Help with Vitamin Blood Test results please

[PJRules]

Hi, I'm searching for answers online but hoping someone on here might be able to help.

I am 47 and soooo tired despite sleeping and eating well. GP said 'it's probably peri menopause' and that was that.

I paid for a Blood Test for vitamins, it's come back as low in pretty much everything and deficient /very low in a few areas.

Vit D 33
Folic Acid 2.6
Vit B12 364
Iron 11.9

I eat very healthily, I've input my diet for the last few days into an app and I'm getting well over the rda of everything. Might there be a reason I'm not absorbing the vitamins, should I try gp again or will he just tell me to buy vitamins ?

Multivitamin type supplements tend to disagree with me, stomach cramps and churns so I'm taking individual vitamins to cover the above at 200% rda plus a liquid iron supplement. Is it likely to be enough?

Many thanks for any help. I promise to cross reference any recommendations and not take medical advice from strangers on the Internet!

A nutrient in a food database doesn't mean the nutrients are present with the same amount in the food item you are holding in your hand. In addition to that, your ability to absorb said nutrient varies greatly from one person to the other. Take iron. If you have any coffee or tea in a two hours window before ingesting your iron rich food, your ability to absorb it plummets. However on your app, you will hit your RDA. Same thing with spinach and calcium, on paper or on an app, there is plenty of calcium in spinach, however their oxalate content will block the body's ability to absorb it.
Then there is the misunderstanding on the RDA. That number is the bottom line below which you can get deficient and sick. The RDA is not your goal , nor is it the optimal quantity because it doesn't exactly differentiate for activity level, health and other individual factors.
B12 is often added to food. Said food becomes what is called "fortified" . This is the case for cereals, vegetable milks and so on. The quality and shelf life of the supplement added to the food can vary. B12 is is also given to livestock. A cow eating grass on the Swiss Alps might produce b12 naturally, a cow living all its life in a metal barn eating corn and soya will not, so 90% of livestock is given b12.

It is incredibly hard to nail nutritional needs from food alone. Many produces are heard in fridges for months (apples) or in CO2 (a lot of the vegetables) and this alters their nutritional content.

Then apps vary greatly in quality. MFP is pure crap as a lot of the data is given by users. Cronometer is a good one if you don't use it already

Take a good quality multivitamins once every 3 days . Thorne 2 a day is a good one that won't give GI disturbance. or take the one you have straight before going to bed.

Lastly , test your omega 3 index. Omegaquant is the best and simplest way to do it.

Thanks, I'll look for those. I'm just trawling the Internet for good supplements.

I thought maybe part of my problem could be that I don't eat processed foods, therefore I don't eat anything fortified like bread and cereals. But from what you've said its probably not that anyway.

I dont drink any caffeine, don't smoke, hardly ever drink alcohol. Eat 5 veg plus fruit daily, eat lean meats, healthy fat, oily fish 2/3 times a week. I'd hoped my results would be much better 😞

Well, it is complex. Soil quality and farming practice might affect minerals and vitamins content.
Then not all vegetables are equal. Kale has a lot of folic acid, cucumbers don't , so unless you eat leafy greens, you won't easily reach your folate needs. Then if you cook them, for example, spinach, you will lose the folic acid in water.
Vitamin D is quite low in food. It is your body that makes it when exposed to the sun. You can place mushrooms in a sunny spot to increase their vitamin D content but it is really hard to meet to your need with food.

You don't mention grains or legumes. Do you eat those? Many avoid carbs, but they are the body preferred source of energy.

Or your fatigue could be unrelated to diet. Changes of hormones can caused fatigue. What did the GP say?

The GP said probably peri menopause, come back if/when I think symptoms are bad enough to warrant hrt.

I eat minimal grains, they just don't agree with me. We have a family history of foods with digestive problems, no real investigation ftom the gp other than just don't eat it then. Some pulses, humus and sweetcorn/peas mainly. Nuts also don't agree with me but I love them so eat quite a lot daily but as dessert after my main meal which limits digestive upset.

My greens are mainly Brocolli daily which I love and leafy stuff in salads. I don't like salad much but try to have some raw veg daily. And sauerkraut, not sure where that sits for nutrition but I like it.

I'm sure my diet could improve, I've realised I might not get enough calcium too so trying to sort that with natural yoghurt and extra cheese. I used to drink tons of milk but tried an exclusion diet for autism and when I reintroduced it found it gave me diarrhea so I have to avoid now.

I have ordered the Thorne 2 a day plus their liquid vit d and a liquid ferrous iron supplement.

Thank you very much for sharing your knowledge.

If you can afford it, you might get some insight from the Zoe Nutrition study. It is used to understand how food affects your health.
We all have a quite unique glucose and lipid metabolism. The speed at which we clear glucose from our blood or the spikes in blood glucose can sometimes explain low energy levels. Do you dip very low during the night.

In the Zoe project you wear a continuous glucose monitor and you also analyse with a prick test your lipids clearance. A lot of people use it for weight loss, but looking at how you process your nutrients allows you to select foods on which your body and mind work at their best.
Foods that you body struggle with, even without your knowledge because of the lack of symptoms , will waste energy .

A few more points to consider. If you are using an app, do you know your protein intake? Again this is something that is unique for each.

Have you considered to eat soya to help with the possible perimenopause?

I hate how women are thrown in that bucket just because we are past mid 40s, but the phytoestrogens in soya can help with symptoms. Fatigue is a very vague and general symptom and if it doesn't resolve in 3 months with an iron supplement, book a new appointment. If you were to go to the GP because of hot flushes, then yes, peri could be to blame, just fatigue on its own, even combined with age, doesn't point necessarily to peri. Are you periods still regular in time (frequency, duration) and usual in flux (more or less abundant) ?

On Calcium, you need to know that unless you take K2 - or eat natto if you can stomach it - it won't necessarily go where you want it , in your bones. The Thorne multi has K2 in it so you are covered.

Do you use any wearable such as an Oura ring or Apple Watch / fit bit? Good sleep is far more than duration and heart rate variability at night, can help explain fatigue .

Try to keep a diary of sleep, energy , because if your fatigue is affecting your daily living, you are declining dinners out with friends, no longer going to cinema or unable to go for long walks, it warrants investigations, but you need to tell your GP a bit more than " I am sooooo tired" and ask him/her : if I was a man , would you do something differently?

See how you go with the multi and iron supplements.

You don't need a prescription to retest your iron. Some pharmacies sell prick tests, a couple of drops from your fingertip and result is immediate.

I would ask the GP to check your ferritin levels, do a blood test. Mine just did this along with other tests such a vitamin D and hormones. I'm mid 40s.