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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do these following blood reports indicate?

Answered by
Kathy
Kathy Shattler

Dietitian & Nutritionist

Practicing since :1985

Answered : 872 Questions

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Posted on Wed, 8 Mar 2017 in Vitamins
Question: Hi

I have deficiency in Vitamin C, E, D and B2.
What should I do? how much to take per day to raise up the levels?

all reports are attached.
Thank you XXXXXXX
doctor
Answered by Kathy Shattler 1 hour later
Brief Answer:
Welcome to HCM

Detailed Answer:
I understand your concerns. You have multiple deficiencies. The vitamin D deficiency is common and I suggest repletion and then maintenance. The most common repletion program is ergocalciferol 50,000 IU once weekly for 4 weeks followed by 50,000 IU once monthly for 5 months. I suggest you see your doctor for repletion. Maintenance may be done by including the following foods or taking a supplement with the minimum daily requirement of 10 microgram/day. Fish, tuna, fortified beverages like milk all have vitamin D.

B2 or riboflavin is found in milk, eggs, leafy green vegetables and brewers yeast. Drinking of alcohol can drain b2. If you were my client I would suggest Probiotics to help make riboflavin in the gut and a B complex supplement until repleted. It is also one of the commonest deficiencies in my country, the US. 1.3 mg/day is average requirement and is essential to the body.

Vitamin E - if you were my client I would suggest 200 IU per day while still looking for the cause of these deficiencies. The daily requirement is set at 15 mg/d. Foods high in vitamin E are:
Almonds. Almonds are one the best vitamin E foods. ...
Raw Seeds. ...
Swiss Chard. ...
Mustard Greens. ...
Spinach. ...
Turnip Greens. ... XXXXXXX ...
Plant oils. Suggest canola oil or extra virgin olive oil.

Vitamin C is a water soluble vitamin. As a species, we used to make it in our bodies but somewhere in our evolution lost that ability. The body requires about 90 mg/d mostly from fresh fruits/vegetables. If values were low, I might suggest to my client 500 mg/day ascorbic acid with food, recheck blood in 3 months.

If values have not normalized, I refer you to a local Dietitian for a complete work-up and meal plan prescription.

And, seriously, the probiotics might be very helpful for your gut mucosa and the metabolism of your nutrients. Look for greek yogurt with active cultures or can be taken by pill.

I hope I have answered all your questions.
Sincere Regards, Kathy Shattler, MS,RDN
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Kathy Shattler 26 minutes later
I think the problem is my diet.. bexause I rely alot on fast food.. I eat less fruits and vegetables. could that be the problem?

also.. now Im on Vitamin D 2000 IU daily. would that be enough or better I take 50k IU once a week?

so in conclusion:
I balance my diet.. add much more fruits and vegetables.
I take 500mg of Vitamine C once daily for a month.
I eat almond daily.
I take probiotics. from yugurt or pills (for how long if from pills?)

Thanks XXXXXXX
doctor
Answered by Kathy Shattler 18 minutes later
Brief Answer:
Good, I am glad you identified dietary problems

Detailed Answer:
Generally the first thing an RD does is analysis of food diaries. Since you have identified inadequacies, yes, we can try boosting your diet in those food areas you are deficient in. It will just take longer to replete.

So, yes, add 3 minimum fresh fruit per day. Lemons and limes are very high in C.Definitely add more fresh or lightly cooked vegetables. That will also help increase your fiber, which we did not discuss.

Yes, 500 mg vitamin C for a month and with your change in diet, this may suffice.

Also, have you had your zinc checked? I noticed an earlier query

Eat a handful of almonds daily/switch oils used and please cut down on the fast food with the bad oils.

Probiotics is one of those healthy things that many people take every day to keep their gastrointestinal tracks healthy with good bacteria so the bad bacteria do not take over and harm out absorption and function of digestion.

Are you lactose intolerant as many of are? If the Greek yogurt gives you gas you have options. First, greek yogurt has lower amount of milk sugar lactose so stick to greek. Still bother? Take a lactaid pill to digest the milk sugar for you when you eat yogurt. It will not harm you, just help with any gas you may experience or go to pills and read label as different for each brand.

You just started D 2000 IU? There are many theories on repletion. Go ahead and continue with that. We can only tell our success by re-measuring. Since the lifespan of a red blood cell is usually 3 months, testing early may not show true progress.

Also, I noticed from a 2012 query that you may need to also have your zinc level checked. That is the most common nutrient lost in ejaculation.

Most kind regards, Kathy J. Shattler, MS, RDN
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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