Habitual eating habits that lack variety, medications or certain medical conditions put us at risk for nutrient deficiency. A medical expert review of your current health condition, medications and diet diary is key to screening and finding potential changes that could be a substantial difference in your health and well being. This short review may provide some reminders and insight. Daily requirements for any vitamin vary on age, gender and current system demands. Some supplementation of one vitamin can mask a deficiency of another.
Part 1 of 2:
Part 1: Vitamin A, B1, B2, B3 and Folic Acid
Vitamin A: Conditions that may be associated with Vitamin A deficiency include hypothyroidism (thyroid plays a role in converting beta carotene from our diet to vitamin A), liver disease, alcoholism, gastric or intestinal surgery, intestinal parasites, other gastrointestinal disturbances that cause malabsorption like Celiac, Crohn’s or food sensitivities. Increased levels of inflammation in the body will also decrease your vitamin A status.
Often you can tell if you are deficient if you have mild follicular hyperkeratosis – often felt at the back of the upper arms as you run your hands along, skin has multiple little bumps or feels rough to the touch. Night blindness can also be from Vitamin A deficiency but this can also be from a Zinc deficiency. Vitamin A is best absorbed from your diet and is found in foods like liver, fish liver oils, dairy, eggs. Foods that are high in beta carotene that your body converts to vitamin A are carrots, spinach, kale, cantaloupe and other fruits and vegetables. Women who are pregnant or are capable of becoming pregnant and smokers should never supplement with vitamin A. Vitamin A can put the baby at risk for birth defects and has been linked to increased risk of lung cancer in smokers.
Vitamin B1: Thiamine Conditions associated with psychiatric conditions, aging or insomnia can often be helped with supplementation. A diet low in thiamine can lead to deficiency is as little as 4-5 days. Other triggers can include pregnant women with severe morning sickness including multiple bouts of vomiting, alcoholism, thyrotoxicosis, and major surgery.
Thiamine deficiency is known as “beriberi”. Signs of mild deficiency include fatigue, insomnia, loss of appetite, vague headaches, pain, and difficulty with mental concentration and memory. Some people also experience weakness, weight loss, peripheral neuropathy, edema, tachycardia. Deficiency can also contribute to congestive heart failure. Severe deficiency is known as Wernicke’s encephalopathy in the early stages and Wernicke-Korsakoff syndrome in the later stages. Early signs include psychiatric disturbances, ataxia, ocular palsy, nystigmus. Later stages progress to a chronic neuropathic/psychiatric condition.
Good food sources of B1 include whole grains, legumes, nuts, meat, and enriched flour products.
B2: Riboflavin. B2 is important for helping convert B6 to its active form and is active in homocysteine metabolism, something that is important to cardiovascular /cholesterol health. B2 is also used to help prevent or treat migraines, Parkinson’s disease, psoriasis and some myopathies (muscle pain).
Indications that you may be deficient in vitamin B2 include cracks at the corners of your mouth, swollen tongue, changes in personality, anemia, weakness, depression, seborrheic dermatitis (moist, oily flaky skin condition – cradle cap in newborns and psoriasis/eczema mocking skin reaction in adults aged 30-60), excessive tears, inflammation of the clear membrane that lines your eye (results in vision distortion). Good food sources include meat, dairy, eggs, legumes, fish, poultry, green leafy vegetables, fruits, and whole grains.
Vitamin B3: Niacin B3 is critical in supporting health as it relates to cardiovascular, dermatological, hearing, taste, balance, Alzheimer’s, anxiety, ADHD, dementia, schizophrenia, sleep, osteoarthritis, trigeminal neuralgia, diabetes and alcohol addiction.
Classic deficiency is known as pellagra – the “three d’s”: diarrhea, dementia, dermatitis and sometimes the fourth D…. death.
Early signs that you may be deficient include nervousness, headaches, forgetfulness, apprehension and/or gastrointestinal disturbances.
Food sources include meat, chicken, fish, whole grains, legumes and dairy products.
Folic Acid: Known as folate in foods, folic acid in supplements. Folic acid is key to the intrauterine development of the spinal cord. It is also involved in cardiovascular health, dermatological and neurological conditions, psychiatric many other conditions within the body as it is a key methylator to many biochemical transactions.
As adults, folic acids needs stomach acid to help absorb, so if H.pylori present or on a proton pump inhibitor you may be at risk for deficiency. However people with low stomach acid are also at risk for overgrowth of bacteria in small intestine, and these bacteria can make folic acid – so deficiency is not eminent. If you are supplementing with high doses of B12, you may not be able to tell if you have a folic acid deficiency as they present as one in the same – megaloblastic anemia. Other symptoms can be vague or similar to other B vitamin deficiencies: depression, anxiety, headache, fatigue, apathy, confusion, dementia, polyneuropathy, cracks at the corners of your mouth, swollen tongue, brownish pigmented skin, low muscle tone in babies, poor immune response. This is just one of many reasons why it is always advised to seek a medical expert opinion on your supplement regime.
Gaby, A. (2011) Nutritional Medicine. Fritz Perlberg Publishing. Concord, NH.