Groups at risk for deficiency include individuals with
- Inadequate parenteral nutrition
- Severe malabsorption
- Chronic alcoholism
- Excessive use of aluminum-containing antacids (aluminum forms insoluble, non-absorbable compounds with phosphate, so phosphate absorption is inhibited)
- Certain renal dysfunction
- Hyperparathyroidism
- Vitamin D deficiency
- X-linked familial hypophosphatemia (phosphate deficiency; dysfunction of intestinal and/or renal phosphate carriers), which is associated with rickets and dwarfism
- Distribution disorders (without cellular phosphate deficiency), for example, by translocation of phosphorus into the bones with increased mineralization or into the cells for phosphorylation of glucose and fructose and for ATP synthesis – often occurs after a period of fasting by resumption of food or after insulin therapy for metabolic acidosis
- Excessive iron intake (high iron concentrations reduce the bioavailability of phosphorus).
- Excessive intake of calcium (high calcium intake leads to complex formation, which can inhibit the absorption of phosphorus).
- Increased renal phosphate excretion (due to parathyroid hormone, calcitonin, calcium intake, estrogens, thyroxine and an acidosis).
- Pregnant women, breastfeeding
Since phosphorus is one of the most common vital substances in food and is added to many industrially produced foods, the supply of German citizens is sufficient overall. The supply of phosphorus is sometimes even above the requirement values. Risk groups for an excess – risk of hyperphosphatemia (phosphate excess) – include persons with
- Restricted kidney function, for example, in chronic renal insufficiency.
- An underactive adrenal thyroid glands (hypoparathyroidism).
