Why Normal Doesn’t Mean Optimal

Time and time again, you’ll find yourself complaining about low energy levels, stress, and just feeling unwell. You may receive an annual blood test, to measure important health markers, only for the phone call to come and conclude that “everything is normal”.

However, there are a few nutrients, linked to energy, that need to be at optimal levels rather than just normal levels so you can feel as energetic as possible. Let’s take a deeper dive:

1. Vitamin D

Vitamin D is an important nutrient, helping to maintain bone health and immune health. This sunshine nutrient also plays an important role in energy levels. The mitochondria, always touted as the “powerhouse of the cell”, uses vitamin D for energy production.¹ Studies show that healthy individuals with low vitamin D levels had significantly improved fatigue after vitamin D supplementation.² While there is an ongoing conversation about what the cut-off to define a deficiency is, Health Canada maintains that vitamin D levels below 30 nmol/L are considered as deficiency relative to bone health.³ Vitamin D levels at or above 50 nmol/L are considered to be sufficient for bone health.³ However, the Endocrine Society recommends a preferred range of 100 – 150 nmol/L.⁴ Certain individuals, like post-menopausal women or those with higher fracture risk, could benefit from higher levels than just 50 nmol/L and should speak to their family doctor to determine what their optimal level should be.⁵

2. Ferritin

Ferritin is a protein that stores iron in the body and is measured in the blood. It is one way to know the body’s iron stores and it can help determine iron deficiency. The reference range, for most labs, is 5-272 ug/L and anything within this range is considered normal. With such a large range, it’s important to break it down further and determine the likelihood of having iron deficiency anemia.

The Government of British Columbia defines ferritin levels:⁶

• Below 15 ug/L is diagnostic of iron deficiency.
• At 15-30 ug/L is probable iron deficiency

If your ferritin levels are within the range of 15-30 ug/L but you experience symptoms of low iron like low energy, headaches, nail changes, hair loss, impaired immune function and low mood⁶, talk to your healthcare practitioner to see if iron supplementation is right for you.

3. Vitamin B₁₂

This vitamin has various roles in the body: it helps with the function of the nervous system; it’s utilized in red blood cell formation and helps make DNA. It also plays a really important role in energy production and deficiency is linked to fatigue.⁷  Certain individuals, like vegans, vegetarians or those on vitamin B12 lowering drugs, are more prone to being deficient. The normal range of this vitamin, in most labs, is 118-701 pmol/l.⁸ Anything below 118 pmol/l is considered deficient but health experts may consider levels in the lower end of the range as a deficiency.⁹  If you are experiencing symptoms of deficiency, like fatigue, numbness in hands and feet, and headaches⁸ or are at an increased risk of developing it, talk to your healthcare practitioner to see if extra support would be beneficial for you.

Everybody is different, and normal levels of certain vitamins may not be optimal for you. Always consult with a regulated healthcare practitioner to determine which supplements, at what dose, are essential for optimizing your health.

References

1. Dzik, K.P., Kaczor, J.J. Mechanisms of vitamin D on skeletal muscle function: oxidative stress, energy metabolism and anabolic state. Eur J Appl Physiol 119, 825–839 (2019). https://doi.org/10.1007/s00421-019-04104-x
2. Nowak, A., Boesch, L., Andres, E., Battegay, E., Hornemann, T., Schmid, C., Bischoff-Ferrari, H. A., Suter, P. M., & Krayenbuehl, P. A. (2016). Effect of vitamin D3 on self-perceived fatigue: A double-blind randomized placebo-controlled trial. Medicine, 95(52), e5353. https://doi.org/10.1097/MD.0000000000005353.
3. Janz, T., & Pearson, C. (2015, November 27). Health at a glance. Vitamin D blood levels of Canadians. Retrieved February 22, 2023, from https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11727-eng.htm
4. Chauhan K, Shahrokhi M, Huecker MR. Vitamin D. [Updated 2022 Sep 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441912/
5. Tello, M. (2020, April 16). Vitamin D: What’s the "right" level? Harvard Health. Retrieved February 22, 2023, from https://www.health.harvard.edu/blog/vitamin-d-whats-right-level-2016121910893
6. Health, M. of. (2022, November 28). Iron deficiency – diagnosis and management. Province of British Columbia. Retrieved February 22, 2023, from https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/iron-deficiency#eleven
7. Shipton, M. J., & Thachil, J. (2015). Vitamin B12 deficiency - A 21st century perspective . Clinical medicine (London, England), 15(2), 145–150. https://doi.org/10.7861/clinmedicine.15-2-145
8. Vitamin B12 level. Mount Sinai Health System. (n.d.). Retrieved February 22, 2023, from https://www.mountsinai.org/health-library/tests/vitamin-b12-level#:~:text=Normal%20values%20are%20160%20to,your%20specific%20test%20results%20mean.
9. MD Editorial Contributors. (n.d.). Vitamin B12 Test & Normal vitmain B12 levels: Procedure & results. WebMD. Retrieved February 22, 2023, from https://www.webmd.com/a-to-z-guides/vitamin-b12-test