column logo

As a nutritionist, I want to partner with a doctor so I can recommend good health practices to those with chronic health issues. For example, one thing that patients with alpha-1 antitrypsin deficiency (AATD) usually need is a multivitamin. Even if the patient is good at eating plenty of fruits and vegetables, multivitamins can fill in “gaps.”

I know most doctors recommend daily prenatal vitamins to women of childbearing age, for good reason. Pregnancy or potential pregnancy calls for plenty of certain nutrients. So why should it be any different with a person with lung or liver disease?

Obviously, anyone with liver disease is going to have issues with nutrient absorption. Many liver-affected individuals need help identifying how to properly eat for their specific disease, which can often limit their nutrient intake.


Continue Reading

Although a multivitamin is not a cure for any disease, it can help. For instance, iron deficiency can cause a host of issues for someone who already has issues with diffusion capacity. Often, liver-affected patients with AATD are told to stop eating red meat, which is OK, but it is one of the most bioavailable sources of iron that Americans have.

Read about experimental therapies for AATD

Thankfully, I don’t struggle with liver or anemia issues. But, I do know that bone thinning is something a close relative of mine struggles with, so I like to take calcium. I found out some multivitamins do not contain this.

Not all multivitamins are created equal. Sometimes, this it is not the fault of the manufacturer—it’s a safety precaution. The move is taken by the manufacturer because, for example, some people shouldn’t have too much extra calcium.

Specific guidance is called for when it comes to multivitamins. If a patient needs to control their calcium, they may need direction regarding which supplement to take. If they need extra iron, they may need to take a multivitamin and an iron supplement.

Why does someone with lung issues need a multivitamin? As someone who has studied it, I know that anyone trying to improve their nutritional status is going to need to understand not just one part of a puzzle, but all of it.

Most patients with AATD are lung affected, or at least the ones I have talked to. So, with their higher risk for complications from respiratory diseases, it would make sense that they need certain nutrients to prepare for an infection. It is not necessarily going to prevent lung illnesses, but at the very least, these nutrients shouldn’t hurt them.

In addition, those who are on a ketogenic or low-carb diet may not be getting the B vitamins they normally would from grains and other carbohydrates. They may need to supplement.

Read more about guidelines in AATD

This group of individuals also will need other electrolytes they would normally get from fruits and starchy vegetables. Each person is different in what they need, so it may be best appropriate for these individuals to have their vitamin levels monitored. They may also need to be referred to a nutritionist or dietician to make sure they are getting enough calories.

I noticed that many multivitamins don’t contain magnesium, which is important for most people (me, for instance) with asthma. However, this is not the case for everyone. Some people may need more and some people may not need any at all.

That’s why I generally tell people that a multivitamin is a good place to start because tricky things like calcium are safely avoided in most of them. It can help them to feel a little better.

The whole subject of diet is tricky. It’s a very private matter that most people don’t like to discuss with many others. it needs to be handled with patient and gentle, but firm, answers.

Generally, a multivitamin is a safe way to introduce the idea of adding in sometimes-missed nutrients. It’s not everything, but it can really help a patient who is willing to be proactive or who sees the need to improve.

It helps a person with a chronic health issue to overcome an obstacle. This will be encouraging and help a person feel empowered to not let their condition win. This can lead to another positive change, and then another, a great feedback loop.

That’s why I became a nutritionist, because I loved how empowered I felt when treating my body correctly and well. Although I’m far from perfect, I am so much farther from where I started.