Vitamin and minerals are micronutrients you need in tiny amounts. If you don’t get enough of these it can lead to a nutrient deficiency. A blood test can be done to diagnose a deficiency. If you know you’re deficient in something you might need to take a supplement.

 

What are vitamins and minerals?

Vitamins and minerals are types of micronutrients — something your body needs in tiny amounts. They influence nearly every process in your body and are essential for your health.

Causes of vitamin and mineral deficiencies

A varied and balanced diet usually provides you with enough vitamins and minerals for optimal health. But deficiencies can happen for a number of reasons. Some common causes include:

  • poor absorption of nutrients — for example, if you have coeliac or Crohn’s disease
  • a diet lacking in fruit or vegetables
  • a poorly planned vegan or vegetarian diet
  • drinking excessive amounts of alcohol
  • medications — like proton pump inhibitors (PPIs)
  • pregnancy — as your body has additional nutritional demands

So it’s a good idea to check your vitamin and mineral levels, especially if you’re more at risk of a deficiency or have any symptoms.

Symptoms of vitamin and mineral deficiencies

As there’s such a wide range of vitamins and minerals, the symptoms of a deficiency can vary. Here are some of the most common vitamin and mineral deficiencies outlined below.

Iron deficiency
Iron is a mineral that your body needs to make red blood cells — these carry oxygen around your body. If you don’t get enough iron you might:

  • feel weak
  • feel tired
  • feel dizzy
  • feel short of breath
  • get heart palpitations
  • get headaches

Blood loss is a cause of iron deficiency so women are more at risk due to periods and pregnancy. If you follow a vegetarian or vegan diet you might also be at an increased risk because plant-based sources of iron are harder for your body to absorb.

Vitamin D deficiency
Vitamin D is used by every cell in your body and is essential for your bone and muscle health, as well as supporting your immune system. If you don’t get enough vitamin D you might:

  • feel tired
  • get sick often
  • have weak bones — putting you at risk of osteoporosis long-term
  • have muscle pain
  • feel anxious or depressed

You get most of the vitamin D you need from sunlight but it’s also found in foods like eggs, oily fish, liver, and dairy — although it’s hard to get enough from diet alone. In the UK, low vitamin D levels are common because you don’t get enough sun exposure during winter.

Folate (vitamin B9) deficiency
Folate is a B vitamin that’s required to make red blood cells and to make and repair your DNA. It’s sometimes called folic acid — the synthetic (man-made) version of this vitamin. If you don’t get enough folate you might:

  • feel tired
  • feel weak
  • feel short of breath
  • get heart palpitations
  • get headaches
  • feel irritability
  • have difficulty concentrating

Folate isn’t stored in your body so you can become deficient in a matter of weeks if you don’t get enough from your diet or a supplement.

Vitamin B12 deficiency
Vitamin B12 (cobalamin) plays a really important role in red blood cell production and helps your nervous system to function properly. If you don’t get enough vitamin B12 you might:

  • feel extremely tired
  • feel weak
  • get pins and needles
  • get mouth ulcers
  • have a swollen and sore tongue (glossitis)
  • have blurry vision
  • have difficulty remembering things
  • feel depressed

The most common cause of vitamin B12 deficiency is a lack of a stomach protein called intrinsic factor — which you need to absorb vitamin B12. Medications, like PPIs, can affect the amount of intrinsic factor that you produce. You might also produce less once you’re over 50 years. Vegans and vegetarians are also at risk of a deficiency since vitamin B12 isn’t naturally found in plant-based foods.

How to test your vitamin and mineral levels

Most vitamin and mineral deficiencies can be picked up with a blood test, like:

  • a venous blood test — a trained professional will use a needle to puncture a vein, usually in your arm, to collect a blood sample.
  • a finger-prick blood test — using a lancet, you can prick your own finger and collect a small blood sample.

Where to get a vitamin and mineral deficiency test

NHS vitamin and mineral tests
The NHS offer blood tests which can be done at your GP’s or a local hospital. A trained nurse or doctor will take your blood, usually a venous sample.

Home vitamin and mineral tests
It’s possible to order home vitamin and mineral test kits online and do it yourself. For this test, you’ll use a lancet to collect a finger-prick blood sample. Your results will be reviewed by a GP and are available for you to view online.

Common vitamin and mineral result ranges

Iron ranges
There are several tests to check your iron levels. The ideal ranges for each test are:

  • serum ferritin — 13-150 ng/l for women and 30-400 ng/l for men
  • haemoglobin — 120-160 g/L for women and 130-170 g/L for men
  • transferrin saturation — 20-55% for both women and men (the % of transferrin in your blood that’s free to carry iron)
  • total iron-binding capacity (TIBC) — 45-72 umol/L for both women and men
  • unsaturated iron-binding capacity (UIBC) — 24.2-70.1 umol/L for women and 22.3-61.7 umol/L for men

Vitamin D ranges
A 25-hydroxy vitamin D test is the best way to measure your vitamin D levels. Vitamin D reference range:

  • between 50-175 nmol/L is normal
  • between 75-100 nmol/L is optimal

Vitamin B12 ranges
An active B12 test is the best way to measure your levels — this measures the amount of vitamin B12 that’s available for your body to use. You can also do a total B12. Vitamin B12 reference ranges:

  • active B12 — between 37.5- 188 pmol/L is normal
  • total B12 — between 300- 569 pmol/L is normal

Folate (vitamin B9) ranges
Folate (vitamin B9) reference range:

  • between 8.83-60.8 nmol/L is normal

When to take a supplement

Most people can get the nutrients they need from diet alone. So if you don’t have a nutrient deficiency, you shouldn’t take a supplement just for the sake of it. Synthetic nutrients don’t always match up to the those found naturally in foods.

A good approach is to monitor your vitamin and mineral levels with a blood test. If you’re low in a certain nutrient, you can up your intake of foods rich in these nutrients. However, supplements are definitely necessary in some cases.

Vitamin D supplements
During autumn and winter, Public Health England advises that everyone should consider taking a 10 mcg daily vitamin D supplement from October to March. And if you’re more at-risk, they recommend taking them year round.

If you’re someone who doesn’t get much sunlight during the summer months, wear sunscreen top to toe, or have darker skin, then it’s recommended that you take a supplement all year.

Vitamin B12 supplements
If you’re a vegan or vegetarian then you’re more at risk of vitamin B12 deficiency. If a blood test shows that you’re deficient or if you follow a strict vegan diet then it’s recommended that you take a supplement.

A cyanocobalamin supplement is a good choice as it’s a form which your body can easily use. It’s also possible to get a vitamin B12 injection — this is especially useful if your deficiency is caused by absorption issues in your stomach. The form hydroxocobalamin can be given every three months.

Folic acid supplements
If you’re a woman, it’s recommended that you take a 400 mcg folic acid (synthetic folate) supplement before and during the first 12 weeks of pregnancy. In some cases, you might need to take a higher dose — it’s a good idea to work with a health professional to figure out the right dosage for you.

It’s also really important to make sure your vitamin B12 levels are normal when starting a folic acid supplement. Folic acid supplements can mask the symptoms of vitamin B12 deficiency, which if left untreated can cause irreversible damage to your nervous system.

References:

National Institue of Health (2018). Office of dietary supplements. Folate: Fact sheet for health professionals. Retrieved 5 November 2018 from https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/.

National Health Services (2017). Overview: Vitamins and mineral. Retrieved 5 November 2018 from https://www.nhs.uk/conditions/vitamins-and-minerals/.

Stabler, S. P. (2013). Vitamin B12 deficiency. New England Journal of Medicine368(2), 149-160.

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