Wednesday, 11 May 2016

The most common nutrient deficiencies in our population

Do you suffer from annoyingly recurring illnesses like the cold? Do you get headaches or feel tired all the time? Do you have trouble remembering things or staying focused? Believe it or not but a lot these symptoms may actually be due to nutrient deficiencies that are quite common even in developed countries such as those in North America. Now I'm not talking about frank deficiencies and the development of conditions such as scurvy, however suboptimal levels of important vitamins and minerals can leave us functioning..well, sub-optimally. So here are a few of the most common deficiencies we face, and some easy ways to better manage them.

Vitamin D

"The Sunshine Vitamin" actually acts more like a hormone than a vitamin, and is incredibly important in many aspects of how we function. Unfortunately, it is much more commonly deficient than most people think. We do have the ability to make this vitamin when sunlight comes into contact with our skin, however to achieve optimal levels we would need to be out in the sun far longer than what would be good for us. Those of us at a higher risk of having sub-optimal levels? - anyone who lives somewhere where winter is one of the seasons (less daylight, less time outside), individuals with darker skin (ability to synthesize Vit D is decreased in this population), and sedentary or overweight individuals (may be more due to decreased time spent outdoors). With low levels being linked to lowered immune function and increased risk of developing osteoporosis and even multiple sclerosis, this is one important vitamin. There are foods that contain higher amounts of Vit D, such as fish, cheese, egg yolk and liver, however supplementation may actually be the best bet. Doses vary depending on the preexisting status of the individual, so it is always best to visit your ND for help before considering supplementing on your own.


This little mineral is endlessly useful in the body and very commonly deficient in so many people. Some signs of inadequacy can include; fatigue, weakness, muscle twitching and cramping. Magnesium also plays a large role in decreasing blood pressure, making it very useful in the cardiovascular system. This is because magnesium is a widely used catalyst in the body which means it's presence is required for many chemical reactions to occur within us. So while we may be getting enough magnesium to avoid seeing signs of frank deficiency, not getting optimal amounts can also lead to the presentation of annoying symptoms. Where can we find magnesium? Good food sources would include nuts (almonds, cashews and peanuts), spinach, beans, avocado, potatoes, and brown rice. Those of us at risk for sub-optimal levels of this mineral would be anyone not eating much of the previously mentioned foods, anyone with gastrointestinal issues as absorption will be decreased, diabetics (excrete more magnesium in their urine), and the geriatric population due to a decrease in food intake and decreased absorption due to aging.

Omega 3 Fatty Acids

These are as good as "good fats" get. I don't even know where to begin or what studies to cite because the benefits of these fats are incredible and new research continues to come out on how useful they are in various conditions. Ideally, when consuming fats we would want to have a ratio of omega-3 to omega-6 at 1:1. That is ideal, however anything close to that would be beneficial. Unfortunately, a standard North American diet contains a ratio somewhere in the range of 1:20 or more. This supports an overall inflammatory state within the body and inflammation is bad. Low levels of omega-3 fatty acids can present as dry or flaky skin and hair, decreased ability to focus or remember and even increased aches and pains throughout the body. Achieving and maintaining an adequate amount of omega-3s may help improve all of those things and has also been linked to benefiting cardiovascular disease, cognition, diabetes, arthritis, Alzheimer's disease and even cancer. It has actually been shown in the research to decrease "all causes of mortality" which is kind of big deal since this includes literally any cause of death. So yeah, if you can achieve adequate amounts of omega-3's, statistically speaking you will decrease your chances of dying in a car accident. Pretty impressive. Where can we find more omega-3's? Rich sources are flax, fish, vegetable oils, and nuts. There is a kicker though. EPA and DHA are further components of omega-3's and the best benefits are seen when we get higher amounts of EPA than DHA. So when we look at our naturally occurring sources, fish constitutes the best available option as the vegetarian options are not easily converted in our bodies and yield lower amounts of useful EPA. Another problem... eating too much fish can be harmful for us because of the high levels of mercury often found within. Fortunately this can be avoided or at least minimized by choosing smaller fish (as the larger fish have higher amounts accumulated) or supplementing with fish oils (as the mercury is eliminated and EPA and DHA are all rigorously accounted for). As always, it is best to consult with an ND before deciding if supplementation is a good option for you as each person is unique and will require a unique prescription.


This one is much more prevalent in women but can be seen in men as well. Iron is a component of hemoglobin in our blood which is responsible for carrying oxygen throughout the body. Low iron can present as general fatigue, pale skin, feeling cold (especially hands and feet), brittle nails and even cravings to eat ice. Those at higher risk for iron deficiency are women of childbearing age (even more so in those who experience heavier menstrual cycles), vegetarians, or anyone who has lost a lot of blood for any reason (donating too frequently included). The best sources of iron are from meat as the iron contained within is in "heme" form which is the most absorbable form. Red meat, oysters, beef or chicken liver and sardines are great sources of heme iron. While legumes, nuts, grains and green veggies all contain fairly high amounts of iron, it is in the non heme form and only a fraction is absorbed when compared to the heme sources. For this reason it is important for vegetarians to watch their iron levels and ensure they are getting adequate amounts. A vegetarian friendly option would be the use of cast iron pans in cooking. Not only do these things make meals taste better (totally biased) but cooking in them can actually absorb some of the iron from the pan into your food. Additionally, if you are cooking up more acidic foods (something like tomatoes), the iron will actually be converted into a more active form, further increasing the ability of your body to absorb it. Supplementation with iron is always a viable option as well but it would be best to consult with an ND first as dose, duration, and form are all important factors that need to be considered before beginning any supplementation regime.

Vitamin B12

Ok, so this one isn't as common as those previously mentioned but definitely deserves a spot on the list because it can have some serious impacts to certain individuals. These individuals being vegetarian/vegans or anyone who does not consume a lot of meat. Vitamin B12 is responsible for the production of energy, and also for the formation of blood and myelin (this is the stuff that coats your nerves and helps with the transmission of signals from the brain). With these actions, it may be easy to guess what suboptimal levels can present as; fatigue, muscle weakness, and also mental fog and memory problems. What makes this more concerning is that in order for deficient signs to present themselves, the individual would have had to have been fairly deficient for many years. The main complication of this is the impact on the neurological system and that function of coating the nerves with myelin. If someone is left without Vitamin B12 for too long, they can have irreversible neurological damage which can impair their reflexes and sensations of touch. Now this is pretty rare but also quite severe and can be easily avoided. Extreme symptoms like this one are not very common but can be seen in a North American population where meat is excluded. More common however, are the suboptimal levels and their associated symptoms. In the case of Vitamin B12 deficiencies, meat is really the best way to go but for those who do no consume meat for any reason, supplementation of an active form of this vitamin is a must. Sublingual and injection form are the best approaches and the posology is best determined by your ND.

There we have it, a 5 item list of some common nutrient deficiencies that can be seen even in developed countries like Canada and the US. If you are experiencing some of these signs or symptoms, it could be attributed to one of the previously mentioned nutrients. Remember to always consult with a health care practitioner when experiencing any of these symptoms as deficiencies may not be the cause.

Comment, share and ask any questions you may have and I will do my best to answer them!

Rob Raponi, CISSN, B.Kine,
Naturopathic Intern

Studies for those interested,

1. Wang, Thomas J., et al. "Vitamin D deficiency and risk of cardiovascular disease." Circulation 117.4 (2008): 503-511.

2. Holick, Michael F., and Tai C. Chen. "Vitamin D deficiency: a worldwide problem with health consequences." The American journal of clinical nutrition87.4 (2008): 1080S-1086S.

3. Munger, Kassandra L., et al. "Vitamin D intake and incidence of multiple sclerosis." Neurology 62.1 (2004): 60-65.

4. Al-Ghamdi, Saeed MG, Eugene C. Cameron, and Roger AL Sutton. "Magnesium deficiency: pathophysiologic and clinical overview." American Journal of Kidney Diseases 24.5 (1994): 737-752.

5. Kass, Lindsy, J. Weekes, and Lewis Carpenter. "Effect of magnesium supplementation on blood pressure: a meta-analysis." European journal of clinical nutrition 66.4 (2012): 411-418.

6. Delgado-Lista, Javier, et al. "Long chain omega-3 fatty acids and cardiovascular disease: a systematic review." British Journal of Nutrition107.S2 (2012): S201-S213.

7. Lee, Lai Kuan, et al. "Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (MCI): a 12-month randomised, double-blind, placebo-controlled trial." Psychopharmacology 225.3 (2013): 605-612.

8. Vaucher, Paul, et al. "Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial." Canadian Medical Association Journal 184.11 (2012): 1247-1254.

9. Stabler, Sally P. "Vitamin B12 deficiency." New England Journal of Medicine368.2 (2013): 149-160.

10. Moore, Eileen M., et al. "Among vitamin B12 deficient older people, high folate levels are associated with worse cognitive function: combined data from three cohorts." Journal of Alzheimer's Disease 39.3 (2014): 661-668. **Interesting study on relationship between B12 and folate in the elderly for those interested

11. Tayyebi, Ali, et al. "The effect of Vitamin B12 supplemention on fatigue in hemodialysis patients." Iran J Crit Care Nurs 6.1 (2013): 39-48.

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