Electrolytes play a vital role in maintaining homeostasis within the body.

They help to regulate myocardial and

neurological function, fluid balance, oxygen delivery, acid-base balance and much more.
What is an eIectroIyte imbaIance?
Loss of body fIuids from proIonged vomiting, diarrhea, sweating or high fever
Inadequate diet and Iack of vitamins from food
MaIabsorption - your body may be unabIe to absorb these eIectroIytes due to a variety of stomach
disorders, medications, or may be how food is taken in
HormonaI or endocrine disorders
Kidney disease
A compIication of chemotherapy is tumor Iysis syndrome. This occurs when your body breaks
down tumor ceIIs rapidIy after chemotherapy, causing a Iow bIood caIcium IeveI, high bIood
potassium IeveIs, and other eIectroIyte abnormaIities.
Electrolyte imbalances can develop by the following mechanisms: excessive ingestion; diminished elimination of
an electrolyte; diminished ingestion or excessive elimination of an electrolyte. The most common cause of
electrolyte disturbances is renal failure.
The most serious electrolyte disturbances involve abnormalities in the levels of sodium, potassium,
and/or calcium. Other electrolyte imbalances are less common, and often occur in conjunction with major
electrolyte changes.

What are some symptoms of e|ectro|yte |mba|ance to |ook for?
elecLrolyLe lmbalance may creaLe a number of sympLoms 1he sympLoms of elecLrolyLe lmbalance are
based on whlch of Lhe elecLrolyLe levels are affecLed
lf your blood LesL resulLs lndlcaLe an alLered poLasslum magneslum sodlum or calclum levels you may
experlence muscle spasm weakness LwlLchlng or convulslons
8lood LesL resulLs showlng low levels may lead Lo lrregular hearLbeaL confuslon blood pressure
changes nervous sysLem or bone dlsorders
8lood LesL resulLs showlng hlgh levels may lead Lo weakness or LwlLchlng of Lhe muscles numbness
faLlgue lrregular hearLbeaL and blood pressure changes
@reatment of an e|ectro|yte |mba|ance
ldenLlfylng and LreaLlng Lhe underlylng problemcauslng Lhe elecLrolyLe lmbalance
lnLravenous flulds elecLrolyLe replacemenL
A Mlnor elecLrolyLe lmbalance may be correcLed by dleL changes lor example eaLlng a dleL rlch ln
poLasslum lf you have low poLasslum levels or resLrlcLlng your waLer lnLake lf you have a low blood sodlum
level


The RoIe of CaIcium
alcium is needed for our heart, muscles, and nerves to function properly and for blood to clot. nadequate calcium
significantly contributes to the development of osteoporosis. Many published studies show that low calcium intake
throughout life is associated with low bone mass and high fracture rates. National nutrition surveys have shown that
most people are not getting the calcium they need to grow and maintain healthy bones. To find out how much
calcium you need, see the Recommended alcium ntakes (in milligrams) chart below.

'itamin D
The body needs vitamin D to absorb calcium. Without enough vitamin D, one can't form enough of the hormone
calcitriol (known as the "active vitamin D). This in turn leads to insufficient calcium absorption from the diet. n this
situation, the body must take calcium from its stores in the skeleton, which weakens existing bone and prevents the
formation of strong, new bone.

onversely, inadequate levels of vitamin D can inhibit intestinal absorption of calcium, causing hypercalcemia, or
an excess of calcium in the blood. Symptoms include headache, anorexia, nausea, vomiting, gastrointestinal
disturbances, abdominal cramps, dry mouth, metallic taste, weakness, fatigue, muscle and bone pain, ataxia,
tinnitus, and vertigo. More severe stages of hypercalcemia may show up as mental confusion, hypertension,
cardiac arrhythmias, seizures and renal insufficiency.

AmIodipine (as besylate, mesylate or maleate) is a long-acting calcium channel blocker(dihydropyridine (DHP) class)
used as an anti-hypertensive and in the treatment of angina. Like other calcium channel blockers, amlodipine acts by
relaxing the smooth muscle in thearterial wall, decreasing total peripheral resistance and hence reducing blood pressure;
in angina it increases blood flow to the heart muscle (although DHP-class calcium channel blockers are more selective for
arteries than myocardium, as the cardiac calcium channels are not of the dihydropyridine-type).
ontraindications
breast feeding
cardiogenic shock
unstable angina
aortic stenosis: amlodipine causes vasodilation, which can result in reduced cardiac output in patients with
severe aortic stenosis.
Cobamamide (Adobl), which is also known as adenosyIcobaIamin and dibencozide, is, along
with methylcobalamin (Mebl), one of the active forms of vitamin B
12
. As a nutritional supplement, it is available in
tabletted form, but, (unlike cyanocobalamin, methylcobalamin, andhydroxocobalamin), it is not available in injectable
form.
An enzyme that uses adenosylcobalamin as a cofactor is methylmalonyl-oA mutase (MM)

'ertebraI Compression Fracture Overview
A vertebral compression fracture occurs when the bones of the spine become broken due to trauma. Usually the trauma
necessary to break the bones of the spine is quite large. n certain circumstances, however, such as in elderly people and
in people with cancer, these same bones can break with little or no force. The vertebrae most commonly broken are those
in the lower back
The Iumbar vertebrae are the largest segments of the movable part of the vertebral column, and are characterized
by the absence of the foramen transversarium within the transverse process, and by the absence of facets on the
sides of the body. They are designated L1 to L5, starting at the top.
,sc|es
L2 supplles many muscles elLher dlrecLly or Lhrough nerves orlglnaLlng from L2 1hey may be lnnervaLed wlLh L2 as
slngle orlgln or be lnnervaLed parLly by L2 and parLly by oLher splnal nerves
1he muscles are
uadraLus lumborum (parLly)
lllopsoas (parLly)

The term IIiopsoas refers to the combination of three muscles:
psoas major
psoas minor
iliacus
These muscles are distinct in the abdomen, but usually indistinguishable in the thigh. As such, they are usually given a
common name and are referred to as the "dorsal hip muscles"
[1]
or "inner hip muscles".
[2]