The 3 Biggest Nutrient Deficiencies in Anorexia & Bulimia
Researchers in Australia did a study on people with eating disorders including; anorexia, bulimia, anorexia/bulimia and eating disorder not otherwise specified (ED NOS) to determine what alterations they have that is reflected in their blood work. It turns out that the strongest differences were in mineral status.
Manganese
The mineral found to be much lower in those with eating disorders was manganese. It’s likely that many people haven’t even heard of this mineral. Having a deficiency of manganese is considered to be rare so this being a finding in this research is probably unique to those with eating disorders.
Source: https://lpi.oregonstate.edu/sites/lpi.oregonstate.edu/files/manganese-flashcard.pdf
Iron
Ferritin levels were shown to be the marker that came in second place. Ferritin is a good way to assess iron status. This is my go-to in routine blood work for this purpose. I usually refer to it as one’s “iron savings account”. Often people can not have anemia on their CBC (complete blood count) and their iron level will be low as reflected by low ferritin. Supplementation with iron is indicated for those with a low ferritin level and can take a number of months to rise to optimal levels. I aim for a minimum of 50 ng/mL. It can be a little tricky in the eating disorder population as so many struggle with constipation so I want to be sure that the iron supplementation is not making this worse.
Vitamin D
The deficiency that comes in third place is vitamin D. In the U.S. 41.6% of the population are deficient in vitamin D. Deficiency is considered to be less than 20 ng/mL. Most functional medicine providers consider optimal levels to be much higher. I usually aim for 40-60 ng/mL in my patients. For those with eating disorders, they are at higher risk for osteopenia and osteoporosis so ensuring excellent vitamin D levels is especially important for them. Patients frequently believe that they are getting enough sun exposure to maintain adequate vitamin D levels. It’s actually the rare person that does in my experience. Generally, the only folks with optimal levels are those that are supplementing with a vitamin D supplement.
I think it’s important to evaluate each individual to determine what their unique needs are. Even though manganese deficiency is a common finding in this study, high levels can be toxic so one wouldn’t want to presume that more is needed. However, I do believe that most people can benefit from taking a high potency, high quality multivitamin.
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