Central  South  Dakota  Medical News
The Clinical View
  by P.E. Hoffsten, M.D.
26 NOV 03

WHAT ARE TRACE ELEMENTS?

     A patient recently came to the clinic for an annual review of her health status.  She brought with her a large baggie with 14 different nutritional supplements.  She wondered which ones were important and why she was taking them.  She said that over the years she had read various magazine articles and newspaper clippings and had the impression that each of these was important for her health maintenance.  She had an adult multi-vitamin pill which I think is a good idea.  I have indicated before that taking an adult vitamin pill with a full milligram of folic acid is a useful health maintenance practice.  She had calcium pills with a Vitamin D supplement.  They had 600 mg of elemental calcium each and she indicated that she took two a day. I suggested that this was an excellent practice to avoid osteoporosis and the resulting broken bones.  She had Vitamin E tablets which I told her have yet to be shown to have a benefit to prevent heart disease or strokes.  They are however harmless except to your pocket book.  She had fish oil supplements.  There is good information indicating that people who eat ocean fish have a lower risk of heart attack and stroke than people who don’t. The fish oil pills have not been shown to be as effective as eating fish.  The jury is still out on this idea but at least the fish oil pills do not appear to be harmful.

     Then she had a bottle of kelp pills that are made from plants that grow in the ocean.  There is no demonstrated benefit for these supplements.  She had liposin pills that were suppose to provide essential fatty acids.  Simply eating an egg will supply all the essential fatty acids that you need and multiple other beneficial nutrition in addition.  Liposin pills have no demonstrated medical benefit.

        But then she had five additional bottles from the same company that were labeled as “trace elements”.  They were listed as “essential to life”.  She wanted to know what trace elements were.

     A trace element is a simple atomic chemical that the body uses to perform various life functions.  They are chemicals that are found in the body in very tiny amounts but without which the person cannot live.  They are indeed “essential for life”.  Most are supplied in more than adequate amounts in a normal diet.  Rarely are supplements needed.  For some trace elements, too much is worse than too little and one has to be careful about supplementing any nutritional element.

     The first “trace element” that she asked about was her iron pill.  Iron really isn’t considered a trace element although there is only one gram of iron in the total body.  One gram is about 1/5 of a teaspoon or the amount of iron that it would take to make a one inch wood screw.  Most of the body’s iron is contained in the red blood cells.  When an adult doesn’t have enough iron, it is rarely because they don’t eat enough iron.  Almost always it is because they are bleeding internally and losing iron in their stools.  Thus an iron supplement is really only important in women during childbearing age.  An iron supplement is also helpful for children especially during their growing phase.  For the rest of normal adults the daily iron intake need is only 2 mg per day.  This is the amount of iron in the head of pin.   Iron provides an example of an element for which the body has no dedicated mechanism to get rid of it.  If a person gets too much iron in their system they become poisoned and develop a series of  medical problems called hemochromatosis.  Thus, just as too little iron is not a good deal, too much iron creates a significant disease state.

     The next trace element that she asked about was copper.  Unlike iron, the body has very little copper. The total body copper stores are only a 100 mg or about 1/10 as much as the iron stores.  Copper is truly a trace element.  But there is more than enough copper in the normal adult diet so that supplementation is not a useful step in health maintenance for normal adults.

     She next had a bottle labeled zinc sulfate.  The amount of zinc in the body is small but has not been accurately measured to this time.  Zinc plays an important role in healing.  A supplement may be helpful in those individuals with extensive burns or individuals who have psoriasis where their skin flakes off in large amounts.   The amount of zinc needed to maintain balance in the normal adult is around 12 mg per day or the amount equal to a small BB of birdshot.  It doesn’t take much.  Zinc pills are often associated with abdominal discomfort that feels a lot like ulcers.  Supplements are not recommended in a normal adult diet.

     Next, she had a bottle of selenium.  Among the millions of different body proteins, we know of 11 that need selenium to work.  Thus, it is truly a trace element.  The adult minimum daily requirement is 40 micrograms per day (a microgram is 1/1000th of a milligram).  You can’t see an amount of material that small with your eye alone.  Selenium deficiency is essentially unknown in the normal adult population of the United States.  Selenium overload due to over- zealous intake of a nutritional supplement causes brittle hair and brittle nails.  Supplementation with this trace element is not a useful step in health maintenance.

     Lastly, she a bottle of cobalt chloride that she said helped her make blood and prevented diabetes.  This trace element has been shown to have such an effect in research animals.  But there is no demonstrated use in humans.  In fact excess cobalt causes skin rashes, nausea, and liver damage.  I recommended that she not use this supplement.

     From a philosophical approach, it helps to realize that our ancestors ate berries and fruit and leaves and roots and fish/eggs/meat that they could get.  Nature put the right amount of “trace elements” in their food and we are here today because of what they ate.  It is just plain meddlesome to go using supplements which have no demonstrated use and may actually be harmful.  The health care professionals at you local clinic are aware of appropriate dietary supplements and can help find the ones that are useful.