Nutritional Deficiencies and a Paleo Diet

To this day one of the most common questions that I get around the Paleo diet is regarding nutritional deficiencies. Is there any correlation of nutritional deficiencies and a Paleo diet? It seems that many just can’t fathom how a diet void of grains, legumes and dairy could possibly be “healthy”. While there may have been a day when wheat was considered the “staff of life”; today’s varieties (of wheat and most other grains) have been altered, genetically modified and highly processed to point where they are stripped of many remaining vitamins and minerals and in many cases not recognized by our bodies. Thus, to maintain optimal health you really are better off getting the most for your nutritional buck by trading out those grains for the vegetables, fruits, nuts, seeds and organic animal proteins recommended by the Paleo diet.

While I firmly believe that an ancestral diet is the ideal lifestyle, the bitter truth is that modern-day agricultural methods are stripping increasing amounts of nutrients from the earth’s soil leaving even our fruits and vegetables lacking the amounts of vitamins and minerals that they once contained in abundance. A study through the University of Texas at Austin’s Department of Chemistry and Biochemistry published in December 2004 in the Journal of the American College of Nutrition, reviewed data from the U.S. Department of Agriculture from both 1950 and 1999 for 43 different vegetables and fruits, finding “reliable declines” in the amount of protein, calcium, phosphorus, iron, riboflavin (vitamin B2) and vitamin C over the past half century. (1) Unfortunately, it seems that even the most complete and colorful array of organic and grass-fed Paleo staples can leave room for nutritional gaps.

Many of my local patients and even individuals on the other side of the country contact us with the concerns about which vitamins they should take for optimal wellness. With all of my patients, I always stress the importance of obtaining one’s primary supply of vitamins and minerals through a balanced diet. With that said, due to the aforementioned changes in agricultural practices and environment over the past few centuries, I do recommend daily EPA/DHA, vitamin D and probiotics for a majority of the population. For those experiencing chronic fatigue, brain fog, low energy, mood issues, and other common health issues; I can usually get a good idea of their possible (or probable) nutritional deficiencies by simply examining their diet; whether it be Vegan, the typical overly-processed American diet or even the Paleo diet (in some cases). It is important to remember that for even the most well intentioned Paleo enthusiast, components such as age, genetics, underlying pathologies, healthy history, medications, intestinal permeability, environment, and lifestyle factors (such as stress and activity levels) play substantial rolls in proper absorption of nutrients.

Research has shown that deficiencies in B vitamins, vitamin D, vitamin E, antioxidants, calcium, magnesium, selenium and coenzyme Q10 (to name a few) are significant in the treatment of insulin resistance, type II diabetes, cancers, osteoporosis and metabolic syndrome. (JANA, Vol 8, No 2, 2005) Thus, it is my practice in treating these common chronic health conditions to utilize quality nutritional and micronutrient lab testing to uncover any potential nutrient deficiencies before moving forward with dietary changes and supplement regimens. As it is very common for nutrient deficiencies to be missed by the traditional serum, hair, and urine analysis; it is vital that patients and doctors are utilizing the proper tests and testing methods to uncover these potential deficiencies (JAMA, June 19, 2002-Vol 287, No 23, JANA, Vol 8, No 2, 2005).

When working with patients suspecting potential nutritional deficiencies or athletes seeking that competitive edge, I’ve had great success by utilizing a few simple and accurate lab tests to help me pin- point deficiencies and imbalances in a wide array of individuals. While there are many lab tests on the market today, the typical serum tests only examine a snapshot of nutrient values in the blood stream at that one particular moment, rather than measuring whether the nutrient is properly functioning within the body. One particular micronutrient test actually measures the function of selected vitamins, minerals, antioxidants and other essential micronutrients within the white blood cells by growing an isolated mixture of lymphocytes in a defined culture medium and then analyzing the resulting growth responses. This test can reveal a person’s functional nutrient status over a much longer time period than conventional testing allowing for a deeper understanding of what is happening in each individual’s body (4,5,6,7,8,9,10). Another great aspect of these modern day lab tests is the informative reviews that contain both the recommended dosing for deficiencies as well as information on which foods to consume to boost levels naturally.

I recently reviewed the test results with an elite athlete and uncovered some interesting results. This individual maintains a vegan diet and is severely deficient in vitamin A. As I discussed dietary changes that would allow her to obtain more vitamin A, she informed me that she eats carrots, sweet potatoes, and winter squash in abundance and actually craves those foods. How could she be deficient in this vitamin that she seemed to be eating an excess of through her diet? First, as mentioned in the above study the rapidly-grown, pest-resistant fruits and vegetables being farmed today are truly less nutrient dense than those grown in years past. In addition, this particular situation turned out to be a perfect example of what standard tests can miss by testing only blood levels. While this patient may have had adequate levels of vitamin A in her bloodstream, her body was likely unable to utilize it. Another possibility is that her low fat diet was not allowing her to absorb this fat soluble vitamin in the first place.

Lastly, of the 3 forms of vitamin A (retinols, beta carotenes, and carotenoids) Retinol, or pre- formed vitamin A, is the most active form and is found most abundantly in animal sources. As a vegan, this individual was not obtaining Retinol from animal products and must begin supplementing with this specific form of vitamin A and increase her dietary fat intake to reverse this deficiency.

As I’ve said, I’m a firm believer in utilizing a balanced (preferably Paleo) diet to reach optimal health and prevent most nutritional gaps. I also believe that by listening to our bodies we really can begin to understand what we are needing based on what we are craving (with exceptions of course, sugar cravings are best ignored). However, we can’t deny that we live in a fast paced world that can make it extremely challenging to maintain a perfect diet every day. Add to that, the flaws in today’s farming practices and the fact that many of today’s most common nutritional deficiencies can be traced back to genetics, childhood, environment, activity level, and our body’s inability to actually utilize the nutrients from our diet; and it should become clear that even the most perfectly balanced Paleo diet can leave somebody with nutritional deficiencies. For athletes seeking optimal performance, women planning to conceive, those with unexplained symptoms of brain fog, chronic fatigue, hair/skin/nails abnormalities, mood issues, or chronic pain and for individuals simply seeking optimal health; I highly recommend utilizing this advanced nutritional or micronutrient testing. I personally prefer Spectracell’s Micronutrient Test or Genova Diagnostics NutraEval test to uncover potential nutritional gaps and ultimately unlocking one’s ability to thrive.

If you truly want to fill in any of these micronutrient gaps, you can either take a shotgun approach to supplementation by taking a bunch of everything or find a practitioner in your area that performs these types of specialty laboratory testing and really begin to understand what nutrients your body can truly benefit from.

-Jason M. Kremer, DC, CCSP, CSCS

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(1) Scientific American, April 27, 2011; Dirt Poor: Have Fruits and Vegetables Become Less Nutritious?
(2) JAMA, June 19, 2002-Vol 287, No 23; Vitamins for Chronic Disease Prevention in Adults
(3) JANA, Vol 8, No 2, 2005; The Metabolic Syndrome
(4) JANA, Vol 7 No 1, Winter 2004; Health Personnel Antioxidant Study (HPAS): Effects of Antioxidant Supplementation on Functional Antioxidant Capacity.
(5) JANA, Vol 4, No 1, Spring 2001; Functional Intracellular Analysis of Nutritional and Antioxidant Status.
(6) JANA, Vol 4 No 2, Summer 2001; Pilot Study: Whole Food Nutritional Supplement Increases Antioxidant Levels in the Blood.
(7) Am Clin Lab, 1994 May; 13(5):10-1; A Functional Analytical Technique for Monitoring Nutrient Status and Repletion. Part 3: Clinical Experience.
(8) Am Clin Lab, 1994 Mar; 13(3):25-7; A Functional Analytical Technique for Monitoring Nutrient Status and Repletion. Part 2: Validation
(9) Am Clin Lab, 1993 Jun; 12(6):8, 10; A Functional Analytical Technique for Monitoring Nutrient Status and Repletion.
(10) Biochem Biophys Res Commun, 1994 Jan 28; 198(2):451-8; Glucose and Insulin Responses in Isolated Human Lymphocytes Reflect in Vivo Status: Effects of VLCD Treatment.

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