Introduction:
Comparison of one's singular blood work with the laboratory's reference values or accepted clinical norms can be representative to a limited degree, and the most informative tests are when a person's blood works are performed and studied periodically in response to changing conditions, nutritional factors, and supplementation.
The objectives of this article are:
To demonstrate the essential data set that could indicate common nutritional deficiencies
To discuss the relationships between various metrics
To observe the influence of proper supplementation on vital characteristics
To demonstrate different facets of anemia and its relation with the diet and suplementation
To demonstrate the importance of sufficient vitamin D supplementation and synthesis
To discuss what measures can be taken to further improve the anemic status and vitamin D deficiency
This article is written for entertainment purposes only, and the author encourages you to communicate your health-related questions and concerns to your primary physician.
Experimental Details and Design of Study:
This is an anecdotal evidence study representing the data collected from a single person (further, subject).
The data presented in this overview was collected in 2018, 2019, 2020, 2021, 2023, and 2024. Years 2018 - 2021 correspond to "before raw diet". A 2021 data point was acquired in the very beginning of the year, a couple of weeks after switching to a raw diet. Prior to embarking on a raw vegan diet, a Mediterranean diet with the exclusion of dairy was followed. A typical daily nutrition prior to raw vegan diet consisted of cooked buckwheat, nut butters, flax seeds, sauteed or baked vegetables, sweet fruits, eggs, fish, chicken, and occasional red meat, such as lamb, cooked starches in a form of rice and potatoes, and white and whole wheat pasta, olive oil, and salad mixes. Supplementation in a form of B12 swallow-pills (as opposed to sublingual forms), vitamin D3 (cholecalciferol) was consistent throughout the years 2018 - 2021. An introduction of calcium supplements in a form of calcium citrate took place for a short period of time in 2018, as well as magnesium supplementation.
A data point titled as 2021Iron corresponds to a follow-up blood work conducted after 1 month of taking a supplement - multivitamin Garden of Life Mykind Organics for Women due to a diagnosed iron deficiency. This multivitamin complex provided 9 mg or 50%RDV (recommended daily value) of iron daily. Besides, a fortified protein shake from Garden of Life, Raw Organic Protein Unflavored, was consumed daily as a part of the iron boosting regimen (the protein powder provided additional 6 mg or 35%RDV of iron) leading to a total of 15 mg or 85%RDV of supplemented iron daily. The doctor instructed me to stop any iron supplementation because, as will be evident from the data, my iron levels went far beyond the reference range, while raising ferritin too little.
The data points 2021Iron, 2023, and 2024B12 correspond to the period of time when a mostly raw vegan diet was followed. During this period of time, no animal products (dairy, eggs, fish, or meat), except unknowingly, were consumed by the subject of the study. The average daily nutritional profile was balanced to exceed the RDV of essential amino acids (targeting 0.9 g of complete protein per pound of body mass), essential vitamins (A, B1-B9, C, E, K1, and to some degree K2, which is arguably a vitamin of microbiotic synthesis also found in sauerkraut), essential minerals (Ca, Na, K, Cl, Mg, Mn, P, I, Fe, Zn, Cu, S, Se), and essential fatty acids (large amounts of ALA targeting the RDV of EPA and DHA considering limited conversion rate of ALA into EPA and DHA, as well as some amounts of preformed EPA and DHA from seaweeds) while targeting 2000 - 2500 kcal daily from food sources such as hemp, flax, nuts and seeds, sprouted and boiled legumes, leafy greens, sugary and starchy fruits, sea vegetables, and fermented foods (sauerkraut, fermented kelp, kimchi, coconut kefir, coconut yogurt). A D3 supplement has been administered in the doses alternating between 1000 IU, 2000 IU, and 5000 IU in different periods of time from September to May.
There was no blood work performed in 2022, so this data point is missing.
The data points corresponding to the year 2023 are unique among the entire data set because for at least 6 months prior to the 2023 blood sample collection the subject was not taking any B12 supplements to evaluate if it is possible to extract necessary amount of this vitamin from nori seaweed as some studies indicated or if internal B12 synthesis took place. Outside of this period, B12 supplementation in a form of sublingual methylcobalamin or, from 2018 to 2021, cyanocobalamin in a pill form, has been consistent.
In the period from 2018 to 2021, a turmeric supplement was introduced as well. For short periods of time (1 - 2 months at a time), vitamin C, calcium citrate, and magnesium were supplemented as well throughout years 2018 - 2021. The exact doses are unknown, but these data are not particularly relevant for the presented study.
To conduct a comparative study, the data is normalized, unless otherwise specified where absolute values of the parameters are relevant for analysis. Note that the reference values may vary from provider to provider and will depend on the clinic/lab.
Results and Discussion:
The data will be classified in relation to the common concerns associated with raw vegan diet.
Concern 1: Hormonal disorders due to not consuming cholesterol.
All steroid hormones are derived from cholesterol and are lipophilic. Hence, there is an ongoing discussion around the necessity of supplementing cholesterol for sustaining hormone synthesis by consuming meats and eggs. However, it is also known that cholesterol is synthesized by the liver from fat, sugars, and proteins. Cholesterol can be bound to lipoproteins (most known are LDL and HDL, low- and high-density lipoproteins, respectively) to circulate through the bloodstream. LDL is cholesterol-saturated and delivers cholesterol to the tissues, whereas HDL helps to bind and remove cholesterol from the artery walls and blood stream and delivers it to the liver.
Does raw vegan diet allow to sustain adequate levels of cholesterol and healthy HDL/LDL ratio? - this was one of the blood tests I was interested in. After 3 years of following raw vegan diet, my results were:
Cholesterol = 157 mg/dL (should be* below 200 mg/dL)
Triglycerides = 81 mg/dL (should be below 150 mg/dL)
LDL calc = 82 mg/dL (should be below 130 mg/dL)
HDL = 59 mg/dL (should be above 40 mg/dL)
Cholesterol/HDL = 2.7 (should be below 3.5)
*The recommended values may not be strictly representative of one's health status.
All of these metrics are typically discussed in the context of having too much bad cholesterol due to the prevalence of this concern over having too little, yet LDL levels under 50 mg/dL may be caused by certain health conditions (hepatitis C, some types of cancer, hyperthyroidism, malabsorption, and malnutrition). In rare circumstances, too low LDL may be associated with increased risks of cancer, hemorrhagic stroke, depression, anxiety, and preterm births, but there is no proven correlation and order of causality between those conditions and low LDL.
Elimination of cholesterol-containing foods from the diet typically doesn't affect the total cholesterol levels and, consequently, the hormone production, since cholesterol is not an essential nutrient and is synthesized by the liver, unless serious underlying health conditions or extreme malnutrition are present.
My blood work, in turn, illustrates that I successfully synthesize sufficient amounts of cholesterol and do not have lipid metabolism issues.
In summary: it is possible to maintain a healthy cholesterol balance with prevalence of HDL through internal synthesis of cholesterol.
Concern 2: Iron-deficient and B12-deficient anemia.
The idea of removing heme iron from the diet in people prone to developing anemia often appears to be a dangerous move promoting worsening of the anemic condition, making it chronic, and imposing serious health risks due to chronic low-grade hypoxia. In addition, red meats, organ meats, and some other animal products carry not only easily-available iron, but also vitamin B12, so such foods are regarded as a one-stop solution for preventing and reversing the anemia. At the same time, while B12 deficiency is rare in a general population in the U.S. and U.K. (6% of people under 60 and 20% of people at the age of 60 and older), likely attributed to the high rate of consumption of animal products and fortified foods, the incidence of anemia is surprisingly high (31% of women and 17% of men) with iron deficient anemia making up 66% of all anemia cases.
I myself had been struggling with iron deficiency before I started eating predominantly raw foods, which led me to trying natural supplements, however, my ferritin was not recovering proportionally to the iron supply and concentration.
Figure 1(a) shows year-to-year progression of iron level, total binding capacity, transferrin, saturation, and ferritin. Unfortunately, some metrics were not collected in 2019 and 2020, so the data is missing. Shaded rectangles represent the reference range, and for ferritin the maximum value is beyond the upper bound of the diagram. Data points labeled as 2021Iron are collected after 1 month from acquisition of the 2021 data and continuous supplementation with iron. From this chart, both iron supplementation and following a well-balanced raw diet lead to increase in serum iron and ferritin, with the later reaching historic maximum after 3 years on a raw diet without supplementation (2024). Total iron binding capacity (TIBC) declines with increase in ferritin and iron while on the raw diet, indicating better supply of dietary iron on the raw diet. A steady increase in transferrin and iron saturation are also observed, again, likely correlated with a higher dietary supply of iron, usable protein, and iron absorption, which may be associated with consistent supply of high doses of vitamin C coming from raw foods daily (on average, 500 - 100% RDV). While on the iron supplement, an increase in ferritin is associated with dangerously high levels of serum iron, on a raw diet, increase in ferritin is in a stronger correlation with iron. Figure 1(b) shows dependency of ferritin on iron, including the data point collected after the supplementation (labeled). Natural restoration of ferritin due to the dietary changes follows a steep trend (more data would be needed to establish a functional relationship), while on the supplement, where increase in ferritin was associated with too high doses of iron (and saturation), there could have been an issue with iron absorption and utilization leading to the too high amounts of iron circulating in the blood stream, which was the reason for abandoning the supplementation. From Figure 2(b), it becomes evident that consistently receiving non-heme iron with all necessary co-factors, from anti-inflammatory, gut-restoring raw vegan diet may be beneficial over supplementation since increase in ferritin (by 4.2 ng/mL) follows smaller elevation in the serum iron (18 ug/dL). Interestingly, in the beginning of 2021 and before, when a Mediterranean diet with daily consumption of grains, boiled legumes, and animal products, including eggs and occasional red meat, the iron deficient anemia persisted. In a hypothetical scenario, in that time frame, iron supply could be increased only by increasing the fraction of red and organ meats in the diet, which could potentially help in reversing iron deficiency via uptake of heme iron, but substituting some plant foods and lean meats with red meat would potentially pose other health risks, especially given that the subject has family history of deaths caused by colon cancer in several family members who were following high-meat diets. In this context, restoration of ferritin via raw diet appears to be a more viable path.
Another curious observation from Figure 1(a) is that there is a notable increase in iron (16%), iron saturation (20%), and ferritin (36%) that took place within 4 months between 2023 and 2024 tests. While dietary habits did not undergo any considerable changes, supplementation with B12 was resumed. For 6 months prior to the 2023 test, NO B12 supplement was taken (before the abandonment of the B12 supplement, it was taken every week as methylcobalamin in a sublingual form, 1000 mcg, and before the raw diet it was administered in a pill form). This caused development of the B12-deficient megaloblastic, macrolytic anemia which became evident from the complete blood count (CBC) test (Figure 2).
From Figure 2, it is evident that failure to supply enough B12 while on a raw vegan diet with adequate supply and absorption of dietary iron and folic acid, resulted in reduction in RBC and hemoglobin, by 5% and 8%, respectively, it led to the slight increase (3%) in MCV (which remained high even after 4 months of supplementation), reduction of mean corpuscular hemoglobin and mean corpuscular hemoglobin concentrations decreased as well, and the most notable change, unambiguously indicating B12 deficiency in the conditions of adequate B9 supply, was observed in RDW. While RDW historically remained steady in the presence of animal foods with a supplement and with the supplementation alone, reaching 11.6% (absolute value) on average, it increased to 13% absolute, which, given the tight normal range of this metric (from 12% to 16%) and how steady it remained throughout the years, appeared concerning indicating a risk of developing B12-deficient anemia. Its reduction back to 11.9% absolute followed the B12 supplementation for 4 months. An increase in MCV and reduction of RBC, MCH, MCHC, and HGB in 2023 are likely linked to the B12 deficiency, given that iron deficiency was gradually reversed on a raw diet. The observed recovery of RDW, MCH, MCHC, HBG, and platelet count appear to be linked specifically to the B12 restoration, which after 4 months on a supplement was measured to be 313 pg/mL. Folate level was measured as well and was 14.9 ng/mL (should be 2.5 - 20 ng/mL). Two parameters appear surprising: reduction in RBC, hematocrit, and increase in MCV in 2024 after B12 supplementation. While still being within a normal range, these parameters are worth further testing after a longer period of sustained B12 supplementation and further recovery of the iron deficiency because there are no nutritional factors that could be associated with the loss of red blood cells, neither there are symptoms linked to the diseases that could lead to the excessive destruction of the erythrocytes. One of the factors that could contribute to the reduction in RBC and hematocrit might be some blood loss from menstruation, since 2024 blood test was performed on the last day of period, and it takes just 2 days to make a mature red blood cell, so perhaps, this metric is an artifact of some hemorrhage.
Ensuring the right conditions for healthy erythropoiesis (B12, B9, Mg) may lead to further increase in ferritin and reversing the anemia caused by both, B12 and iron deficiencies in the past. Supplementing synthetic B12, consuming large amounts of foods rich in folate, iron, magnesium, and vitamin C, abundant in a well-balanced raw diet, and working on the gut health by continuing to supply raw fiber and probiotic foods, and by supplementing / synthesizing vitamin D are the pathway to further improvements because it is unambiguous that a well-balanced raw vegan diet allows to increase iron and iron absorption and usage as opposed to a Mediterranean diet, that is regarded as a widely accepted nutrition standard and the most renown health diet.
In summary: with adequate B12 supplementation, a well-balanced raw vegan diet can aid in reversing all-cause anemia.
Concern 3: Copper toxicity/overload and zinc deficiency.
Copper toxicity can be caused by using copper cookware or by ingesting copper with water or other sources. It may also be caused by the use of copper intrauterine devices, if other conditions favoring development of copper toxicity or overload are met in a specific user, or by taking oral contraceptives. It is a rare condition, and even though some sources claim that copper toxicity can be caused by foods containing large amounts of copper, it is typically not a point of concern, because unless copper is administered in high doses in a form of copper salts, supplements, a healthy body, without disorders impairing copper metabolism, can regulate its uptake.
However, a 2300 kcal raw vegan diet can supply up to 500% RDV of copper with plant foods that becomes a point of concern (somewhat unbased) for some. While it is commonplace that people take Zn supplements and actually develop copper deficiency, the relationship between Zn and Cu is regarded mainly in the light of co-supplementing with copper to avoid the disbalance favoring zinc. At the same time, some authors emphasize the necessity of limiting copper intake and boosting the consumption of zinc to bring Zn/Cu ratio to 8:1 by specifically introducing Zn-rich meats or Zn supplements (the later are harsh on the body causing gastric disturbances, so it is preferred to get sufficient amounts of Zn through diet). This article describes the roles of Zn and Cu and their interaction in detail.
Common symptoms of Zn deficiency include poor immunity and proneness to frequent colds, oily skin and acne, alopecia, testosterone imbalances and sexual dysfunction, slow wound healing, skin ulceration, weight loss, sensory problems, inability to focus, depression. It affects ~12% of the overall U.S. population and 40% of the elderly people. Copper deficiency appears to be rare partially due to the inability to accurately test for it, yet many people do not get enough copper through their diet.
Even though zinc deficiency, especially in the conditions when it is not in nutritional balance with copper, can manifest even if its serum levels are within a normal range because body keeps Zn levels steady, it is still a method of identifying if there is an adequate level of Zn. Thus, Zn testing was performed in 2023 (unfortunately, the clinic didn't provide copper testing, so this result is isolated). Red blood cell zinc was measured to assess the long-term zinc status unaffected by the short-term diet fluctuations and inflammations. And even though low RBC zinc is commonly caused by thyroid disorders, obesity and obesity-associated health complications, certain medications, and physical activity, failing to consistently supply enough zinc with food can also lead to the RBC zinc reduction.
Zn, RBC = 1371 ug/dL (should be 878-1660 ug/dL)
The dietary supply of zinc has been maintained at 150 - 200% RDV from raw plant foods (~12 - 16 mg) and primarily supplied with hemp seeds (54% RDV in 60 g), pumpkin seeds (49% RDV in 70 g), lentil sprouts (14% RDV in 100 g) and other foods, including nuts, greens, and fruits. Dietary copper from the raw foods reaches ~5 mg, bringing the Zn : Cu ratio to ~3. As the blood work result indicates, there is no apparent evidence of Zn deficiency, which can arise rather not from disproportion of Zn and Cu in raw plants, but from consuming too much sugar and consumption of alcohol, as well as from impairments of the gut and ability to absorb the nutrients. One of the debates that is especially sound in the near-scientific articles is that Zn absorption is dampened by the antinutrients, such as phytate. However, it may hold true for people who do not yet have a habit of consuming raw plant foods. Gut microbiota is capable of synthesizing phytase to enable absorption of bound minerals coming with plants, which comes in a symbiotic relation, as raw plants supply both, bacteria and prebiotic substrate feeding the bacteria.
In summary: there is no apparent zinc deficiency, and given that there are no symptoms of possible zinc deficiency, it is likely that nutritional supply of zinc from a well-balanced raw diet is sufficient and there is no copper-zinc unbalance.
Concern 4: Protein deficiency.
It is still a mainstream notion that it is impossible to get all essential amino acids on a vegan diet, and given how general public and medical specialists unfamiliar with the full spectrum of raw vegan nutrition regard raw vegan diet through the prism of (not necessarily unfounded) the stereotype, the protein debate is still prominent.
Common overall protein deficiency symptoms include fatigue, susceptibility to infections, fragile hair and hair loss, brittle nails, irritability, craving protein-rich foods. Protein deficiency can be caused not only by not supplying enough of essential amino acids with food, but also by liver disorders that make it impossible to synthesize necessary proteins from the amino acids, by kidney disorders that cause loss of protein through urine, also by celiac disease and inflammatory bowel disease which reduce the absorption of amino acids from the GI tract into the blood stream.
Given that a raw diet containing high amounts of raw fiber, antioxidants, vitamins, minerals typically quickly restores healthy gut lining, it is likely that absorption of amino acids from food becomes very efficient. Restoration of liver and kidneys, restoration of stomach pH, supply of simpler protein complexes with raw plants as opposed to the animal products, which requires less digestive enzymes (also proteins), supply of protein synthesis co-factors - all should make protein breakdown into simple amino acids, their absorption, and assembly into the proteins that body needs more efficient on a raw vegan diet.
On the flip side, are there enough essential amino acids coming with food on a raw vegan diet? The answer is yes. If you eat more than 2000 kcal worth of raw foods, if you balance your nutrition, you can cover essential amino acid needs indicated by the Food and Nutrition Board. It is worth mentioning that depending on the level of physical activity and physique goals, the recommended values for protein intake will vary and there is no consensus on that.
Protein deficiency is typically determined via blood test where total protein, albumin, and albumin/globulin ratio are measured, where albumin and albumin/globulin are used to evaluate if there is a kidney, liver, or autoimmune disorder.
Protein test was conducted in 2021, 2023, and 2024. Blood urea nitrogen (BUN), creatinine, and total protein are plotted on Figure 3 (reference range is represented by shaded rectangles, for BUN and creatinine, the normalized maximum bounds of the reference ranges are beyond the limits of the axis and are 1.85 and 1.65, respectively). Globulin data was not collected, so albumin and globulin metrics are not included in the comparative analysis.
The apparent reduction in BUN on a raw diet in 2023 can be a consequence of either low-protein diet, overhydration, or a liver disease, but this trend is not supported by the 2024 data, so it remains inconclusive. BUN is released when amino acids are broken down in the liver, which is a small fraction of amino acids coming with food - less than 10%, as a result of turning toxic ammonia (NH3) formed from the nitrogen in the destroyed amino acids into urea. Typically, high levels of BUN are a point of concern (indicating a possibility of kidney disease, trauma, heart failure, dehydration, high-protein diet, GI bleeding) and low BUN is typically linked to low protein intake.
Creatinine is released when muscle tissue is broken down when the muscle is in use and can temporarily noticeably increase after a strenuous workout. A blood test is usually concerned with the kidneys' ability to filter it out, however, nutritional deficiency can also manifest in reduced creatinine blood test values as creatinine can be low if muscle wasting occurs. Creatinine remained steady, close to the midpoint of the reference range, indicating that there is no protein supply or metabolism abnormalities. This is in turn supported by the total protein measurements. Total protein (albumin and globulin) stays near the middle of the reference range and exhibits an ascending trend with time peaking at 7.2 g/dL in 2024. This result corresponds to a dietary protein intake of 70-120 g daily from raw plants with the body weight of 112 lbs, 83% muscle mass, and moderate fitness activity including weight-bearing exercises.
While there are no symptoms or conclusive blood test markers of protein deficiency, increasing physical activity and reduction of muscle anabolism rate with age might require some dietary adjustments to ensure supply of 1 g of protein per pound of body mass daily, which can be achieved by introducing more dense protein sources. A question here is whether more efficient amino acid usage due to the absence of thermal processing could lead to reduction of BUN or is it simply lack of protein?
In summary: total protein and creatinine remain steady and within a normal range near the midpoint of the reference range indicating that there is no protein deficiency. BUN level in 2021 and 2024 are normal, however, in 2023 it was low possibly indicating low protein intake around the time of the blood sample collection.
Concern 5: Calcium deficiency.
Abandoning dairy products is still regarded by some people as a risk factor for developing calcium deficiency and osteoporosis, which in reality may be the opposite. And while dairy consumption poses serious health complications in people in the modern world, there are surely other sources of calcium and other minerals participating in bone formation. In a framework of raw diet, major calcium sources are parsley, cruciferous vegetables, oranges, dandelions, nuts and seeds. Its absorption from the plant sources is facilitated by the symbiotic gut microbiota. However, how to know if we get enough Ca and are not at risk of deficiency?
Diagnosing calcium deficiency is challenging because it is a crucial mineral that participates in transmission of electric signals enabling the heartbeat, so in the absence of hormonal disorders, body retains blood Ca levels within a very tight range, from 2.1 mmol/L to 2.6 mmol/L. When calcium metabolism or supply are disrupted, it is pulled from the main Ca depot - skeleton, and the rate of desorption can be assessed by conducting a transient bone density study. In some serious cases of prolonged malnutrition, calcium deficiency does manifest in the reduction of Ca concentration in blood, but it is best to not let it happen.
The main cause of calcium deficiency and increased risk of fracture is vitamin D deficiency. Majority of the world population living away from the equatorial zone are deficient in vitamin D, and most people from the developed countries are unable to handle sunshine (partially, due to following pro-inflammatory diets) to ensure sufficient synthesis of this hormone. Dietary vitamin D coming from fish oil, eggs, fish, mushrooms, milk and dairy are hard to assimilate because its absorption relies on the gut health and proper balance of other fat-soluble vitamins. Supplements can also be inferior to the natural synthesis due to the same reasons. Low vitamin D can stimulate excessive production of parathyroid hormone which stimulates desorption of calcium from the bones. This is why it is important to test not only calcium levels, but vitamin D and parathyroid hormone. Another useful metric that can bring clarity in determining Ca status is alkaline phosphatase. Note: parathyroid hormone can be artificially low when magnesium deficiency is present.
Table 1.
Calcium, vitamin D, parathyroid hormone, and alkaline phosphatase test results from 2021 to 2024.
2021 | 2023 | 2024 | Reference Range | |
Calcium, mg/dL | 9.3 | 9.7 | 9.7 | 8.5 - 10.5 |
Vitamin D, ng/mL | N/A | 24 | 34.9 | 30 - 100 |
Alkaline Phoshatase, U/L | 50 | 55 | 55 | 30 - 120 |
Parathyroid Hormone, pg/mL | N/A | N/A | 111.6 | 10.0 - 75.0 |
From Table 1, it becomes evident that vitamin D deficiency likely takes place regardless of its 2024 value being inside of the reference range. This conclusion is only possible because with normal Ca and alkaline phosphatase, the only parameter that can indicate the existence of Ca metabolism problem is parathyroid hormone that is far beyond the maximum reference value. The rate of vitamin D level recovery, even on a supplement is slow, only coming from 24 ng/mL to 34.9 ng/ml on a daily 4 months-long supplementation regimen of 1000 IU of vitamin D, which appears to be the maximum safe supplement concentration as of medical authorities and state officials (my current supplementation is with 5000 IU). It appears that there is no calcium deficiency per se, but there is a problem with allocating it in the bones. This corresponds to the dietary intake of calcium of ~90 - 105% RDV from raw plants. The recommended calcium intake recommendations vary and sometimes are based on the guidelines for menopausal women and senior people with osteoporosis, yet extended to the entire population without taking vitamin D deficiency and vitamin K2 deficiency into account. In the circumstances of the author, where vitamin D deficiency is apparent, increasing calcium supply or supplementing with calcium pills may even be dangerous due to the improper assimilation of calcium posing risk of calcification of soft tissues and kidney stones, so the primary focus is in replenishing vitamin D. At the same time, there is no hypocalcemia that would indicate a dramatic depletion of Ca in a circumstance of sustained serious lack of Ca supply with food.
In summary: While there is no evidence of calcium deficiency or serious phosphorus-calcium unbalance, low level of vitamin D combined with an elevated parathyroid hormone indicate the possibility of bone density loss due to desorption of calcium from the bones.
Conclusion:
On this singular subject, it was demonstrated that a well-balanced raw vegan diet rich in minerals, vitamins, and essential amino acids, with proper supplementation of vitamin B12 and access to sunshine enabling natural synthesis of vitamin D is not associated with development of nutritional deficiencies and in contrary leads to a gradual reversal of the iron deficient anemia, as it is rich in folate, magnesium, iron, and vitamin C. It was proven that failure to supplement with adequate amounts of B12 lead to a rapid development of B12 deficiency and B12-deficient anemia causing red blood cell degradation and reduction of hemoglobin. Also, inadequate reception of vitamin D even through D3 supplements leads to the increase of parathyroid hormone that leads to the loss of calcium from the bones, which suggests that pursuing natural synthesis of vitamin D through exposure of skin to UVB light should be pursued to further optimize body functioning, as sufficient vitamin D is needed not only for proper calcium absorption, but for gut health and nearly all systems of the body. Overall, tailored to the personal specifics and with adequate supplementation addressing environmental limitations, a well-balanced raw vegan diet can be considered safe, at the same time bearing significant health benefits as it supplies a well-rounded nutrition along with nutraceutical compounds and antioxidants, it allows internal regulation of mineral uptake and hormonal regulation, it has anti-inflammatory properties aiding in reversing most common degenerative diseases prevalent in the West.
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