Micronutrients
Chuong Pham-Huy, Bruno Pham Huy in Food and Lifestyle in Health and Disease, 2022
The use of calcium supplements in tablet form is controversial because their efficacy largely depends on their water-solubility. Calcium citrate and lactate are water-soluble, contrary to calcium carbonate and phosphate. The first ones are more absorbed by the intestinal tract than calcium carbonate and phosphate, hence their efficacy is higher than that of carbonate and phosphate. Ca with vitamin D3 supplement is also used to treat some bone diseases. Calcium gluconate is the calcium salt of gluconic acid. It is easily water-soluble and used as an intravenous medication for the treatment of some diseases such as tetany and hypoparathyroidism due to calcium deficiency, and hypocalcemia due to pregnancy or rapid growth of skeleton. The use of Ca supplements also varies between countries. In the United States and Canada, around 40% of the adult population was reported to have taken Ca supplements, and 70% in the older women group (10). In contrast, in Argentina and in Europe, very few people are reported taking Ca supplements, even during pregnancy. This difference is mainly due to the habitude of each population rather than due to the lack of Ca in their diet because both populations have similar diets (10).
Pharmacologic alternatives to blood
Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond in Transfusion Medicine in Practice, 2020
Ferric gluconate (Ferrlecit, Schein Pharm Corp, Florham Park, NJ) was approved for use in the USA in February 1999 as an intravenous iron preparation in renal dialysis patients.54 The rate of allergic reactions (3.3 episodes per million doses) appears to be lower than that of iron dextran (8.7 episodes per million doses), and the safety profile of iron gluconate is substantially better; in the period 1976–1996, among 74 adverse events reported as severe, there were no deaths.50 Adverse events that have been reported to be associated with ferric gluconate include hypotension, rash, chest or abdominal pain, with an incidence of less than 5%.55 Another potential adverse effect of intravenous iron therapy is a clinical syndrome of acute iron toxicity (nausea, facial reddening, and hypotension), which has been attributed to oversaturation (>100%) of transferrin. This has been described with rapid infusion of ferric gluconate (62.5–125 mg within 30 minutes) in a study of 20 dialysis patients.56 However, the existence of this effect has been disputed – two laboratory assays for measurement of serum iron yield misleading results for transferrin saturation if performed within 24 hours after infusion.57 Serious reactions, including one hypotensive event, were reported in only three (1.3%) of 226 patients undergoing renal dialysis while treated with ferric gluconate in one European study.58
Complications of Thyroid Surgery
Madan Laxman Kapre in Thyroid Surgery, 2020
If hypocalcemia is identified on serial calcium checks or predicted on iPTH levels, calcium replacement is recommended. In the acute setting with serum calcium levels less than 7 mg/dL, IV calcium gluconate is administered to alleviate symptoms which can include paresthesia, muscle cramps and spasms, twitching, tetany, seizures, and cardiopulmonary dysfunction. If serum calcium is at least 8 mg/dL, then it is treated with oral calcium carbonate and vitamin D. The starting dose of calcium is usually 500–1000 mg three times a day with upward titration if symptoms persist. Vitamin D plays a crucial role in calcium absorption and bone metabolism and should therefore be administrated, in the most active form, 1,25-dihydroxy D3 (calcitriol), 0.25 μg PO once daily, when the thyroid surgeon has identified a patient with hypocalcemia. In patients warranting IV calcium therapy, calcium gluconate is preferred to calcium chloride, as there is less risk of tissue necrosis if extravasation occurs [54]. Ionized calcium, phosphorous, PTH, and Vitamin D should be checked at regular intervals if the patient is not improving or getting worse. The goal is to maintain a low normal serum calcium with normal phosphorous levels and low urinary excretion of calcium. For patients with permanent hypoparathyroidism, maintaining calcium and phosphorous levels is more difficult and requires routine monitoring, adjustments to supplementation as needed, and long-term management by an endocrinologist with expertise in this area.
The Effects of Zinc and Selenium Supplementation on Body Composition and Thyroid Function in Individuals with Overweight or Obesity: A Systematic Review
Published in Journal of Dietary Supplements, 2023
Antonis Zavros, Christoforos D. Giannaki, George Aphamis, Zoe Roupa, Eleni Andreou
The combined effects of Zn and Se supplementation on body composition were studied only in one trial conducted by Mahmoodianfard et al. (46). In particular, the co-administration of 30 mg of Zn gluconate/day and 200 μg of Se yeast/day for four months did not result in any favorable changes in the body composition of hypothyroid overweight-obese patients as assessed by BMI. These results are in contrast with those of another study, where 50 mg/day of Zn gluconate for four months significantly decreased the BMI of overweight patients with type II diabetes mellitus (61). It is difficult to conclude if the higher dosology of Zn gluconate used can explain the difference between those results because a decrease in BMI was also observed in studies with lower or the same dosages with 30 mg/day. In particular, a significantly decreased in BMI was observed with dosages of 20 mg/day (51) and 30 mg/day (43) of elemental Zn gluconate. Yet, caution must be taken in doses >40 mg/day because such a dose excesses the recommended upper limit for adults. This is something that might have negative effects on HDL-c concentrations and copper-zinc superoxide dismutase activity (81). Zn doses beyond the upper limit can also increase the risk for suppressed immunity, anemia, and gastrointestinal problems (82). On the other hand, in the study by Mahmoodianfard et al. (46), Se yeast was used instead of L-selenomethionine, which was previously found to be effective for improving the BMI of people with overweight or obesity (45).
Hyperosmolar Potassium Inhibits Corneal Myofibroblast Transformation and Prevent Corneal Scar
Published in Current Eye Research, 2023
Kai Liao, Zekai Cui, Zhijie Wang, Yu Peng, Shibo Tang, Jiansu Chen
A previous study that demonstrated the effectiveness of potassium gluconate treatment on skin wound healing suggested that it could be an efficient treatment to prevent scar formation.14 Consistently, we found that KCl could inhibit corneal myofibroblast transformation, and the antifibrotic effect of KCl was dose-dependent. However, no changes were observed in the NaCl treatment group, suggesting that potassium is an effective critical component of the antifibrotic effect. Besides, our results showed that KCl eye drops could prevent corneal scarring. KCl is a metal ion that can easily penetrate the corneal epithelial barrier. Therefore, the application of KCl eye drops was selected instead of subconjunctival injections. In addition, the effect of medication of our eye drops in other days is worth further study.
Non-pharmacologic approaches for hidradenitis suppurativa – a systematic review
Published in Journal of Dermatological Treatment, 2021
Aleksi J. Hendricks, Penelope A. Hirt, Sahil Sekhon, Alexandra R. Vaughn, Hadar A. Lev-Tov, Jennifer L. Hsiao, Vivian Y. Shi
Zinc supplementation alone or in addition to topical triclosan is a promising adjunctive HS treatment. However, both aforementioned zinc supplementation studies reported gastrointestinal distress symptoms in ∼20% of patients, including nausea, abdominal pain, and esophagitis with zinc gluconate supplementation (72,73). Zinc picolinate is an alternative zinc complex with improved absorption that releases less free elemental zinc, thereby minimizing gastrointestinal distress (74). Patients should be cautioned that excess zinc supplementation might lead to copper deficiency. Higher doses of zinc should be taken with trace copper to avoid copper deficiency, at a minimum of the recommended dietary allowance of 900 µg daily (75). In patients taking high-dose zinc long-term, providers should be vigilant for signs and symptoms of copper deficiency including anemia, neutropenia and in severe cases, neurological manifestations such as neuropathy or ataxia (76,77).
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