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HOW TO RECOGNIZE A SHORTAGE OF PHOSPHATE


Phosphate is a mineral that is commonly found in nature as phosphorus. It is a mineral that appears in up to 85% of your teeth and your bones. It's processed by your kidneys. Besides, this substance is used by enzymes as a building block, so that your energy supply functions appropriately. These enzymes are proteins that help speed up various reactions in the body (1). Hypophosphatasemia, or a low phosphate level, occurs when there is too little phosphate in the blood.

Because humans do not produce phosphate themselves, we have to get this mineral from our food. Fortunately, it is a common substance and can be found in dairy, organ meats, meat, eggs, whole grain products, cocoa, nuts, legumes, plankton, fish, oysters and plankton.

Within your body, there is always a balance between phosphate and calcium. When the phosphate level rises, the calcium level in the blood will also increase. To achieve this, calcium is released from the bones. However, this can lead to brittle bones and bone fractures. 

People rarely suffer from a phosphate deficiency. When there is not enough phosphate in your diet, your body will compensate for this by re-absorbing the phosphate from your blood. If you suffer from mild hypophosphatemia, you will experience little to no symptoms. These only appear when you have a deficient phosphate level. About 2% of all patients suffer from hypophosphatemia (2).

There are certain groups of people that have a higher risk of creating a phosphate deficiency. Those people may benefit from using phosphate supplements next to their daily meals. It is, however, important to note that if you suspect you have a shortage of phosphorus, you should always consult a doctor before taking any supplements.

People with a higher risk of developing a phosphate deficiency include:

- People who abuse alcohol
- Recovering diabetics who have had a diabetic ketoacidosis episode
- People with a respiratory alkalosis (a change in the acidity of the body)
- People with malnutrition or an eating disorder such as Anorexia and Bulimia
- People with hypophosphatemia due to a hereditary disease
- People with chronic diarrhea
- People with Fanconi syndrome (kidney disease)
- People who use drugs excessively, including antacids

A shortage of phosphate can be recognized by the following symptoms. Should you still recognize one or more of these symptoms? Then you should contact your physician. 


1. MUSCLE WEAKNESS



The reason why this symptom occurs in hypophosphatemia is still unknown. What is known, however, is that a shortage of phosphate can cause muscle weakness in humans. The respiratory muscles, in particular, have to do with this.

An old study from 1988 found that patients with respiratory problems were diagnosed with a phosphate deficiency in more than 50% of cases. In a control group of 11 people without a deficiency, it was found that they had no breathing problems at all (3).

Another 2016 study on mice indicated that the mice with a phosphate deficiency showed more muscle weakness than the mice that did not. The researchers reported that this may explain why signs of muscle weakness are often seen in patients with a reduced phosphate level (4). However, the same study also indicated that when the mice got enough phosphate again, they also had less muscle weakness.


In short: if you are deficient in phosphate, you are likely to experience muscle weakness, mainly around your respiratory muscles.


2. RICKETS



Rickets is a bone disease that arises due to a lack of phosphate, calcium, and vitamin D. Especially young children suffer from this. Rickets can occur both hereditary and autosomal (not one of the gender chromosomes, but one of the others). In both cases, the disease arises because the body either gets too little phosphate or because the body cannot process the phosphate (5).

Rickets causes the bones and bone tissue to develop less well, causing problems quickly. For example, the limbs can become curved, the teeth grow less well, and scoliosis can occur.

Rickets can also be caused by Dent's disease. This condition ensures that the processing of substances such as phosphate is blocked. This blockage mainly occurs in the Proximal Tubulus (part of the urethra), where usually, the most significant amounts of phosphate and calcium are absorbed (6).

In short: if you have a shallow content of phosphate, or if your body cannot process it properly, you have the chance of contracting Rickets. However, Rickets can also occur as a symptom of Dent disease. 


3. FATIQUE



When you have too little phosphate in your body, your ATP (adenosine triphosphate) will function less well. This is a substance in your body that transports energy through different cells and tissues to the right destination (7). As you can see from the name, this substance consists partly of phosphate.

When your body can no longer transport energy, it can lead to faster fatigue of your muscles, including your brain. As a result, your muscles recover less quickly after activities, and your heart has more difficulty pumping your blood. As a result of this, you feel more tired and listless.

In short: a shortage of phosphate can cause fatigue because less energy is transported through the body.


4. COGNITIVE DECLINE



Phosphate is linked to the production of Cerebral Amyloid Angiopathy (CAA). CAA plays a significant role in the discovery of Alzheimer's in patients. A 2017 study found that patients with mild cognitive decline and patients with Alzheimer's had lower levels of phosphate in their bodies than the healthy control group (8).

The same study shows that the correlation with Alzheimer's and CAA does not occur with other minerals, such as calcium and iron.

A 2009 article shows that phosphate does affect human brains and intelligence when present in sufficient amounts (9). When we follow this line, likely, a phosphate deficiency can negatively affect our cognition.

In short: phosphate deficiency can affect our cognitive skills because it can promotes decline due to Alzheimer's. 


5. LOSS OF APPETITE



When someone has anorexia, they often have a shortage of energy-supplying proteins or enzymes. These come from minerals such as phosphate, zinc, magnesium, and potassium. These deficiencies contribute to a decreased appetite (10). This appetite is caused by the body's decision to burn fat rather than sugar, which prevents spikes in blood sugar.

However, a person does not need to have anorexia to experience a loss of appetite. That's because a phosphate deficiency triggers the same process of burning fat. However, this only happens when a shortage has arisen that it can no longer be reversed with the aid of food or supplements.

In short: a severe shortage of phosphate can lead to a decreased appetite. However, this is a very late stage of a phosphate deficiency.


6. SLOWED GROWTH IN CHILDREN



A 2012 study found that children and mice with hereditary hypophosphatemia have abnormal growth during childhood (11). However, the usage of supplements has no effect on this. This abnormal growth is characterized by a shorter stature, with longer limbs on the upper body than on the lower body.

Even with non-hereditary hypophosphatemia, there is a chance that children will suffer from growth retardation. However, no research has been done into this because young children generally consume a lot of phosphates, thanks to milk and breastfeeding. That is why a feeding mother must consume enough phosphate.

In short: due to a hereditary condition, it is a possibility that children will have growth retardation due to a shortage of phosphate.


7. TOOTH DECAY



In 2012, a study was conducted with 19 low phosphate patients aged 3-17. During this study, a dentist looked at the teeth of the patients and their overall health (12).

In half of the cases, the patients suffered from cavities, just under half suffered from deteriorated enamel, and 15% suffered from taurodontism: a condition in which the dental bodies are enlarged at the expense of the roots.

Another 2010 study found that over 80% of patients aged between 4 and 26 had poor mouth occlusions. In this study, more than 50% suffered from deteriorated enamel (13).

In short: a shortage of phosphate can have a bad influence on dental health, especially in children and teenagers.


8. PARESTHESIA



In addition to helping transport energy, phosphate also helps transport oxygen around the body. When you are deficient in phosphate, less oxygen and energy is transported through your body. This combination of deficiencies can cause numb or tingling sensations in the human body parts, also known as paresthesia (14). 

Due to the lack of oxygen, less blood is pumped to the brain, so there is less attention to activate the right nerves when muscles relax or contract. The reduced energy that comes on top of that ensures an even slower or non-functioning effect so that your muscles start to "tingle".

In short: a shortage of phosphate can cause a tingling sensation in your limbs due to a lack of oxygen and energy.


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