Spotting Common Micronutrient Deficiencies


Experiencing digestive problems, nausea, or trouble seeing at night? You might be suffering from a common micronutrient deficiency or chronic micronutrient inadequacy.

And there’s a good chance it has to do with your food choices. Keep reading to learn how to spot the signs for 11 common micronutrient deficiencies and inadequacies!

What are micronutrient deficiencies?

A micronutrient deficiency can be defined as a lack of essential vitamins and minerals that are required in small amounts by the body for proper growth and development. (1)

Micronutrient deficiencies happen when our bodies don’t (or can’t) absorb or get the necessary amount of nutrients we need from diet or other sources.

Did you know?
Micronutrients aren’t needed in the same quantities as the three macronutrients (fats, carbohydrates, and protein), but are still equally as important.

How common are micronutrient deficiencies?

Wondering just how many people are walking around with micronutrient deficiencies?

Analysis of data from the National Health and Nutrition Examination Survey (NHANES) concluded that nearly one-third of the U.S. population is at risk of micronutrient deficiency in at least one vitamin or mineral. (2)

Practitioners and patients in the U.S. have undoubtedly put more focus on the importance of healthful, balanced nutrition— yet data still shows the diets of more than 90% of Americans fall short of reaching recommended daily allowances (RDAs) and Adequate Intake (AIs) for one or more essential vitamins or minerals. (2)(3)(4)

Did you know?
Micronutrient deficiencies affect an estimated 2 billion people worldwide. (5)

Will a micronutrient deficiency cause long-term problems?

When you address a deficiency, most symptoms and health impacts from nutritional deficiencies will cease once you are no longer deficient, but in some cases there can be lasting damage.

This usually occurs when a deficiency has been severe and has lasted a long time.

Unchecked deficiencies can lead to a variety of health problems and diseases, including digestion problems, skin disorders, severe illness, stunted bone growth, and even death.

What about micronutrient inadequacies?

A lot more people fall into the range of micronutrient inadequacies than deficiencies in developed countries such as the U.S. or Canada. You can consider inadequacies the ‘less acutely bad’ version of deficiencies.

Micronutrient inadequacies are defined as micronutrient intake levels that are less than the Estimated Average Requirement (EAR) but above the levels associated with deficiencies.

Compared to deficiencies, micronutrient inadequacies can be much more clinically covert and difficult to detect. Inadequacies —which are the less ‘bad’ versions of micronutrient deficiencies — are quite common in developing countries such as the U.S — while full-blown deficiencies are more rare. (6)(7)

man and woman at the grocery store holding bread

A lot of foods you buy at the grocery store – such as milk, bread, or orange juice – are fortified with micronutrients to help prevent nutritional deficiencies.

Did you know?
According to the 2015-2020 Dietary Guidelines, potassium, calcium, magnesium, choline, iron, dietary fiber, vitamins A, C, D, and E are micronutrients that are consumed in inadequate amounts by the U.S. population. (1)

Micronutrient inadequacies can cause serious health issues

Chronic micronutrient inadequacies have been found to have severe implications for your long-term health. They also increase your risk for chronic diseases such as type 2 diabetes, cardiovascular disease, and osteoporosis. (8)(9)

Typical signs of micronutrient inadequacies: (10)

  • General fatigue
  • Reduced ability to fight infections
  • Loss of focus and attention
  • Impaired memory
  • Mood swings

Did you know?
Among older adults in Western countries, vitamin D, thiamin, riboflavin, calcium, magnesium, and selenium are some of the most common micronutrient inadequacies. (11)

Many diseases and illnesses are directly or indirectly caused by essential nutrients missing from diet.

11 common micronutrient deficiencies and inadequacies

When you notice things just seem to feel ‘off,’ this is often your body’s way of trying to tell you something is missing. There’s a good chance it has to do with micronutrients you’re missing out on in your diet.

We’ve mapped out the most common vitamin and mineral deficiencies found in developing countries below. (12)

Vitamin A

Vitamin A (beta-carotene) is heavily involved in skin health, immune function, vision, reproduction, and cellular communication.

Did you know?
Even with fortified and enriched foods, 45.1% of the U.S. population is estimated to have vitamin A intake levels below the EAR. (13)

Health impacts of vitamin A deficiency or inadequacy

Night blindness (xerophthalmia), dry skin, dry hair, color-blindness, infected or ulcerated eyes, acne, ridges on nails, macular degeneration, and recurring conjunctivitis. Vitamin A deficiency also increases the risk of diarrhea and the severity of infections early on before the onset of xerophthalmia. (14)

Groups at high risk for vitamin A deficiency or inadequacy (14)

  • Premature infants
  • Infants and young children in developing countries
  • People with cystic fibrosis
  • Pregnant and lactating women

Foods rich in vitamin A

Sweet potatoes, carrots, spinach, red or yellow bell peppers, kale, pumpkins, dried apricots, peas, and broccoli.

Vitamin D

Vitamin D is naturally found in very few foods, added to others, and comes in the form of a dietary supplement. It is produced endogenously when ultraviolet rays from sunlight hit your skin and trigger vitamin D synthesis. It has several vital roles in the body, including building strong bones.

Did you know?
A national survey found that 93.3% of the U.S. population does not meet the daily requirements for vitamin D. (15)

Health impacts of a vitamin D deficiency or inadequacy

Osteomalacia and rickets are the ‘classical’ vitamin D deficiency diseases. Symptoms of vitamin D deficiency may include bone pain and muscle weakness, but the signs can be very subtle and go undetected in the initial stages. (16)(17)(18)

Groups at high risk for vitamin D deficiency or inadequacy (15)

  • Older adults
  • Vegans
  • People with lactose intolerance
  • People with limited sun exposure
  • People with dark skin
  • Breastfed infants
  • People with inflammatory bowel disease
  • People with fat malabsorption
  • People who are obese or have undergone gastric bypass surgery

Foods highest in vitamin D

Cod liver oil, swordfish, salmon, fortified orange juice and milk, sardines, egg yolk, and swiss cheese.

supplement on a wooden spoon and wooden board

Obtaining vitamin D from diet alone is difficult. That is why people often choose to take vitamin D supplements.

Vitamin C

Vitamin C, which is also known as L-ascorbic acid, acts as an antioxidant in the body. It helps to protect cells against damage caused by free radicals. Vitamin C also helps the body produce collagen, boosts immune function, and improves the absorption of iron from plant-based foods. (19)

Did you know?
According to data collected from 2003-2006, an average of 25% of the U.S. population was found to have vitamin C intakes below the EAR. (20)

Health impacts of a vitamin C deficiency or inadequacy

An acute case of vitamin C deficiency is rare, but when it does happen, it leads to scurvy. Signs of a nutrient gap can appear in as early as one month if there’s no vitamin C intake (which is anything under 10mg/day). Initial symptoms include fatigue, malaise, and inflammation of the gums.

As it becomes worse, symptoms may include joint pain, poor wound healing, bleeding gums, and loss of teeth. Overt deficiency symptoms occur only if vitamin C intake falls below 10mg/day for about ten weeks. (21)

Groups with a higher risk for vitamin C deficiency or inadequacy

  • Individuals with limited food variety
  • Smokers
  • Infants fed evaporated or boiled milk
  • People with malabsorption, cachexia, certain cancers, and end-stage renal

Foods high in vitamin C

Oranges, grapefruits, strawberries, red peppers, broccoli, Brussels sprouts, and tomato juice. (21)

Vitamin E

In addition to acting as an antioxidant, vitamin E is involved in immune function, gene expression regulation, cell signaling, and other metabolic processes. (22)

Did you know?
Almost 91% of the U.S. population over two years old is below the EAR level for vitamin E. (20)

Health impacts of a vitamin E deficiency or inadequacy

Our digestive tract requires fat to absorb Vitamin E, so often problems are first seen in the form of chronic diarrhea and muscle weakness. Though the health implications of a deficiency stem much farther than in the gut. Other vitamin E deficiency symptoms include a weakened immune system, visionary problems, loss of feeling in the arms or legs, and a general loss of body movement control. (23)

Groups at high risk for vitamin E deficiency or inadequacy

  • People with fat-malabsorption disorders
  • Babies born at a low birth weight
  • People with Crohn’s disease
  • People with cystic fibrosis (CF)

Foods rich in vitamin E

Wheat germ oil, sunflower seeds, almonds, hazelnuts, peanuts, and spinach. (22)

family of four eating at dinning table

Many Americans are exceeding energy (caloric) needs but not meeting micronutrient requirements.

Potassium

Potassium performs a wide range of roles in the body. It helps regulate muscle contractions, regulate fluid balance, and maintain overall healthy nerve function.

Did you know?
Among U.S. adults, fewer than 3% of all adults surveyed in NHANES 2009-2010 had adequate potassium intake. (24)

Health impacts of potassium deficiency or inadequacy

Insufficient potassium intake can increase your blood pressure, kidney stone risk, bone turnover, urinary calcium excretion, and salt sensitivity. In severe deficiency cases, it can cause hypokalemia, which affects up to 21% of hospitalized patients.

Hypokalemia is characterized by symptoms of constipation, fatigue, malaise, and muscle weakness. Low potassium intake can also increase your risk of hypertension, stroke, osteoporosis, and type 2 diabetes. (25)

A potassium deficiency is often triggered by a sudden loss of bodily fluids. Common causes include vomiting, diarrhea, and excessive sweating.

Groups at high risk for potassium deficiency or inadequacy (26)

  • People with inflammatory bowel disease
  • People with pica
  • People on certain medications including diuretics and laxatives

Foods high in potassium

Apricots, bananas, lentils, prunes, squash, raisins, orange juice, and kidney beans are good food sources for potassium. (26)

Calcium

Though it’s essential for bone health, muscle function, nerve transmission, and so much more, surveys show that many Americans are not meeting their daily requirements for calcium.

Did you know?
Over 40% of the U.S. population are unable to meet their recommended calcium requirement from diet alone. (27)

Health impacts of calcium deficiency or inadequacy

Inadequate levels of calcium don’t produce any apparent short-term symptoms, but over the long term, it can cause osteopenia, which can lead to osteoporosis.

Data from observational and experimental studies have also found a connection between calcium intake and colorectal cancer risk. (27)

Groups at high risk for calcium deficiency or inadequacy

  • Postmenopausal women
  • Amenorrheic women and the female triad
  • People with lactose intolerance
  • Vegetarians
  • Older adults
  • Older children
  • Adolescents
  • Women, including pregnant women
  • Heavy caffeine drinkers
  • People dependent on alcohol
  • People with high sodium intake or protein intake

Foods rich in calcium

Milk, yogurt, cheese, sardines, and orange juice are rich natural sources of calcium.

Magnesium

Magnesium does a lot for the body. It’s involved in over 300 enzyme systems that regulate a diverse range of reactions in the body. Our bodies need magnesium for the construction of DNA and bones. (28)(29)

Did you know?
More than half of U.S. adults have intake levels lower than the EAR set for magnesium. (20)

Health impacts of magnesium deficiency or inadequacy

Early signs of magnesium deficiency include vomiting, loss of appetite, fatigue, nausea, and weakness. Severe symptoms include numbness, tingling, muscle contractions, cramps, seizures, abnormal heart rhythms, and coronary spasms.

Habitually low intakes of magnesium can increase your risk of hypertension, cardiovascular disease, Type 2 diabetes, osteoporosis, and migraine headaches. (28)

Groups at high risk for magnesium deficiency or inadequacy

  • People with gastrointestinal diseases
  • People with type 2 diabetes
  • People with alcohol dependence
  • Older adults

Foods rich in magnesium

Almonds, spinach, cashews, cereal, edamame, soymilk, and black beans are rich natural sources of magnesium.

Choline

Choline is an essential nutrient that is used in many steps in the metabolism and also plays an integral part in mood, muscle control, memory, and other brain and nervous system functions.

Did you know?
91% of the U.S. population is not hitting the EAR levels set for choline. (20)

Health impacts of choline deficiency or inadequacy

Choline deficiency can cause muscle damage, nonalcoholic fatty liver disease, and liver damage. Low amounts of choline in the body have also been connected to an increased risk of neural tube defects in pregnancies. (30)

Groups at high risk for choline deficiency or inadequacy

  • Pregnant women (particularly ones on total parenteral nutrition)
  • People with certain genetic alterations
  • Vegans

Foods rich in choline

Beef liver, hard boiled eggs, soybeans, chicken breast, beef, fish, mushrooms, potatoes, wheat germ, beans, and quinoa.

pregnant woman with her husband and daughter on a couch

Approximately 90-95% of pregnant women consume less choline than they are recommended.

Iron

Iron is an essential component of hemoglobin, which works to transport oxygen from your body’s lungs to the tissues. Our bodies need iron for growth, development, normal cellular functioning, and the synthesis of some hormones and connective tissue.

Did you know?
Adolescent girls have a heightened risk of iron deficiency. (31)

Health impacts of iron deficiency or inadequacy

When iron stores in the body are low, you may start to experience iron deficiency anemia. You may experience feeling out of breath, extreme fatigue, pale skin, weakness, chest pain, headaches, cold hands and feet, brittle nails, lightheadedness, fast heartbeat, poor appetite (especially in infants & children), and unusual cravings for things like dirt or ice. (32)(33)

Mild iron deficiency anemia usually doesn’t cause complications, but if left untreated it can lead to severe health problems such as an enlarged heart, heart failure, premature births, low birth weight babies, delayed growth and development in children, and increased susceptibility to infections. (34)

Groups with a high risk for iron deficiency or inadequacy

  • Pregnant women
  • Vegetarians
  • Infants and young children
  • Women with heavy menstrual bleeding
  • Frequent blood donors
  • People with cancer
  • People with gastrointestinal disorders or surgery
  • People with heart failure

Foods rich in iron

Red meat, seafood, poultry, spinach, lentils, chocolate, white beans, peas, and tofu.

Did you know?
Foods that contain vitamin C enhance your body’s ability to absorb iron. (21)

kiwi in a bowl

You can enhance your body’s absorption of iron by eating fruits high in vitamin C like grapefruit, kiwis, or strawberries.

Folate (for women of child-bearing age)

Sometimes called vitamin B9, folate is vital for red blood cell formation and average healthy cell growth and function. It’s particularly crucial for women of child-bearing age.

Health impacts of folate deficiency or inadequacy

Weakness, fatigue, difficulty concentrating, shortness of breath, heart palpitations, depression, poor response to antidepressants, and frequent headaches are all possible symptoms of low folate levels. (35)(36)

Folate deficiency can also lead to soreness and shallow cuts on your tongue. It may also lead to changes in skin, hair, or fingernail pigmentation. Women with insufficient folate intakes also have an increased risk of birth defects.

Groups at high risk for folate deficiency or inadequacy

  • Pregnant women
  • Women looking to become pregnant
  • Breastfeeding women
  • People with an alcohol use disorder
  • People with malabsorptive disorders
  • People with MTHFR polymorphism
  • People on medications (Sulfasalazine, Antiepileptic medications, and Methotrexate)

Foods rich in folate

Spinach, beef liver, black-eyed peas, asparagus, avocado, rice, broccoli, mustard greens, and white rice. (35)

Vitamin B12

B12 is a water-soluble vitamin that plays an active role in metabolism, red blood cell formation, and DNA synthesis.

Did you know?
It takes about three years for a vegetarian to develop a B12 deficiency from a lack of dietary intake. (37)

person taking a vitamin with water

It is estimated that 10-15% of adults over the age of 60 have seriously low B12 levels, and up to 20% are consuming inadequate amounts. (38)

Health impacts of a vitamin B12 deficiency or inadequacy

A deficiency of vitamin B12 is often caused by poor intake or malabsorption from a condition or caused by old age. It can be expressed as fatigue, weakness, megaloblastic anemia, constipation, loss of appetite, and weight loss. Neurological changes may also occur, such as tingling or numbing of the hands and feet. (39)

Groups at high risk for vitamin B12 deficiency or inadequacy

  • Older adults
  • Vegetarians and vegans (40)
  • Individuals with gastrointestinal disorders
  • People with pernicious anemia
  • People who have undergone gastrointestinal surgery
  • Pregnant or lactating women who are also vegetarian

Foods rich in vitamin B12

Clams, beef liver, salmon, fortified cereals, trout, tuna fish, haddock, nutritional yeasts, and cheeseburger.

The bottom line

Wondering how to prevent micronutrient deficiencies or best manage them?

Focus on four things:

  • Eat a well-balanced diet full of essential nutrients and minerals (lots of fruits and vegetables).
  • Schedule regular check-ups and have conversations about your personal nutrition plan with an integrative healthcare practitioner.
  • Consider supplements (age and gender specific multivitamins!) to fill nutritional gaps.
  • Keep an eye out for early micronutrient deficiency symptoms.

Have tips or ways you fill or avoid nutritional gaps in your diet? Let us know by commenting below!

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