The World Health Organization defines health as the following: “health is not merely the absence of disease but also a state of complete physical, social, mental well-being.” I wholeheartedly agree with this statement. Just because we don’t have a diagnosis doesn’t necessarily mean we are healthy. I think many people can relate to having symptoms, going to the doctor, and being told that everything looks normal. It’s frustrating and has left many (myself included) looking for alternatives to conventional healthcare. I think a big area that is lacking in conventional healthcare is nutrition and a lack of knowledge around what is optimal. For example, nutrient deficiencies and recommended dietary allowances give me a headache. When we look deeper at how we define nutrient deficiencies and what the recommended amount of a nutrient is, we will see that they are the amounts that prevent disease. If we are defining health as more than the absence of disease, I don’t know why we would only recommend enough of a nutrient to prevent disease. You would think that we would recommend enough to support optimal health, but unfortunately, we don’t.
Have you ever wondered how recommendations for different nutrients are set? Let’s breakdown what an RDA is and how they are set with first defining what a recommended dietary allowance is:
“Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.”
One important thing I want to highlight from this definition:
These recommendations are based on healthy individuals. What about individuals that are not healthy or have health concerns? Can they not benefit from more of specific nutrients?
A great example of how RDAs can fail us is with iodine. The RDA for iodine has been shown to help prevent thyroid disease, but it has not proven to reverse it if it’s already present. Yet, we don’t have a different recommendation for those that are struggling with hypo or hyperthyroidism and also have an iodine deficiency. It’s all the same.
Another example is potassium. There actually isn’t an RDA but instead an Adequate Intake. What is an adequate intake you ask? Here’s the definition:
Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
If only we did better research on things like vitamins and minerals. They can’t make anyone money, so they aren’t prioritized. Either way, the Adequate Intake (AI) is an assumption, which if I’m struggling with my health and more of a nutrient could help me, I don’t love. Especially since again, these numbers are based off the average potassium intake from healthy individuals. The AI for an adult female for potassium is 2600mg and 2900mg for pregnant female. If someone is deficient in potassium, this recommendation is not enough to significantly increase levels. You’d need closer to 4700mg a day in order to do that.
Another example of an inadequate RDA is magnesium. The RDA for adult women is 310-320mg (350mg if you’re pregnant) despite the fact that research has shown us that magnesium is essential for over 3,000 functions in the body. Not to mention we live in such a fast paced, high stress world where we are overwhelmed with technology and underwhelmed with time in nature. There’s not doubt in my mind that we are using up more magnesium now than we have in the past. If someone has a deficiency and is told that they need 320mg of magnesium a day, that likely will not move the needle much for them.
I am not recommending that people megadose on vitamins or minerals. We have to remember that they are both synergistic. If we take a large amount of one, it could throw off the balance of another and also have health consequences. What I am suggesting is that we need to adjust the way we look at nutrient recommendations and consider a recommendation for individuals that are not healthy and likely need more support.
The only nutrient that I see widely accepted and recommended in large amounts in the form of a supplement is vitamin D even though vitamin D acts more like a hormone. It’s also different from other nutrients in that a vitamin D deficiency is often a sign of other deficiencies in the body like magnesium, vitamin A, and boron. So is it really vitamin D that you need or is it a sign from your body that someone else is lacking?
After reading about RDAs you might be wondering how to know if you have a deficiency and might need more than the recommended amount of a nutrient. This is where the tricky and often times frustrating world of lab testing comes in. A logical thought would be to go to your doctor and ask for blood work. The issue with this is they are often measuring serum levels. What’s wrong with the serum? Our serum is very tightly regulated and takes a long time to see something out of range. For example, magnesium levels in your serum have to be tightly regulated otherwise it could impact your blood pressure significantly. This is why our bodies will take nutrients from other places in the body in order to have a healthy serum level. By the time you see a deficiency on serum based blood work, that deficiency has likely been present for a very long time. Another thing to consider is that minerals like potassium and magnesium are intracellular, meaning 99% of them are found inside our cells. Regular blood work is measuring outside of our cells.
So what’s a better solution? Measuring nutrients like red blood cell magnesium shows you how much magnesium is inside the red blood cell and is much more accurate. You can do the same for other minerals like potassium, zinc, etc. My favorite type of testing and what I think gives people the most information is hair mineral testing. It measures levels inside the tissue and is looking at your unique response to stress. You also get to see the optimal range, which you don’t get from blood work unless you’re working with a practitioner and they have this knowledge. The normal range for blood work is based on an average and again isn’t optimal, but normal. Again, blood work isn’t my first go-to because it takes a long time to see a shift. Most people come to me because their blood work is all normal but they still don’t feel like themselves.
On hair mineral tests, you can see the optimal range as well as more severe deficiencies as well. See the image below. You will notice the white boxes in the middle–those are optimal. Then you have the light purple box that’s a little suboptimal and then the darker purple boxes that are deficient.
Hair tests are not as straight forward as blood work because you are looking for patterns and just because something is high doesn’t mean you have too much. For example, in the test above, potassium is high. This means this person is likely using up potassium and it is a loss. It could also mean that they are experiencing a good amount of stress. Typically a potassium that is higher than sodium is a sign of being in the compensation stage of stress. They are not in the alarm stage anymore and their body is trying to adapt and adjust. You can learn all about hair mineral testing and how to read your own inside my Master Your Minerals course.
Now all of this brings us to supplements. Time and time again I’m asked what my favorite multivitamin or prenatal is. My answer is always the same: I don’t have one. Why? Because multivitamins and prenatals are based on RDAs. Many brands also try to sell them as meeting 100% of someone’s needs because they meet the RDAs when for most people, this is not true. There always needs to be some level of individuality when it comes to food and supplements. Just because a prenatal says it has all of the iodine you need during pregnancy, doesn’t mean it does for you specifically. It means it meets the RDA. The 350mg of magnesium may meet the requirement, but it most likely won’t meet your needs, especially if you have a deficiency. 60% of women of reproductive age are deficient in iodine and iodine levels in the US alone have dropped by over 50% in the past 40 years, according to an NHANES study. Even if they take a prenatal with 150mcg (RDA for pregnancy) they will most likely still be deficient during and especially after pregnancy.
Supplements are mean to do just that–supplement your food intake, so I don’t think you need to get 100% of your nutrients from supplements nor should you. But the promises these companies make really rub me the wrong way, especially with prenatals. And then if a company has an amount of a nutrient that is higher than the RDA they have to defend it like there’s no tomorrow. I’ve seen prenatals raise the amount of nutrients like vitamin E and iodine in them (which I commend) and then they are hit with so many complaints because it’s above the RDA. It’s hard to strike a balance for sure.
If you suspect that you have suboptimal levels of a certain nutrient but your blood work doesn’t show that, get a second opinion! Consider hair mineral testing and even experimenting with getting a higher amount of nutrients from food. When we focus on food first we are less likely to overdo certain nutrients and are able to balance vitamins and minerals like nature intended.
References:
If you want to learn more about how to eat in a way that helps you get more nutrients listen to this podcast episode on building a nourishing nutrition foundation and also check out my free nourishing meal guide.
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