Daily multivitamins can be a useful tool when it comes to tackling fatigue. Photo / Getty Images
We need tiny amounts of powerful nutrients to keep our bodies in tip-top condition and help us fight disease. Are you getting enough?
Grinding, numbing tiredness that weighs us down every day has become such an accepted part of modern life that doctors even have an acronym, TATT (tired all the time), to describe persistent fatigue.
When I go through a phase of waking up feeling bleary-eyed, or catch myself falling asleep on the sofa, my focus turns to my diet. I try to eat enough protein and the “right” healthy carbs and fats – the macronutrients we all need to fuel the body. But what I, and many others, are missing out on are the miniature powerhouses of the body; micronutrients that perform just as important a role.
While most of us understand the importance of good nutrition, dietitians and scientists divide the sources of nutrition into macro and micronutrients. While our bodies require micronutrients (or vitamins and minerals) in very small quantities, they are vital for our health and wellbeing. Deficiencies can not only affect your day-to-day health, but also impact your body’s ability to fight disease – as well as leave you feeling exhausted.
In an ideal world, a balanced diet should provide all the micronutrients you need, but it’s not always possible to whip up three healthy, wholesome meals a day that tick off all the nutritional boxes. If you restrict any food groups, or have an underlying health condition, you could be missing out on vitamins and minerals your body needs – leaving you feeling even more tired and run down.
Here, we ask the experts for advice on the most important micronutrients to include in your diet, or in supplements – and how to spot the signs that you’re not getting enough.
Signs that you’re deficient
“If you’re deficient in vitamin D, you’re likely to experience muscle aches and pains and poor immunity,” says Sophie Medlin of City Dietitians. Other potential signs include fatigue, hair loss and slow wound-healing. Take away the guesswork by asking your GP for a simple blood test to check your levels.
Why is it important?
Vitamin D helps regulate the amount of calcium and phosphate in the body. “It’s needed for strong bones, teeth and muscles,” says dietitian Emma Shafqat. “A lack of it can cause rickets in children and bone pain caused by a condition called osteomalacia in adults.” Some studies also suggest a link between low levels of vitamin D and an increased risk of heart failure and type 2 diabetes. There’s also evidence that low levels of vitamin D can affect your mental health, increasing the risk of low mood, depression and sleep disorders.
How much do you need?
Adults and children over the age of 1 need 10 micrograms (μg) of vitamin D daily. During the summer months, most people should be able to make all they need from sunlight on their skin. However, people with darker complexions, or those who cover up or spend little time outdoors, may need to take supplements all year round.
How to boost your intake
“Vitamin D is found in a small number of foods: oily fish, red meat, egg yolks and fortified food, such as fat spreads and breakfast cereals,” says Shafqat. As sunlight is the main natural source of vitamin D, supplementation is recommended for everyone in the UK between October and the end of March, and all children aged 1 to 4 should take a daily supplement throughout the year, unless they are having more than 500ml of infant formula each day. The same applies for people who are housebound or keep their skin covered.
Vitamin D supplements
If you decide to take supplements, you can choose between pills, sprays or drops that you put under your tongue, while some multivitamins also contain vitamin D. They all work the same, regardless of the brand, so choose which formulation you like best. The NHS recommends that 10μg a day will be enough for most people; don’t take more than 100μg (4000 IU), as this could be harmful.
Signs that you’re deficient
“Early signs of iron deficiency include breathlessness when walking up stairs or moving around, and fatigue,” says Medlin. A simple blood test known as a CBC (complete blood count) will show if you’re deficient. “Copper deficiency is rare but can happen in people with problems absorbing nutrients, such as those living with inflammatory bowel disease. It causes fatigue, pale skin, greying of the hair and poor immunity,” says Medlin.
Why is it important?
Iron plays an important role in making the red blood cells that carry oxygen around the body, and it’s also vital for the immune system and keeping us well. Copper helps to produce red and white blood cells, and helps to form haemoglobin – a protein found in red blood cells. It also helps to keep our body and brain healthy.
The risks if you are deficient in either can be serious. “Pregnant women, anyone who has bleeding in the bowel or small intestines, or women with heavy periods are at risk of iron-deficiency anaemia, as are vegans and vegetarians,” says Medlin. If left untreated, this can affect the immune system, increase your risk of heart failure, and lead to pregnancy complications. Studies suggest that copper deficiency can increase the risk of osteoporosis, and Alzheimer’s disease.
How much do you need?
Men need 8.7mg of iron each day, while pre-menopausal women need 14.8mg. After menopause, women also need 8.7mg daily. All adults need 1.2mg of copper a day.
How to boost your intake
Eat more iron-rich foods, such as dark green leafy vegetables, eggs, fortified cereals, pulses, dried fruit and two portions of red meat per week. If you drink a lot of tea or coffee, it’s wise to cut back, as they make it harder for your body to absorb iron.
Iron and copper supplements
Your GP may prescribe a course of iron tablets, which are stronger than over-the-counter supplements, if you have heavy periods or have been diagnosed with anaemia. If you’re not anaemic, a good multivitamin should provide all the iron you need. “Nuts. seeds, wholegrains and mushrooms are great sources of copper. Copper supplements aren’t usually needed, but it can be taken as part of a good multivitamin product at a dosage of 1.2mg daily,” says Medlin. Bear in mind that high doses can cause sickness and diarrhoea though.
Signs you’re deficient
“Magnesium deficiency is relatively common, as we often don’t get enough from our diet,” says Medlin. “Deficiency can cause muscle cramps, mood changes, high blood pressure and poor sleep. Anyone who has gut problems, type 2 diabetes, regular alcohol users and people taking diuretics and PPIs (proton pump inhibitors), such as omeprazole, are at higher risk of magnesium deficiency.
Why is it important?
Magnesium plays an important role in more than 300 bodily processes. It turns the food we eat into energy; controls muscle and nerve function, blood pressure and blood sugar levels; keeps bones strong and regulates the heartbeat. Low magnesium, known as hypomagnesia, can cause mild symptoms such as muscle cramps and fatigue, and more serious issues such as heart problems and seizures. Research indicates that magnesium deficiency may also increase the risk of developing type 2 diabetes.
How much do you need?
Men need 300mg a day, and women need 270mg a day.
How to boost your intake
“Soy products are an excellent source of magnesium, as are legumes, nuts, seeds and wholegrains,” says Medlin.
Magnesium supplements
“Many people do benefit from supplementation and you should look for magnesium bisglycinate – also known as glycinate – products, as this form is most bioavailable [absorbable] and doesn’t cause bowel irritation. If you’re taking prescription medication, always check with your doctor first,” adds Medlin.
Signs you’re deficient
“Not getting enough selenium can cause muscle weakness and brain fog as well as impaired immunity,” says Medlin. “People who have bowel or kidney issues are most at risk of selenium deficiency.”
Why is it important?
A powerful antioxidant, selenium helps the immune system work properly and prevents damage to cells and tissues. Studies suggest that it may help to protect against heart disease and slow the progression of Alzheimer’s disease, while recent research has found a link between selenium deficiency and some types of cancer, including breast, lung and prostate. Low levels of selenium have also been linked to depression.
How much do you need?
Men need 75mcg a day, and women need 60mcg.
How to boost your intake?
“Brazil nuts are an amazing source of selenium, as is yellowfin tuna,” says Medlin.
Selenium supplements
“If you don’t regularly eat tuna or Brazil nuts, then having your recommended daily dose of selenium as part of a multivitamin is a good idea – it’s included in most multivitamin and mineral formulations. Always speak to your doctor, a pharmacist or a dietitian first, though, as an excessively high dose could cause selenium toxicity,” advises Medlin.
Signs you’re deficient
“Common symptoms of zinc deficiency include impaired wound healing, hair loss, rashes and changes to taste and smell,” says Medlin.
Why is it important?
Not only does it aid digestion and metabolism, support the immune system and help wound-healing and skin health, but it may also have anti-cancer properties, as it supports the activity of cancer-destroying T-cells.
Being deficient in zinc, especially as an older adult, has been linked to cognitive decline, including problems with memory and the development of Alzheimer’s disease. It’s also linked to an increased risk of age-related macular degeneration (AMD).
How much do you need?
Men need 9.5mg a day, and women need 7mg a day.
How to boost your intake
Zinc comes from oysters, red meat, chicken and shellfish, as well as some being found in wholegrains, eggs, beans and nuts.
Zinc supplements
“Women who are following a vegetarian or vegan diet should take 7mg of zinc (or 9.5mg for men), which can be taken as part of a multivitamin,” says Medlin.
Signs you’re deficient
“In the early stages, vitamin C affects the immune system, so you may be more prone to picking up bugs. Low levels of vitamin A may cause dry skin and vision changes, such as night blindness,” says Medlin.
Why is it important
Vitamin A supports vision, immunity and skin health. Vitamin C works as an antioxidant, protecting cells from environmental damage. It’s essential for collagen production, supporting skin, blood vessels, cartilage and bones, and it enhances the absorption of iron. Vitamin A deficiency is linked to infertility and a higher risk of miscarriage. Studies show that low levels of vitamin C and vitamin A can also increase the risk of heart disease.
How much do you need?
Men need 700μg of vitamin A per day, and women need 600μg. All adults need 40mg of vitamin C per day.
How to boost your intake
“Cheese, eggs, oily fish, milk, yoghurt and liver are all good sources of vitamin A. You can also get it from beta-carotene in yellow and red fruit and vegetables like carrots, peppers, sweet potatoes and mango,” says Shafqat. “Vitamin C is found in a wide variety of fruit and vegetables, including potatoes, so you should be able to get it from your diet. However, as it’s a water-soluble vitamin, it’s not stored in the body, so you need to eat these foods, or take a supplement, every day.”
Vitamin A & C supplements
There’s no need to take a dedicated vitamin C supplement as most multivitamins contain the recommended amount. Supplementation is particularly helpful for people with anaemia, as it enhances iron absorption.
Signs you’re deficient
“Anyone who has excluded dairy from their diet is at risk of not getting enough calcium,” says Medlin. Mild symptoms of calcium deficiency include fatigue, muscle cramps, brittle nails and dry skin.“Without adequate dietary calcium, our bones become porous and weak,” says Medlin.
Why is it important?
“Calcium is one of the key minerals that make up the structure of our bones. The body also needs adequate vitamin D so that calcium can be adequately absorbed: think of calcium as the bricks, and vitamin D as the mortar,” says Medlin.
If you don’t have enough in your diet, you are at risk of bone pain and an increased risk of fractures, with dental issues. There’s some evidence that low levels of calcium can speed up cognitive decline in older adults, as well as causing irregular heartbeats.
How much do you need?
Most adults need 700mg of calcium daily, but breastfeeding mothers and women past the menopause need 1250mg.
How to boost your intake
Calcium is found in dairy products, fortified plant milks, bread made with fortified flour, leafy greens, and fish such as sardines where you eat the bones.
Calcium supplements
“If you don’t consume dairy, then calcium supplementation is advised,” says Medlin.
What is the difference between a macronutrient and a micronutrient?
There are three macronutrients – proteins, carbohydrates and fats – that form the main building blocks of our diet. These contain vitamins and minerals, known as micronutrients, which our bodies need in much smaller quantities.
How to increase your micronutrient intake
“The best way to increase your micronutrient intake is through a balanced, varied diet that includes plenty of fruits, vegetables, wholegrains, lean proteins, dairy or fortified alternatives, nuts and seeds,” says Shafqat. “Food provides nutrients and other compounds that help the body absorb and use micronutrients effectively. For example, vitamin C can help the body absorb iron. Supplements can be helpful for certain nutrients, such as vitamin D during the winter months.”
Should I use an at-home micronutrient test?
“Some over-the-counter tests can give useful indicators, but their accuracy and interpretation vary, so there’s a risk of false reassurance or unnecessary worry,” says Amuthalingam. “They can be a starting point, but I’d always advise confirming results through your GP – not just for accuracy but to ensure you get the right follow-up [advice]. A borderline or abnormal result needs to be interpreted in context with your symptoms, medical history and possible underlying causes, which at-home kits can’t always assess.”