Symptom Surveys

Another approach that can help determine the potential need for a dietary supplement, and one used throughout The Big Book of Endurance Training and Racing, is the use of a survey. In this instance, it’s a group of questions based not on nutrient levels in the body or in the food you eat but on certain signs and symptoms associated with a low level of a particular nutrient. For example, fatigue, excess blood loss, and the habit of chewing on ice may be associated with the need for iron, a micronutrient. Sleepiness after meals, intestinal bloating, and frequent hunger and craving for sweets may be associated with excess intake of carbohydrates, a macronutrient. Symptom surveys are based on commonly defined changes in the body when particular nutrients levels are low.

Here is an example of an actual survey I’ve used in private practice. Use it and see which items apply to you:

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  1. History or risk of heart disease
  2. History or risk of Alzheimer’s disease or other reduced mental capacity
  3. Female (childbearing age)
  4. Outdoors often in sun or use tanning salons
  5. Live in Southern climate (below San Francisco or Washington, D.C.)
  6. Over age fifty
  7. History of anemia or other red blood cell problem
  8. Feelings of depression
  9. History of taking doses of vitamin C above 500 mg
  10. Reduced intake of meat, fish, and eggs
  11. Increased caffeine intake (coffee, tea, soda—more than three per day)
  12. Increased alcohol intake (more than two drinks per day)

If you check even one or two questions, it could indicate a need for more vitamin B12 and/or folic acid, with the likelihood increasing significantly as you get past two checked items. The necessary dose can not be determined from a survey as other follow-up tests as noted above may be necessary; dosing is very individual. While most vitamin B12 and folic acid in dietary supplements are synthetic, natural forms are available (and are discussed later).