassium. Symptoms of hypomagnesemia, such as twitching and
convulsions, may actually result from the hypocalcemia. Other symptoms,
such as cardiac arrhythmias, actually occur because of low potassium. All
three minerals will be measured.
Iodine deficiency is diagnosed by measuring the concentration of iodine in
urine. A urinary level greater than 0.05 mg iodine per gram of creatinine
(another metabolite excreted in urine) indicates adequate iodine status.
Levels under 0.025 mg iodine/gram creatinine indicate serious risk. The
doctor may also examine the neck with the eyes and hands to see if a
goiter is present.
Urinary zinc levels will differ between normal dietary intake (16 mg per
day) and low-zinc diets (0.3 mg per day); normal urinary zinc is about
0.45 mg per day while low-zinc urinary levels are about 0.150 mg per day.
Plasma zinc levels tend to be maintained during a dietary deficiency in
zinc. Plasma and urinary zinc levels can be influenced by a variety of
factors, and for this reason cannot provide a clear picture of zinc
Selenium can be measured in plasma or red blood cells and compared to
normal values. The activity of an enzyme (glutathione peroxidase) in
platelets (small blood cells essential in blood clotting) may be evaluated
to assess selenium status.
Most mineral deficiencies can be successfully treated through diet or
supplementation, except when caused by disease, which requires treatment
of the disease.
Treating fluid imbalances and related deficiencies in sodium, potassium,
calcium, and phosphate usually requires intravenous (IV) infusion of the
deficient mineral in fluid over a period of time. Sudden changes in sodium
and potassium levels can be just as dangerous as low levels; caution is
used to restore balance gradually. Children may be given oral pediatric
preparations to gradually restore fluids and minerals.
Iron deficiency requires oral supplementation or injectable iron. Vitamin
C helps to assimilate iron.
Iodine deficiency is easily treated and prevented by consuming foods
fortified with iodine, such as table salt. Goiter is reversible with
treatment but cretinism is not.
A magnesium-rich diet will correct magnesium deficiency. If deficiency is
due to prolonged depletion, treatment may include injections of magnesium
sulfate; if severe enough to provoke convulsions, intravenous infusions
may be given.
Selenium deficiency can be treated by supplementation. Children can be
given supplements containing 1.0 mg sodium selenite.
Zinc and copper deficiencies are rare and can be treated with
The prognosis for mineral deficiencies depends on the extent of deficiency
at diagnosis, the degree of effects or symptoms, and the overall health of
the individual. Correction through diet or supplements usually produces
good results. Symptoms may sometimes be relieved promptly with
supplementation. Some deficiencies produce permanent effects of varying
In iodine deficiency, the prognosis for treating goiter is excellent.
Sodium and potassium deficiencies or imbalances can be corrected if
diagnosed and treated promptly, but can be life-threatening if untreated.
Anemia and other effects of iron deficiency are not usually
life-threatening and can be corrected with supplementation.
"Silent" or undiagnosed calcium loss may result in
osteoporosis, which may produce disability or complications by the time it
Sea vegetables (sea weeds such as dulse, kelp, wakambe, and hijiki) are an
excellent source of minerals obtained from the ocean. They can be used to
make soup stock, added to stews and casseroles, or served with vegetables.
Herbs are a valuable source of minerals as well. For example, calcium is
found in alfalfa, burdock root, chamomile, dandelion, flaxseed, paprika,
raspberry leaves, rose hips, and other herbs. Iron is found in the same
herbs as calcium, and in the Chinese herb
(angelica), as well as other herbs.
Ensuring an adequate intake of essential nutrients through a balanced diet
and supplements is the best way to prevent mineral deficiencies. The
Required Dietary Allowances (RDA) guidelines can help ensure that minerals
are being obtained. Safe amounts of certain minerals are often included in
multivitamins. Because excess mineral levels can also cause health
problems, taking excessive amounts of any mineral supplement is not
advised unless a deficiency is diagnosed. When mineral deficiency is the
result of disease, medical attention, other than preventive measures, is
—Salts and minerals that produce electrically charged particles
(ions) in body fluids. Common human electrolytes are sodium chloride,
potassium, calcium, and sodium bicarbonate. Electrolytes control the
fluid balance of the body and are important in muscle contraction,
energy generation, and almost all major biochemical reactions in the
—Substances in food that supply the body with the elements needed
for metabolism. Examples of nutrients are vitamins, minerals,
carbohydrates, fats, and proteins.
—Literally meaning "porous bones," this condition
occurs when bones lose an excessive amount of their protein and mineral
content, particularly calcium. Over time, bone mass and strength are
reduced leading to increased risk of fractures.
Recommended Dietary Allowance (RDA)
—The Recommended Dietary Allowances (RDAs) are quantities of
nutrients in the diet that are required to maintain good health in
people. RDAs are established by the Food and Nutrition Board of the
National Academy of Sciences, and may be revised every few years. A
separate RDA value exists for each nutrient. The RDA values refer to the
amount of nutrient expected to maintain good health in people. The
actual amounts of each nutrient required to maintain good health in
specific individuals differ from person to person.
Good nutrition is a concern of all parents. In the United States, it is
relatively easy to provide a balanced diet with essential nutrients if a
wide variety of whole foods are prepared for
meals and snacks, while avoiding refined and prepared foods high in fats
and sugars. RDA guidelines and public health resources can help assure
parents that they can prevent dietary deficiencies in their young children
Balch, James, and Phyllis Balch.
Prescription for Nutritional Healing,
3rd ed. New York: Avery Publishing Group, 2002.
San Diego: Academic Press, 1998.
American Society for Nutritional Sciences (ASNS).
9650 Rockville Pike, Suite 4500, Bethesda, MD 20814. (301) 634-7050. Web
Food and Nutrition Information (FNIC).
[cited October 9, 2004]. Available online at: