Essential vitamins and minerals to fight fatigue (part 4)

Boost your vitamins and minerals

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Finally we move to the last point:
  1. Stabilising your blood sugars
  2. Ensuring you drink enough
  3. Ensuring you get the right vitamins, minerals and essential nutrients
According to The National Institute for Health and Care Excellence (NICE), there is insufficient evidence for the use of supplements to help with chronic fatigue syndrome (CFS). Multivitamins and minerals are not prescribed to treat the symptoms of this condition but some people with chronic fatigue have reported finding them helpful as a part of a self-management strategy (1.4.7 NICE, 2007). Vitamins and minerals that may be effective include Vitamin B12, C, and Magnesium. The MS Trust suggest Vitamin D may also be beneficial for fatigue associated with MS.
I will be highlighting the foods that are rich in these nutrients but it is also worth considering that some people may need supplements because they have a restricted dietary intake or because nutritional deficiencies have been identified. NICE also advise people with CFS (and this is true for anybody else too) who are using supplements, not to exceed recommended safe levels.

Vitamin B12

Performing several important functions in the body, B12 has a particular role in energy production. A deficiency can often be associated with fatigue so boost your intake with these foods –

Choose meat, fish, cheese, milk and other dairy products, eggs, yeast extract (marmite) and fortified breakfast cereals (that have added vitamins).

As you can see these foods are pretty much all from animals. Vegans and some vegetarians are at greater risk of B12 deficiency because they are unlikely to consume enough through diet alone due to the exclusion of some or all animal products.  This is a good example when a B12 supplement may be beneficial.

The vegan society recommend looking for plant milks, yoghurts, breakfast cereals, spreads, yeast extracts and nutritional yeast products that are fortified with vitamin B12.

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Vitamin C

This is great antioxidant. It helps protect our cells and is vital to the healing process in the body. Another benefit is that it also helps the absorption of iron which like vitamin B12 is also essential for energy processes (iron helps deliver oxygen to the body’s cells and tissues). We need Vitamin C all year round so choose the following foods when they are in season –

Good sources of Vitamin C include fresh fruits (especially citrus), blueberries, strawberries, blackberries and raspberries. Go for peppers, green veg, new potatoes and tomatoes too.



Needed for nerve and muscle function (amongst other roles in the body), Magnesium is required for body movements. Deficiency is rare (because it is found in most foods) but low levels are seen in unwell people.

Magnesium is found in all green plants so ensure you include dark green leafy veg (broccoli, brussels sprouts, green cabbage & watercress) in your diet.

Other good sources include  meat and dairy, fish, wholegrains (oats, bran, bread & cereals), fruit (banana, kiwi, blackberries, strawberries, oranges, raisins) and nuts.


Vitamin D

Vitamin D is unlike other vitamins because of also has the ability to work like a hormone and as we are realising, has many different roles within the body.  It has long been associated with bone health (it helps get Calcium into out bones to make them stronger) but more recently we have discovered many other roles within the body. There is much interest and research into the role of vitamin D in MS.

The 2 questions are

  • 1) whether a lack of vitamin D increases the risk of developing MS
  • 2) whether low levels of vitamin D affect the number of relapses

Although  we don’t exactly know HOW Vitamin D might affect MS, evidence is growing that seems to link the amount of sunlight exposure to it.

Our body can make vitamin D and we use sunlight to do this (uv rays). This is why Vitamin D is often called the sunshine vitamin. In the UK uv light is only strong enough to make vitamin D in the spring & summer months (April to September). To help us make enough, we need to expose the skin on our hands, face and arms or legs between the hours of 11am – 3pm.  The problem in the UK is that we have more of an indoor lifestyle, we plaster on the high factor sun-cream when we do go out (for good reason too!) and for the remaining 6 months of the year, the uv simply isn’t strong enough for us to make enough of the vitamin ourselves.

Therefore we need to rely more heavily on foods that contain it.

Good sources of vitamin D are oily fish (salmon, sardines, pilchards & mackerel). If you tend to give fish a miss, try something different! There are some nice healthy fish recipes here and here!

Eggs, meat and milk contain quite small amounts which may well vary during the seasons so they are not necessarily reliable sources. Margarine, some breakfast cereals and yoghurts (that have added or are ‘fortified’ with vitamin D can be useful too so ensure you have some of these in your shopping basket.


Linoleic Acid

Pronounced ‘Lin-o-lay-ic‘, this is what we call an essential (omega-6) fatty acid. ‘Essential‘ comes from the fact that the body does not have the ability to make them, so it MUST be supplied in the diet.  The oil from nuts and seeds are excellent sources of this important nutrient, particularly sunflower and soya bean oils, corn seeds or walnuts.

There has been quite a bit of research into Linoleic acid and it’s ability to help with MS, some of it of questionable quality. The NICE Guideline for the Clinical Management of MS is due for an update in October of this year so we are yet to see if their recommendation will change but at the moment they “recommend linoleic acid for people with relapsing remitting MS as a treatment that may help to slow the disabling effects of MS“.

As with any of the vitamins or minerals mentioned above, natural food sources are often cheaper than supplements and are often absorbed better by the body.

Foods that contain seed or nut oils can be valuable additions to our diet.  As with all oils, we need to use them sparingly because they are all high in Calories but they are a much healthier alternative to saturated fats (that are linked to heart disease). Linoleic is viewed as a ‘healthy’ fat as evidence shows it can help protect the heart so choose these:

  • Sunflower margarine (not lighter versions or those low in fat / fat reduced – there will be much less linoleic acid).
  • Mayonnaise (again, not the reduced fat versions)
  • Peanut better, almond butter etc
  • Sesame oil
  • Sunflower oil
  • Walnut oil
  • Walnuts, Brazil nuts, sesame, sunflower, peanuts, almonds, pumpkin or poppy seeds

20-30g of nuts with a couple of teaspoons of margarine, mayo or oil each day will help you on your way to getting what your body needs.

Linoleic acid is  heat and light sensitive so when using spreads or oils, do not heat them. Instead use them cold in salad dressings, or spread onto bread. Store them in a cupboard (not next to the oven or microwave) where it will be cool and dark. Add nuts and seeds to your breakfast cereal or yoghurts as well as just eating them on their own.

For additional reading, The British Dietetic Association have a nutrition fact sheets here on chronic fatigue and on rheumatoid arthritis here . The diet fact sheet from the MS trust can be found here.

I hope you have found this series of posts useful.  I really welcome any feedback / thoughts so please comment away and I will happily reply 🙂