Hypophosphatemia is a condition where phosphate levels drop to a dangerous point, causing serious health problems. It can be caused by increased excretion of phosphate, inadequate dietary intake, or excessive use of antacids. Chronic deficiency can cause bone wasting, kidney disease, and hyperparathyroidism. Treatment depends on the cause of the deficiency. Acute deficiency can cause heart and neurological symptoms and is treated with phosphate-containing preparations.
Hypophosphatemia, or phosphate deficiency, is a condition in which phosphate levels drop to a point that can become dangerous. Phosphate is an essential mineral required by many cellular processes and hypophosphatemia can cause serious health problems. There are several mechanisms that can cause phosphate deficiency and several health conditions of which this deficiency is a feature.
Phosphate is one of the most used minerals that the body needs. Most of the body’s phosphate is stored in bones and is part of the mineral matrix that is secreted and maintained by bone cells. Phosphate is an essential component of DNA and other nucleic acids, and is a key component of ATP, the molecule essential for nearly all cellular processes that use energy.
The requirement for phosphate for these key cellular functions means that acute or chronic deficiency can have serious consequences. The most common cause of hypophosphatemia is increased excretion of phosphate. This means that phosphate is excreted in the stool or urine instead of being used in the body. Increased phosphate excretion can be caused by a variety of metabolic deficiencies, many of which are hereditary.
Inadequate dietary phosphate intake is not a common cause of deficiency, because nearly all foods contain phosphate. However, a diet generally low in nutrients such as vitamin D, which facilitates phosphate uptake by cells, can exacerbate a pre-existing chronic phosphate deficiency. Excessive use of some types of antacids can cause hypophosphatemia, especially those that contain aluminum, magnesium, or calcium.
The type of hypophosphatemia symptoms that may develop in a given individual depends on the cause of the phosphate deficiency and how long it lasts. Most cases of mild or short-term deficiency do not cause any symptoms, as the body is able to compensate for the short-term lack of phosphate. The most troubling symptom for people with chronic diseases caused by phosphate deficiency is bone wasting which causes bone pain, brittle bones and a greatly increased risk of fractures.
Children who are chronically deficient in phosphate are also at risk for kidney disease and hyperparathyroidism. This condition is a dysfunction of the parathyroid gland which can cause symptoms such as fatigue, depression, pain and nausea. Children may also develop hypophosphatemic rickets, which causes their legs to bend severely. Most cases of chronic phosphate deficiency in childhood are caused by an inherited metabolic disorder.
Treatment for chronic phosphate deficiency is given based on the cause of the deficiency. In situations where the problem is caused by an impaired absorption capacity of dietary phosphate, such as severe vitamin D deficiency, the underlying cause is treated in addition to providing supplemental phosphate. People with metabolic disorders that reduce phosphate metabolism can usually manage the problem with high-phosphate diets and vitamin D supplements.
Acute hypophosphatemia can cause a variety of potentially dangerous symptoms. Phosphate deficiency can cause heart symptoms including low blood pressure and increased risk of dangerous arrhythmias. Acute deficiency can also cause neurological symptoms such as confusion and other cognitive impairments, paralysis, seizures or coma. This type of phosphate deficiency is commonly treated with oral or intravenous phosphate-containing preparations.
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