Pain and Vitamin/Mineral deficiencies

[cookiebaker]

I recently saw a pain management Nurse Practitioner (NP) to discuss my current medication, and looking for potential nutritional reasons that my pain levels are so high.
She ordered a battery of tests to check levels in common pain related vitamin/mineral deficiencies and the results are kind of surprising to me..
I knew from previous testing that my Vit D and Ferritin Iron levels would probably be on the low side, but the B vitamins - well...

Note that the "Goal" levels are quite different than the "Normal" levels - the Goals are more an optimal level, rather than just being "in normal range"

If you have never had nutrient testing done, might not be a bad idea to ask your doctor about it. (these are just a small sampling, btw, mostly related to pain and fatigue - there are plenty of others as well)

Also, the Magnesium RBC level is a different test than the standard serum magnesium... my serum magnesium is fine (range of 1.7-2.4 ng/dL, with mine being 2.2), but the RBC level is at the low end according to my pain management specialist. The nice thing is, all of these can be treated pretty easily with over the counter supplements - which i will be starting very soon.. hopefully tomorrow!

 

[JayCS]

Thanks for your update and details!
I'll then get my RBC Mg checked - and be researching how much that actually tells us when I have time.
My recent energy related deficiencies riboflavin/B2, phosphate and protein have demonstrated the range of what can go wrong - way to the side of normal testing.
I do hope your deficiencies will be improved quickly with your supps.
Unfortunately, at least in my case, it's a lot harder than thought.
Even with the very best forms of each supp, best products, maximum or higher doses, either the deficiencies have not been easy to improve, or the deficiencies have improved a lot (B12 using methoxy-cobalamin s.c., B6 with P-5-P), but it makes absolutely no difference to my pain or fatigue.
This makes people like my practitioner believe in the "leaky gut theory" or at least that the gut or other part of the body (see Morley Robbins for iron) simply isn't able to take the supplement up properly. That would also explain why we get the deficiency in the first place, despite - at least in my case - an extremely strictly "healthy" diet. It seems completely viable to me that my gut with all its intolerances is not working well, even if I my diet minimizes almost all gut symptoms. But neither going easy on it, nor the leaky gut theory or up to now the ideas of my practitioner seem to be working for me...
That said, I do think I've been able to improve some of the deficiencies and that has improved some symptoms, so I'm definitely agreeing to get as much checked as in any way affordable, not just the normal ones which often come back OK. And also to research ourselves what normal and what optimal means. When my cardio says my phosphate may be deficient, but she has people with much less than me, that may be OK for them, but if I have much less energy than them and phosphate is responsible, then it's important to find ways to increase it. In this case difficult, because it's not possible to supplement it, it needs to be done by diet and that's tricky on a healthy diet....

 

[cookiebaker]

......that the gut or other part of the body (see Morley Robbins for iron) simply isn't able to take the supplement up properly. That would also explain why we get the deficiency in the first place, despite - at least in my case - an extremely strictly "healthy" diet. It seems completely viable to me that my gut with all its intolerances is not working well.....

oh yeah, malabsorption is a big issue and one not easily corrected.

i had minor issues before, but things really went south after a colonoscopy - having to flush the entire system for that did me no favors. I did use probiotics to help kick start the system again, but honestly, it did not really seem to help very much.

 

[JayCS]

oh yeah, malabsorption is a big issue and one not easily corrected.

Ah yes, that's that word...! I'll try to remember...

i had minor issues before, but things really went south after a colonoscopy - having to flush the entire system for that did me no favors. I did use probiotics to help kick start the system again, but honestly, it did not really seem to help very much.

Good reminder! I got probiotics (Symbioflor) prescribed for my IBS stuff, 7 months did absolutely nothing.

 

[cookiebaker]

Good reminder! I got probiotics (Symbioflor) prescribed for my IBS stuff, 7 months did absolutely nothing.

maybe not the correct strain you need?
there are several different strains, and a good mix is what we should naturally have.

I think I may look into probiotics again, but going for a mix this time, rather than a single strain.

 

[seniorzala]

These are ,not scuh bad resultet,you could say borderline cases.
Hemoglobin Ok?
Senior

 

[cookiebaker]

These are ,not scuh bad resultet,you could say borderline cases.
Hemoglobin Ok?
Senior

My hemoglobin is fine - but long term deficiencies - even borderline ones - can cause problems, some of which may never get resolved.

In doing my research, I have found that folate (B9) and B12 deficiency can cause increased RDW (red cell distribution width) which means the cells do not properly carry oxygen through the body...

information from "NHS Inform" (Scottish Health agency)

Vitamin B12 or B9 (commonly called folate) deficiency anemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that can't function properly.

Complications of vitamin B12 or folate deficiency anemia
Although it's uncommon, vitamin B12 or folate deficiency (with or without anemia) can lead to complications, particularly if you've been deficient in vitamin B12 or folate for some time.
Potential complications can include:

• problems with the nervous system
• temporary infertility
• heart conditions
• pregnancy complications and birth defects

Adults with severe anemia are also at risk of developing heart failure.
Some complications improve with appropriate treatment, but others – such as problems with the nervous system – can be permanent.

And here is the kicker - I have had high "normal" to above range RDW going back to at least 2010, if not further back, suggesting long term folate and B12 problems. My B12, while still in range, is at the low end of the range and far below what is considered "optimal" by many sources, not just this one practitioner - and has been there for some time.

I guess my question is why none of my doctors ever caught this before... the relationship between the high RDW and the B12 and folate deficiencies...

 

[JayCS]

maybe not the correct strain you need?
there are several different strains, and a good mix is what we should naturally have.

True, but the prescriptions were varied and it was a GP / internist / naturopath who concentrated very much on treating this, so I was pretty sure if he doesn't get it, "no one" will.
7 months is a pretty good chance I gave it, and him saying well then we'll have to continue, it might take a year, after it had had absolutely no effect on really severe symptoms, and then getting 60% down inside of 2 weeks of elimination diet.... it was just a line I had to draw, where I withdrew trust and hope...

 

[JayCS]

I guess my question is why none of my doctors ever caught this before... the relationship between the high RDW and the B12 and folate deficiencies...

Yeah, I can well imagine that these combinations overtax them. But I think it also overtaxes most research, so things that someone has found out will be from just very few small studies and a pointer, not proof.

 

[cookiebaker]

.....and a pointer, not proof.

yeah, a pointer that no one ever thought to look into.

 

[Badger]

Interesting to note vitamin absorption may be an issue for us. I have been taking vitamin D for the past year, Vitamin B with meals for the past few months and have been eating probiotic cereal for the last few weeks. I id try magnesium for a few months but felt no different, perhaps it might be worth revisiting in future. I'll have to try making simple fresh meals with the microwave and maybe invest in a soup maker for better nutrition.

 

[seniorzala]

It doesn't matter when and with what and of course it doesn't matter how damage the gastric mucosa is either.
Do not use the microwave oven.
senior

 

[cookiebaker]

I id try magnesium for a few months but felt no different, perhaps it might be worth revisiting in future.

doing a bit more research on this.. most mag supplements do not get absorbed very well - even by healthy people, and can cause issues (loose stools), depending on the formulation.
I am not endorsing any specific products - please do not think that.
That said, the magnesium supplement that was recommended to me is a specific brand that comes in a liquid form. It gets mixed into water, or good juice and is supposedly highly absorbable by our systems.. and according to the claims, never really makes very far into the digestive system, so no issues with it there, either.
The down side to this product is that it is not exactly cheap - an 8oz bottle is nearly $30 US - but, if you consider that there are approx 96 servings in that bottle (roughly $0.31 per serving), and if it really is better absorbed than most standard supplements, then it may be more cost effective than the ones that dont get absorbed well?
I did manage to find it slightly cheaper locally (at a health food type store) which is the only reason I am using the 1st choice recommended for this supplement, lol.
I dont know - i guess only time will tell... today was my first day with it, and it was recommended to start out low & slow with it.. get my system used to it.