Ongoing medical education

Vitamin D is essential for the absorption of calcium into our body from food sources, as well as the regulation of calcium within the blood. Calcium regulation is extremely essential not only for bone health but also in the functioning of muscles, the intestines, the heart, and the brain.

Vitamin D is sourced mainly from sunlight, and to a lower extent from food.

Factors that affect your vitamin D levels include:

• Skin pigmentation, i.e. darker skin - prevents the UV light from converting inactive Vitamin D to the active form within your skin.

• Lack of sunlight exposure, including covering up with long-sleeved clothing or sunscreen lotion. - for the same reason as above.

• Lack of particular enzymes within your kidney, liver, or skin, as these are the locations wherein Vitamin D is formed and gradually activated.

If you are lacking in Vitamin D, which can be determined by a simple blood test, the best solution would be to take oral supplements.

Vitamin B12 is an essential vitamin, required for:

• General cell growth

• Nerve growth

• Formation of red blood cells

It's primarily sourced from meat and dairy products.

A lack of vitamin B12 can lead to unexplained tiredness, nerve pain, itchiness or tingling on the skin.

If you feel you may be lacking in B12, I would advise checking your B12 levels with a blood test, before deciding on supplementation.

Creatine is a type of protein found only in seafood and meat. The body produces its own creatine as well, but not in adequate amounts.

Creatine helps not only in energy and muscle growth, but also in cognitive function and immunity. A lack of it results in tiredness, muscle weakness, low mood, and frequent infections.

Discuss with your doctor regarding this supplement. If your liver and kidneys are in good condition, a creatine supplement may help you.

A lack of protein is a potential side effect of going on any diet be it to reduce weight/cholesterol, indigestion symptoms, or a vegetarian diet. This can then lead to lower muscle mass, weaker muscle function, and other unexplainable symptoms in the body since proteins are involved in a variety of functions other than in muscles.

Do note that a simple blood test of for protein or creatinine is not a very accurate measure of the level of protein in your body, though it does provide an adequate hint. A more accurate test would be a '24 hour Creatinine Excretion Ratio (CER)', but it is more difficult to do since a 24 hour urine collection is necessary.

Omega-3 oils found in fatty fish (e.g. Salmon) help with reducing cholesterol levels, reducing inflammation, and support brain and heart health. The types of Omega-3 that effect our body are Alpha-linolenic acid (ALA), Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA).

Vegetarian sources of Omega-3 oils are various, and include walnuts, flaxseeds, chia seeds, hemp seeds, edamame, seaweed, and algae. Of these, only the oils from algae (or microalgae) are as helpful as fish oil is to the body, as it has DHA in addition to EPA and ALA. The other options contain mainly ALA, which is then converted to EPA within the body, and very minimally converted to DHA.

Our body requires both EPA and DHA for the helpful effects of Omega-3 oils stated above.

In fact fish do not directly make their own EPA and DHA either. They too source it from the algae they consume. Hence consuming algal oil is actually superior to depending on fatty fish for omega-oils, especially since the various ways that fatty fish are farmed result in an unreliable amount of omega oils within them.

Omega-6 and Omega-9 oils are also required but in small amounts. In large amounts they can interfere with the functioning of Omega-3 oils.

Nutrients specifically lacking in a meatless diet:

• Vit. B12

• Creatine

• Protein in general

• Omega-3 fatty acids, which are divided into the subtypes ALA, EPA, and DHA

There are readily available supplements for the above. Discuss with your doctor on whether you require them.

Information will be added periodically

The nutrients important for brain health are: Vitamin B12, Omega-3 fatty acids especially EPA and DHA, Creatine, Coenzyme Q10...

A lack of these nutrients can cause:

• Depression / Anxiety

• Problems with memory / concentration

With proper planning of the correct foods, or with the correct supplements, the physical cause for the mood disorders can potentially be resolved. 

Common non-pathological causes of digestive problems include:

• Additional fiber in your diet

• Natural laxatives in your diet including acidic vegetables such as tomatoes, and citrus fruits such as oranges

• Complex carbohydrates in foods which are difficult to digest within the intestines, such as broccoli, cabbage, and heavy beans.

• Overfilling of the stomach during meals

• Not providing enough time for the stomach to digest food prior to sleeping.

Understand which foods commonly cause problems, test yourself to see which foods cause problems for your digestive tract, and adjust your diet accordingly in order to be undisturbed by symptoms of indigestion throughout the day.

Food-related causes of fatigue include:

• A lack of protein, or a lack of specific amino acids.

• A lack of iron or vitamin B12

• A lack of zinc

• Foods that require a lot of effort for the intestines to digest, e.g. meat and certain beans.

  • This causes an increased requirement of bloodflow in the intestines, which reduces bloodflow to the brain and makes you feel drowsy

Iron is found both in meat and in green leafy vegetables, dates, brown rice, etc. 

Your body's iron levels cannot be determined solely by the 'serum iron' blood test, but a combination of the following tests:

• Serum Iron

• Transferrin

• TIBC (Total Iron Binding Capacity)

• Ferritin (essential to be checked)

Based on these results, your doctor can prescribe you the correct dose of iron supplements. A satisfactory increase in your iron levels will occur after 2-3 months of oral iron supplements.