Nutritional deficiencies in autoimmunity & why they matter

Nutritional deficiencies, particularly those involving micronutrients like iron, iodine, and folate (vitamin B9), are highly prevalent worldwide. They affect about two billion people in both developed and developing countries, especially women, young children, and those with chronic health conditions such as hypothyroidism and autoimmune disease. 

In fact, there’s a strong link between nutrition and autoimmunity, and the effects are bidirectional. This means that having a vitamin or mineral deficiency can contribute to the development of autoimmune disease, just as autoimmunity can play a role in causing one or more nutritional deficiencies. 

To truly promote healing, however, we need to address the causes and consequences of nutrient deficiencies. Not just one or the other. This is where functional nutrition comes in!

Personalised nutrition for vitamin & mineral deficiencies

Personalised nutritional therapy uses intake questionnaires, comprehensive consultations, and functional nutrition testing to identify and address many common vitamin and mineral deficiencies associated with chronic health conditions. This holistic approach to healing helps us determine why these deficiencies are occurring in the first place and come up with an individualised plan to address them. 

Functional lab testing for nutritional deficiencies

In my nutrition practice, I rely on functional lab testing and several more traditional blood tests to identify nutrient deficiencies and insufficiencies among clients. These tests also help identify other factors that might impair nutrient absorption and cause one or more vitamin and mineral deficiencies to develop (e.g. food intolerances, increased intestinal permeability, restrictive diets, and hormone imbalances).

Common nutrient deficiencies

As a nutritional therapist specialising in thyroid hormone dysfunction and autoimmune disease, I regularly support clients with iron, folate, iodine, vitamin B12, and vitamin D deficiencies. However, deficiencies in several other nutrients should be considered as well. These include deficiencies in vitamin A, vitamin B2, and vitamin C, plus insufficiencies in essential minerals like selenium and magnesium. 

These types of deficiencies are frequently seen in clients with non-autoimmune thyroid conditions like hypothyroidism and in various autoimmune diseases such as Hashimoto’s, rheumatoid arthritis (RA), and multiple sclerosis (MS). We’ll take a closer look at the link between nutrient deficiencies and autoimmunity in the next section.

Nutritional deficiencies in autoimmune diseases

If you’ve been diagnosed with non-autoimmune thyroid disease (hypothyroidism), Hashimoto’s thyroiditis, or another type of autoimmune disease, one or more nutritional deficiencies could be at least partly to blame for your symptoms. Especially if you’re not feeling any better despite starting treatment!

As mentioned earlier, the effects of nutrition and autoimmunity are bidirectional. Nutritional deficiencies can play a role in autoimmunity development in susceptible individuals, just as autoimmune diseases might affect nutrient status in some people. 

Autoimmune disease as a cause of nutritional deficiencies

Certain autoimmune diseases like inflammatory bowel disease (IBD), celiac disease, and MS can impair nutrient absorption and digestion, making nutritional deficiencies a common consequence of autoimmunity. If we can’t digest or absorb nutrients optimally — for example, due to structural abnormalities — vitamin and mineral deficiencies might occur as a result.

For instance, in autoimmune conditions such as celiac disease — a disorder affecting the small intestine — vitamin B12 deficiency, vitamin D deficiency, and vitamin B9 (folate) deficiency are all quite common. Iron, calcium, and zinc deficiencies are also frequently seen in celiac disease, which makes sense since the small intestine is responsible for digesting and absorbing nutrients. 

Vitamin and mineral deficiencies also occur in more than half of IBD patients, an autoimmune disease affecting the GI tract. Iron, vitamin D, vitamin B9, and vitamin B12 are a few of the most commonly seen nutrient deficiencies in IBD, especially among patients with Crohn’s disease. This is likely because Crohn’s affects the entire GI tract, while ulcerative colitis (UC) — another type of inflammatory bowel disease — primarily affects the colon and rectum. 

Autoimmune disease as a consequence of nutrient deficiencies

On the other hand, several nutrient deficiencies are associated with an increased risk of developing an autoimmune disease. This is because there are three main triggers that contribute to the development of autoimmunity:

1. Genetics.
2. Increased intestinal permeability (AKA leaky gut).
3. Environmental factors (like sun exposure, diet, lifestyle, food intolerances, and toxins in water, soil, and air). 

Take vitamin D deficiency, for instance. As one of the most common nutrient deficiencies globally, vitamin D — a nutrient that’s obtainable via diet, sun exposure, and supplementation — seems to be associated with multiple sclerosis (MS), Hashimoto’s, and RA. Common vitamin D deficiency symptoms include bone and muscle pain, fatigue, hair loss, and depression. 

Iodine deficiency is another common health concern among hypothyroidism and Hashimoto’s patients, as iodine, is essential for thyroid hormone production. Iodine deficiency is associated with non-autoimmune thyroid diseases, and it’s the leading cause of hypothyroidism worldwide. Common symptoms of iodine deficiency include thyroid issues, fatigue, scaly skin, weight gain, and swelling in the neck. 

That being said, too much iodine can also be harmful to the thyroid gland — particularly in those with elevated Hashimoto’s antibodies or an increased risk of developing Hashimoto’s. You can learn more about iodine and its impact on thyroid function in this blog post.

Other causes & consequences of poor nutrition

Along with the potential to cause nutritional deficiencies, poor nutrition can trigger intestinal permeability: a risk factor for autoimmunity. In fact, leaky gut is thought to precede autoimmunity, making it a pretty significant risk factor.

Intestinal permeability also promotes inflammation of the GI tract, impairs nutrient absorption, and causes vitamin and mineral deficiencies to occur. This is why addressing intestinal permeability is an integral part of any nutritional therapy plan! 

In addition to leaky gut, other factors that may affect nutrient status (and potentially trigger autoimmunity) include:

• Genes that affect nutrient absorption and metabolism.
• Long-term use of certain medications (like antacids).
• Eating a low-nutrient diet (for example, consuming lots of ultra-processed foods).
• Inadequate food intake or not meeting dietary requirements.
• Restrictive eating habits (strictly plant-based diets can deplete zinc, iron, and vitamin B12 levels in the body). 
• Poorly planned gluten-free diets. 
• Sun avoidance (for vitamin D deficiency).
• Impaired nutrient absorption.

How to address nutritional deficiencies

In my nutritional therapy practice, I use functional lab testing to better understand whether any of these factors could be impacting your nutrient status, digestion, and overall health. I offer iodine urine tests and many other functional labs including stool, blood, hair, saliva, and breath tests. 

Tests for certain nutrients (like iron, folate, vitamin D, and vitamin B12) can also be ordered through a GP and shared with me prior to your nutritional therapy appointment. This may be a more convenient or affordable option for some. You can learn more about how to prepare for nutritional therapy in this blog. 

Do you suspect you could have one or more of these nutrient deficiencies? I can help. Review my personalised nutritional therapy services and book your free 20-minute inquiry call.