Review Article

Vitamin D, Essential Minerals, and Toxic Elements: Exploring Interactions between Nutrients and Toxicants in Clinical Medicine

Table 1

Interactions of vitamin D, essential minerals, and toxic elements.

InteractionVitamin D (VTD)Calcium (Ca)Magnesium (Mg)Zinc (Zn)Copper (Cu)Iron (Fe)Selenium (Se)

Vitamin DNIL ↑ absorption of Ca [12] ↑ absorption of Mg [12] ↑ absorption of Zn [12] ↑ absorption of Cu ↑ absorption of Fe [12] ↑ absorption of Se

Cadmium (Cd) absorption
of Cd [12]
↑ absorption results in ↓ active VTD (renal)
Low Ca intake results in ↑ Cd absorption and results in Cd osteodystrophy [13]Low Mg intake = ↑ Cd absorption
↑ osteodystrophy
Cd competes with Zn for absorption replaces Zn on metallothionein [13] ↑ Cd decreases Cu absorption
and interferes with Cu metabolism; increased Cu protects from Cd toxicity [13]
Cd decreases Fe absorption; low Fe intake = ↑ Cd absorption [14]Se protects against Cd toxicity [15]

Lead (Pb) ↑ absorption of Pb [12]
↑ absorption results in active VTD
(renal) and promotes Pb toxicity
Low Ca results in ↑ Pb absorption and ↑ Pb in tissues and brain to impair cognition; calcium and phosphorous supplementation decreases Pb absorption and retention [16, 17] Increased calcium and magnesium may protect against lead induced hypertension in pregnancy [18]Pb competes with Zn for intestinal absorption and replaces zinc on hem enzyme; Zn supplementation decreases tissue Pb accumulation [16, 17, 19]Copper insufficiency leads to increased toxicity of Pb;
dietary copper reduced Pb absorption [19]; together, iron and copper completely inhibited the effects of Pb
Low Fe intake = ↑ Pb absorption competing for transport system;
supplementation may decrease Pb absorption and toxicity [17]
Se is useful as an adjunct in chelation treatment in Pb intoxication

Mercury (Hg)No effect on absorption of Hg [43]
Vitamin D may help detoxify the brain from excess Hg [20]
↑ Hg releases intracellular Ca stores disrupting neuronal transport
Ca protects against mercury toxicity [21]
Mg protects against Hg toxicities but less than Ca [21]Zn is protective against methylmercury damage [22] Cu protects against Hg toxicities but less than Mg [21]Iron protects against Hg toxicity; Hg exposure may result in iron deficiency [23]Se protects best against Hg toxicity and binds mercury [15, 17]

Cobalt (Co) ↑ absorption of CoN/AN/AAdministration of Co increases Zn concentration in liverAdministration of Co increases urinary Cu excretion [24]High iron interferes with Co absorption [25]Cobalt may reduce the absorption of Se [26]

Aluminum (Al) ↑ absorption
of Al [12]
Low calcium in presence of Al results in ↑ Al absorption and osteodystrophy [17]Ca deficiency and low Mg intake result in ↑ Al absorption and Al induced neurodegenerationAl may have a protective effect on testis in Zn deficiency state (rat study) [27]Al may have a protective effect on testis in Cu deficiency state [27]Low Fe intake = ↑ Al absorptionSe may have a protective effect from Al [28]

Strontium (Sr) ↑ absorption
of Sr [12]
↓ intestinal absorption of calcium
must have adequate VTD present [29]
↓ intestinal absorption of Ca and Mg; Sr bone benefits disappear with low Mg [30]Bone benefits disappear with low Zn [30] Sr may reduce the level of Cu in the blood [31]Sr competes for iron absorptionN/A

Arsenic (As)UnknownCa has protective effects against As toxicity [32]Mg may have protective effects against As toxicity [32]Zinc may increase As elimination; mechanism is unknown [33, 34]As may increase copper deposition in the kidney [35]Iron is used as a precipitant to remove arsenic from water; the combination may cause hepatic damage in humans [36] ↓ or ↑
moderate Se will ↓ As toxicity [32]
High level of Se may ↑ As toxicity [37]

NIL = no interaction, N/A = information not available, ↑ = increase, and ↓ = decrease.