You may be surprised to learn that you can eat a healthy, balanced diet and still be at risk of developing a vitamin (or mineral) deficiency. Your risk skyrockets if you’re under stress or have a chronic disease, including a rheumatic disease.
Behnam Khaleghi, MD, at Pacific Rheumatology Medical Center, pays close attention to the nutritional status of each patient, knowing that they’re at risk for vitamin deficiencies and understanding they need optimal nutrition to manage their disease.
Here, we explore the three causes of vitamin and mineral deficiencies (inadequate diet, malabsorption, and increased need) and give you some insight into the nutritional challenges of people with rheumatic diseases.
The nutrients your body needs to keep you alive and healthy must come from your diet. An unbalanced meal plan won’t deliver the nutrients you need. It’s also hard to get enough vitamins and minerals through your meals if you have one or both of the other causes of nutrient deficiencies.
Absorption problems (malabsorption)
Proper nutrient absorption relies on steps that occur in your mouth (chewing and salivary enzymes), stomach (acid and churning movement), and small intestine (digestive enzymes).
Your small intestine absorbs nutrients and sends them into your bloodstream. Though the large intestine is better known for collecting and eliminating waste, it also absorbs water and electrolytes. And the bacteria in your gut metabolize fiber and produce some vitamins.
The bottom line is this: Any condition that affects your gastrointestinal (GI) tract and disrupts the digestive process can lead to a nutrient deficiency. Here are a few examples:
Rheumatoid arthritis, vasculitis, and lupus can cause inflammation in your GI tract. Some medications used to treat rheumatologic conditions may also irritate your GI system.
Older adults have a higher chance of developing atrophic gastritis and pernicious anemia, conditions that interfere with absorption and put you at risk of deficiencies in vitamin B12, iron, calcium, and magnesium.
Common GI conditions
GI conditions that interfere with absorption include:
- Crohn’s disease
- Ulcerative colitis
- Irritable bowel syndrome
- Peptic ulcer
- Pancreatic diseases
- Short bowel syndrome
- Autoimmune diseases (celiac disease)
- Small intestinal bacterial overgrowth (SIBO)
Imbalanced gut bacteria may also contribute to nutritional deficiencies.
Increased nutritional needs
Even if you eat a well-balanced diet and have a healthy GI tract, you can still be at risk for a vitamin deficiency. This happens when your body needs more vitamins and minerals than usual.
Nutritional deficiencies caused by an increased need are more common than you may realize. That’s because your body uses more nutrients when you face any circumstance, activity, or health condition that causes physical or emotional stress.
If your body needs more nutrients than normal and you don’t increase your intake, you end up with a deficiency.
Your risk of a deficiency increases if you:
- Engage in intense physical training
- Participate in athletic activities
- Experience chronic stress
- Have anxiety or another mental health disorder
- Have a current or recent illness
- Have a chronic health condition
- Have severe allergies
- Have recurrent infections
- Are exposed to environmental toxins
- Suffer an injury
- Undergo surgery
- Are pregnant
As you can see, many positive and negative aspects of your life boost your body’s nutrient requirements and deplete your vitamins and minerals.
Nutritional deficiencies in rheumatic disease
Like all chronic conditions, rheumatic diseases place an incredible stress on your nutritional needs. Your body burns more energy and consumes more nutrients as it works to fight inflammation and heal damaged tissues.
You could be low on any vitamin or mineral. However, people with rheumatoid arthritis, lupus, and other rheumatic conditions often have a vitamin D deficiency. And being low in vitamin D increases the frequency and severity of disease flare-ups.
If you take steroids to ease your inflammation, you’re also at risk of a calcium deficiency. Prolonged steroid use reduces calcium absorption and speeds up bone loss. Then you need to get more calcium to prevent osteoporosis.
We specialize in identifying nutritional problems and providing the care you need to regain optimal health, from anti-inflammatory supplements to IV vitamin therapy.
If you have questions about your nutritional status, call Pacific Rheumatology Medical Center or book an appointment online today.