What we call Vitamin D is not technically a vitamin, but a series of compounds that function similarly to a hormone. They're important to metabolic function and especially to calcium homeostasis, the movement of calcium throughout the body.
Vitamin D's unique in that it's not present in most foods, but most readily in sunlight. A person could potentially get a healthy amount of Vitamin D from sun exposure. However, this might not be practical for everyone. Other sources include:
- Certain mushrooms: portobello, crimini.
- Fish liver oils.
- Fatty fish: tuna, salmon, mackerel, sardines.
- Cooked egg yolk.
- Beef liver.
- Fortified foods: many manufactured foods are fortified with Vitamin D or a synthetic form of it. This may include fruit juices and drink mixes, soy protein-based beverages, cheese products, flour products, instant formulas, energy bars, breakfast cereals, and milk.
- Supplements: available in forms like capsules and liquids.
- Recurrent illnesses.
- Inflammatory bowel disease: Crohn's disease and ulcerative colitis.
- Bone disorders: osteoporosis, osteomalacia (bone thinning) and rickets, periodontitis (bone loss that can result in tooth loss).
- Increased risk of bone fracture.
- Muscle aches and weakness.
- Muscle fasciculations: twitches and spasms.
- Pre-eclampsia: High blood pressure and protein loss via urination during pregnancy.
Deficiency Risk Factors
- Age: older adults have a higher risk of Vitamin D deficiency.
- Darker skin pigmentation.
- Lack of sun exposure.
- Malabsorption: often due to other health problems, such as celiac disease, short bowel syndrome, inflammatory bowel disease.
- Critical illness: those deficient in Vitamin D may experience increased mortality rates during critical illnesses.
This vitamin is one of the most important in the human body, as it's involved in the metabolism of all of our cells. It's required for DNA synthesis, metabolizing fatty acids and amino acids, the development of red blood cells, and the creation of myelin, which insulates cells in the nervous system and allows them to travel faster and more effectively.
Most people in developed countries obtain the necessary amounts of B12 through eating animal products. Vegan and even vegetarian diets may require additional sources.
- Animal products: meat, fish, eggs, and milk.
- Plants and algae: dried and fermented plant foods such as tempeh as well as seaweed products like nori and laver.
- Supplements: multivitamins or Vitamin B12-specific supplements.
- Fortified foods: some manufactured foods are fortfied with Vitamin B12, including grain-based foods like pasta and bread, soy products, cereal, energy bars, and nutritional yeast.
- Parenteral administration: injections of B12 can be administered in situations where digestive absorption is impaired.
A Vitamin B12 deficiency can cause many serious conditions, the most common of which is the development of anemia, a disease in which the body does not produce enough red blood cells. Red blood cells carry oxygen throughout your body and lacking enough can cause many symptoms, including:
- Weakness or fatigue.
- Heart palpitations.
- Shortness of breath.
- Bruising or bleeding easily.
- Bleeding gums.
- A smooth, red tongue.
- Gastrointestinal issues: sore tongue, weight loss, diarrhea, constipation.
Vitamin B12 deficiency can cause even more complications. Its associated anemia is known as pernicious anemia, and has specific symptoms:
- Megaloblastic anemia: large immature and dysfunctional red blood cells.
- Gastrointestinal issues: diarrhea or constipation, loss of bladder or bowel control.
- Neurological issues: loss of reflexes, diminished ability to sense vibrations or touch, spinal cord degeneration, seizures, and dementia symptoms.
Pernicious anemia is very serious, as you can tell from those symptoms. It can lead to severe and irreversible damage to the brain and nervous system, as well as developmental delay and regression in children.
Deficiency Risk Factors:
- Gastrointestinal diseases affecting absorption: celiac disease, Crohn's disease, or bacterial or parasitic growth.
- Surgical procedures: some bariatric surgeries, removal of the small bowel.
- Atrophic gastritis: thinning of the stomach lining.
- Immune system disorders: Graves' disease and lupus.
- Inadequate intake of B12: vegans are particularly at risk.
Vitamin B9, or Folate
Vitamin B9 is the natural form of folic acid present in your body, and it's crucial in the production of new cells. It's important for DNA and RNA synthesis, and its use in preventing changes to DNA helps guard against cancer. Folate is particularly important during periods of rapid cell growth, such as pregnancy or infancy.
- Dark green leaf vegetables: Brussels sprouts, kale, spinach, lettuce.
- Legumes: chickpeas, lentils, beans, runner beans, soybeans.
- Nuts: hazelnuts, walnuts.
- Some meats: liver and kidneys.
- Tomato juice.
- Red bell peppers.
- Fortified foods: many manufactured foods, especially cereals.
- Supplements: available separately, but often found in multivitamins and women's health supplements.
- Prenatal vitamins: capsules and gummies specially designed for the health of pregnant women.
- Parenteral administration: injections of folate can be administered in situations where digestive absorption is impaired.
Folate deficiency, like Vitamin B12 deficiency, can cause anemia. This can cause the same basic symptoms as B12 deficiency anemia, but may be indicated by some particular symptoms:
- Loss of taste.
- Muscle weakness.
- Numbness: especially in hands or feet.
- Paresthesia: a "pins and needles" feeling, especially in the extremities.
Getting enough folate is also vitally important during pregnancy, as it reduces the risk of neural tube defects (birth defects affecting the brain and spinal cord) such as spina bifida and anencephaly. Pregnant women should get 600 to 800 micrograms of folate every day; prenatal vitamins may help.
Deficiency Risk Factors
A water-soluable vitamin, folate isn't stored in fat cells and must be replenished by diet. Anything that disrupts this replenishment is dangerous.
- Age: infants are at increased risk of folate deficiency.
- Certain diseases: gastrointestinal ailments like celiac disease, Crohn's disease, severe kidney problems requiring dialysis, and certain cancers.
- Certain medications: among them sulfasalazine, trimethoprim-sulfamethoxazole, phenytoin, and methotrexate.
- Excessive alcohol consumption: alcohol interferes with folate absorption and increases its loss via urination.
- Genetics: some genetic mutations hinder the metabolizing of folate.
PLEASE CONSULT WITH YOUR DOCTOR OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL BEFORE TAKING ANY MEDICATION, SUPPLEMENTS, OR BEGINNING ANY HEALTH REGIMEN.