Abstract

2nd INTERNATIONAL WORKSHOP ON PHOSPHATE

Heidelberg, Germany – June 26-30, 1976

SIGNIFICATION OF PHOSPHATE DEFICIENCY IN MAN.

Harald O. Bergengren, Institute of Pathology, University of Umeå, S-901 87 Umeå 6, Sweden.

The most important clinical aspect of inorganic phosphate is deficiency in the food and this may be a pathogenetic factor for a number of diseases. This has always been denied in medicine. Careful investigations in Sweden (cit. BERGENGREN, H.: Sv. Läkartidn. 60:3114- 33, 1963) and USA (OHLSON, M. et al.: J. Am. Dietet. Ass. 24:286-91, 1948) have shown that part of the population (in S. 20%) gets less P in the food than the accepted standard. This is totally neglected.

Under many circumstances even a standard P content may be insufficient. Resorption is highly dependent of HCl, and this acid is often lacking in chronic diseases. Principally all acid metabolic states increase a loss of P in urine. Rheumatoid affections, multiple sclerosis, diabetes mellitus, tubular acidosis and chronic hypoxia belong to those conditions.

Concerning P-deficiency, man is a very odd species. All other animals can be afflicted, particularly cattle, which give out so much P in the milk. The connection geology-soil-crops-animal, opened in the early thirties the opportunity to discover P-deficiency as the cause of serious degenerative disturbances in cattle. Some experimental research complemented these experiences. As result of proven P-deficiency may follow rachitis, retarded growth, osteoporosis, osteomalacia, joint pain, arthritis, cartilage degeneration, periarthritis, abnormal calcifications, weak tendons, tendovaginits, muscular weakness and atrophia, anaemia and haemolysis, disturbed peripheral circulation with cyanosis, degeneration and demyelination in CNS, neuritis and paralysis with common weakness, poor synthesis of energy-rich P-compounds, retarded metabolic and anabolic actions, decreased phosphorylations and vitamin effects, acidosis and hereby increased elimination of P and a trend for the condition to aggravate itself. All this may be seen as a loss of the three major actions of the phosphate ions, viz. to build up protein, take part in metabolism and be a factor in acid-base-balance. Plenty of phosphate supplements in the fodder has made those complaints very uncommon to-day.

What can we expect from addition of phosphate to the food of man? In my own experience, many painful affections of a rheumatic type may respond in a month or two, but many need continuation of P supply. I have even seen that disturbed vision in diabetes, retarded healing of fractures, scoliosis, Bechterew and parodontitis may respond rather well.

I believe that most of you are not prone to accept all this. If you don’t, take it as a challenge and prove the opposite.