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Phosphorus
Overview

Next to calcium, phosphorus is the most abundant mineral in the body. These two important nutrients work closely together to build strong bones and teeth. About 85% of phosphorus in the body can be found in bones and teeth, but it is also present in cells and tissues throughout the body. Phosphorus helps filter out waste in the kidneys and plays an essential role in how the body stores and uses energy. It also helps reduce muscle pain after a hard workout. Phosphorus is needed for the growth, maintenance, and repair of all tissues and cells, and for the production of the genetic building blocks, DNA and RNA. Phosphorus is also needed to help balance and use other vitamins and minerals, including vitamin D, iodine, magnesium, and zinc.

Most people get plenty of phosphorus in their diets. The mineral is found in milk, grains, and protein-rich foods. Some health conditions such as diabetes, starvation, and alcoholism can cause levels of phosphorus in the body to fall. The same is true of conditions that make it hard for people to absorb nutrients, such as Crohn's disease and celiac disease. Some medications can cause phosphorus levels to drop, including some antacids and diuretics (water pills). Symptoms of phosphorus deficiency include loss of appetite, anxiety, bone pain, fragile bones, stiff joints, fatigue, irregular breathing, irritability, numbness, weakness, and weight change. In children, decreased growth and poor bone and tooth development may occur.

Having too much phosphorus in the body is actually more common and more worrisome than having too little. Too much phosphorus is generally caused by kidney disease or by consuming too much dietary phosphorus and not enough dietary calcium. As the amount of phosphorus you eat rises, so does the need for calcium. The delicate balance between calcium and phosphorus is necessary for proper bone density and prevention of osteoporosis.

What is Phosphorus ?
An essential macromineral and vital to adequate human nutrition, phosphorus plays a key part in the function and structure of the body. In its pentavalent phosphate form, phosphorus is central to the process of bone mineralization and structural makeup of bone. In fact, the phosphorous present in bone accounts for roughly 85% of all phosphorus found in the adult human body. In addition, phosphorus is included in the structure of nucleotides and nucleic acids (including adenosine triphosphate). And, the structure of cellular membranes is composed of phosphorus in its phospholipid form. It has been said that life is built upon phosphorus.

Mineralization of bone relies on cell ability to actively transport phosphate. Recent evidence suggests that expression of a particular gene, regulated by phosphate, may be involved in bone mineralization. Science has also discovered phosphate to be involved with regulating the expression of the phosphorylated glycoprotein osteopontin, which among other things, is thought to modulate hydroxyapatite crystal elongation.

Deficiency Symptoms
Because the amount of phosphorus consumed as part of a regular diet is generally sufficient, deficiency problems are rare. However, it is possible for alcoholics and people who take large doses of antacids containing aluminum to develop a phosphorus deficiency. In addition, when looking at the relationship between calcium and phosphorus, both important for healthy bones, one study showed that the absorption of phosphorus can be negatively affected by taking calcium. The diets consumed by most individuals throughout the United States contain ample amounts of phosphorus. Still, elderly people who supplement their diets with large amounts of calcium may have an increased chance of becoming deficient in phosphorus. Because of this, those conducting the study recommend that elderly people take at least some of their calcium supplement in the form of tricalcium phosphate or other preparation containing phosphorus.

arw Bone pain
arw Weak, soft bones
arw Twitching muscles
arw Loss of appetite
arw Fatigue

Where it is found
Protein-rich foods, such as meat, poultry, fish, eggs, dairy products, nuts, and legumes, are good sources of phosphorus. Other sources include whole grains, hard potatoes, dried fruit, garlic cloves, and carbonated beverages.

Benefits / uses
It is hard to find a cell function that does not include Phosphorus. Phosphorus protects cells, strengthens ectoplast, helps to nourish organism, and regulates the functions of hormones and chemical substances. Phosphorus probably activates the vitamin B and initiates its effectiveness.

One of the most important qualities of Phosphorus is its harmonization with calcium during strengthening bones. The harmonization of calcium and Phosphorus is fundamental for healthy teeth. Furthermore, Phosphorus combines with fats and creates compound called phospholipids which play fundamental structural and metabolic role in ectoplast. The transformation of saccharine, fats and proteins into energy would not be possible without Phosphorus presence in the organism. Phosphorus is essential for ATP (adenosine-tri-phosphate) molecule production. ATP is considered to be small battery accumulator supplying all organism cells with energy needed.

Phosphorus helps to coordinate several organism processes such as muscular contractions, nerve impulses transport from brain to all tissues, and hormonal secretion. Proper usage of Phosphorus might increase physical performance and suppresses fatigue. Phosphorus is a mineral essential for acid-basic balance in blood and for nucleic acids – fundamental genetic compounds – production.

Doses
Recommended dietary allowances (RDAs) for dietary phosphorous are listed below. Most people do not need to take phosphorus supplements.

Pediatric
Infants 0 - 6 months: 100 mg daily
Infants 7 - 12 months: 275 mg
Children 1 - 3 years: 460 mg
Children 4 - 8 years: 500 mg
Children 9 - 18 years: 1,250 mg
Adult
Adults 19 years and older: 700 mg
Pregnant and breastfeeding females under 18 years: 1,250 mg
Pregnant and breastfeeding females 19 years and older: 700 mg

Possible Side effects / Precautions / Possible Interactions:
Too much phosphate can be toxic. It can cause diarrhea and calcification (hardening) of organs and soft tissue, and can interfere with the body's ability to use iron, calcium, magnesium, and zinc. Athletes and others taking supplements that contain phosphate should only do so occasionally and with the guidance and direction of a health care provider.If you are currently being treated with any of the following medications, you should not use phosphorus preparations without first talking with your health care provider.

Alcohol -- Alcohol may leach phosphorus from the bones and cause low levels in the body.
Antacids -- Antacids containing aluminum, calcium, or magnesium (such as Mylanta, Amphojel, Maalox, Riopan, and Alternagel) can bind phosphate in the gut and prevent the body from absorbing it. When these antacids are used long-term, this can lead to low phosphate levels (hypophosphatemia).
Anticonvulsants -- Some anticonvulsants (including phenobarbital and carbamazepine or Tegretol) may lower phosphorus levels and increase levels of alkaline phosphatase, an enzyme that helps remove phosphate from the body.
Bile acid sequestrants -- Bile acid sequestrants are drugs that lower cholesterol. They can decrease the oral absorption of phosphates from the diet or from supplements. Oral phosphate supplements should be taken at least 1 hour before or 4 hours after these drugs. Bile acid sequestrants include:

Cholestyramine (Questran)
Colestipol (Colestid)
Corticosteroids -- Corticosteroids, including prednisone or methylprednisolone (Medrol), may increase phosphorus levels in the urine.
Insulin -- High doses of insulin may lower blood levels of phosphorus in people with diabetic ketoacidosis (a condition caused by severe insulin insufficiency).
Potassium supplements or potassium-sparing diuretics -- Using phosphorus supplements along with potassium supplements or potassium-sparing diuretics may result in too much potassium in the blood (hyperkalemia). Hyperkalemia can be a serious problem, resulting in life-threatening heart rhythm abnormalities (arrhythmias). Potassium-sparing diuretics include:
Spironolactone (Aldactone)
Triamterene (Dyrenium)
ACE inhibitors (blood pressure medication) -- Drugs called angiotensin-converting enzyme (ACE) inhibitors, used to treat high blood pressure, may lower phosphorus levels. They include:
Benazepril (Lotensin)
Captopril (Capoten)
Enalapril (Vasotec)
Fosinopril (Monopril)
Lisinopril (Zestril, Prinivil)
Quinapril (Accupril)
Ramipril (Altace)

Other drugs -- Other drugs may lower phosphorus levels. They include cyclosporine (used to suppress the immune system), cardiac glycosides (digoxin or Lanoxin), heparins (blood-thinning drugs), and non-steroidal anti-inflammatory drugs (such as ibuprofen or Advil). Salt substitutes also contain high levels of potassium and may lower phosphorus levels if used long-term.

Research studies / References
arw Pennington JA, Schoen SA. Total diet study: estimated dietary intakes of nutritional elements, 1982-1991. Int J Vitam Nutr Res 1996;66:350-62.


arw Knochel JP, Agarwal R. Hypophosphatemia and hyperphosphatemia. In Brenner B, ed. The Kidney, 5th ed. Philadelphia: WB Saunders, 1996, 1086-133 [review].


arw Lotz M, Zisman E, Bartter FC. Evidence for a phosphorus-depletion syndrome in man. N Engl J Med 1968;278:409-15.


arw Heaney RP, Nordin BEC. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis. J Am Coll Nutr 2002;21:239-44.m


arw Bour NJS, Soullier BA, Zemel MB. Effect of level and form of phosphorus and level of calcium intake on zinc, iron, and copper bioavailability in man. Nutr Res 1984;4:371-9.


arw Calvo MS, Park YK. Changing phosphorus content of the U.S. diet: potential for adverse effects on bone. J Nutr 1996;126:1168S-80S [review].


arw Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington, DC: National Academy Press, 1997, 181-6 [review].


arw Shuster J, Jenkins A, Logan C, et al. Soft drink consumption and urinary stone recurrence: a randomized prevention trial. J Clin Epidemiol 1992;45:911-6.


arw Rodgers A. Effect of cola consumption on urinary biochemical and physicochemical risk factors associated with calcium oxalate urolithiasis. Urol Res 1999;27:77-81


arw Curhan GC, Willett WC, Rimm EB, et al. Prospective study of beverage use and the risk of kidney stones. Am J Epidemiol 1996;143:240-7.