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Comment by jaggederest | Hacker News Reader

So far as I can tell, the only reasonably common deficiencies are vitamin D and magnesium, and among women anemia.

Every other deficiency is in the tenths of a percent range, well outside of the level at which people in the general population would be treated if it were e.g. antibiotics or other non dietary drugs.

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Iodine deficiency is still shockingly widespread. According to World Health Organization, "Iodine deficiency is the world’s most prevalent, yet easily preventable, cause of brain damage." http://www.who.int/nutrition/topics/idd/en/

And many believe it is even still widespread in first world countries: https://hypothyroidmom.com/busting-the-iodine-myths/

B12 is another deficiency that is definitely more common than tenths of a percent in the United States. [1]

[1] https://www.ars.usda.gov/news-events/news/research-news/2000...

Yep, though I'd imagine tablets won't address the deficiency for most of those.

Though you’re referring to those who require regular or semi regular injections—

As an aside to the larger topic I’ve a B12/iron and D deficiency. A combination of diet and tablet form supplement has been life changing.

Why? It has been accepted that oral supplementation is as good as injectable for a while now.

Most people who have B12 deficiency like my mother, are unable to absorb the oral form due to some type of malignancy. Injections are the only way to increase serum levels for her.

There are varying forms of oral B12 supplementation.

The sublingual kind does not involve the digestive system, it's absorbed diffusely at the mouth/throat. Jarrows makes them in methylcobalamin form.

Note however in my experience it caused painful neck stiffness after a week of use. But there were other positive effects observed, so it was definitely doing something. The lucid dreaming on the first couple days was quite interesting.

The methylated tablets work well. Methylation problems are very widespread

In a study of college athletes, males were deficient in about 40% of the vitamins and 50% of the minerals required. The female athletes were better but were still deficient in 29% of the vitamins and 40% of the minerals RDA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129155/

That paper is remarkably low quality.

About 1-3% of middle aged people have insufficient stomach acid, meaning that nutrients are not fully absorbed.

Any suggestions for good treatment options? Taking acid pills with meals (Betain HCL) is one possibility. Any others?

Not highly confident about this, but i've heard anecdotes that lemon juice sometimes helps.

Perhaps it works better if you combine it with beetroot juice (which contains a lot of betaine).

What about K2?

It is being thoroughly investigated.

Vitamin K2 is important insofar as it's synergistic with magnesium and vitamin D.

Also potassium. Very few hit the RDA and most are shocked how high it is.

A tenth of a percent of the U.S population is 300,000 people. (I don't really understand what the rest of your comment means.)

Zinc as well.

Story with zinc is much less than certain actually... likewise with boron.

I would disagree.

https://examine.com/supplements/zinc/#summary1-3

Read the page again about 10% estimated below RDA in the US. Then the RDA is not exactly very well validated and being below it does not mean being deficient.

Boron? What on earth would you do with that? Is it used in some metabolic process somewhere?

edit: Ok, according to "Devirian, T.A. and Volpe, S.L., 2003. The physiological effects of dietary boron."

> Boron is known to influence a variety of metabolic actions. It interacts with calcium, vitamin D, and magnesium, which are all important in bone metabolism. Boron accumulates in bone in concentrations dependent on the amount of boron consumed. Boron has also been found to increase steroid hormone concentrations in postmenopausal women and to have antioxidant properties, which could make it beneficial in preventing atherosclerosis

You can tell if you have zinc deficiency if you have those white dots on your fingernails. Although that's more in the range of "severe deficiency" so if you ever notice that symptom you should try to be more mindful about your zinc intake in the future (food or supplements).

No. White dots on your fingernails can have tons of reasons. It’s more likely that it’s not due to zinc deficiency. [1]

[1] https://en.wikipedia.org/wiki/Leukonychia

Zinc is a really significant one for vegetarians, and no-one talks about it, because pretty much the only usual dietary sources for zinc are meat-based.

Wouldn't want to upset the narrative that meat eating is unnatural and completely optional.

Eating meat is perfectly natural, humans are opportunistic omnivores. It's weird that I don't, and I wish it were an option for me, but I've just always been too creeped out by the thought of eating parts of another animal's body.

> Other good sources of zinc are nuts, whole grains, legumes, and yeast. [1]

I've found nuts are basically a super food. No need for refrigeration or preservatives/processing to keep edible. I always have bags of shelled organic nuts on hand and eat handfuls on a daily basis. The only down side I've found is cost; nuts, especially organic ones, are more costly than filet mignon per lb at whole foods.

[1] https://medlineplus.gov/ency/article/002416.htm

This page details actual zinc contents of foods: https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/

Note that the first non-meat source (other than fortified breakfast cereal) is baked beans and you'd have to eat at least a full can a day to get your RDI. Or I guess you could eat 2.2kg of yoghurt.

That's quite a sparse list,

Walnuts have 3mg/100g (33% DV) [1]

Sunflower seeds 5mg/100g (53% DV) [2]

I'm currently holding a 340g bag of raw organic walnuts I opened this morning, and it's nearly empty just from snacking throughout the day. Also snacked on sunflower seeds, but not much.

Dinner was a large bowl of lentils, which have 3.5mg/100g (35%) [3]

Without even optimizing for it I'm over the RDI for Zinc without animal products, this is just what I happen to be stocked up on currently. So clearly it's not much of a challenge for a vegetarian to get sufficient Zinc.

[1] https://en.wikipedia.org/wiki/Walnut#Nutritional_value

[2] https://en.wikipedia.org/wiki/Sunflower_seed#Nutrition

[3] https://en.wikipedia.org/wiki/Lentil#Nutritional_value

Vitamin D supplementation is also still controversial, so there isn't even good consensus on that.

Can you elaborate? I've never heard anything about that before.

Your body can handle massive amounts of vitamin C and D, so its a bit surprising to hear that supplementing the (generally) small amount you'd find in a vit D pill could be harmful.

While it is basically impossible to overdose on Vitamin C, you can overdose on Vitamin D. It is fat-soluble, thus overdosing has a cumulative and delayed effect.

https://en.wikipedia.org/wiki/Hypervitaminosis_D

However, that does not mean that vitamin D supplements are suspect in principle, just that before starting on a course of supplements, it might make sense to have your Vitamin D levels checked and the right dosage determined.

From your page: > The recommended dietary allowance is 15 µg/d (600 IU per day; 800 IU for those over 70 years). Overdose has been observed at 1,925 µg/d (77,000 IU per day).

So it seems you could even take 10x the recommendation and be fine. The risk of a reasonable supplement pushing you into overdose territory seems negligible.

And according to EPIC series epidemiology somewhere between 2000 and 3000 IU seems best at total mortality. It is a very flat J curve though.

BTW, rumor has it the RDA was miscalculated and should be about twice as high.

https://examine.com/nutrition/should-1000-iu-be-the-new-rda-...

As far as I've heard 10,000 IU is regarded as almost definitely non-toxic, and toxicity seems to have been noticed around 40,000 IU per day.

However, in the summer you may want to drop that below 5,000 or even stop supplementing completely, depending how much you're in the sun.

Vitamin K2 also seems to be necessary in combination with D3. But it's not clear to me if 100 mcg MK-7 is enough or if you need to supplement Mk-4 more often or eat more MK-4 foods (the latter is probably preferable).

The largest-dose individual, non-prescription vitamin D supplement pill I have ever seen is 5000 IU, so you'd have to take 10 of those every day, for months, to develop a toxicity symptom. At that point, the per-pill cost of the supplement and the sheer number of pills combine to discourage overdose.

If you have a confirmed deficiency, a doctor can prescribe a limited course of higher-dose pills to get your serum levels back up quickly.

I take cholecalciferol (D3) and menatetrenone (K2-MK4) daily, along with a multivitamin that was essentially a gratis 2.7-year supply, thanks to a fortuitous coupon + sale price interaction, so it isn't actually just making my pee more expensive. I'd feel wasteful throwing it away after someone paid me to take it home, and it'd be great if it activated a placebo effect.

Also, I can't bring myself to like natto.

Yes, indeed!

http://www.mayoclinicproceedings.org/article/S0025-6196(15)0...

"The evidence is clear that vitamin D toxicity is one of the rarest medical conditions and is typically due to intentional or inadvertent intake of extremely high doses of vitamin D (usually in the range of >50,000-100,000 IU/d for months to years)".

The significant advantages of D3 supplementation for sun-starved people are evident in the literature.

Vitamin D is the only supplement that the NHS recommends for the general population, particularly over winter. I’m happy to take it.

Vitamin D supplementation for vitamin D deficiency that is quite common is not controversial at all.

If you mean taking more D than is needed, your are correct.

You can measure the D vitamin levels from blood serum.

  <    30  nmol/L is vitamin D deficiency

  30 - 50  nmol/L is considered inadequate

  50 - 125 nmol/L is adequate

  >    150 nmol/L evidence of potential adverse effects

Adequate level has increased over the years.

but shouldn't you always complement vitamin d intake with vitamin k? If I recall correctly (I am not sure!) then vitamin d without vitamin k can be harmful.

Vitamin K is found in vegetables, so you don't need to supplement it. I think the worry is that too much Vitamin D contributes to buildup in arteries over the long term, and K helps to clean it.

>Vitamin K is found in vegetables

"Vegetables" is a category that's about as useful in this context as "food".

Greens.

I think with vitamin D supplementation you also need to consider vitamin A intake.

Spinach and eggs every morning more than covers you there

Greens and broccoli are the only vegetables I believe in. Everything else is guinea pig food.

I'll bite: https://en.wikipedia.org/wiki/Vitamin_K#Food_sources

Ironic how the majority of replies in a geek thread are so confident about health when we know - statistically speaking - the majority of you geeks are in terrible health!

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