Deficiencies: vitamins, minerals and laboratory tests

Unexpected Vitamin and Mineral Deficiencies
Folate Deficiency

A young lady recently had her baby delivered here in Ireland. Not feeling well, she visited her local hospital back home in Singapore. There it was explained she was deficient in folate – the metabolized form of folic acid. She had taken folic acid supplements throughout her pregnancy to be told, “60% of people don’t assimilate folic acid; it just builds up.”

Their advice was to take folate, the metabolized form of folic acid, rather than folic acid supplements.

Iron Deficiency

Over the years I have suggested to clients – based on symptoms – to take iron supplementation. “Oh, my bloods are fine; I had them checked recently,” they’ll say. And true, their bloods may be within the normal range yet after beginning supplementation the client’s symptoms improve. Because the blood report was normal it doesn’t follow she had assimilated the iron from her blood. She still benefited from supplementation. Why?

B12 Deficiency

B12 vitamin deficiency folate iron lab As with folic acid deficiency, vitamin B12 deficiency appears to be a common problem too. There are
many symptoms of B12 deficiency: chronic fatigue,
a sore/shiny tongue (glossitis), balance problems, memory loss and sensory abnormalities in the hands and feet, pins-and-needles and muscle weakness – which Dr Le Fanu has commented on here, here, and here. Of note is that blood tests are not reliable in determining deficiency of B12 – and that’s apart from a physician considering B12 deficiency being a possible problem in the first place and therefore requesting a blood analysis. It’s easy to assume symptoms are due to disease rather than a nutrient deficiency.

Laboratory Deficiency

Over a number of weeks Dr Le Fanu has documented problems with B12 deficiency but also refers to experts who explain problems with laboratory analysis when screening for B12 deficiency. Surely this lab deficiency applies to other deficiencies such as iron and folate (folic acid)?

Outlining the problem, Le Fanu advises:

The plot thickens considerably following the account last week of the gentleman whose self-medication with a small daily dose of oral vitamin B12 – despite having “normal” blood levels of the vitamin – cured his shiny red tongue and restored his vitality…

First, the question of defining “normal”. The standard reference range is wide, from 160 to 720ng/l, but the retired consultant biochemist Paul Garrick suggests that the reliability of this measurement at the lower end of the scale is questionable. Doctors should consider treating anyone with “suggestive symptoms” and a level of 300ng/l or less. Still, the improvement following self-treatment with oral B12 is rather surprising because the deficiency is most commonly due to the stomach not secreting a protein (known as intrinsic factor) that is required for the vitamin’s absorption across the gut wall. Hence the necessity to give it by the different route of intramuscular injection, warranting a doctor’s prescription.

Science Deficiency

Quoting another expert, Dr David Yang’s research, he explains:

There is yet more to the very important issue of whether those with symptoms strongly suggestive of vitamin B12 deficiency… are none the less being denied effective treatment because their blood tests fall within the “standard range”.

… Dr David Yang of the University of Wisconsin, writing in the New England Journal of Medicine (Spurious Elevations of Vitamin B12 with Pernicious Anemia), notes there is “insufficient awareness within the medical community” that the automated methods for measuring B12 levels can give “spuriously high results”, thus pushing the measurements of those with low levels into the normal range.

Supplementation and Dosage

As revealed above, it has always been assumed B12 needs to be given intramuscularly as it was thought to be poorly absorbed due to the stomach not secreting intrinsic factor needed for absorption. Yet experience has shown otherwise and that experience has been backed up by research.

Dr Sally Stabler, reporting in the New England Journal of Medicine: Vitamin B12 Deficiency, suggests high doses of B12 taken orally (2,000 mcg per day) can be as effective as the recommended dose of weekly injections for a month followed by monthly injections.

That’s the dosage but, as with folate rather than folic acid, in what form is it preferable to take B12? Since B12, as cyanocobalamin, is possibly poorly assimilated, again, the metabolized form of the vitamin is now available. Methylcobalamin is the active, coenzyme form of Vitamin B12.

Addendum: calcium, phosphorous and magnesium
“I’ve given up all my calcium and medicine from the doctor. He diagnosed me with osteopenia and I took everything he gave me and now I have osteoporosis,” a lady announced to me in a shop recently.

One problem with the calcium prescribed for bone density issues is that it is often a cheap form of calcium; chalk – calcium carbonate. Another is that it is obviously not doing the job!

Bisphosphonates are phosphorous containing compounds. They have been linked to cancer of the jaw and other jaw problems. This doesn’t surprise as homeopaths pointed this out long ago. For example Dr John Henry Clarke, in his Dictionary of Practical Materia Medica, reminded us at the end of the nineteenth century that workers in match factories developed cancer of the jaw – due to a major ingredient; phosphorous (click here). So it is not surprising to find bisphosphonates such as Fosamax causing serious problems with the jaw. (It was cancer of the jaw from which Sigmund Freud died).

nitrogen phosphorous Antimonium bismuth Arsenicum

Group 15 elements

It is not difficult to deduce phosphorous can cause cancer since all the elements in the same group (15) of the Periodic Table of Elements – Nitrogen, Arsenic, Antimony and Bismuth (used in PPI drugs to reduce stomach acid) – all cause cancer.

A neglected element – neglected by Hahnemann during his proving of it and a remedy, as discovered by Dr James Tyler Kent, for the neglected; orphans suffering from diarrhoea, and a remedy neglected by physicians is magnesium.

According to R. Swaminathan “Magnesium Metabolism and its Disorders”

The normal adult human body contains approximately 1,000 mmols of magnesium (22–26 g). About 60% of the magnesium is present in bone, of which 30% is exchangeable and functions as a reservoir to stabilise the serum concentration. About 20% is in skeletal muscle, 19% in other soft tissues and less than 1% in the extracellular fluid.

At present, there is no simple, rapid and accurate laboratory test to indicate the total body magnesium status. The most commonly used method for assessing magnesium status is the serum magnesium concentration.

So, because only 1% of magnesium in the body is available in extracellular tissue, testing for magnesium depletion is impossible.

Magnesium should be considered for preventing osteoporosis as it hardens the bones and may need to be supplemented since soil is becoming deficient in it and many drugs prevent its absorption.

Further Reading
Nitric oxide levels and magnesium reduced due to stomach acid inhibitor drugs (also here: Fertility Clinics’ tricks of the trade).

Pernicious Anaemia – the Forgotten Disease by Martyn Hooper

Dr Sally Stabler has further research available here

Vitamin B12 Support Groups
Martyn Hooper’s website:

Image of elements: Wiki Commons

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