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  • Dr. Cindy Howard

Getting the Right Micronutrients? Why You Should Test​

Today more and more patients are becoming aware of what they are eating.  There are more products in the stores than ever that promote gluten-free, dairy-free, soy- and corn-free, non-GMO, no high fructose corn syrup, and even claims that they are indeed healthy.  One area not concentrated on is micronutrient levels.  We know that there is a recommended daily allowance for nutrients, some of which are displayed on the back of the product, for our education.  What we may not know is how nutrient-dense is the food that doesn't come with a label, such as meat from the counter, fruit and veggies on the outside aisle of the grocery store, or even trail mix that we pour into a bag for consumption. If you pick up food from a fast food joint or eat out, how many times do you request the nutrition information, so you know if you are getting your daily dose of fat-soluble vitamins or even enough vitamin B during the day? Another important question is, then, how much are we actually absorbing, or are we over-consuming, even if we have all of the nutrient information on the food we consume? 

For those of us who have patients taking prescriptive medications, micro-nutrient testing becomes essential, because quite a few prescription medicines can deplete these nutrient stores.  For example, statins such as Lipitor, Crestor, and Zocor commonly deplete coenzyme Q10.  This becomes interesting when recognized that COQ10 is a powerful antioxidant that stops oxidation of LDL particles and plays a role in energy production that is inhibited when cholesterol is driven too low. (1)  Antacids such as Pepcid and Prilosec will delete vitamin B12, folic acid, vitamin D, calcium, iron and zinc, and antibiotics will deplete B vitamins, vitamin K and B6, calcium, magnesium, iron and zinc. (7)

Do you also have patients that are constantly sick or sick longer than most?   How about under chronic stress? 

The roles of micronutrients are many:

• Increase energy • Strengthen the immune system • Reduce inflammation • Slow down the aging process • Protect against free radical damage • Help balance hormones • Support all tissues in the human body

Taking a multivitamin is a common fix for people who think it will fill in what is missing.  What is missing may be way more than what a multivitamin can provide, if there are true deficiencies.   Micronutrient testing can look at 35-plus nutritional components, including vitamins, minerals, antioxidants, metabolites, and amino acids that may be missing in our patients. 

So why not just throw in a couple of extra supplements without testing?  There is a good reason for saying no. Some micronutrients work better in conjunctions with others.  Calcium is best absorbed with nutrients like vitamin D, vitamin K and magnesium.  Some supplements will actually interfere with or potentiate absorption.  For example, vitamin C will increase iron absorption, while calcium can reduce iron absorption (2).  Testing allows you to accurately assess for need and over-consumption. 

The following can be assessed easily from a simple blood sample: Vitamin A, B1, B2, B3, B6, B12, biotin, folate, pantothenate, vitamin C, vitamin D, vitamin K, calcium, magnesium, manganese, zinc, copper, iron, the 9 essential amino acids, alpha lipoid acid, CoQ10, glutathione, selenium, vitamin E, choline, inositol, carnitine, methyl melonic acid, chromium, oleic Acid, and intracellular RBC magnesium, folate, iron and omega fatty acids. 

Vibrant America, a lab that provides a micronutrient test that chiropractic physicians can order, states that there are multiple benefits to both extracellular and intracellular testing of these nutrients.  Extracellular testing can “identify baseline deficiencies, deter higher than normal levels, identify excesses of nutrients caused by uncontrolled supplementation to prevent toxicity, avoid unnecessary spending on costly supplements and look at the nutritional status.”  Deficiencies of extracellular micronutrients have correlated to multiple chronic diseases including cancer, Alzheimer’s, diabetes and cardiovascular disease. (3, 4, 5, 6) Intracellular testing can give a better look at the nutritional status of your patient for the last 4-6 months.  This is a much more sensitive tissue measurement for absorption.  

An easy way to see if your patients could benefit from micronutrient testing is to ask a few questions that can reveal the possibility of a deficiency:

1. Do you have a history of any chronic diseases, weak immune system, digestive disorders or skin problems? 2. Are you feeling stress or are chronically tired or depressed? 3. Have you been using prescription medications for a long time? 4. Do you have a poor diet? 5. Are you a vegan/vegetarian? 6. Do you engage in excessive exercise or none at all? 7. Do you engage in smoking, alcohol consumption?

A few quick questions to determine if micronutrient testing is warranted is a great place to start.  However, testing can be important for everyone, due to the lack of nutrient dense food and chronic GI disturbances that we experience daily.  This testing makes it extremely easy to dose correctly, as well, so that we can get it right for our patients.  Just pulling these nutrients off our shelves to prescribe might just be a good guess but being “spot on” for the individual makes supplementation that much more effective.  Re-testing can be done at 6-month or 12-month intervals to check progress and status, thus allowing patients to see the changes with consistent supplementation. Getting this right for our patients can dramatically increase wellness and keep them healthy.  It is also a fabulous tool for patient compliance, due to the individual results and documented evidence of need.  It also makes you look like a genius for getting it right! 


1. Golomb BA, Evans MA, Dimsdale JE, White HL. Effects of statins on energy and fatigue with exertion: results from a randomized controlled trial. Arch Int Med. 2012; published online June 11, 2012. 2. Achieving Iron Balance with Diet, Iron Disorders Institute, 18 Sept. 2017, Accessed 18 Sept. 2017. 3. Ames B. DNA damage from micronutrient deficiencies is likely to be a major cause of cancer. Mutat Res. 2001;475:7–20. [PubMed] 4. Kamphuis, Patrick J.G.H., and Philip Scheltens. “Can Nutrient Prevent or Delay Onset of Alzheimer’s Disease?” Journal of Alzheimer’s Disease vol. 20 (2010): 765-75. doi:IOS Press Content Library. 5. Via, Michael. “The Malnutrition of Obesity: Micronutrient Deficiencies That Promote Diabetes.” ISRN Endocrinology 2012 (2012): 103472. PMC. Web. 18 Sept. 2017. 6. Klaus K.A. Witte, Andrew L. Clark, John G.F. Cleland, Chronic heart failure and micronutrients, In Journal of the American College of Cardiology, Volume 37, Issue 7, 2001, Pages 1765-1774, ISSN 0735-1097. 7. Pelton, Ross, James B. LaValle, Ernest B. Hawkins, and Daniel L. Krinsky. Drug-Induced Nutrient Depletion Handbook. 2nd ed., Lexi Comp, 2001. #micronutrients

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