VITAMINS AND MINERALS

Vitamin B12 and folate work closely together in many of the body’s most important processes, including energy production, DNA synthesis, red blood cell formation, brain function, nerve health, and methylation. When either one is low, the other may not be able to function optimally, which is why I prefer to look at them together rather than treating them as completely separate nutrients.

Both nutrients are especially important for the brain and nervous system. B12 supports healthy nerve cells and neurotransmitter function, while folate is essential for DNA production and methylation. When levels are inadequate, people may experience fatigue, brain fog, weakness, mood changes, poor concentration, numbness or tingling, and reduced mental clarity.

The form of these nutrients can also matter. Methylated and active forms, such as methylcobalamin or other appropriate forms of B12 and 5-MTHF (methylfolate), are already closer to the forms the body uses. This can be particularly important for people with genetic variations affecting folate metabolism, such as certain MTHFR variants.

I also believe optimal levels matter, not simply avoiding a clinical deficiency. B12 and folate are foundational nutrients, and maintaining adequate status helps provide the building blocks your brain, nervous system, blood cells, and energy-producing pathways need to function well.

This is why B12 and folate are included in my foundational lab evaluation. Looking at the numbers alongside symptoms and other markers can help identify nutritional patterns that may otherwise be missed.

Your brain needs nutrients to function. Your energy needs nutrients to thrive. And B12 and folate work best as part of a balanced nutritional system.

Know your numbers. Understand your needs. 

Support your body with the right nutrients, in the right forms, at the right amounts.

Iron and vitamin C work together, making this an important nutrient partnership to understand. Vitamin C can enhance the absorption of non-heme iron, which is why combining iron-rich foods with vitamin-C-rich foods can be a simple way to support healthy iron status.

For food-based nutrition, some excellent sources include beef and liver for iron, paired with vitamin-C-rich foods such as acerola, citrus, peppers, and other colorful fruits and vegetables. Eating these foods together can help your body make better use of the iron in your meal.

For some people, however, food alone isn't enough to restore iron status and supplementation may be appropriate. When supplementation is needed, I often prefer gentler forms such as iron bisglycinate, which many people tolerate better than some other forms of iron.

I also prefer whole-food sources of vitamin C, such as acerola, when appropriate. Acerola naturally contains vitamin C along with other plant compounds, making it a useful option for people who prefer a food-based supplement. Ascorbic acid is a commonly used synthetic form of vitamin C, and there are possible risks with synthetic supplements, so individual tolerance and overall health history should be considered when choosing.

Most importantly, test before supplementing with iron.

Fatigue, weakness, brain fog, reduced exercise tolerance, and other symptoms associated with low iron can also occur with B12 or folate deficiency. Assuming that fatigue automatically means you need iron could lead you in the wrong direction.

Iron also isn't something everyone needs more of. I work with clients who have hereditary hemochromatosis, a genetic condition that can cause excessive iron accumulation. For these individuals, unnecessary iron supplementation can be harmful, and managing iron intake and monitoring iron markers is especially important.

That's why I like to look at a complete iron panel, including iron, TIBC, transferrin saturation, and ferritin, rather than relying on serum iron alone. We can then consider your B12, folate, symptoms, health history, and other markers to understand the bigger picture.

Iron is essential—but more is not always better. The goal is balance.

Know your numbers. Find out what your body actually needs. 

Then choose the right foods, forms, and support for you. 

Iodine and selenium are two minerals that I pay close attention to because they work together throughout the body. Most people think of iodine as simply a “thyroid mineral,” but its role is much broader. Iodine is required for the production of thyroid hormones, which influence metabolism, energy, temperature regulation, brain function, growth, and development. Iodine is also concentrated in tissues outside the thyroid, including the breast and stomach, which is one reason I don't believe we should think about iodine solely in terms of thyroid health.

Selenium is the partner that helps make iodine work properly. Selenium is needed for enzymes involved in thyroid hormone metabolism and antioxidant protection. When iodine and selenium status are both adequate, they support the processes involved in producing and converting thyroid hormones while helping protect thyroid tissue from oxidative stress.

This is why I prefer to look at iodine and selenium together rather than treating them as completely separate nutrients.

Excellent food sources include seaweed and algae depending on the individual's diet and food choices. Sea vegetables can contain substantial amounts of iodine, making them one of the richest natural sources. 

Selenium is abundant in foods such as Brazil nuts, seafood, meat, eggs, and other protein-rich foods.

The challenge is that many people simply aren't eating these foods consistently.

You might enjoy sushi occasionally, but are you eating seaweed every day? Do you regularly eat seafood? Are Brazil nuts part of your daily routine?

For many people, the answer is no.

This is where high-quality supplementation can be useful when a person's diet and laboratory findings indicate a need. But quality, form, and dose matter. These are powerful nutrients, and the goal is to provide the body with what it needs. 

One reason is simply that our food supply does not consistently provide the same amount of iodine from person to person. Iodine content in foods varies considerably depending on where food is grown, what animals are fed, and whether iodized salt is being used. Historically, this was a major problem in parts of the United States.

The Great Lakes, Midwest, Appalachia, and surrounding regions became known as the “Goiter Belt” because iodine deficiency was widespread and goiter was common.

This history is particularly interesting to me because I work with many clients who live around Akron and northeastern Ohio. Akron has an important place in iodine history: physician David Marine conducted early iodine research in Ohio, and a landmark schoolgirl study in the region demonstrated that iodine supplementation dramatically reduced thyroid enlargement.

Those findings helped lead to the introduction of iodized salt in the United States during the 1920s, which was incredibly successful at reducing severe iodine deficiency and goiter.

But preventing severe deficiency is not necessarily the same thing as determining whether an individual has an optimal nutritional status. Modern diets, reduced use of iodized salt, restrictive diets, changes in food sources, and individual differences can all affect iodine intake.

Another part of the conversation that often gets overlooked is exposure to substances that can interfere with iodine transport.

Certain halides—including bromide and chloride—can compete with iodide for the sodium-iodide symporter (NIS), the transport system responsible for moving iodide into thyroid cells. Environmental exposure can occur through city water, pools, spas, cleaning chemicals and other sources.

This is one reason I pay attention to the bigger environmental picture rather than looking at nutrition in isolation.

There are also naturally occurring goitrogenic compounds in certain foods. Cassava/tapioca, for example, can generate thiocyanate compounds, while cruciferous vegetables contain glucosinolates that can reduce iodine uptake under certain circumstances.

That does not mean you should stop eating broccoli, kale, cauliflower, or other cruciferous vegetables. These are highly nutritious foods and are generally part of a healthy diet. The concern becomes more relevant when iodine intake is already inadequate, exposure is high, or large amounts of particular foods are consumed consistently.  

Iodine deficiency can affect far more than the thyroid because thyroid hormones influence virtually every organ system. Adequate iodine is important for energy production, metabolism, brain function, nervous-system development, growth, reproductive health, and overall cellular function.

There is also growing research investigating iodine's relationship with breast and prostate health. For example, a prospective prostate study found that men in the highest urinary-iodine group had a hazard ratio of 0.71 compared with the lowest group—approximately 29% lower observed risk.

Breast-cancer research is similarly interesting. One prospective study found that higher serum iodine was associated with lower breast-cancer risk among women who also had higher selenium.

Adequate iodine and selenium status may be important pieces of a larger strategy for supporting healthy cellular function, while research continues to investigate their relationship with cancer risk.

This is ultimately why I like to look at nutrients as a system.

If iodine is low, selenium status matters. If selenium is low, thyroid hormone metabolism may be affected. Iron, magnesium, vitamin A, and other nutrients also participate in thyroid-related processes.

Your diet, environment, genetics, symptoms, medications, health history, and laboratory results all contribute to the bigger picture.

You need to know what your body actually needs.

Small minerals can have a huge impact. 

Test your levels, understand the balance, and create a plan that's personalized to you.