People most at risk of isoleucine deficiency

The following are the only people who may experience a isoleucine deficiency:

• People on low protein diets
• Strict vegans and vegetarians
• Athletes and mountain climbers

People who are on low protein diets may become deficient not just in isoleucine but all of the amino acids (and especially the essential amino acids) if their protein intake is not sufficient.

Some really strict vegans and vegetarians may become deficient not just in isoleucine but all of the amino acids (and especially the essential amino acids) if they are not combining their foods correctly to get the correct balance of protein and amino acids.

Athletes and mountain climbers may require more isoleucine due to the strenuous nature and high pressure of the physical activity they engage in.

Maple Syrup Urine Disease (MSUD)

People who do experience a deficiency of isoleucine may have the following deficiency condition:

• Maple syrup urine disease (MSUD)

Maple syrup urine disease (MSUD) is a genetic disorder in which the body cannot metabolise and use the essential amino acids isoleucine, leucine and valine. MSUD produces urine that smells like maple syrup.

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Groups at risk of vitamin K deficiency

In general, there are few people who become deficiency in vitamin K, as most people get enough from their diet and also from the bacteria creating it in their intestines, but deficiency does occur in some people:

• Long term users of antibiotics
• People who cant digest fats properly
• People who do not eat enough leafy green vegetables
• People who have serious liver disease
• People who take cholesterol-lowering drugs
• People with gastrointestinal disorders

People who take antibiotics over the long term may have reduced ability to create their own vitamin K from the bacteria in their intestines, as the antibiotics kill all bacteria (good and bad) and especially the bacteria responsible for making the vitamin K in the intestines. People who use antibiotics long term need to ensure they eat enough foods rich in vitamin K (especially leafy green vegetables) every day and to discuss possible supplementation with their doctor in order to avoid deficiency in this very important vitamin.

People who find it difficult to digest fats may be at risk of vitamin K deficiency because some fat in the diet is required to be able to digest the vitamin K and if they cannot digest fats, they may not be absorbing the vitamin K properly and may need supplementation.

People who do not eat leafy green vegetables may not be getting enough vitamin K in their diet, because these foods are very high in vitamin K, so may need supplementation.

People with serious liver disease may not be able to use Vitamin K properly partly because they cannot digest fats properly and partly because their liver is not working properly, so this means they could become deficient and may need supplementation.

People taking cholesterol lowering medications may become deficient in vitamin K, as these medications block absorption and effectiveness of vitamin K from foods eaten, so supplementation may be required.

People with certain intestinal disorders such as Crohn’s disease, ulcerative colitis, diverticulitis, have an impaired gastrointestinal system and their small intestine may not function effectively and so lack the ability to produce any vitamin K. In addition to this, people with these types of intestinal disorders do not digest fats very well, so the vitamin K they get from the food in their diet may not be well absorbed.

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Groups at risk of vitamin H (biotin) deficiency

Deficiency of vitamin H (biotin) is really rare, but some people can still become deficient. The only people that could possibly be at risk for vitamin H (biotin) deficiency are:

• Body builders and athletes
• People that use antibiotics long term

Many body builders and athletes consuming raw eggs to help build up protein, but this may cause a vitamin H (biotin) shortage, as raw eggs contain avidin, a substance which binds with the vitamin H (biotin), making it impossible for it to be absorbed by the body.

People that use antibiotics long term may become deficient in vitamin H (biotin) as the antibiotics can destroy not just the bad bacteria causing infection, but also the “good” bacterial that naturally populates the intestines and helps with gastrointestinal health. People taking antibiotics may need supplementation. People taking this medication need to get advice from their doctor before trying vitamin H (biotin) supplements.

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Groups at risk of betacarotene deficiency

Many groups of people may be at risk of vitamin C deficiency:

• People over 65
• People that have recently had surgery
• People under major and prolonged stress
• People with allergies
• People with asthma
• People with chronic or acute infections / illnesses
• People with diabetes
• Smokers
• Women that are pregnant or breastfeeding

People over 65 may need more vitamin C in general as they may not be absorbing it properly from the foods they eat. They may especially need more vitamin C if they take medications that interfere with vitamin C absorption, so they can easily become deficient.

People that have recently had surgery may require more vitamin C because their body is quickly using up all the stores of vitamin C to heal the wounds faster and fight any infections, so they could be depleting their stores of vitamin C and supplementation may be required..

People under major and prolonged stress are using up all of their stores of vitamin C really quickly to deal with the metabolic effects of the stress and could become deficient (even mildly), so supplementation may be required.

People with allergies are using up all of their stores of vitamin C really quickly to deal with the metabolic effects of the allergies on their body and could become deficient (even mildly), so supplementation may be required.

People with asthma are using up all of their stores of vitamin C really quickly to deal with the metabolic effects of asthma on their body and could become deficient (even mildly), so supplementation may be required.

People with chronic or acute infections / illnesses especially need more vitamin C, as it is necessary to help boost the immune system so that it can fight the infection or illness; supplementation may be required.

People with diabetes may not be absorbing enough vitamin C from the food they eat very well and may be excreting a lot of it in their urine, so they could become deficient and require supplementation.

Cigarette smoke breaks down vitamin C very quickly so that it is not absorbed properly and becomes excreted. In addition to this, extra vitamin C is needed to combat the oxidative damage smoking does to cells. Even people who are exposed to passive smoking need extra vitamin C supplementation because they are also being exposed to the damaging oxidative effects of the cigarette smoke when they passively inhale it.

Women that are pregnant or breastfeeding may need a little more vitamin C to top up their reserves, because much of the nutrients in the foods they eat are being passed onto the baby.

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Groups at risk of vitamin D deficiency

There is a lot of concern in the medical profession that a high number of people are at risk of vitamin D deficiency, mainly because most people stay indoors for most of the day and so do not get much sunlight. In addition, when people do go outside, they may wear sunscreen most of the time and this is a concern because in order for the sunshine to bring vitamin D into the body, it needs to shine on bare skin.

In order to prevent deficiency of vitamin D, everyone should get between 10-15 minutes of direct sunshine on the skin (face, arms and legs) every day when the sun is at the weakest (before 11am or after 4pm).

The following people may be most at risk of vitamin D deficiency:

• Alcoholics
• People on very low fat diets
• People over 65 years
• People taking certain medications
• People that have a part of their gastrointestinal system removed
• People who do not get much sunlight
• People with cystic fibrosis
• People with kidney or liver disease

People that drink excessive amounts of alcohol may be deficient in vitamin D because alcohol prevents the body from absorbing and storing it. People with severe alcoholism are at the greatest risk of deficiency, but even people who regularly consume more alcohol than is advised are at risk of deficiency too.

Vitamin D needs some fat in the food in the diet to be able to be absorbed and used properly, so people who are on really low fat diets may become deficient in this very important vitamin and will need to either increase the (healthy) fat in their diet or to get vitamin D supplements.

People who are over 65 tend to have some difficulty with the absorption of vitamin D and their body is only able to metabolise about half of the amount of this vitamin that younger people do, so supplementation may be required. This is the reason why the recommended daily intake of vitamin D is much higher for people over 70, but it is also higher for people over 50 (than people under 50 years).

Certain medications either block absorption of vitamin D or they prevent vitamin D from being as effective as it should be. People taking any type of medications should seek advice from their doctor to determine how much (if any) extra vitamin D supplements they need to be taking. Caution: Some medications actually accelerate the rate of absorption of vitamin D and can cause really high levels in the body, with associated toxicity symptoms, so people on medications should not self-prescribe, always seek medical advice.

People that have had any part of their gastrointestinal tract removed by surgery (for any reason) may not be able to absorb vitamin D properly and so may not be able to use it properly. This is because a part of the gastrointestinal system is missing, which is necessary to help absorb the vitamin D, the level of deficiency depends on the part that was removed.

People who do not get much sunlight may be deficient in vitamin D and may need supplementation. People who are house-bound, people who are sick, people in nursing homes and even office workers who stay inside all day and do not get much sunlight are all at risk for vitamin D deficiency. People who fit in this category need to get a blood test to determine levels of vitamin D to find out if there is a deficiency and if supplementation is required.

People with the condition cystic fibrosis have an excess of mucous in their body. This condition does not just affect the lungs, the intestines are also exposed to an abnormal amount of mucous and this may impair their ability to absorb and utilise vitamin D. People with this condition need to seek the advice of their doctor about vitamin D supplementation, as it could interact with medication they are taking.

The sunlight form of vitamin D is an inactive form of vitamin D (D3) and needs to be converted into the more active form of vitamin D through a processed involving the liver and kidneys and if these organs are not working, a deficiency may result, especially if foods rich in vitamin D are also not consumed on a regular basis.

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Groups at risk of vitamin B12 (cobalamin) deficiency

There are many groups of people who may be at risk of vitamin B12 (cobalamin) deficiency:

• People taking certain medications
• People taking potassium supplements
• People over 50 years
• People who have had a partial stomach removal
• People who smoke cigarettes
• Strict vegetarians or vegans
• Women who are breastfeeding
• Women who are pregnant

Various types of medications block or reduce absorption of vitamin B12 (cobalamin) so people taking them may become deficient, especially if the medication is taken longer term. Supplementation may be needed. People taking any type of medication need to seek medical advice prior to taking any vitamin B12 (cobalamin) supplements to ensure they are appropriate for their individual circumstances.

People taking potassium supplements may require vitamin B12 (cobalamin) supplementation, especially if the potassium is taken at high levels, which can interfere with vitamin B12 (cobalamin) absorption.

People who are over 50 years may have less intrinsic factor being made in the intestines (which is just a natural factor of ageing in many people), while some older people stop making intrinsic factor altogether. This means that the vitamin B12 (cobalamin) in foods eaten could be absorbed at a decreased amount and deficiency may result.

People that have had a part of their stomach or intestines removed may not be able to make enough intrinsic factor to help with the absorption of vitamin B12 (cobalamin) from foods eaten and a vitamin B12 (cobalamin) deficiency may result.

People who smoke cigarettes tend to have low levels of most of the vitamins, including vitamin B12 (cobalamin) as the body uses the vitamins to try to rid the body of the adverse health effects of the cigarettes, including trying to eliminate the free radicals that are produced.

People who are vegetarians of any type may not be getting enough (or any at all) vitamin B12 (cobalamin) because this vitamin only occurs in high enough levels in foods of animal sources (or animal products), so a deficiency may occur. It is highly recommended that vegetarians take a vitamin B12 (cobalamin) supplement to help prevent a deficiency.

Women who are breastfeeding need more vitamin B12 (cobalamin) in their diet because the baby requires so much of it to help with the development of their nerves and for other functions, so the breastfeeding mother may become deficient if she is not eating enough foods to provide at least the recommended daily intake. Supplementation may be required, but only after seeking advice from a doctor.

Women who are pregnant need more vitamin B12 (cobalamin) in their diet because the unborn baby requires so much of it to help with the development of their nerves and for other functions, so the pregnant woman may become deficient if she is not eating enough foods to provide at least the recommended daily intake. Supplementation may be required, but only after seeking advice from a doctor.

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Groups at risk of vitamin B6 (pyridoxine) deficiency

Certain people are at higher risk for vitamin B6 (pyridoxine) deficiency:

• Alcoholics
• People taking certain prescription drugs
• Smokers
• Strict vegetarians or vegans
• Women taking contraceptive pills
• Women that are pregnant or breastfeeding

People who drink excessive amounts of alcoholism do not absorb as much of the vitamin B6 (pyridoxine) and many other nutrients and may not eat properly, so may be deficient in this vitamin and may need supplementation to avoid severe deficiency symptoms.

Certain medications can decrease absorption and effectiveness of vitamin B6 (pyridoxine) from foods eaten and deficiency may result, especially if the medication is taken longer term.

Tobacco reduces absorption of vitamin B6 (pyridoxine), so people who smoke cigarettes may become deficient and could need supplementation.

Most fruit and vegetables have little or no vitamin B6 (pyridoxine), while milk and dairy products contain very little vitamin B6 (pyridoxine) and the only non-meat sources are nuts and whole grains, which means that strict vegetarians or vegans may become deficient in vitamin B6 (pyridoxine) and could need supplementation.

Women taking contraceptive pills may need supplementation because they may be excreting too much of their vitamin B6 (pyridoxine) stores and could become deficient, so supplementation may be required.

Women that are pregnant or breastfeeding may need more vitamin B6 (pyridoxine) because they are passing on so much of it to their child and as a consequence may become deficient themselves. Women that are pregnant or breastfeeding need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

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Groups at risk of vitamin B5 (pantothenic acid) deficiency

Vitamin B5 (pantothenic acid) deficiency has never been reported in humans, as it is available in adequate amounts in almost all foods. Some people may need a little more of this vitamin, due to their specific health condition:

• Alcoholics
• Athletes
• People over 65 years
• People that have recently undergone surgery
• People under excessive and prolonged stress
• People with certain gastrointestinal disorders
• Women who are pregnant or breastfeeding

People who drink excessive amounts of alcoholism do not absorb as much of the vitamin B5 (pantothenic acid) and even other nutrients and may not eat properly, so may be deficient in this vitamin and may need supplementation. The only group who is at real risk of vitamin B5 (pantothenic acid) deficiency are chronic and long-term alcoholics.

Athletes need more vitamin B5 (pantothenic acid) as they are using up so much of it when they engage in their vigorous physical exercise and need to replenish it quickly. Supplementation may be required for athletes (or anyone else that exercises strenuously).

People over 65 years may need a little more vitamin B5 (pantothenic acid) as they may not be able to absorb enough of it from the foods they eat and they may not be eating properly too.

People that have recently had surgery may need more vitamin B5 (pantothenic acid) as their body is using up so much of it for healing the damaged tissues that have undergone surgery and a deficiency may result. People that will be undergoing surgery need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

People that are experiencing high levels of stress may need more B5 (pantothenic acid) as their body is using up so much of their stores trying to deal with the metabolic effects of the stress, so they need to be replenished.

People with certain gastrointestinal disorders such as sprue (celiac disease) or enteritis may not be able to absorb adequate amounts of vitamin B5 (pantothenic acid) from the foods they eat and may need a supplementation

Women that are pregnant or breastfeeding may need more B5 (pantothenic acid) because they are passing on so much of it to their child. Women that are pregnant or breastfeeding need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

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Groups at risk of vitamin B3 (niacin) deficiency

While vitamin B3 (niacin) deficiency is quite rare in the Western world, there are still people who can experience deficiency (and it is quite common in poorer countries):

• Alcoholics
• Infants with certain congenital disorders
• People that have recently undergone surgery
• People under excessive and prolonged stress
• People with certain gastrointestinal disorders
• People with recent severe burns or injuries
• Women who are pregnant or breastfeeding

People who drink excessive amounts of alcoholism do not absorb as much of the vitamin B3 (niacin) and many other nutrients and may not eat properly, so may be deficient in this vitamin and may need supplementation to avoid severe deficiency symptoms.

Infants with certain congenital disorders (which are due to abnormalities in their chromosomes) may have an impaired ability to absorb and utilise vitamin B3 (niacin) from the food they eat and could become deficient.

People that have recently had surgery may need more vitamin B3 (niacin) as their body is using up so much of it for healing the damaged tissues that have undergone surgery and a deficiency may result. People that will be undergoing surgery need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

People that are experiencing high levels of stress may need more vitamin B3 (niacin) as their body is using up so much of their stores and will need to be replenished, resulting in a deficiency if the vitamin B3 (niacin) are not restored.

People with certain gastrointestinal disorders such as pancreatic insufficiency, sprue (celiac disease) or liver cirrhosis may not be able to absorb adequate amounts of vitamin B3 (niacin) from the foods they eat and a deficiency may result.

People with recent severe burns or injuries may need more vitamin B3 (niacin) as their body is using up so much of it for healing the damaged tissues that have been burnt or injured some way and a deficiency may result.

Women that are pregnant or breastfeeding may need more vitamin B3 (niacin) because they are passing on so much of it to their child and as a consequence may become deficient themselves. Women that are pregnant or breastfeeding need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

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Groups at risk of vitamin B2 (riboflavin) deficiency

While vitamin B2 (riboflavin) deficiency is not common, it does happen and can especially occur in the following people:

• Athletes
• Diabetics
• People over 65 years
• People taking tricyclic antidepressants
• People that are experiencing ongoing or severe stress
• People that are lactose intolerant
• People that have had recent surgery
• People with hyperthyroidism
• Women that are pregnant or breastfeeding
• Women that take oral contraceptives

Athletes require more vitamin B2 (riboflavin) as they are using up so much of it when they engage in their vigorous physical exercise and need to replenish it quickly. Supplementation may be required for athletes (or anyone else that exercises strenuously).

People with diabetes may be excreting a lot of their vitamin B2 (riboflavin) and could become deficient, needing supplementation. People with diabetes need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

People that are over 65 years may not be able to absorb vitamin B2 (riboflavin) properly (this happens to older people) and may not be eating enough foods rich in vitamin B2 (riboflavin) to help, so they could become deficient and require supplementation.

People taking tricyclic antidepressants may develop a vitamin B2 (riboflavin) deficiency as this medication causes it to be less easily absorbed and less effective. People taking tricyclic antidepressants need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

People that are experiencing high levels of stress may need more vitamin B2 (riboflavin) as their body is using up so much of their stores and will need to be replenished, resulting in a deficiency if the vitamin B2 (riboflavin) are not restored.

People that are lactose intolerant may not be absorbing enough of their intake of the vitamin B2 (riboflavin) in the foods they eat due to their inability to digest lactose. People with a lactose intolerance need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

People that have recently had surgery may need more vitamin B2 (riboflavin) as their body is using up so much of it for healing the damaged tissues that have undergone surgery and a deficiency may result. People that will be undergoing surgery need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

People that have hyperthyroidism, a health condition in which the thyroid is overworking and is causing metabolism to be increased, may be excreting a lot of their vitamin B2 (riboflavin) and could become deficient, needing supplementation. People with hyperthyroidism need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

Women that are pregnant or breastfeeding may need more vitamin B2 (riboflavin) because they are passing on so much of it to their child and as a consequence may become deficient themselves. Women that are pregnant or breastfeeding need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

Women that take oral contraceptives may develop a vitamin B2 (riboflavin) deficiency as this medication causes it to be less easily absorbed and less effective. People taking oral contraceptives need to seek the advice of their doctor to determine how much of this vitamin is required for their individual circumstances.

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Groups at risk of vitamin B1 (thiamin) deficiency

Vitamin B1 (thiamin) deficiency is quite rare as it is easily found in many foods, so that few people are seriously deficient. The only people that may be at risk of deficiency are:

• People that are over 65 years
• People that are under prolonged stress
• People that diet frequently
• People that drink alcohol excessively
• People that fast
• People that have recently undergone surgery
• People with an overactive thyroid
• People with chronic or acute infections
• People with diabetes
• People with liver disease
• People with prolonged diarrhoea
• Women that are breastfeeding
• Women that are pregnant

People that are over 65 years of age may not be absorbing the vitamin B1 (thiamin) from the foods they are eating and may not be eating properly too. They may need vitamin B1 (thiamin) supplementation to ensure that they do not become deficient.

People that are under prolonged and chronic stress may be using up most of their stores of vitamin B1 (thiamin) to deal with the metabolic processes that the stress is causing, so may not be getting enough vitamin B1 (thiamin) to deal with the high usage due to the stress and may become deficient. Supplementation is advised for people who are stressed, but not just of vitamin B1 (thiamin), the other B vitamins and other nutrients are also required too.

People that are always on some type of calorie restrictive diet (less than 1500 calories) may not be including enough foods that are high vitamin B1 (thiamin) in their diet and may become deficient. Most calorie restrictive diets do recommend supplements as an adjunct to the diet in some recognition that the diet could be too low in many nutrients.

People that drink excessive amounts of alcohol may have low levels of vitamin B1 (thiamin) as alcohol can block intestinal absorption of vitamin B1 (thiamin) in the intestine. People that are chronic and long term alcoholics will most likely be deficient in this vitamin and will need supplementation.

People that fast, either on a particular food or by eating very of certain foods, greatly restricting their calorie (and food) intake will not be getting enough vitamin B1 (thiamin) nor will they be getting enough of many other nutrients and will be deficient if the fast continues for more than one day. These types of diets are not recommended, but if they are undertaken, people should also take a good multivitamin and mineral supplement to ensure there is no deficiency.

People that have undergone surgery ma need extra vitamin B1 (thiamin) as most of their stores will be used up in helping heal the body from the surgery, whatever type of surgery. People that have recently undergone surgery (or who are about to have surgery) will need to discuss supplementation with their medical practitioner to determine how much and when vitamin B1 (thiamin) and other vitamins and minerals should be taken after surgery.

People that have an overactive thyroid (a condition called hyperthyroidism) may become deficient in vitamin B1 (thiamin) due to the thyroid’s effect of stimulating increased metabolism and using up or excreting too much of the vitamin B1 (thiamin).

People that experience chronic or acute infections (such as bronchitis, influenza) that cause fever (from low grade to high grade) may have lowered vitamin B1 (thiamin) levels because the fever causes the body metabolism to speed up and use up more of the vitamin stores, so more is required. This could cause a vitamin B1 (thiamin) deficiency, especially if the fever and infection is severe or ongoing.

Recent research shows that people who have diabetes may be excreting a great deal of their vitamin B1 (thiamin) through their urine. If the diabetes is not being managed properly, it can cause a great deal of vitamin B1 (thiamin) loss and result in a deficiency which will need supplementation.

People with liver disease may not be able to absorb or utilise vitamin B1 (thiamin) properly and so may become deficient when levels become too low for good health.

People with prolonged diarrhoea (that occurs over many days to weeks), may be excreting too much of their absorbed vitamin B1 (thiamin) through the diarrhoea and could be deficient in many nutrients, not just in vitamin B1 (thiamin).

Women that are pregnant or breastfeeding will be passing on a significant amount of their intake of vitamin B1 (thiamin) to their child and if the pregnant or breastfeeding woman is not eating enough foods rich in vitamin B1 (thiamin), then the baby may not be getting enough resulting in deficiency for both mother and child.

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Groups at risk of inositol deficiency

Inositol deficiency is rare, because the body can make its own inositol if it is not obtained in the diet. The only people who may be at risk of inositol deficiency are:

• Alcoholics
• People taking certain medications
• People who are taking antibiotics
• People who are under prolonged stress
• People who drink a lot of coffee
• People who have high blood pressure
• People who have high LDL (“bad”) cholesterol levels

People who drink excessive amounts of alcohol may have reduced absorption of inositol and supplementation could be required.

People taking certain medications may have reduced levels and effectiveness of inositol, as some medications block its absorption, so supplementation could be required. People taking any type of medication need to seek their doctor’s advice to avoid adverse interactions.

People taking antibiotics may not be absorbing inositol (nor the other B vitamins or the co-factors) and could need supplementation, especially if the antibiotic use is long term.

People who are under prolonged stress will be using up their inositol (and the other B vitamins or the co-factors) at a much faster rate, so supplementation could be required.

People who drink copious amounts (more than 3 cups) of coffee each day may have reduced levels and effectiveness of inositol, as high intake of caffeine can block inositol’s absorption, so supplementation may be needed.

People with high blood pressure may have lower levels of inositol, so supplementation may be needed. People with high blood pressure, need to seek their doctor’s advice about supplementation prior to taking it.

People with high LDL (“bad”) cholesterol may have lower levels of inositol, so supplementation may be needed. People with high LDL (“bad”) cholesterol, need to seek their doctor’s advice about supplementation prior to taking it.

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Groups at risk of PABA deficiency

Deficiency of PABA is extremely rare as it is freely available in many foods and the body can make enough of its own if required. If a deficiency does occur, the following people are the only ones who may become deficienct:

• Malabsorption of PABA
• Malnutrition

PABA may not be absorbed properly in the intestines due to a problem in the absorption process.  The only people who may have this issue are those with gastrointestinal diseases, such as inflammatory bowel disease (IBD) or even irritable bowel syndrome (IBS).

People who are malnutritioned or starving will not just be deficient in the water soluble vitamin B co-factor PABA, but also all the other vitamins as well.

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Groups at risk of folic acid (folate) deficiency

The following are the groups who may be at a high risk of having a folic acid (folate) deficiency:

• People over 65 years
• People taking certain medications
• People who abuse alcohol
• People who smoke cigarettes
• Women taking oral contraceptives
• Women who are breastfeeding
• Women who are pregnant or trying to conceive

People who are over 65 years may be absorbing less of the folic acid (folate) and the other B vitamins from their foods and also may not be eating properly, so could become deficient.

People taking certain medications could become deficient in folic acid (folate) because the medications could be causing the folic acid (folate) to be less absorbed, less effective and less available, so supplementation may be required.

People who drink excessive amounts of alcohol can become deficient in folic acid (folate) because the excessive amounts of alcohol can cause the folic acid (folate) to be less absorbed and have less effectiveness. In addition, these people may not be eating properly so may not get enough folic acid (folate) in their diet anyway.

Research shows that women taking oral contraceptives can become deficient in folic acid (folate), especially in the cervix, as this medication interferes with the absorption of folic acid (folate), so supplementation is usually advised.

Some women who are breastfeeding may require extra folic acid because the baby requires so much of it from the mother’s intake (due to the baby’s rapid growth and development) and if the mother is not eating enough foods rich in folic acid (folate), then both mother and child may become deficient in this important vitamin.

Women who are pregnant or trying to conceive have to ensure they get enough folic acid (folate) in their diet due to this vitamins’ effect on reducing many types of birth defects in the growing foetus (including neural tube defects). Women who are trying to conceive and those who are already pregnant need more of this vitamin than women who are not pregnant or not trying to conceive. Recommended daily intake and tolerable upper limit of folic acid (folate) for pregnant women.

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Groups at risk of choline deficiency

There are no known groups of people who are at risk of choline deficiency. The following people may be the only ones at risk of choline deficiency in the rare occasions that it does occur:

• People with Alzheimer’s disease
• People with fatty liver
• People with high homocysteine levels

Research shows that people with Alzheimer’s disease have much lower levels of the neurotransmitter acetylcholine (adequate intakes of choline are required to enable the creation of this neurotransmitter) than people without this condition. While it is not know if choline deficiency may cause this condition, it certainly does not help having low levels of choline, as it is so vital in the functioning of the brain through its function as enabling the creation of the neurotransmitter acetylcholine.

People that have fatty liver may have low levels of choline as sufficient intake of choline is required to prevent this condition.

The substance homocysteine (an amino acid by-product), is created by various natural metabolic processes in the body. Homocysteine is a substance which is detrimental to heart health, as high levels of homocysteine are implicated as being a high risk factor for heart disease and stroke. Choline enables the conversion of homocysteine to methionine, a harmless and actually a very beneficial amino acid which is not a threat to heart health at all. Low levels of choline may precipitate higher homocysteine levels, especially when there is also a deficiency in the other B vitamins too.

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Groups at risk of betacarotene deficiency

Certain people may be at risk of betacarotene deficiency:

• People taking certain medications
• People who are exposed to environmental toxins
• People who are under major stress
• People with cataracts
• People with certain illness
• People with chronic infections
• Women who use oral contraceptives

Certain medications may reduce the absorption of betacarotene from foods causing a deficiency in this important antioxidant vitamin. People who are taking any type of medication should consult their medical doctor for advice.

People who are constantly being exposed to environmental toxins such as cigarette smoke, industrial and exhaust fume pollution, toxic chemicals could have an elevated amount of free radical activity in their body and may have lowered betacarotene levels because it is being very quickly used up to mop up and neutralise the existing free radicals, but because the exposure is ongoing, it causes too many for free radicals and there may not be enough betacarotene to deal with them and may cause a betacarotene deficiency.

People who are undergoing any type of major (and ongoing) stress, such as physical or physiological stress, overworking, fatigue, not eating enough or properly and exercising too much all create free radicals which lowers betacarotene levels and may cause a deficiency.

People with cataracts may have lowered levels of both betacarotene and vitamin A. The eyes need sufficient levels of both of these vitamins to ensure that the eye functions effectively and eyesight is healthy.

People with certain illnesses such as liver disease, cystic fibrosis or chronic diarrhoea all may have lower betacarotene levels.

People with chronic infections may have lowered immune resistance due to the higher levels of free radicals in the body and may also then have lowered betacarotene levels, which could cause deficiency in this vitamin.

Women who use oral contraceptives may have high levels of betacarotene in their blood, but low levels stored in the liver so this could signify a deficiency of this vitamin.

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Groups at risk of vitamin A deficiency

There are many people who may be at risk of vitamin A deficiency:

• People that are on a very low fat diet
• People that drink alcohol excessively
• People that have recently undergone surgery
• People that smoke cigarettes
• People that take certain medications
• People under a lot of stress
• People with certain illnesses
• People with chronic infections
• People with recent severe burns
• Strict vegetarians and vegans

People that are on a very low fat diet may not be eating enough foods that are rich in vitamin A, because most foods high in vitamin A tend to be high in fat also. This type of low fat diet could contribute to a deficiency of vitamin A and supplementation may be required.

People that drink excessive amounts of alcohol may be deficient in vitamin A because the alcohol prevents the body from transporting and using vitamin A properly. In addition, people who drink excessive amounts of alcohol may not be eating enough food, so may not get enough vitamin A from their foods anyway.

People that have undergone surgery may be deficient in vitamin A, as all the reserves will be used to help the body heal from the surgery, so may need vitamin A supplementation.

Tobacco reduces the amount of vitamin A that is absorbed from foods eaten, so people who smoke cigarettes may become deficient in vitamin A and need supplementation.

Many prescription as well as over-the-counter (OTC) medications cause a decreased absorption of vitamin A, which could cause a deficiency (while some medications cause an increased absorption of vitamin A). People who take any type of medication should seek advice from their doctor before trying any vitamin A supplements to ensure it is suitable for their individual circumstances.

People that are under a great deal of stress, especially if it is constant and prolonged, may have used up most of their vitamin A reserves to combat the free radicals that are produced at times of stress (which is constant for them) and could be deficient and may need supplementation.

People with certain illness may have low vitamin A levels – illness such as cystic fibrosis, liver disease and chronic diarrhoea. People with any type of illness should seek advice from their doctor before trying any vitamin A supplements to ensure it is suitable for their individual circumstances. People with chronic infections (such as bronchitis) usually have low levels of vitamin A due to the infection and may have used up most of their vitamin A reserves to combat the free radicals that are produced at times of infection, so could be deficient and may need supplementation.

People that have recent severe burn may be deficient in vitamin A, as all the reserves will be used to help the body heal from the severe burns, so may need vitamin A supplementation. Vitamin A only exists in food that is of animal origin – meats and meat products such as milk, cheese, eggs and butter.

People that do not eat animal foods (or only very little animal products) may be at a high risk of being deficient in vitamin A and could need supplementation.

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People most at risk of zinc deficiency

Zinc deficiency is common, with at least 45% of the population being at risk of zinc deficiency. The following are the groups who may be at a high risk of having a zinc deficiency:

• People eating a very high fibre diet
• People over 50 years
• People taking diuretics
• People who abuse alcohol or other drugs
• People who are under prolonged stress
• People who have undergone surgery
• People with severe burns or injuries
• People who live in areas where zinc in the soil is low
• People with chronic diarrhoea
• People with various digestive disorders
• Strict vegetarians or vegans
• Women who are pregnant or breastfeeding

People who eat a high fibre diet, especially when the fibre is from whole grains, may become deficient in zinc because the fibre binds with the zinc in the diet and keeps it from being absorbed by eliminating it before it can be absorbed.

People who are over 50 years of age may become deficient in zinc because the body’s ability to absorb and use zinc from foods decreases with age.

People taking diuretics are eliminating a lot of fluid from the body, so could become deficient not just in zinc but in many other nutrients, especially the electrolytes too (calcium, chloride, phosphorus, potassium, sodium).

People who abuse alcohol and other drugs may not have a very good diet in general, so may not get enough dietary zinc as a start, but the alcohol (and other drugs) also eliminates the zinc too quickly from the body, so a zinc deficiency may ensue.

alcohol abusers do not eat very well in general and even moderate amounts of alcohol flush out the zinc stored in your liver and make you excrete it.

People who are under prolonged stress are using up the body stores of zinc more quickly than usual and may become deficient in zinc.

People who have undergone surgery may need extra zinc because the body is using it to help the body heal more quickly from the injuries to the body tissues from the surgery (all surgery causes some damage to tissues but zinc helps to heal the body much more quickly and enable faster recovery).

People with severe burns or injuries may need extra zinc because the body is using up so much of it very quickly to help heal the severe burns and injuries in order to aid in the wound healing.

People who live in areas where zinc in the soil is low may become deficient in zinc because the plant-based foods they are eating could have much lower than normal levels of zinc due to the soil quality.

People with chronic diarrhoea will not be absorbing much of the dietary zinc because of the continual excretion through the diarrhoea, so could become deficient not just in zinc but in many other nutrients, especially the electrolytes too (calcium, chloride, phosphorus, potassium, sodium).

People with various digestive disorders such as Crohn’s disease or celiac disease may need more zinc in their diet through either zinc-rich foods or supplements because these digestive disorders inhibit the absorption of zinc (and other nutrient) thus limiting the effects of the zinc intake and causing a deficiency.

Strict vegetarians or vegans may become deficient in zinc because animal foods have the highest dietary levels of zinc (oysters and meat especially), while fruits have basically no zinc and vegetables have some. Children who do not eat any animal foods may be at most at risk of zinc deficiency.

Women who are pregnant or breastfeeding need a higher dietary intake of zinc to help the growing foetus (during pregnancy) and the growing baby (when breastfeeding) with its development and health.

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People most at risk of vanadium deficiency

Vanadium deficiency is extremely rare in human as so little is required to maintain good health. There are no known groups who may be at risk of vanadium deficiency, as so little of this mineral is needed for good health.

In general, vanadium supplements are not needed as there is no current evidence that anyone is at risk of deficiency of this mineral.

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People most at risk of sodium deficiency

Sodium deficiency is very rare, as it is widely available in a number of natural foods as well as processed foods and most people get enough. The only groups of people who may be deficient are:

• People who drink excessive amounts of water
• People who have cancer of the adrenal glands
• People who sweat excessively
• People who use diuretics
• People with Addison’s disease
• People with chronic kidney disease
• People with severe diarrhoea or vomiting

People who drink excessive amounts of water (more than 3 litres a day) may have unbalanced levels of sodium and the other electrolytes, as water dilutes the amount of the electrolytes in the body and may cause a deficiency of sodium.

People who have cancer of the adrenal glands may not be processing sodium properly because the adrenal hormone aldosterone, which is critical for sodium balance may not be functioning properly.

People who sweat excessively either through engaging in heavy exercise or due to air temperatures (high heat) may be sweating too much of the sodium in the body and could become deficient.

People who use diuretics may be eliminating too much sodium (as well as the other electrolytes) and could become deficient if the diuretics are taken over a long term.

People with Addison’s disease, a condition which produces adrenal gland insufficiency, have low sodium (and chloride) levels, but high potassium levels. This condition causes a deficiency of sodium levels in the body.

People with chronic kidney disease may not be able to process sodium (or the other electrolytes) properly and could be excreting too much of the sodium in the body and become deficient.

People who have severe diarrhoea or vomiting (or even both) may become deficient in sodium (and the other electrolytes) because they may be excreting too much of the sodium in the body.

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People most at risk of silica deficiency

Silica is found abundantly in so many foods, so silica deficiency of a human has not yet ever been reported (or even recorded).

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People most at risk of potassium deficiency

In general, deficiency in any of the electrolytes, including potassium does not normally occur as not much is required to meet RDI and most people get enough potassium from their foods.

The only people who may be at a risk for a potassium deficiency are:

• People that have been vomiting excessively
• People that have diarrhoea
• People who smoke

People who have severe diarrhoea or are vomiting excessively will lose a lot of all their electrolytes very quickly when the fluids are lost through vomiting and/or diarrhoea, but especially potassium levels can go down very quickly. Unless the fluids and electrolytes are replaced quickly, this can have very serious health consequences, especially in small children.

Smoking tobacco cigarettes can cause a potas