Signs of a deficiency?

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DS is 20. Since he was small he's had stomach issues, used to pick up bugs easily, often had tummy ache etc, borderline underweight. When he was about 15 doctor concluded it was IBS and prescribed low daily dose of loperamide which seems to keep it under control.
Over the past year or so he's had several bouts of mouth ulcers, looks pale, has dry skin (especially on his hands) and more recently has had boils on his face that take ages to clear. He's had one lot of antibiotics for that which helped for a couple of weeks but now they are recurring.
He eats really well, is a good cook (away at uni) and cooks everything from scratch eating plenty of fruit and veg. Doesn't drink very often, just the occasional night out. He is on a demanding course so works hard, I've also wondered if it could be stress related. He is thinking of seeing the doctor but just wondered if these symptoms seem to point to anything?

My friend had similar and went to his GP and it turned out he was severely deficient in vitamin D.

Has he been to his GP recently?

He went about the boils a few weeks ago but didn’t mention the dry skin/fatigue. Vitamin D is lack of sunlight isn’t it? He doesn’t spend much time outside as he’s always working. I’ll look into it and send him back to the GP I think.

I was like that at 20. It was undiagnosed CMPA.

Also vitamin b12 deficiency. The mouth ulcers are typical sign.

How do you end up with a deficiency when you eat well? He has a varied diet, eats lean meat, veg, brown rice, wholewheat pasta, stir fry veg, cheese, berries, green veg. I've never heard of CMPA, I'll look it up.

Jiltedjohnsjulie ah cow's milk. That was looked into when he was younger because of the stomach issues, although it was more a case of eliminating from diet rather than any diagnostic tests. It didn't seem to make any difference to his digestive problems when he cut it out.

Has he had bloods done for coeliac disease?

When he cut out dairy, did he cut it out completely? If he did and there was no difference it's unlikely to be CMPA. I felt completely different after 3 days. If he didn't cut it out completely, it's worth trying. Have a read of this from Allergy Uk first though. The information is aimed at parents of babies and children but is still good for adults as it gives symptoms.

I also second the suggestion of asking for a coeliac teat too

Vitamin D is the one supplement everyone should consider taking because it's so hard to get the full dose from diet alone. You could eat really well, and still be deficient.

Try a vit D supplement for a few weeks to see if he's any better, but also B12 as a PP said, the mouth ulcers are a classic sign.
Has he had any bloods done recently?

Does he exclude gluten? You can be deficient in things if your gut is too inflamed to absorb the nutrients you’re eating.
I would definitely look into high dose vitamin D, omega oils, B vitamins and a good quality probiotic and multivitamin. Definitely the probiotic-he needs to get his gut as healthy as possible.

Sounds very similar to me before I was diagnosed coeliac. Def worth considering

Vitamin D3 deficiency can cause those symptoms and possibly low iron? As mouth ulcers can be a symptom of iron deficient anaemia. Even with a good diet, so much of the foods we cook with are depleted now of vitamins so a supplement is often necessary. It's important to take K2 alongside D3. We take Cytoplan Whole food multi (Cytoplan are a very good company and great customer service) and Solgar-C is a good vitamin C supplement. HTH.

Oh a mushrooms stored on a sunny windowsill will absorb lots of sunlight and therefore another good source of Vit D 👍

Has he ever been tested for coeliac? He would need to keep eating gluten while getting the diagnosis

That was exactly me before I was diagnosed as coeliac

You can be b12 deficient from an autoimmune condition (pernicious anaemia) so you would not be able to absorb b12 from your food. Vitamin d is mainly from sunlight. There is not enough light in the U.K. in the winter for anyone to get enough vitamin d. Everyone should be supplementing in the winter.

He needs to go to his doctor and get some tests run - FBC, vitamins, thyroid. Could be lots of things.