How the Body Prioritizes Micronutrients During Shortfalls
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In this clip from Dr. Rhonda Patrick's appearance on Mayim Bialik's Breakdown, she explains why nutrient intake can be inadequate long before a classic deficiency disease appears. National survey analyses estimated that roughly 38% to 47% of Americans consumed less vitamin C than the Estimated Average Requirement across 1999–2018, while an earlier biomarker survey found clinical vitamin C deficiency in about 7%. Those are different thresholds and should not be treated as the same diagnosis. [1] [2]
Choline and vitamin E show a similar distinction between intake targets and clinical deficiency. In one US analysis, only 10.8% of people met the adequate intake for choline. A young-adult biomarker study found that 87% had serum alpha-tocopherol below a proposed adequacy threshold, but only 1% met its clinical-deficiency definition. These findings support attention to diet quality without implying that nearly everyone has overt disease. [3] [4]
Vitamin K supports normal coagulation and proteins involved in bone and vascular biology. Survey data found that 43% of men and 62.5% of women met the adequate-intake target, leaving many below it. The practical framework is to identify recurring dietary gaps, prioritize nutrient-dense foods, and use supplements when intake, laboratory data, life stage, or clinical guidance supports them. [5]
The nutrient-triage hypothesis proposes that when supply is limited, the body preserves functions needed for immediate survival—such as energy production and clotting—before spending the same nutrients on long-term maintenance. Less visible work can include DNA repair, antioxidant defense, methylation, membrane integrity, and bone or vascular protein activation. The hypothesis is that small shortfalls can permit cumulative damage over years; it does not show that one low intake measurement directly accelerates aging or that supplements reverse aging.
This clip is excerpted, with permission, from Dr. Rhonda Patrick's appearance on Mayim Bialik's Breakdown. Thank you to Mayim Bialik's Breakdown for allowing us to share it.
- ^ Sun, Hongbing; Karp, Jonathan; Sun, Kevin M.; Weaver, Connie M. (2022). Decreasing Vitamin C Intake, Low Serum Vitamin C Level And Risk For US Adults With Diabetes Nutrients 14, 19.
- ^ Schleicher RL; Carroll MD; Ford ES; Lacher DA (2009). Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES). Am J Clin Nutr 90, 5.
- ^ Wallace TC; Fulgoni VL 3rd (2016). Assessment of Total Choline Intakes in the United States. J Am Coll Nutr 35, 2.
- ^ Mcburney, Michael I.; Yu, Elaine; Ciappio, Eric D.; Bird, Julia; Eggersdorfer, Manfred; Mehta, Saurabh (2015). Suboptimal Serum α-Tocopherol Concentrations Observed Among Younger Adults And Those Depending Exclusively Upon Food Sources, NHANES 2003-20061-3 Plos One 10, 8.
- ^ Harshman, Stephanie G; Finnan, Emily G; Barger, Kathryn J; Bailey, Regan L; Haytowitz, David B; Gilhooly, Cheryl H, et al. (2017). Vegetables And Mixed Dishes Are Top Contributors To Phylloquinone Intake In US Adults: Data From The 2011-2012 NHANES The Journal Of Nutrition 147, 7.
Dr. Rhonda Patrick: I think people aren't thinking about, when they think about disease risk, they think about like what's happening right now, right? Like, so I talked about micronutrients, and these are, you know, 30 to 40 essential vitamins and minerals that we have to get from our diet. We can't make them, we need to get them. And when you think about a deficiency in one of them, for example, you know, vitamin C comes to mind, because this is one people think about, scurvy, right? You don't look in the mirror and say, well, I don't have scurvy, therefore I'm getting enough vitamin C, right?
Mayim Bialik: That's exactly what I do, actually. Right? I mean, I'm like, every morning I'm like, scurvy? No, good.
Dr. Rhonda Patrick: But what you don't realize is, is that, well, there's subclinical deficiencies. In fact, like 40% of people aren't getting enough vitamin C, believe it or not, and the requirements aren't even that high. And so, what happens is wound healing is not as well. So, you're not gonna like, your wounds aren't gonna heal as good. Your immune system isn't gonna be quite up to snuff, so you're gonna be getting sick more. So, things like that collagen production, it's gonna affect your blood vessels, they're gonna be, stiffer and weaker, and that sort of insidious type of damage accumulates with age and leads to age-related diseases. So you're exactly right, and I gave vitamin C, but that's not the best example because—
Mayim Bialik: Yeah, give us another one.
Dr. Rhonda Patrick: Yeah, there's examples where people are not, I mean, 90% of people aren't getting enough choline from their diet.
Mayim Bialik: What's choline?
Dr. Rhonda Patrick: Choline is a really important nutrient that is abundant in egg yolk. It's abundant in egg yolk. It's also in vegetables. You have to eat, you can eat soybeans or chickpeas as well, but you have to eat a lot of them. or you have to supplement. And choline, the reason it's so important, and I said 90% of the population's not getting an adequate intake of it, the reason for that is because they're not really eating enough eggs or, you know, the vegetables that have choline in it. And choline is, first of all, it's a precursor for acetylcholine, which is an important neurotransmitter. It's also important to make phosphatidylcholine, which is important for all our cells, including neurons and neurotransmission. But maybe even more important, it plays a very important role in what's called this methyl metabolism in our body and methylation. You hear a lot about that. Well, I'll just save going into the weeds for another episode, but essentially what happens is something called homocysteine in our body doesn't get reconverted into methionine, and so we end up having high homocysteine. You may have heard of this. High homocysteine dramatically increases atherosclerosis risk, cardiovascular disease risk, also dementia, and Alzheimer's disease, and that's just if you have a little bit less choline than you're supposed to have. This isn't like a clinical deficiency. When you start to have a clinical deficiency, you start to get fatty liver, non-alcoholic fatty liver. So, 90% of people are walking around and they probably have high homocysteine, and it's not something that's routinely measured. You go to your physician and you get like a, you know, a standard test.
Mayim Bialik: Mm-hmm.
Dr. Rhonda Patrick: They're not measuring for homocysteine usually. You have to like ask for it, or you have to have a really good doctor. that's looking into that, and it's really important because it does biomark your cardiovascular disease risk and your Alzheimer's disease risk, and there's a simple solution. You can, you know, eat your eggs. About 3 eggs a day is enough to get women to their choline.
Mayim Bialik: There's a shortage, you know.
Dr. Rhonda Patrick: There's a shortage in eggs? Yeah. Or you can supplement, is the other option as well. So phosphatidylcholine from lecithin is another option. So choline is very important also for, the way our brain is functioning, and brain development, even. In fact, there's been studies showing that pregnant women, there was a randomized controlled trial showing pregnant women, even those meeting the RDA, which is around 500, they were giving a little over that, so about 500 milligrams a day, their children did good, but when they doubled that to about 900 a day, those women had children that had dramatically better IQ tests, they scored better on cognitive function, so— Choline plays a very important role in brain development and brain function as well, and that's just one example. There's also another one that's very common is vitamin E, believe it or not,
Mayim Bialik: and you might be going, vitamin E? It's the one you put on scars to make scars go away.
Dr. Rhonda Patrick: Right, vitamin E, that's like, you know, why is, seriously, like 87% of the population's not getting enough vitamin E from their diet? If you consider supplementation, 60% is not getting enough. So even after supplementation, people are not getting enough vitamin E.
Mayim Bialik: What's with vitamin E?
Dr. Rhonda Patrick: So there's different forms of vitamin E. There's the tocotrienols and the tocopherols. We're just gonna focus on one, and that is the essential one that you need. That's alpha-tocopherol. That's the main form of vitamin E, and why do you need vitamin E? Well, if you don't get vitamin E, what ends up happening is a disease that's acute, and that's the kind of stuff you're talking about. You don't really see every day, so you don't really, you think you're fine until you keep going along, and then all of a sudden, boom, you have it, you have, atherosclerosis or whatever. So, with vitamin E, the disease is you get, it's called hemolytic anemia. So, your red blood cells start to just burst because of oxidative stress. Vitamin E is a very potent antioxidant. It's found in, it's able to go, it's fat soluble, so it's able to go into the membranes of cells and do its antioxidant thing. But most people are not walking around with that severe form. Some people are, but the subclinical deficiency of it is you end up having oxidized LDL. cholesterol. A lot of people have heard of LDL cholesterol. Oh, that increases my cardiovascular disease risk. But what people don't understand is the oxidized form of it is really bad. And so, a lot of people are walking around with oxidized LDL because they're not meeting their vitamin E requirement. And what that does is it essentially tells your immune system, inflammation, inflammation. Immune system comes and tries to attack the oxidized LDL, and then you have a form— formation of a foam cell. So you're getting the beginnings of atherosclerosis, essentially.
Mayim Bialik: Can you give us a general framework of how we should be looking at and thinking about the human body as, you know, kind of a mechanistic conglomeration?
Dr. Rhonda Patrick: Gosh, if I could just pull up this one figure, it's— if you Google biochemical pathways and you look at image, there's, like, this image of— it's just— it's overwhelming how many pathways are in this image, and it's true. I mean, it's just thousands and thousands of reactions going on, and these reactions require not only energy, we think about getting energy in the form of glucose or fatty acids, they require these vitamins and minerals as cofactors to do things so that they're able to do them. And so, if you don't have those cofactors, it's like you have this orchestra ready to play, but there's no conductor there telling you how to play it or when to do it. this instrument's gonna play that piece, and this one's gonna play that, right? So, it's kind of all out of sync.
Mayim Bialik: Mm-hmm.
Dr. Rhonda Patrick: And with the micronutrients, I mean, it's so easy to forget about them, 'cause we're so focused on, oh, I shouldn't eat processed foods. Oh, I'm so worried about my glucose spiking. How much protein did I get today? And protein is important, but if you think about food, looking at your plate and going, okay, what is in this food? Okay, I talked about eggs having choline, and then, Broccoli, soybeans, chickpeas also having choline. Vitamin E, why aren't people getting vitamin E? Well, the main source of it is nuts and seeds, and people aren't eating nuts and seeds. It's just not part of our diet anymore, and if you're not eating nuts and seeds, you're not going to be getting enough vitamin E, and so what do you have to do? Okay, well, eat an ounce or 2 of almonds. You eat an ounce of almonds, that's like 25 almonds or so. That's half of the RDA, half right there.
Mayim Bialik: Wow.
Dr. Rhonda Patrick: So, you know, you're good, 'cause then you can get the rest from maybe a multivitamin supplement. Vitamin K is another one. I mean, this one is also 50% of the population, even after supplementation.
Mayim Bialik: What is vitamin K?
Dr. Rhonda Patrick: Vitamin K, vitamin K is interesting because it's actually required by plants to undergo photosynthesis. So, plants are a really good source of vitamin K, and there's 2 types of vitamin K, K1 and K2. is the vitamin K1. It's called phylloquinone, and that is the actual form of vitamin K that is required, that you need. Vitamin K2 is found in some fermented foods. Natto, like fermented soybeans, are a really good source of it. You can also find it in some dairy as well, but vitamin K2 isn't as essential because vitamin K1 can do all the functions that K2 does, and the reason people aren't meeting their vitamin K requirements is because they're not eating enough greens. They're not eating enough plants. And vitamin K is a cofactor
Mayim Bialik: Uh-huh.
Dr. Rhonda Patrick: I was talking about a cofactor. You know, it's required for an enzyme to work properly, and it's a— it does 3 really important functions. One, it goes to the liver and it regulates blood clotting, so coagulation, and that's the most essential one. When your vitamin K is really, really low, you have blood clotting problems where you're not able to clot. Very, very important. Number 2, it also activates proteins that are not in your liver, but they're sort of in the periphery. that shuttle calcium out of your blood vessels and bring it to your muscle and your bones, and that's really important because calcium precipitates easily, very easily, and so you wanna get the calcium out of your vascular system and bring 'em to other tissues where it's required and needed. That's number 2, and number 3, it also activates another protein called osteocalcin, which is important for bone, rebuilding your bone and making sure bone mineral density doesn't drop too low. And so vitamin K does all those things, and if you think about it, back to this, I keep going back to this, you know, this image that you gave of yourself going through life, and like not realizing anything's wrong until you have the heart attack or whatever, you know, something happens. And it's so true, because we think about these vitamins and minerals, it's like, well, if something isn't going wrong, then I must be fine, right? Oh, my blood's clotting, I've got enough vitamin K. Well, this is something that was proposed by my mentor, Dr. Bruce Ames, and he basically proposed that these vitamins and minerals are essentially longevity vitamins. They're not just required for the short-term prevention of death, which is essentially what all the RDAs are established for. RDAs are established for, okay, what happens? Oh, there's this disease that causes death. Let's go a little couple standard deviations above that, and that's the RDA, right?
Mayim Bialik: Yeah.
Dr. Rhonda Patrick: Well, he, what he proposes, actually, there's all these other functions of these vitamins and minerals that are involved in this insidious type of damage that accumulates over time, year after year, decade after decade. You don't see it, you don't look in the mirror. I mean, your gums aren't bleeding and falling off like scurvy. right? You can't see the oxidation of your LDL. You can't see that—
Mayim Bialik: You flatter me.
Dr. Rhonda Patrick: Right? You're not— you're not visually seeing it, so it's not happening, therefore it's not happening, right? But it is happening silently and insidiously. And so, what happens when you're with the vitamin K? Well, if you, you know, year after year keep not getting enough vitamin K, you're going to have calcium buildup in your arteries. That's a known thing that is involved in atherosclerosis, right?
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Micronutrients News
- Vitamin D, iron, and protein may improve hair growth and thickness while sugar-sweetened beverages and alcohol may worsen hair loss.
- Copper-rich diets can boost cognitive performance by up to 25% in older adults.
- Regular intake of vitamin K1, found in leafy greens and plant oils, reduces risk of atherosclerotic disease-related events by 29% and related deaths by 43% among older women.
- Nearly half of people with type 2 diabetes have multiple micronutrient deficiencies—the most common being vitamin D.
- Lower levels of active B12 linked to slower visual processing and cognitive decline, suggesting current guidelines may not adequately ensure brain health.
