You know that vitamin B12 is essential for energy production, right?
But what about all the other vitamins?
Could your fatigue be caused by a shortage in a rarely tested vitamin or mineral…
The vitamin and mineral deficiencies that commonly cause fatigue are vitamin B12, iron, and vitamin D. But when those labs are shown to be in normal ranges, the investigation into vitamin and mineral levels stops. If you don’t have a deficiency of iron, B12, or vitamin D, vitamins/minerals are not causing your fatigue.
Or, are they…
There are far more vitamins and minerals than the three I listed. Thorough testing of all vitamin and minerals should be done to determine if those dealing with chronic fatigue have any specific deficiencies that need to be accounted for. Only then can we say that vitamins and minerals do or do not cause fatigue.
In today’s post, we’ll look to see if the simple addition of some vitamin or mineral supplements will be enough to improve your fatigue. Let’s get going!
Can you supplement yourself out of chronic fatigue?
This is the myth the supplement industry wants you to believe. All you need to do is take this fancy new supplement and your fatigue woes will be banished. In just four short weeks, you’ll be greeting the morning with a bundle of energy.
Chronic fatigue syndrome is complex. Incredibly complex. The likelihood of a supplement getting rid of your fatigue is small. Very, very small. If a supplement was to get rid of your fatigue, you were not dealing with chronic fatigue.
If your practitioner is pushing bottles and bottles of supplements on you, it’s time to find a new practitioner. You cannot supplement yourself out of chronic fatigue syndrome.
What vitamins and mineral deficiencies cause fatigue?
If you’re dealing with fatigue, start your road to recovery by getting the following vitamins and minerals tested:
- Vitamin B12
- Vitamin D
- Iron
These three are the low hanging fruit. Meaning they’re three of the more obvious potential causes of fatigue. Fortunately, they’ll almost always be tested for by your family doc. If you’re feeling tired all the time, make sure you’ve tested those three vitamins and minerals.
While iron, vitamin D, and vitamin B12 may be potential causes of fatigue, they’re not necessarily implicated in chronic fatigue syndrome. Remember, CFS is more than fatigue, it’s an inflammatory condition!
Do those with chronic fatigue have lower vitamin and mineral levels?
It seems plausible that those with CFS would have lowered vitamin and mineral levels when compared to members of the population not dealing with fatigue. But when researchers compiled data on this very question, there wasn’t a lot of compelling evidence to suggest that those with CFS had lower levels of vitamins or minerals. (1)
In fact, the evidence suggested that those with CFS had normal levels of the following vitamins and minerals:
- Magnesium
- Vitamin C
- Calcium
- B vitamins
- Potassium
- Iodine
- Sodium
- Iron
Now, let me add one very large caveat here – the tests used to test vitamin/mineral status were the same tests used by your family doctor. And these particular tests are not all that sensitive. Meaning that a lot of people with a deficiency will show normal test results.
Let me give you a couple of examples:
Vitamin B12
In conventional medical settings, doctors test something known as serum B12 – also known as total cobalamin. The reference range for this test allows for relatively low levels of B12 to still fall within normal ranges. The conventional reference range is usually, 211–946 pg/mL.
Compare that to the functional reference range of 450–2000 pg/mL. You can see that the low end of the functional reference range is more than twice as high as the conventional range. I’d be curious to see what the actual B12 levels of chronic fatigue patients were.
Another problem with serum B12 testing is the lack of sensitivity. Meaning it’s not the best marker to determine your B12 status. A better marker for B12 status is known as holotranscobalamin. (2, 3)
Holotranscobalamin reflects the level of available vitamin B12 in your blood. Holotranscobalamin is known as active B12 – it’s the form that delivers usable B12 to your tissues. I’d be curious to see the vitamin B12 status of chronic fatigue patients using this more sensitive marker.
If I was to wager a guess, I’d suspect that those dealing with chronic fatigue to have low normal levels of vitamin B12. So, if you’re dealing with chronic fatigue, adding a sublingual B12 supplement is not a bad idea!
Magnesium
Much like vitamin B12, the typical test done for assessing magnesium levels is woefully inadequate. Serum magnesium – the test done for magnesium status in conventional medical settings – accounts for only 1% of your body’s total magnesium levels. (4, 5) The other 99% of your magnesium is stored in your bones and cells.
At the time of this writing, there is not a magnesium test known to be highly accurate in assessing the body’s total magnesium levels. (6) Thus, we should take the results of CFS patients having normal magnesium levels with a large grain of salt. The test used only checked 1% of these patient’s total magnesium levels.
Knowing this brings into question the accuracy of the study showing that chronic fatigue patients had normal vitamin and mineral levels. But as I said earlier, chronic fatigue syndrome has many, many different but concurrent issues. Low vitamin or mineral status could be one of the many issues.
Just remember that while vitamin/mineral deficiency could be adding to your fatigue, it is likely not the sole cause. Since taking a modest supplemental form of magnesium brings about no risk, adding a magnesium glycinate supplement to your arsenal could help to improve your energy.
Other vitamins and minerals that may be altered in chronic fatigue syndrome
The study I quoted earlier is what is known as a meta-analysis or systemic review. This type of study looks at the results of multiple other studies (in this case 27 other studies on chronic fatigue and vitamin status) and pools the results together. The hope or aim of a meta-analysis is to use the larger data set to see if there really is a causal relationship between variables. In this case whether or not vitamin and mineral levels affected fatigue.
Now, the meta-analysis did not suggest there to be a connection between vitamins/minerals and fatigue. But some individual studies did find a link. These individual studies found a connection between vitamin A and vitamin E levels and their effect on fatigue.
Let’s see what the studies found!
Vitamin A and chronic fatigue
Vitamin A is an incredibly important nutrient in the context of immune system function and good vision. (7) Most vitamin A deficiency occurs in developing countries where there is a lack of vitamin A in the diet. (8)
Those with CFS were thought to have lower vitamin A levels when compared to healthy controls. (9, 10)
I could see the plausibility here. Vitamin A helps to regulate the T cells of your immune system. (11) You have vitamin A to thank for helping prevent autoimmunity in your body. (12)
Chronic fatigue syndrome is more than just fatigue. There’s often a chronic inflammatory response associated with the condition. While I don’t think that low vitamin A levels would be causal in this context, it most certainly could be playing a role!
If you are dealing with chronic fatigue, I’d recommend you opt for a cod liver oil supplement. This will give you a healthy serving of both vitamin A and vitamin D. The vitamin A from the oil could be just what your body needs to help regulate its immune system!
Vitamin E and chronic fatigue
A vitamin E deficiency is a rare bird. I’ve never seen it in my clinical practice. If Vitamin E deficiency is to occur, it’s typically the result of impaired fat metabolism rather than low levels from one’s diet. (13) If you were to get a vitamin E deficiency, some of the more common symptoms would include nerve problems (like peripheral neuropathy), ataxia, and/or impairment of your immune system. (14, 15)
Two small studies found vitamin E deficiencies in those with chronic fatigue syndrome. (16, 17) Now, researchers weren’t quite sure what exactly was causing the low vitamin E deficiency in CFS patients. They suspected an increase in oxidative stress could be playing a role.
I think a lot more investigation is warranted here. The two studies on vitamin E and chronic fatigue used sample sizes of 40 and 27 participants. That’s far too small to draw any firm conclusions. For now, hold off on supplementing vitamin E until we know more!
Should you bother with supplements if you have chronic fatigue?
As I said, you’re not going to supplement yourself out of CFS. So, if you find yourself taking 10+ supplements and you’re still tired, you can most certainly scale them back.
With that said, I do think there are a couple of supplements worthy of your consideration. These include:
- Magnesium
- Cod liver oil
Depending on the study you read, a good portion of the population in developed countries is low in magnesium. (18) Magnesium is one supplement I take regularly. And I find myself recommending it to most of my CFS patients.
Try taking 300mg of magnesium glycinate before bed. You should find it to help calm your nervous system and promote a night of more relaxing sleep.
Cod liver oil is my favorite supplement. In part because it’s more food than supplement. What makes cod liver oil so important is the fat-soluble vitamins contained within. Namely vitamin A and vitamin D.
Those of you living far away from the equator will need to supplement vitamin D during the winter months. Cod liver oil is a great way to do that. Plus it’s full of anti-inflammatory omega-3 fatty acids!
If you do want to know more about the best supplements for chronic fatigue, be sure to check out my post on that topic! Just remember that there’s no need to take all the supplements.
As this post has suggested, there’s really not much evidence to suggest that chronic fatigue syndrome results from a deficiency in vitamins or minerals. Focus your efforts on your fatigue-fighting nutrition, not your supplements. That will help your energy levels far more!
Ok, now I want to hear from you!
Which vitamins/minerals have made the biggest impact on your fatigue?
Leave your answers in the comments section below!
