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5 Warning Signs You May Have a Nutrition Deficiency

Plus, how to prevent and treat low levels of vitamins, minerals


spinner image blood sample one is order for vitamin deficiency test another is mineral deficiency
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​​​​​ Are you getting enough essential vitamins and minerals?

Research shows it’s a common concern among older adults in the U.S. — the majority of people 55 and older say they use dietary supplements — and for good reason. When our bodies lack essential vitamins and minerals, physical symptoms such as fatigue and muscle aches can ensue. Nutrient deficiencies have also been linked to chronic diseases, like diabetes and osteoporosis.

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Different deficiencies can cause different symptoms. To shed light on some of the warning signs, we spoke with Sameera Talegawkar, an associate professor of exercise and nutrition sciences at George Washington University in Washington, D.C.

How to detect a deficiency

Keep in mind, the only way to know if you have a nutrient deficiency is by scheduling a doctor's visit, which may include blood tests to assess your vitamin and mineral levels. 

Know that diagnosing deficiencies in older age can present greater complexities due to the presence of chronic diseases and the use of medications. Your doctor must carefully consider these factors and their potential impact on nutrient absorption.​ ​“Each nutrient has a physiological function in the body. So, if you have a deficiency, there’s going to be a consequence,” said Talegawkar. “It is important for a physician to take a look at what medications and what health conditions are present before you can diagnose. Some medications might have side effects, which could therefore cause a nutrient deficiency.”​

Be sure to speak to a health care provider if you experience any of the following symptoms. ​​

1. Fatigue, bone pain, muscle weakness

​Feeling tired? Experiencing bone pain? Having muscle weakness? It could be a sign that you're lacking vitamin D. 

This vitamin is important for bone health along with the health of your nervous, musculoskeletal and immune systems.​ ​

Older adults are at higher risk for being D deficient. So are people with darker skin and those who live in areas with limited sunlight. ​ ​

Other symptoms of low vitamin D levels include muscle spasms, cramps, tingling sensations, voice box spasms and changes in personality.​ ​

Where to find vitamin D: You can find vitamin D in foods like fatty fish (salmon, mackerel), fish liver oils, fortified dairy products, orange juice, soy milk, breakfast cereals, eggs from hens fed vitamin D and mushrooms exposed to sunlight or UV light.​ ​

2. Tiredness, weakness, pale skin

​ ​If you’re feeling tired or weak and notice that your skin is pale, it could be a sign of low vitamin B12 levels, a necessary element for nerve and blood health. Other signs that you need more B12 can be weight loss, reduced appetite, numbness and tingling in extremities, confusion and poor memory. ​​ ​

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Since our bodies can't produce B12 naturally, we need to get it from certain foods and drinks. However, the aging process makes it more difficult to absorb vitamin B12 from food. And if you're using stomach acid blockers, it can make the absorption process even harder. ​ 

Where to find B12: To get enough vitamin B12, you can turn to animal products like red meat, poultry, shellfish, dairy and eggs. But if you follow a vegetarian or vegan lifestyle, it's important to consider supplements or fortified foods to make sure you're getting the right amount, said Talegawkar.​ ​

3. High blood pressure, kidney stones

​If you're dealing with high blood pressure or kidney stones, or are experiencing less obvious symptoms like bone turnover and urinary calcium excretion (which includes symptoms such as lower abdominal pain, blood in urine, frequent urination, pain while urinating, and cloudy or foul-smelling urine), it might be a sign of a potassium deficiency.​

​Potassium is an electrolyte that plays a vital role in keeping our muscles, nerves and heart functioning properly. It is also necessary for healthy digestion and maintaining strong bones. Having extremely low levels of potassium, also known as hypokalemia, can be a serious issue and can even result in paralysis. Milder cases of hypokalemia can cause fatigue, muscle weakness and constipation.​ ​

Older adults should be aware that a potassium deficiency can be caused by using diuretic medications or excessive use of laxatives, among other medications, said Talegawkar.​ 

Where to find potassium: Fruits and vegetables are excellent sources of potassium, followed by nuts, seeds and dairy products.​

4. Shortness of breath, fatigue, cold hands and feet

​Feeling tired, having a fast heartbeat, experiencing heart palpitations, struggling to concentrate and having trouble regulating body temperature are all signs of anemia, meaning there is not enough iron in the blood. Other symptoms may include pale skin, a sore or swollen tongue, and nails that are shaped like spoons.​ ​

When your body doesn't have enough iron to produce hemoglobin, a substance found in red blood cells that transports oxygen throughout your body, it can leave you feeling extremely tired and weak.​ ​

While an iron deficiency is most prevalent in young children, women under 50 and pregnant women, older adults can have low iron levels if they aren’t eating enough foods that contain iron.​ ​

Where to find iron: Try to incorporate animal-based foods like meat, poultry and seafood or plant-based foods such as leafy greens, whole grains, legumes, nuts and seeds. ​ ​

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5. Muscle cramps, dry skin, brittle nails

​ ​Muscle cramps, dry skin and brittle nails can be signs of low level of calcium. Ignoring this issue can lead to neurological problems, and severe cases may cause seizures, abnormal heart rhythms and congestive heart failure. That's because calcium in your blood plays a crucial role in nerve function, muscle movement, blood clotting and heart health.​ ​

Low calcium may lead to a condition called hypocalcemia. This typically happens when there are abnormal levels of parathyroid hormone (PTH) or insufficient vitamin D. If you don't get enough calcium in your diet, your body can even start to take calcium from your bones, which can weaken them and lead to osteoporosis.​ ​ ​

Where to find calcium: To increase your calcium intake, include foods like dairy products, calcium-fortified orange juice, leafy greens, black beans, almonds, sesame seeds and chia seeds in your diet.​ ​

Preventing and correcting nutrition deficiencies in older adults ​ ​

Eating a healthy diet packed with essential nutrients is the best way to prevent and treat nutrition deficiencies. The Dietary Guidelines for Americans recommends to:​

  • Personalize your food choices: Tailor your meals to your preferences, cultural traditions and budget.​
  • Prioritize nutrient-rich foods: Select a variety of foods from different groups that give you the nutrients you need while staying within your calorie limit.​
  • Limit unhealthy foods: Cut back on foods and drinks high in added sugars, saturated fat, sodium and alcohol.​

While a healthy diet is important, some older adults may need supplements to meet their nutrient requirements. Before taking any supplements, it's crucial to talk to a doctor or registered dietitian who can evaluate your medical history, current prescriptions and possible medication interactions. Common supplements for older adults include calcium, vitamin D and vitamin B12, said Talegawkar.​​

In severe cases, older adults with nutrition deficiencies may require nonfood-based treatments with the help of a doctor or registered dietitian. They may involve therapeutic nutrition products, supplements, injections or infusions of micronutrients, or tube or intravenous feeding.​ ​

It's never too late to prioritize your nutritional well-being. Taking a proactive approach to your diet and seeking proper medical guidance to ensure you're getting the nutrients you need can help you minimize your risk of nutrition deficiencies and maintain your health and vitality as you age, said Talegawkar.​ ​

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