In America, 6.6% of adults suffer from chronic diarrhea. Although there are many underlying causes of diarrhea, micronutrient imbalances are one of the lesser-known causes. This article will discuss how micronutrient imbalances can cause diarrhea. Functional medicine can help identify micronutrient imbalances, thoroughly assess the function and overall health of the gut, and create a plan of action to resolve the imbalances and dysfunction.

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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 caused by irritable bowel syndrome (IBS), Celiac disease, and inflammatory bowel diseases (IBD), including Crohn’s disease and Ulcerative Colitis. Additionally, micronutrient imbalances can also cause 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 cause diarrhea. The following micronutrients can cause 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 will 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 will cause water to pool into the intestines, causing diarrhea and cramping.

Zinc

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

The following micronutrients can cause diarrhea when in low amounts:

Zinc

In addition to excessive zinc levels causing diarrhea, low zinc levels may do 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, 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, resulting 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, can cause 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 will 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, will 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 signify dysfunction in the absorption of food products, including micronutrients. Inflammatory markers can indicate damage within the tissues of the GI, 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 Treatment for Diarrhea Due to Micronutrient Imbalances

Assessing both micronutrient test results as well as comprehensive stool results will allow for the creation of a personalized treatment plan.

Dietfor Diarrhea

Implementing a whole foods-based diet, such as the Mediterranean Diet, is 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 disease, 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. Ironically, chronic loss of fluids can lead to dehydration, which in turn can cause fatigue, headaches, muscle cramps, and the opposite of diarrhea, and constipation, amongst other things.

Gut Health for Diarrhea

Results of comprehensive gut tests can pinpoint where micronutrient imbalances may stem from. Correcting the dysfunction in the GI tract can prevent further micronutrient imbalances and lead to the cessation of diarrhea induced by 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 stimulate more natural production of enzymes.

Fix Permeability

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

Reduce Inflammation

Phosphatidylcholine can lower inflammation in the GI tract. Phosphatidylcholine is actually a component of the mucosa within the GI tract. A defective phosphatidylcholine layer can induce inflammation, and increasing phosphatidylcholine can have the reverse 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 incredibly 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 can positively affect digestion and absorption, lowering permeability and modulating inflammation. Thus, these supplements may aid in the prevention of micronutrient deficiencies causing diarrhea and may also have a direct effect on diarrhea.

Summary

Diarrhea is a bothersome condition that includes an increased frequency of loose, watery stools. Both high and low levels of certain micronutrients can cause diarrhea, and thus, micronutrient testing can be a valuable tool when investigating the root cause of diarrhea. Additionally, comprehensive GI testing may get to the root cause of micronutrient imbalances, as GI health directly influences circulating levels of micronutrients. Results of micronutrient and comprehensive GI tests can create a targeted treatment plan that prevents further micronutrient imbalances and resolves micronutrient-induced diarrhea.