Top Micronutrient Imbalances That Can Cause Diarrhea

In America, 6.6% of adults experience chronic diarrhea. Although there are many underlying causes of diarrhea, micronutrient imbalances are one of the lesser-known factors. This article will discuss how micronutrient imbalances can be associated with diarrhea. Functional medicine may help identify micronutrient imbalances, assess the function and overall health of the gut, and create a plan of action to address these imbalances and support gut health.

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What is Diarrhea?

Diarrhea is characterized by loose, watery, frequent stools. Accompanying symptoms may include bloating, cramping, nausea, vomiting, urgency, blood and mucus in the stool, and more. Chronic diarrhea can be associated with irritable bowel syndrome (IBS), Celiac disease, and inflammatory bowel diseases (IBD), including Crohn's disease and Ulcerative Colitis. Additionally, micronutrient imbalances may also be linked to diarrhea.

What are Micronutrients?

Micronutrients are vitamins and minerals essential to bodily functions. These nutrients are often required in small amounts and can be obtained through the diet. However, poor diet habits, poor gut health, and supplementation can lead to both high and low levels of micronutrients. Micronutrients are required for cellular functions, including growth and repair, energy production, metabolism, and more. Micronutrients include fat-soluble vitamins, water-soluble vitamins, trace minerals, and macrominerals.

Which Micronutrient Imbalances Are Associated With Diarrhea?

Both high and low levels of micronutrients can be linked to diarrhea. The following micronutrients may be associated with diarrhea when in excessive amounts:

Magnesium

Magnesium is a mineral used in over 300 reactions in the body. Needed for detoxification, energy production, nerve signaling, and DNA and RNA formation, magnesium plays a role in many key processes. Because of this, magnesium can affect blood pressure, blood sugar, muscular contraction, and more. High doses of magnesium can lead to diarrhea, as excess magnesium that is not absorbed may pull water into the intestines while also increasing gastric motility. Magnesium, in the form of magnesium citrate, is likely to have this effect and is often used in colonoscopy preparation when the entire colon must be flushed out. Magnesium carbonate, chloride, gluconate, and oxide are also likely to have GI effects.

Vitamin C

Vitamin C is essential for immune function, creating neurotransmitters, collagen, and l-carnitine, an amino acid. Vitamin C is also a potent antioxidant. Excess vitamin C may cause water to pool into the intestines, potentially leading to diarrhea and cramping.

Zinc

Zinc is a mineral required to activate hundreds of enzymes while also necessary for DNA synthesis and more. Zinc can support cognitive, immune, endocrine, optical, and inflammatory functions. High zinc levels, often due to over-supplementation, may increase gastric motility while also causing water to move into the intestine.  

The following micronutrients may be associated with diarrhea when in low amounts:

Zinc

In addition to excessive zinc levels potentially causing diarrhea, low zinc levels may also be linked to the same. Zinc plays a central role in the integrity of the GI mucosa, and if levels are low, it can lead to impaired functioning and inflammation, potentially causing diarrhea. Zinc deficiency-induced diarrhea is most commonly seen in malnourished children.

Niacin/B3

Niacin is a B vitamin used by every single cell in the body. It is required for most metabolic processes and is involved in creating the body's primary energy source, ATP. Niacin is also essential for antioxidant functioning and the creation of cholesterol and fatty acids in the body. A condition known as pellagra occurs in the presence of a niacin deficiency. In addition to severe skin and cognitive changes, diarrhea is also common. Lack of niacin depletes the mucosal lining of the GI, which may result in diarrhea.

Vitamin B12

Vitamin B12 is required for red blood cell formation, DNA synthesis, and nervous system functioning. A common repercussion of B12 deficiency is anemia, as a lack of red blood cells inhibits oxygen circulation. Lack of oxygen to the tissues of the GI tract, as seen in anemias, may be associated with diarrhea.

Functional Medicine Labs to Test for Micronutrient Imbalances In Relation to Diarrhea

Micronutrient Testing

Micronutrient tests, such as the Micronutrient panel by Spectracell Laboratories, show numerous vitamins and mineral levels in one test. This test may reveal both deficiencies and excessive values of vitamins and minerals. When assessing micronutrient results, care should be taken to evaluate patterns of deficiencies that may indicate a certain food or food group is missing. Alternatively, high levels of certain nutrients may indicate overuse of a certain combination supplement.

Comprehensive GI Test

If micronutrient imbalances are suspected, it's always a good idea to check the GI tract, as systemic levels of micronutrients depend on a healthy functioning GI tract. Comprehensive GI testing, such as the GI Effects Comprehensive Profile by Genova Diagnostics, may assess the functions of the GI tract, including digestion and absorption, permeability markers, inflammatory markers, and the microbiome.

Markers of digestion and absorption include enzymes released by the pancreas, stomach, and liver that aid in the breakdown of food. Increased permeability markers may signify dysfunction in the absorption of food products, including micronutrients. Inflammatory markers can indicate damage within the tissues of the GI, potentially leading to dysfunction. Lastly, the microbiome is a collection of microbes that live within the large intestine. These microbes aid in digestion and absorption, synthesis of vitamins, immune function, neurotransmitter synthesis, and more. All of these steps of GI functioning may influence the number of circulating micronutrients.

Integrative Medicine Approaches for Diarrhea Due to Micronutrient Imbalances

Assessing both micronutrient test results as well as comprehensive stool results may allow for the creation of a personalized plan to support gut health.

Diet for Diarrhea

Implementing a whole foods-based diet, such as the Mediterranean Diet, can be a great place to start when looking to avoid micronutrient imbalances. The Mediterranean Diet consists of fresh vegetables, fruits, nuts, seeds, healthy fats, and unprocessed whole grains. This way of eating also encourages local and seasonal foods, as these foods tend to have a higher nutrient content. The Mediterranean Diet has been shown to be beneficial for cardiovascular health, cognitive functioning, blood sugar balancing, and more.

Hydration for Diarrhea

Drinking plenty of liquids is essential when experiencing diarrhea since diarrhea causes increased loss of fluids. Chronic loss of fluids can lead to dehydration, which in turn may cause fatigue, headaches, muscle cramps, and the opposite of diarrhea, constipation, amongst other things.

Gut Health for Diarrhea

Results of comprehensive gut tests can help pinpoint where micronutrient imbalances may stem from. Supporting the function of the GI tract may help prevent further micronutrient imbalances and manage diarrhea associated with them.

Assist Digestion and Absorption

Digestive enzymes are naturally made by the stomach, liver, and pancreas and function to break food down into absorbable particles. Comprehensive GI testing may reveal low levels of one or more digestive enzymes, inhibiting proper breakdown. Digestive enzyme supplements can serve as replacements for deficient or missing enzymes and may also support more natural production of enzymes.

Support Permeability

Zinc carnosine is a supplement that combines the mineral zinc with the antioxidant carnosine. The combination of the two may aid in supporting the mucosal lining in the GI tract and specifically tighten the junctions between cells, thereby supporting healthy permeability.

Support Inflammation Management

Phosphatidylcholine may support inflammation management in the GI tract. Phosphatidylcholine is actually a component of the mucosa within the GI tract. A defective phosphatidylcholine layer can be associated with inflammation, and increasing phosphatidylcholine may have a supportive effect. Phosphatidylcholine supplementation has been studied in those with Crohn's Disease, an inflammatory bowel condition. Phosphatidylcholine was shown to aid in the discontinuation of anti-inflammatory steroids.

Microbiome Support

Prebiotics and probiotics can be beneficial for the microbiome. Prebiotics serve as food for the microbes within the GI and have been shown to increase the number of beneficial microbes. Probiotics are actual strains of microbes taken in pill form. Similarly to prebiotics, probiotics also can increase the number of beneficial microbes. Prebiotics and probiotics may positively affect digestion and absorption, support healthy permeability, and modulate inflammation. Thus, these supplements may aid in the prevention of micronutrient deficiencies associated with diarrhea and may also have a supportive effect on managing diarrhea.

Summary

Diarrhea is a bothersome condition that includes an increased frequency of loose, watery stools. Both high and low levels of certain micronutrients may be associated with diarrhea, and thus, micronutrient testing can be a valuable tool when investigating potential factors contributing to diarrhea. Additionally, comprehensive GI testing may help identify potential root causes of micronutrient imbalances, as GI health directly influences circulating levels of micronutrients. Results of micronutrient and comprehensive GI tests can help create a targeted plan to support gut health and manage micronutrient imbalances associated with diarrhea.