4 Ways poor metabolic health impacts your micronutrient status

Micronutrients are essential for our cellular machinery to run smoothly, but metabolic dysfunction can impair our ability to make and use key micronutrients.


Micronutrients are vitamins, minerals, and other specialty compounds that are critical for maintaining optimal health. Micronutrients help keep your cells healthy and ensure that biological processes function correctly. Maintaining adequate cellular nutrition supports energy production, stress management, mood balance, sleep, and more. Significant biochemical and clinical evidence connects micronutrients—specifically several B vitamins, vitamin C, iron, magnesium, and zinc—to cognitive and psychological symptoms such as fatigue at a molecular and cellular level.

We get micronutrients from food (naturally occurring or fortified nutrients), supplementation, and internal synthesis, where processes within our cells create micronutrients. When striving for optimal nutrition, pitfalls exist in each source of micronutrients. For example, certain supplemental nutrient forms are less effective than others, and poor microbial synthesis of micronutrients and malabsorption can result from gastrointestinal dysfunction.

Poor metabolic health means that the systems that produce and use energy in our bodies are not functioning optimally. Five markers define poor metabolic health and a person with three or more is said to have metabolic syndrome: high fasting blood sugar, high triglycerides, low HDL cholesterol, high blood pressure, and abdominal obesity. 

Metabolic health and micronutrients are linked in both directions. First, having micronutrient deficiencies can contribute to poor metabolic health. Research indicates that up to 90% of the U.S. has a lack of adequate daily vitamin and mineral intake, which results in micronutrient deficiencies that can have a significant impact on fatigue, mood, stress, sleep, and many chronic diseases.

But poor metabolic health can also impact your micronutrient status. In some cases, it may simply be that the conditions that lead to metabolic dysfunction also lead to micronutrient deficiencies. One example is antioxidants. People with poor metabolic health tend to eat less antioxidant-rich foods, leading to lower levels of antioxidant micronutrients like vitamins A, C, and E, selenium, ALA, and CoQ10. Changes and optimizations across diet, supplementation, and activity level can help improve micronutrient status, including increasing levels of vitamins B2 (riboflavin), B3 (niacin), B6, B9 (folate), and C, magnesium, iron, and copper. 

In other cases, metabolic dysfunction interferes with your body’s ability to use and produce micronutrients. For example, excess fructose can interfere with the liver and kidney’s ability to metabolize vitamin D into calcitriol, which is essential for strengthening bones. 

Here are four more examples of ways that metabolic dysfunction can impair your body’s ability to take advantage of micronutrients to stay healthy.

1. Increased Oxidative Stress

Oxidative stress is caused by an imbalance between antioxidant defenses and free radicals in the cells. Most free radicals are reactive oxygen species (ROS) created from normal biological processes like breathing, exercise, and metabolism. The body utilizes specific micronutrients called antioxidants to control free radicals and combat cellular damage. Often, the body can produce enough antioxidant defenses to combat the free radicals, but sometimes there is an imbalance, which creates oxidative stress that can lead to damage in proteins, DNA, and other parts of the cell.

People with poor metabolic health may experience higher levels of oxidative stress due to hyperglycemia (high blood glucose levels) and insulin resistance (an abnormally low uptake of blood sugar by cells from the bloodstream in response to insulin, which leads to high blood sugar). High blood glucose levels lead to more free radicals being generated beyond standard levels, increasing oxidative stress. This leads to the down-regulation of GLUT4, a protein that helps shuttle glucose into cells. 

At a deeper level, the molecular machinery of the cell shifts in the presence of high insulin levels, amplifying NOX4, a ROS-producing enzyme. Increased cellular glucose levels also stimulate more mitochondrial activity, which elevates cellular ROS, as this is a byproduct of mitochondrial energy production. In turn, elevated cellular ROS can induce mitochondrial fission as a stress response, which has been linked to insulin resistance in skeletal muscle. (Mitochondria constantly join and divide—known as fusion and fission—but an imbalance in either direction can cause mitochondrial dysfunction.)

How does this relate back to micronutrients? The higher the free radical levels in the body, the more antioxidants the body uses to combat and control the oxidative stress. This increased use of antioxidants may lead to the depletion of several micronutrients with antioxidant function including vitamin A, vitamin C, and vitamin E. bringing those micronutrients to suboptimal levels unless intake is increased through nutrition or supplementation.

If metabolic health improves or there is a normalization of blood sugar regulation, oxidative stress may naturally decrease

2. Organ Dysfunction

Poor metabolic health and the associated prolonged elevated sugar levels can have a negative impact throughout the body, including dysfunction of the kidneys and liver. Organ dysfunction can impact the body’s ability to absorb, synthesize, and metabolize certain micronutrients including Vitamin D and thiamine (Vitamin B1). For example, kidney disease has been associated with sub-optimal levels of vitamin D. This is largely attributed to the negative impact of kidney dysfunction on 1-alpha-hydroxylase, the enzyme that converts vitamin D into its active form (1,25-dihydroxyvitamin D or calcitriol). 

  • A decrease in renal mass will limit the quantities of 1-α-hydroxylase [source]
  • Reduction in the rate at which the kidneys filter the blood—or glomerular filtration rate (GFR)—may limit delivery of substrate to the 1-α-hydroxylase [source]
  • fibroblast growth factor-23 (FGF-23) is elevated in kidney disease and can directly suppress 1-α-hydroxylase [source]

Vitamin D is an essential nutrient that promotes calcium absorption, bone growth, and is important for the reduction of inflammation, neuromuscular and immune function, and glucose metabolism. Individuals deficient in vitamin D can experience increased fatigue, depression, and weaker bones.

A study in rats also links fructose consumption with vitamin D and calcium. It shows that excessive fructose intake can interfere with the body’s ability to absorb and transport calcitriol, the active form of vitamin D, that’s essential for making calcium ions available that build bone. In the study, young rats fed excessive fructose had impaired vitamin D pathways in the kidneys and intestines, and reduced skeletal growth.  

Thiamine is a water-soluble B vitamin (also known as B1) that plays a key role in energy metabolism and the growth, development, and function of cells. People with low thiamine levels may experience fatigue, irritability, loss of appetite, and abdominal discomfort. Severe thiamine deficiencies can lead to nerve, heart, and brain abnormalities.

3. Excess Weight and Obesity

Excess weight (BMI ≥25) and obesity (BMI ≥30) generally occur due to multifactorial reasons, including genetic mutations, low physical activity, endocrine disorders, and less-than-optimal nutrition. It is generally linked to poor metabolic functioning.

Multiple studies across a variety of age groups and populations show that higher BMI is associated with lower levels of vitamin D and that there is a higher risk of vitamin D deficiency in overweight and obese individuals. Further research is needed to determine the exact relationship between excess body fat and vitamin D, though there is some indication that the vitamin D receptor (VDR) plays a role. 

The direction of causality between micronutrient deficiency and obesity is not clear, although there is evidence in both directions. For example, vitamins A and D can reduce the expression of leptin, a hormone that regulates appetite. Increased calcium slows the body’s ability to store fat. However, there’s also evidence that obesity exacerbates micronutrient deficiencies by, for example, trapping vitamin D in adipose tissue.  

Excess body fat has also been shown to have an association with the status of micronutrients with antioxidant properties including vitamin E, vitamin C, beta-carotene (a precursor to vitamin A, and selenium. B vitamin (thiamine, B6, B12, and folate) and iron deficiencies are also common within overweight and obese adults.

4. Medication-Induced Micronutrient Depletion (for People With More Severe Metabolic Conditions)

Medication to maintain healthy blood sugar levels is a common treatment protocol for metabolic health conditions such as diabetes and prediabetes. Metformin is one of the most commonly prescribed medications for Type 2 diabetes and has been proven an effective treatment. However, research has proposed that metformin may deplete the following micronutrients: vitamins B1 (thiamine), folate (vitamin B9), vitamin B12, magnesium, and CoQ10.

The impact of metformin on vitamin B12 is one of the most well-documented, and studies confirm that metformin makes it harder for the body to absorb the micronutrient leading to between 20%-30% of people taking metformin having a vitamin B12 deficiency. (Additional research here and here.)

Vitamin B12 plays a role in energy generation and metabolism, methylation (a process by which we control the expression of our genes and transform compounds), maintaining normal blood counts, maintenance of nerve cells, and synthesis of DNA. Symptoms of B12 deficiency include anemia, fatigue, memory loss, depression, dementia, numbness, and tingling.

There is also evidence that chlorpropamide, another medication used for metabolic disorders, depletes CoQ10, an antioxidant that plays a role in metabolism and energy generation and the regulation of inflammatory genes. Deficiency in CoQ10 can lead to coordination and balance problems, seizures, muscle problems, and vision loss, among other serious issues. Deficiency can also be caused by mutations in a set of genes involved in the production of CoQ10. 

How to Optimize Micronutrient Status

Maintaining adequate micronutrient levels is critical for feeling and performing your best every day. Personal micronutrient levels are dynamic and can be optimized over time. A diet of nutrient-rich, organic whole foods will give you a strong foundation for micronutrients. Sometimes supplementation may also be helpful for optimizing specific nutrient levels.

Improving metabolic health can also play a role in optimizing your micronutrient levels and in avoiding precursors to additional health conditions beyond diabetes. Measuring and understanding personal responses to diet as well as accessing personal data on micronutrient status and requirements is also helpful in maintaining cellular health through optimal nutrition.


This article was created in partnership with RootineRootine makes it simple to optimize cellular nutrition. Rootine uses in-home testing and technology to empower individuals to access data related to personal micronutrient requirements, creates a precision-dosed daily micronutrient pack to optimize levels, and provides digital tools to track health progress over time.

Rootine unlocks better health and daily performance with precision nutrition. Rootine’s first product focuses on optimizing cellular nutrition through a precision-personalized daily micronutrient membership and a unique digital experience where members can track and improve health. Rootine is differentiated in its test-take-track process, unmatched data and insights, and unique delivery in the form of microbeads. Rootine is helping thousands of members improve their health, from professional athletes like Brian Burns to high-growth startup founders.