*Updated on 5 Feb, 2014*
When we’re feeling ill, vitamin and mineral deficiencies are probably among the farthest things from our minds to be the culprit. After all, when was the last time your doctor asked or advised you about your nutrition, other than perhaps telling you that it would be beneficial to drop a few pounds? Anyone can suffer from nutrient deficiencies, not just people with MTHFR gene mutations. And anyone experiencing health problems can gain an advantage by learning her nutritional status.
Many factors can cause a person to become deficient in vitamins, minerals, amino acids and antioxidants. These include improper diet, absorption issues, metabolism, hormones, disease, environment, lifestyle, parasites, medications and age. Genetics also come into play, as we know from the MTHFR genetic variant, which prevents the enzyme from making key nutrients like methylfolate and methylcobalamin. Another example is in the case of vitamin D, where mutations in DHCR7/NADSYN1, CYP2R1 and GC genes can affect transport of the vitamin. And as genes impact other genes, a deficiency can have widespread effects throughout the body: vitamin D influences more than 200 genes. This article presents an interesting view on how magnesium deficiency can affect MTHFR. So proper nutrition is more important than we may think. What our parents ate (or didn’t) can also affect us.
Nutrient deficiency symptoms vary and often match symptoms of other conditions. Check out the linked chart in the last sentence to learn which nutrients do what and the symptoms associated with a lack of each one. Deficiencies in calcium, magnesium, zinc, N-acetyl cysteine (NAC), glutathione, iron and vitamins B1, B2, B12, D and folate are very common. Current public nutritional guidelines are generally presented as “one size fits all.” Of course we now know that this isn’t appropriate, but processing the big data from the Human Genome Project is taking a long time. It takes many years for studies to be conducted and for their results to be verified and then trickle down to a policy level. The hope is that enough information will be gathered from nutritional genomic studies to allow a wider understanding of how certain groups of people may be harmed by fortification policies. This information is currently available to many individuals through personal genomic testing, but most of us are on our own to decipher it properly and take the appropriate steps.
In the meantime you can’t just start guessing where you’re deficient and taking supplements randomly. The best approach is to learn exactly what nutrients you lack by doing the appropriate testing. Some forms of testing can be misleading though. Take, for example, the serum tests for folate and B12. It’s possible to have high numbers and still be functionally deficient. Luckily there are at least two specialized test panels that can look beyond simple serum levels of nutrients, giving patients the ability to check on their nutrient levels annually. The first is the Spectracell MicroNutrient assessment, which is the one I’ll be discussing here (as it’s the only one I have experience with). The second is Genova Diagnostics’ NutrEval test. They are a bit different from each other, but I found Spectracell to be pretty comprehensive and it’s the one my doctor recommended. Unfortunately these tests are expensive and not all insurance carriers/plans will cover the cost. But if you have the means to do at least one of them, I highly recommend that you do so.
The Spectracell MicroNutrient test looks at how the micronutrients are functioning within the white blood cells, making it a very different type of test than the serum RBC tests many doctors order. You want to know your long-term intracellular status for each of the nutrients, rather than the short-term extracellular status that a RBC test provides. What you’ll get back is a report that looks like this. My husband and I both had ours done and were really happy to be able to pinpoint exactly where we needed to supplement. Causes of deficiency aren’t always well-known and your results will probably surprise you. I never thought about the way that medications can deplete your nutrients, for example. Antacids deplete B12, folate, vitamin D, calcium, iron and zinc. Cholesterol drugs exhaust Coenzyme Q10 (important for MTHFR people). Female hormones like birth control pills drain your magnesium, selenium, zinc and vitamins B1, B2, B3, B6, B12 and folate. Even diabetic and antiviral medications cause problems.
Once you’re ready to supplement, it’s important to remember a few things. First, you need to supplement in balance. Certain vitamins and minerals work together, like B12 and folate, and copper and zinc. If you take one without the other, you can end up with an imbalance or, in the case of the first example, an impaired ability for a vitamin to be utilized by the body. Folate is dependent on B12, which explains why I couldn’t tolerate much methylfolate until I started getting enough methylcobalamin. So research each supplement carefully before implementing it. Other famous partners include sodium/potassium and magnesium/vitamin D/vitamin K2/manganese (be sure you’re taking enough co-factors if you go for high dose vitamin D supplements).
You also need to know about the interactions of each supplement and what time is best to take them. Some vitamins and minerals should be taken together or far apart from each other. Be sure to note which ones interact with your prescription medications. I can’t take many things within four hours of my thyroid medication, for example.
Supplement quality is also important. Pharmaceutical grade supplements are the best, followed by medical grade, then nutritional grade, which are the ones you get at your local grocery store (even the specialty ones). The better the grade, the purer and more bioavailable the nutrient, with pharmaceutical grade supplements being independently accredited. Obviously cost will become a factor, especially if you are taking many supplements to achieve certain goals. Purchase the best quality that you can afford, always checking the ingredients for additives and other ingredients to ensure that you aren’t getting anything that you don’t want. I search for the best deals online and often use suppliers who provide frequent discounts.
It’s important to know what you’re buying as well. Most vitamins and minerals will have a few different versions. For the B vitamins, this will usually mean the active forms versus the cheaper, synthetic forms (like cyanocobalamin, which you don’t want). Another example is vitamin E, which I just learned about recently. Did you know that there are eight different types of vitamin E? And taking the wrong one can actually inhibit your body’s ability to absorb the good ones? These are the kinds of mistakes you want to avoid and, unfortunately, cost does become a factor here. The good news is that high doses of supplements are usually only needed for a relatively short period of time while a deficiency is being addressed. In the long run you may be able to switch to a high-quality multivitamin supplement. If you have a serious deficiency you’re better off just biting the bullet and purchasing the expensive supplements now when you need them. The cost of deteriorating health becomes much higher in the long run.
Finally, taking supplements (especially expensive supplements) is pretty useless if your body can’t absorb them. As always, work on your gut health first and ensure that your digestive system (and hence your mind and immune system) are in the best shape they can be. This will go a long way to preventing nutritional deficiencies in the first place.