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Initial treatment focuses on IV fluid replacement (typically 1-2 liters of normal saline) while investigating underlying causes through blood tests and cardiac monitoring

3.2 Bisphenol A Bisphenol A (BPA) is a chemical molecule, widely utilized in many daily use products including containers to line food and beverage, thermal sheets, dental sealants, fillers and cooking utensils

However, they can be used to measure overexposure to chromium Iodine Urinary iodine Excretion 0.78 mol/d indi- Reliable indicator of status cates deficiency Severe iodine deficiency may cause hypothy- roidism Serum total thyroxine (T4) Normal range 68182 nmol/l Iodine deficiency will increase serum TSH level Serum thyroid-stimulat- Values 4.0 mU/l may indi- ing hormone (TSH) cate iodine deficiency or an- other cause of thyroid impair- ment Selenium Activity 30 E/g hemoglobin Sensitive index of status Blood glutathione peroxi- indicates deficiency Index of short-term dietary intake dase Normal range is 0.91.9 Serum selenium mol/l Flouride Normal levels are 0.10.25 Whole blood fluoride mg/l Normal levels are 414 g/l Plasma fluoride Normal levels are 0.31.5 Urinary fluoride mg/d Toxic metals: Normal levels are 340 g/g Hair analysis is a reliable measure of tissue le- Aluminum vels Hair aluminum Levels 1.6 g/g hair may in- Hair analysis is a reliable measure of tissue le- Cadmium dicate elevated tissue levels vels and is superior to blood levels as an index Hair cadmium levels of long-term exposure Lead Blood lead Levels 200 g/l indicate Blood levels are a relatively insensitive index of Hair lead elevated tissue levels and tox- chronic exposure because most body lead is icity deposited in the skeleton Levels 15 g/g may indicate Hair analysis is a reliable measure of tissue le- elevated tissue levels vels

Switzerland) commented on an earlier version of the manuscript and helped to improve the work