Many patients come to me on a multivitamin. I am actually not a big fan of supplementing with multivitamins because they contain small amounts (and often poorly absorbed forms) of vitamins and minerals. Rather than supplement with multivitamin, I am an advocate of a colorful diet rich in vitamins and minerals (think color of the rainbow on your plate). And what you don’t get enough of in your diet, I recommend patients supplement with individual nutrients in which they are deficient-the best forms and adequate dosages of the nutrients of course. Most common deficiencies I see in my practice are:

1. Magnesium

Signs of magnesium deficiency:

• Irregular or fast heart beat
• Muscle cramps (Charlie horses!)
• Chocolate cravings
• Restlessness
• Headaches
• Menstrual cramps
• Insomnia
• Anxiety

Food sources- Dark chocolate, tofu, black eyed peas, millet, red beans, beet greens, seeds, nuts, green leafy vegetables, buckwheat

2. Zinc

Signs of zinc deficiency:

• White spots on fingernails
• Ridged nails
• Poor sense of smell or taste
• Decreased immunity
• Acne
• Fatigue
• Poor wound healing
• Poor appetite
• Diarrhea
• Hair loss

Food sources- Pumpkin seeds, red meat, potatoes, soy, oysters, legumes, wheat germ

3. B12

Signs of B12 deficiency:

• Depression
• Anxiety
• Numbness and tingling
• Fatigue
• Sore  or inflamed red tongue
• Cracks at the corner of the mouth
• Mouth sores or ulcers
• Weakness
• Irritability

Food sources- Animal products, such as eggs, meat and dairy. Vegetarian source- nutritional yeast.

4. Vitamin D

Signs of vitamin D deficiency:

• Frequent illnesses/poor immune status
• Fatigue
• Depression
• Osteoporosis
• Bone pain

Food sources- Tuna, dairy products, sardines, tuna, salmon, egg yolks all contain some vitamin D. But the best source is the SUN!

5. Essential Fatty Acids (EFAs)

Signs of EFA deficiency:

• Excess ear wax, especially the dark wax
• Seborrheic dermatitis (forehead shiny & scaly, c yellow greasy look which extends into eyebrows, down nose, cheeks, chest
• Dry, brittle hair
• Itchy, dry skin
• Eczema
• Dandruff
• Poor memory or cognition

Food sources- Salmon, sardines, walnuts, flaxseeds, chia seeds, hemp seeds

Testing for Micronutrient Deficiencies

Unfortunately, routine serum testing for micronutrients is inadequate. I recommend intracellular micronutrient testing.

I routinely test for micronutrient deficiencies in patients that struggle with fatigue, malabsorption/digestive issues (such as Crohn’s, IBS or Ulcerative colitis), and infertility. Once we have the results I can make recommendations on the most bioavailable form of the nutrient as well as appropriate dosages for supplementation and associated food sources.

Here is the micronutrient test I have found to be an invaluable part of my practice.