Category Archives: Vitamin Deficiency Risk Factors

Is Calories In, Calories Out the Key to Losing Weight?

weight loss, apple, nutrition, orange, calorieIf you have ever tried to lose weight, then you probably have been told to track your calories. Most calorie trackers focus on keeping track of the calories you consume through food.  On the other hand, fitness trackers or workout machines may track how many calories you burn during the day. However, is there more to the story of weight loss, or is calories in and calories out the only key to success?  A recent report by health experts reveal that there may be more than simple math in the weight loss equation.

What are is a calorie?

A calorie is a unit of energy that is found in food and beverages. The four major macronutrients that consist of calories include:

  • protein at 4 calories per gram
  • carbohydrate at around 4 calories per gram
  • fat at 7 calories per gram
  • alcohol at 9 calories per gram

Whatever calories you consume that are not used as energy are stored in the body as fat. In simple terms, you may lose fat stores if you consume less calories than you burn.  Calories can be burned by physical activity, but calorie expenditure may also increase in those who are growing, injured, or ill.  This is because your body will need more energy to support such processes that involve cell reproduction and other related processes.

Are some calories healthier than others?

Not all calories are created equal. The recent report reveals a growing trend of people focusing solely on the number of calories in and calories out, rather than the quality of calories consumed. Although this may lead to a calorie deficit, and in turn weight loss, it is not necessarily healthy.

For example, a piece of candy and an apple may both contain 100 calories. However, the candy mostly contains empty calories because they contain little to no nutritional value. The calories in the candy are mainly from simple carbohydrates like sugar as well as fat.  However, in the apple, those same calories contain many nutrients such as fiber, vitamin C, and potassium. Therefore, the calories from the apple will provide your body with more health benefits than the candy.

Weighing in on the “Calories In, Calories Out” equation

The latest diet craze known as CICO (Calories In, Calories Out), may lead to vitamin and nutrient deficiencies according to experts. If you are not looking at the nutrient quality of the calories you consume, then you may increase your risk of heart disease, osteoporosis, anemia, to name a few. In addition, if you restrict yourself of too many calories, then you may develop fatigue and malnutrition, which does your body more harm than good. Contact a registered dietitian to help you determine how many calories you need to support your lifestyle, while still helping you to lose any excess weight.

How to Work on Weight Loss

There is no one size fits all plan to help everyone lose weight. However, there are several things you can do today to get on the right track towards healthy weight loss and maintenance.

  • Watch your portion sizes at meals and snacks. A simple way to determine how much food you need to eat at each meal involves your protein and fiber needs. Most adults should consume at least 25 grams of fiber a day through whole grains, fruits, and vegetables. Your protein needs, in grams, can be determined by dividing your weight in pounds by 2.75.  Once you determine your fiber and protein needs, use a nutrition tracker to ensure you meet these needs with mostly whole foods, or foods that are minimally processed.  Also, chew your food more per bite, slow your pace of eating to 20-25 minutes per meal, and be mindful of the food choices you make by looking at nutrition labels before you make food purchases.
  • Stay active most days of the week.  Balance out each week with cardiovascular and resistance exercises. Cardio exercises include walking, jogging, swimming, or biking. These exercises work to increase calorie burn. Resistance exercises, on the other hand, such as lifting weights, doing push-ups, or using resistance bands, help to maintain lean muscle mass. Maintaining your muscle mass as you lose weight helps you to maintain calorie-burning power, also known as metabolism.
  • Get plenty of sleep.  Weight loss may be more difficult for those who do not sleep well.  This is because lack of sleep can disrupt the hormones that control hunger and appetite. Try to get at least 6-8 hours of sleep each night. If you have trouble sleeping due to visiting the bathroom regularly, stop drinking fluids at least 2 hours before bedtime.  If pain is keeping you up, visit your doctor to get support.  If you are not sure what is causing your restless sleep, you may have sleep apnea. You can ask your doctor about getting a sleep study done to determine the cause of your sleepless nights.
  • Visit your doctor if diet and exercise are not leading to weight loss. If calories in and calories out are leading to weight plateaus or gains, then there may be an underlying health issue. Research has shown that some people who have a family history of obesity may have a harder time losing weight than those that don’t. This could be due to:
    • genetic factors.
    • increased risk of conditions like hypothyroidism or insulin resistance.
    • environmental factors such as growing up without knowledge of healthy eating behaviors.
  • Fill in your nutrient gaps with vitamins and supplements. At the very least, take a multivitamin such as Zestia by VitaSciences. Zestia contains a blend of Super Food extracts, probiotics, and digestive enzymes helps to support optimal health. If you live in a climate with little sunlight, you may also need to add a vitamin D3 supplement to your daily routine.  Low vitamin D levels can affect many aspects of health such as bone and immune health, to name a few.

-written by Staci Gulbin, MS, MEd, RD, LDN


Centers for Disease Control and Prevention (November 16, 2016) “Finding a Balance” 

Harvard Health Publishing: Harvard Medical School (May 2014) “Eating fiber-rich foods helps keep the heart healthy”

Harvard Health Publishing: Harvard Medical School (updated April 11, 2017) “Why People Become Overweight” 

Harvard T.H. Chan School of Public Health (accessed November 27, 2017) “Protein”

Medline Health News (November 22, 2017) “It’s the Latest Diet Craze, But Is It Safe?”

Medline Plus (accessed November 28, 2017) “Vitamin D” 



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    Hypothyroidism May be Linked to Vitamin B12 Deficiency

    hypothyroidismThyroid conditions can be very frustrating and uncomfortable for those affected.  Hypothyroidism in particular can cause disruptions in daily living through symptoms such as fatigue, difficulty losing weight, and depression. Additional symptoms of hypothyroidism include:

    • feeling colder
    • constipation
    • forgetfulness
    • drier skin

    Current Treatments

    Since hypothyroidism involves an underactive thyroid, traditional treatments have focused on replacing the hormone that your body cannot make.  Therefore, thyroid-stimulating hormone (TSH) and T4 levels should be checked often to make sure hormone levels are brought into and maintained into normal levels.

    The gold standard for treating hypothyroidism is levothyroxine.  This is because levothyroxine is easy to use, its low risk of side effects, good intestinal absorption, long serum half-life, and low cost.  This medicine works to help normalize thyroid and TSH levels in the body.

    If a patient’s levothyroxine dose is higher than expected, the healthcare provider should check for other conditions. These conditions include Heliobacter pylori, gastritis, or celiac disease.  Treatment of any such conditions could help lessen the symptoms of low thyroid levels in some individuals.

    B12 deficiency may cause symptoms of hypothyroidism

    Another condition that may affect thyroid levels in the body is B12 deficiency. Vitamin B12 is found in animal products such as meat, poultry, seafood, eggs, and dairy products as well as in fortified products such as cereals and breads.  Therefore, those most at risk include those that do not eat these foods such as vegans and vegetarians. In addition, those who are older adults, pregnant and lactating women, and those with malabsorption issues may be low in B12.

    Symptoms of B12 deficiency that may parallel those symptoms of impaired thyroid include fatigue and weakness.  In addition, B12 deficiency can cause anemia, constipation, loss of appetite. And if uncontrolled or severe, lack of B12 may cause neurological symptoms such as confusion or numbness and tingling in hands and feet.

    • anemia
    • constipation
    • loss of appetite
    • weight loss
    • numbness and tingling in the hands and feet
    • difficulty balancing
    • confusion

    Since B12 has been found to be lacking in many people with the condition, it is suggested that those diagnosed with autoimmune hypothyroidism should be tested for B12 deficiency.

    Thyradol is a supplement blend containing vitamin B12 as well as alternative medicine compounds like ashwagandha thought to improve thyroid health.  Be sure to talk to your healthcare provider before starting any new treatment.  This is because it is important to make sure this supplement does not interfere with your current medical treatment.

    If you want to find out more about the condition and how you can support research efforts, visit the American Thyroid Association website at for more details.

    by Staci Gulbin, MS, MEd, RD, LDN



    American Thyroid Association (accessed 2017 Jan) “Hypothyroidism (Underactive)”

    Collins, AB and R Pawlak (2016) “Prevalence of vitamin B12 deficiency among patients with thyroid dysfunction.”  Asia Pacific Journal of Clinical Nutrition, 25(2): 221-6.

    Jabbar, A., et al. (2008 May) “Vitamin B12 deficiency common in primary hypothyroidism.” The Journal of the Pakistan Medical Association, 58(5): 258-61.

    Medline (2015 Jan 15) “Levothyroxine”

    National Institutes of Health (2016 Feb 11) “Vitaman B12: Dietary Supplement Fact Sheet.”



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    How to watch for Vitamin Deficiency: This is what happens

    What are the signs of vitamin deficiency? The symptoms of low vitamin and mineral levels can wreak havoc on your entire body. Fatigue, brain fog, muscle pain and insomnia are just a few vitamin deficiency symptoms that go unnoticed, and undiagnosed. Listed are some of the most common clues to watch for.

    vitamin deficiency symptoms list

    Vitamin Deficiency Symptoms: the Complete List

    If you suspect you have vitamin deficiency, then speak to a doctor immediately. Signs of vitamin deficiency anemia may require emergency vitamin supplementation.

    Listed are 13 essential vitamins and minerals that you need for daily health, plus symptoms that may signal a deficiency.

    1) Vitamin A (Retinol)

    Food sources: Yams, beef liver, spinach, carrots, and pumpkin.

    Vitamin deficiency symptoms: Color-blindness, conjunctivitis, dry eyes, Bitot’s spots, farsightedness, corneal ulcers, ichthyosis (scaly skin), macular degeneration, photophobia, night blindness, keratosis, dry hair, ridged nails, peeling nails, acne, skin infections, jaundice, shingles, and wrinkles.

    2) Vitamin B1 (Thiamine)

    Food sources: Mushrooms, sunflower seeds, tuna, and broccoli.

    Vitamin deficiency symptoms: Chronic fatigue, loss of appetite, nerve damage, heart palpitations, mental confusion, depression, dementia, forgetfulness, nervous irritability, Beriberi disease, crossed eyes, dim vision, glaucoma, Raynaud’s disease, sensitivity to insect bites, furrowed tongue, Addison’s disease, fungal infections, itching, white patches on tongue.

    3) Vitamin B2 (Riboflavin)

    Food sources: Liver, mushrooms, spinach, and dark green vegetables.

    Vitamin deficiency symptoms: Loss of appetite, nerve damage, depression, nervous irritability, increased homocysteine levels (heart attack and stroke risk), blurred vision, cataracts, conjunctivitis, dim vision, glaucoma, retinitis, corneal ulcers, macular degeneration, night blindness, photophobia, eyelid tics, acne, Addison’s disease, eczema, fungal infections, seborrhea, itching, white-heads, rosacea, eczema around nose and ears, dandruff, oily hair, sore tongue, cracked lips at corners of the mouth, purplish or magenta tongue, white patches on tongue.

    4) Vitamin B3 (Niacin)

    Food sources: Brown rice, tuna, mushrooms, liver, beans, and lean meat.

    Vitamin deficiency symptoms: Loss of appetite, fatigue, mental confusion, depression, dementia, nervous irritability, diarrhea, acne, Addison’s disease, fungal infections, itching, reddish-brown skin on neck, white patches on tongue.

    5) Vitamin B6 (Pyridoxal phosphate)

    Food sources: Bananas, bell peppers, potato skins, garbanzo beans, prune juice, and dark green leafy vegetables.

    Vitamin deficiency symptoms: Chronic fatigue, depression, nervous irritability, increased homocysteine levels (heart attack and stroke risk), numbness in the hands and feet, blurred vision, conjunctivitis, dark spots in front of the eyes, retinitis, corneal ulcers, macular degeneration, night blindness, eyelid tics, acne, Addison’s disease, eczema, edema, fungal infections, dermatitis around eyes and nose, skin infections, itching, jaundice, pale skin, vitiligo, dandruff, hair loss, white spots on nails, sore tongue, cracked lips at corners of the mouth, bad breath, canker sores, white patches on tongue.

    6) Vitamin B9 (Folic acid)

    Food sources: Organ meat, beans, dark green leafy vegetables, beets, and cauliflower.

    Vitamin deficiency symptoms: Mental confusion, depression, dementia, forgetfulness, nervous irritability, insomnia, aggression, cervical dysplasia, megaloblastic anemia, increased homocysteine levels (heart attack and stroke risk), nerve damage, failure to thrive, low birth weight, neural tube defects, breathlessness, heart palpitations, pale skin, reddish-brown skin on neck, graying hair, hangnails, cracked lips at corners of the mouth, canker sores, beefy, red tongue, gingivitis.

    7) Vitamin B12 (Cobalamin)

    Food sources: Organ meats, cod, halibut, salmon, shellfish, lean meat, eggs, and dairy products.

    Vitamin deficiency symptoms: Chronic fatigue, loss of appetite, nerve damage, painful tingling and numbness in the hands and feet, loss of balance, movement problems, heart palpitations, breathlessness, mental confusion, hallucinations, depression, memory loss, dementia, forgetfulness, nervous irritability, increased homocysteine levels (heart attack and stroke risk), diarrhea, dim vision, retinitis, eyelid tics, miscarriages, fertility problems, Addison’s disease, brown pigmentation around small joints, fungal infections, itching, jaundice, pale skin, shingles, vitiligo, hair loss, sore tongue, beefy, red tongue, canker sores, white patches on tongue, altered sense of taste.

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    8) Vitamin C (Ascorbic acid)

    Food sources: Guava, papayas, strawberries, citrus fruits, broccoli, Brussels sprouts, bell peppers, and dark green leafy vegetables.

    Vitamin deficiency symptoms: Chronic fatigue, loss of appetite, cataracts, conjunctivitis, crossed eyes, dark spots in front of the eyes, dim vision, glaucoma, retinitis, corneal ulcers, near-nearsightedness, acne, Addison’s disease, eczema, edema, skin infections, itching, jaundice, prickly-heat rash, shingles, wrinkles, hangnails, peeling nails, gingivitis.

    9) Vitamin D

    Food sources: Salmon, sardines, shrimp, fish oil, yams, and dairy products fortified with vitamin D.

    Vitamin deficiency symptoms: Nervous irritability, near-sightedness, increased risk for diabetes, rickets, skeletal deformities, muscular weakness, soft bones, muscular pain (especially lower back pain), frequent bone fractures, osteoporosis, rheumatoid arthritis, hypertension, hypocalcemia, muscle twitches, numbness in the hands and feet, irregular heartbeat.

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    10) Vitamin E

    Food sources: Vegetable oils, wheat germ oil, dark green leafy vegetables, avocadoes, seeds, nuts, and whole grains.

    Vitamin deficiency symptoms: Loss of appetite, nausea, anemia, immune system disorders, angina, muscular pain, tingling and numbness in the hands and feet, movement problems, miscarriages, fertility problems, bulging eyes, cataracts, crossed eyes, near-sightedness, acne, jaundice, shingles, wrinkles.

    11) Calcium

    Food sources: Yogurt, cheese, sardines, canned salmon, milk, and dark green leafy vegetables.

    Vitamin deficiency symptoms:Osteoporosis, hypocalcemia, tingling and numbness in the hands and feet, muscular pain, irregular heartbeat, fatigue, loss of appetite, frequent bone fractures, peeling nails, ridged nails, gingivitis.

    12) Magnesium

    Food sources: Wheat bran, almonds, cashews, dark green leafy vegetables, tofu, beans, and seeds.

    Vitamin deficiency symptoms: Loss of appetite, nausea, vomiting, fatigue, weakness, tingling and numbness in the hands and feet, muscular pain, mood swings, irregular heartbeat, hypocalcemia, farsightedness, glaucoma, retinitis, macular degeneration, eyelid tics, Addison’s disease, edema, skin infections, jaundice, dandruff, bad breath.

    13) Zinc

    Food sources: Oysters, crab, lobsters, beef, poultry, and fortified cereals.

    Vitamin deficiency symptoms: Diarrhea, immune system disorders, failure to thrive, poor concentration, dark spots in front of the eyes, retinitis, corneal ulcers, macular degeneration, night blindness, eyelid tics, acne, eczema, edema, dermatitis around eyes and nose, skin infections, jaundice, vitiligo, dandruff, dry and brittle hair, hair loss, white spots on nails, bad breath, canker sores.

    Image by Mike Mozart, Flickr, CC license. Vita Sciences does not own this property.

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    7 Reasons your B12 Levels are Out of Whack and what you can do about it

    7 Reasons your B12 Levels are Out of Whack and what you can do about it

    Always tired, dizzy, sluggish? The cause may be low vitamin B12 levels.  Depression, memory problems, crushing fatigue, and muscular pains all occur when you don’t have enough vitamin B12 in your blood supply.

    You’re not alone. Millions of people your age feel exhausted, run-down, disoriented and achy. And that’s only by mid-morning.

    For many, these symptoms occur from vitamin B12 deficiency anemia.  People as young as thirty can develop B12 deficiency or pernicious anemia.

    This is why your B12 levels are down:

    B12 deficiency is more common that you think. Here are some reasons that many people lose B12 from their blood supply:

    You’ve had weight loss surgery.

    Gastric bypass operations used to be a last resort for weight loss. Today, they’re much more common.  If you’re overweight, then you  can easily receive bariatric surgery to shed the pounds. Unfortunately, many patients aren’t prepared to supplement with vitamin B12  for life. Some weren’t warned about vitamin B12 deficiency; others don’t heed their doctor’s warnings.

    This is important! If you have received any kind of stomach surgery ( for weight loss, Crohn’s disease or ulcerative colitis), then you must take large doses of  vitamin B12 each day.

    You take medications for diabetes or gastro-esophageal reflux disease (GERD).

    Certain medications prevent you from properly digesting vitamin B12 from the foods you eat. Metformin, protein pump inhibitors (PPIs), antacids, long-term antibiotics, and antidepressants are on the list.

    If you take any of the medications on the list below, then please also take extra vitamin B12.

    25 Medications that Cause Vitamin B12 Deficiency

     Your vitamin B12 blood test results are wrong.

    The national standard for testing for serum levels of vitamin B12 is often wrong and inefficient. If your B12 is plummeting from pernicious anemia, then a blood test will tell you to get more vitamin B12 supplements, ASAP.

    But if your B12 levels are moderate to low, then you may get a false negative test result. Even though you suffer from fatigue, memory problems, gloominess, brain fog, and painful numbness. That’s because the blood screenings don’t differentiate between “active” and “dormant” vitamin B12.  The first helps to protect your nervous system and boost energy. The second sleeps in your gut and does nothing.

    So your doctor may tell you that your vitamin B12 levels are okay, but he’d be wrong.

    Your doctor knows nothing about vitamin B12 deficiency.

    Sad but true: many doctors get little or no training  in detecting the earliest signs of pernicious anemia. The idea of a vitamin “curing” an illness  is, in their opinion, laughable. Yet it was only one generation ago that pernicious anemia  was a lethal threat. And it took vitamin B12 supplements to stop the debilitating symptoms.

    How Much Vitamin B12 is enough?

    Your doctor may not take your symptoms seriously. He may refuse to prescribe enough vitamin B12 to treat your symptoms. If that is the case, then you need to buy extra vitamin B12 supplements online.

    You follow a vegan diet.

    Your body doesn’t manufacture vitamin B12, and you can’t get it from vegetables. The only rich sources of vitamin B12 are from chicken, beef, lamb, and seafood.  Eggs, cheese, and milk also have some vitamin B12. If you follow a vegan or vegetarian diet,  then you need to take vitamin B12.

     You suffer from autoimmune disorders.

    For many, vitamin B12 malabsorption happens because of a faulty immune system. People who have autoimmune disorders are most likely  to suffer from vitamin B12 deficiency.  This happens because missing intrinsic factor, a hormone needed for B12 digestion.

    35 Signs of Neuropathy to Watch

    If you have lupus, Crohn’s disease, or other autoimmune disorders, then you are at risk. Don’t rely on faulty B12 blood screenings. Rather,  take extra vitamin B12 supplements each day.

    You are older than 30 years of age.

    As we get older, our ability to digest vitamin B12 weakens. Vitamin B12 levels plummet with age. By the time many people reach their 40’s, vitamin B12 is a must. For great health, supplement with vitamin B12 in your 30s and 40s.

    By the time you reach the age of 50, vitamin B12 usage is mandatory for survival.

    Treatment options

    Vitamin B12 isn’t an easy nutrient to digest; your body doesn’t make it on its own. Any defect in your stomach or intestines can impair vitamin B12 absorption. To boost vitamin B12 levels, you need to get vitamin B12 into your blood stream. Not through the digestive system. Vitamin B12 pills are useless.  B12 shots are painful, impractical, and difficult to administer on your own. For many, vitamin B12 supplements that penetrate the skin are the best option. They’re easy to use, don’t need prescription, and are painless

    Also read:


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    List of Medications that Trigger Vitamin B12 Deficiency

    A common cause of vitamin B12 deficiency is long-term use of certain medications. Even if you don’t suffer from an autoimmune condition or have a family medical history for pernicious anemia, your risk for developing severe vitamin B12 deficiency are increased if you take any of the following medications regularly.

    List of Medications that Trigger Vitamin B12 Deficiency

    Listed are drugs prescribed often for conditions such as diabetes, depression, GERD, or frequent infections that can, over time, impair your ability to absorb vitamin B12 properly from the foods you eat.

    Vitamin B12 malabsorption

    If you take vitamin B complex and eat a diet rich in vitamin B12, such as beef, fish, and chicken, then you’re on the right track to good health. Still, there are many risk factors that can lead to vitamin B12 malabsorption, regardless of how well you take care of your body.

    Vitamin B12 malabsorption is the inability to latch onto vitamin B12 molecules that enter your body and use them efficiently. Instead of being dispersed through your blood stream, essential vitamin B12 passes through your digestive system whole, unaffected. None of the important nutrients needed for good neurological health, energy, or red blood cell development reach their destination. As a result, over time, you experience symptoms of severe anemia caused by low levels of serum vitamin B12.

    What causes vitamin B12 deficiency?

    Vitamin B12 deficiency most often occurs with pernicious anemia, an autoimmune condition that attacks intrinsic factor, a digestive enzyme needed for vitamin B12 absorption. Pernicious anemia can also result from damage to the parietal cells of the stomach. Patients of gastrointestinal surgeries for weight loss or Crohn’s disease are at risk and must supplement with non-dietary vitamin B12.

    If you follow a strict vegan diet, then you may be at risk for dietary vitamin B12 deficiency, as there are no rich natural sources of plant-based vitamin B12.

    Medications that Trigger Vitamin B12 Deficiency

    Please note: Don’t stop using any prescription medication without permission from your doctor. If you use any of the medications listed, then you should check your vitamin B12 levels regularly in order to prevent developing severe vitamin B12 deficiency.

    The following prescription medications may trigger vitamin B12 deficiency:

    • Aminoglycosides
    • Cephalosporins
    • Chlorotrianisene
    • Chlortetracycline
    • Cholestyramine (Cholybar®, Questran®)
    • Cimetidine (Tagamet®)
    • Clofibrate (Atromid-S®)
    • Colchicine- (ColBenemid®)
    • Colestipol
    • Co-trimoxazole
    • Demeclocycline
    • Famotidine
    • Fluoroquinolones
    • Lansoprazole
    • Macrolides
    • Metformin
    • Methyldopa (Aldomet®)
    • Minocycline
    • Neomycin
    • Nizatidine
    • Omeprazole (Prilosec®)
    • Oral contraceptives
    • Oxytetracycline
    • Penicillins
    • Phenobarbital
    • Phenytoin
    • Potassium chloride
    • Ranitidine (Zantac®)
    • Sulfonamides
    • Tetracyclines
    • Trimethoprim- (TMP/SMX)
    • Valproic Acid (Depakene®)
    • Zidovudine

    Did we miss any?

    Are you currently taking any medications that you feel have directly led to vitamin B12 deficiency? Please comment below.

    Image by kdshutterman

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