Following on from last month's article "Do you need supplements?", here's a brief overview of the some of the most common nutrient deficiencies I see in clinic, and how you can find out if they are contributing to your fatigue.
Vitamin D
Perhaps more well known for its crucial role in immune function, studies have shown moderately to severely suboptimal levels in CFS patients(1,2) and a connection between low vitamin D, inflammation and fatigue(3). NHS guidelines recommend everyone in the UK takes a vitamin D supplement between October and March as the sun isn't strong enough for us to make enough via our skin(4). Here's a link to my vitamin D fact sheet if you want to know more.
Ferritin
Ferritin is a protein that stores iron in our bodies to be released when needed. Iron is used to make haemoglobin, a protein that carries oxygen around our bodies. As we need oxygen to make energy in our mitochondria, it's no wonder a shortage of iron may contribute to fatigue as research has shown(5). Iron is also required for optimal thyroid function, and an under-performing thyroid can result in - you guessed it - fatigue.
Food sources of iron include meat, fish & poultry, beans, legumes and pulses. Vitamin C can aid absorption, but avoid tea and coffee with meals as the polyphenols they contain can inhibit absorption.
Vitamin B12
As well as energy production, vitamin B12 is important for making red blood cells that transport oxygen around our bodies, the proper functioning of the nervous system which manages our stress response (among other things), and helping the body use folic acid - deficiency of which can also cause anaemia. Supplementation of vitamin B12 has been found to be beneficial in patients with ME and fibromyalgia(6).
Vitamin B12 is found mainly in animal products such as meat, poultry, fish, eggs, milk and cheese. If you are vegetarian or vegan, supplementation is recommended to ensure you have sufficient levels.
Protein & Fats
It's important to remember the role of macronutrients in energy production too. Many of the amino acids from protein are required for the Kreb's Cycle - the energy making process that takes place in our mitochondria - and dietary omega-3 and other fatty acids are vital ingredients for the phospholipid membranes which surround our mitochondria and cells. These membranes let nutrients and oxygen in and waste products out so need to be working correctly so our mitochondria can do their job.
What you can do?
If you're struggling with fatigue, most GPs should offer basic blood tests which include vitamin D, vitamin B12, folate and iron (ferritin). It's important to rule out anaemia as a possible cause of your tiredness with your doctor - low levels of B12, folate and iron may all cause anaemia. It's worth remembering that "normal" ranges for nutrient testing can vary enormously, and "optimal" levels are what I aim for with my clients.
You can also consider private testing, or work with a nutritional therapist to identify the best tests for your individual circumstances. A practitioner can also suggest dietary changes to increase intake of important nutrients, identify any digestive issues that may be affecting nutrient absorption, and make personalised supplement recommendations if required.
Please do not supplement iron without testing as it can be toxic in high doses.
If you'd like to understand if nutrient deficiencies are a factor in your fatigue, why not book a complimentary discovery call?
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The content on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment.