Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

5 Shevat 5760 - January 12, 2000 | Mordecai Plaut, director Published Weekly








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Home and Family
Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

I don't know Dr. Brunner personally, although I enjoy his columns. With my apologies to him, I want to deal today with medical side of essential minerals in the body, and I hope this will be impetus to him to discuss the matter from his perspective.

There are a lot of essential minerals and metals that the body needs. Today we will discuss the major ones.

Sodium is often heard about because it is in charge of fluid balances. We get most of our sodium from our diet in the form of sodium chloride, or common table salt. Most of our foods have sodium added to them particularly snacks such as pretzels and the like, Chinese food and soups, especially "cup of soups." The kidneys are in charge of getting rid of excess sodium, so if you eat too much salt, you will become very thirsty and drink more fluid. The kidneys will then get rid of the extra sodium and fluid.

If one has a weak heart, such as congestive heart failure, he may need to have less fluid in the body, so salt restriction and diuretics, which are drugs that make one urinate a lot of fluid and sodium are used. Its difficult to have a low sodium if one has normal kidneys, but if one has problems with the body's fluid-set point in the brain, it can happen.

A high sodium is very dangerous, but its also rare, usually only seen in severe fluid losses such as serious dehydration. Salt pills are sold over the counter for athletes without a prescription. Also many females attempt to lose weight by taking diuretics. Both of these are potentially dangerous.

Potassium is very important. Too much and too little in the body can be lethal, as it affects the heart. We lose most of our potassium by vomiting and diarrhea; healthy people will compensate for this by having their kidneys absorb potassium from the urine. Elderly people may have a problem with this. People taking diuretics also lose a lot of potassium; they must be very careful.

You can make sure you are getting enough potassium by using fluids that have potassium in them when one needs to replenish someone with diarrhea and vomiting, such as fruit juices. Do not give tea or straight water to replenish losses. Fruits with a lot of potassium include banana, citrus, avocado (watch it, a lot of fat in avocado), tomato, and raisins.

Too much potassium in the blood stream can come from many causes, most commonly from kidneys that do not work. Eating too much potassium in the diet will normally not affect a person with healthy kidneys, as the body will put most of it into the urine.

Calcium is important in the heart, muscle and bone. People with osteoporosis do not have abnormal calcium. Rather, they don't get the calcium into the bone. Vitamin D is necessary for absorption of calcium. In Israel, our skin makes vitamin D from the sun. In other countries the milk is fortified with this vitamin.

Too little calcium is rarely seen outside of kidney failure, too much calcium is often the product of cancer. Too much dietary calcium is usually sent out of the body through the kidneys, but it can assist in the formation of kidney stones. On the other hand, too much vitamin D can be poisonous to the liver.

Phosphorus and magnesium are needed in every cell, but it is rare to find problems with these since they are part of almost all that we eat.

In summary, the average Israeli and European diet is sufficient to provide us with what we need: healthy people do not need vitamins or nutritional supplements. Indeed, they could be dangerous. Again I apologize to you Dr. Brunner. I hope you will take up the challenge to write your side of things. Write me in care of the Yated.


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