Vitamins, Minerals and Shit You’ve Never Heard Of: How I Think About Fixing Bad Bloodwork

Vitamin D. Zinc. Iron. Copper. NAC. TUDCA. Berberine. Citrus bergamot. Before you start swallowing half the supplement aisle, figure out what the fuck you’re actually trying to fix.

In Part I, we talked about bloodwork.

CBC.

Glucose.

HbA1c.

Lipids.

ApoB.

Kidney markers.

Liver markers.

Basically:

How do I look underneath the hood instead of assuming everything is fine because I can see my abs?

Now comes the obvious second question.

What the fuck do I do when something doesn’t look right?

This is where supplementation gets interesting.

It’s also where people lose their fucking minds.

Cholesterol comes back high?

Take this.

Glucose isn’t where you want it?

Take that.

Vitamin D is low?

Buy three bottles.

Liver markers look weird?

Here’s something else.

Suddenly you’ve got seventeen supplements sitting on your kitchen counter and no idea what any of them actually do.

That’s not how I approach this.

My philosophy is considerably simpler:

Measure → understand → intervene → measure again.

I’ve used vitamins, minerals and other supplements for specific purposes over the years.

Some have helped me.

Some have evidence behind them.

Some have interesting evidence but considerably more marketing than science.

And something working for me doesn’t automatically mean it’ll work exactly the same way for you.

My experience is evidence about my body.

Your bloodwork gets the final vote on yours.

Start With the Actual Problem

Before taking something, I want to know:

What am I trying to accomplish?

That’s important because supplements aren’t Pokémon.

I’m not trying to collect the whole fucking set.

If my bloodwork shows something I don’t like, I want to understand why it’s happening.

Maybe the answer is diet.

Maybe it’s bodyweight.

Maybe it’s training.

Maybe it’s alcohol.

Maybe it’s a medication.

Maybe it’s genetics.

Maybe there’s a deficiency.

Maybe there’s an actual medical problem requiring treatment.

And sometimes supplementation makes sense.

But ideally I’m not throwing shit at a laboratory number and hoping something sticks.

Vitamins: The Alphabet Soup

Let’s start with the basics.

Vitamins are organic compounds your body needs in relatively small amounts for numerous physiological processes.

Some are fat-soluble:

A.

D.

E.

K.

Others are water-soluble, including vitamin C and the B vitamins.

That distinction matters because fat-soluble vitamins can accumulate in the body more readily, which is one reason blindly megadosing them isn’t automatically harmless.

More isn’t always better.

Vitamin A

Vitamin A plays roles in:

Vision.

Immune function.

Cell growth and differentiation.

Reproduction.

It’s also involved in maintaining epithelial tissues—the barriers lining and covering various parts of your body.

You can get vitamin A through foods containing preformed vitamin A and through carotenoids that your body can convert.

But here’s our first lesson in:

More isn’t automatically healthier.

Excessive preformed vitamin A can be toxic.

So I’m not treating vitamin A like protein powder and taking handfuls because somebody said it was “optimal.”

The B Vitamins

The B vitamins aren’t one vitamin.

They’re a family.

You’ve got things like:

B1 — thiamine.

B2 — riboflavin.

B3 — niacin.

B5 — pantothenic acid.

B6 — pyridoxine.

B7 — biotin.

B9 — folate.

B12 — cobalamin.

Collectively, they’re involved in a ridiculous number of processes involving energy metabolism, nervous-system function, red-blood-cell production and DNA synthesis.

For bloodwork purposes, B12 and folate become particularly interesting.

Remember MCV from Part I?

Deficiencies involving B12 or folate can contribute to macrocytic/megaloblastic anemia patterns.

B12 deficiency can also cause neurological problems.

That’s why I’d rather know whether there’s actually a deficiency than blindly eat B12 gummies because the bottle promises ENERGY.

If somebody is genuinely deficient, supplementation can be extremely important.

But again:

Figure out why.

Diet?

Absorption?

Medication?

GI disease?

Something else?

Fixing the number without understanding the cause can mean missing the actual problem.

Vitamin C

Vitamin C is involved in collagen synthesis, antioxidant functions, immune function and iron absorption, among other things.

That last one becomes interesting when we get to iron.

Vitamin C can enhance absorption of non-heme iron, the form found primarily in plant foods.

It’s also another perfect example of why I prefer adequate nutrition before building a pharmacy in my kitchen.

Fruit and vegetables exist.

Eat them.

Vitamin D: One I Actually Pay Attention To

Vitamin D is interesting because it’s both a nutrient and involved in hormone-like signaling.

It plays major roles in:

Calcium regulation.

Bone health.

Muscle function.

Immune function.

And unlike some random supplement promising to increase your testosterone 847%, vitamin D status is something we can actually measure.

25-hydroxyvitamin D is generally the laboratory marker used to assess vitamin D status.

So this fits beautifully into my approach.

Don’t guess.

Measure it.

If it’s low, now we’ve got something objective to discuss and address.

D3 and K2

You’ll frequently see vitamin D3 and vitamin K2 sold together.

I use the two within my own supplementation strategy.

But there’s an important distinction worth making.

K2 isn’t required to make D3 magically absorb.

Vitamin D is fat-soluble, and absorption can be improved when it’s taken with a meal containing fat.

Vitamin K has separate biological roles involving proteins responsible for blood clotting and bone metabolism.

There’s legitimate interest in the relationship between vitamin D, vitamin K, calcium metabolism and bone health.

But I’m not going to turn:

“These nutrients interact within calcium physiology”

into:

“Everyone taking D3 must take exactly X amount of K2 or they’ll calcify their arteries.”

That’s where supplement-world certainty starts outrunning evidence.

My approach?

Understand both nutrients.

Look at your diet.

Look at your circumstances.

Look at your labs.

Then make the decision.

And if you’re taking anticoagulants—especially vitamin-K antagonists—this is absolutely something to discuss with your clinician rather than experimenting on yourself.

Vitamin E

Vitamin E is a fat-soluble antioxidant that helps protect cell membranes from oxidative damage and has roles in immune function.

Sounds fantastic.

So obviously taking enormous doses must make you immortal, right?

No.

😂

Again:

Physiologically important doesn’t mean megadosing it produces additional benefit.

Deficiency is one thing.

Taking huge amounts because the label says antioxidant is another.

Vitamin K

Vitamin K is especially important for normal blood clotting and bone-related proteins.

You’ve probably heard about:

K1 — phylloquinone.

and

K2 — menaquinones.

K1 comes primarily from green leafy vegetables.

K2 includes several menaquinones found in certain animal and fermented foods and produced to some extent by bacteria.

Again, context matters tremendously because vitamin K can interact with certain anticoagulant medications.

This isn’t one to freestyle because some asshole on Instagram said K2 makes your arteries bulletproof.

Citrus Bergamot: This One Helped Me

Now we’re getting into the shit most people haven’t heard about.

Citrus bergamot.

This one is personal for me.

I had lipid markers I wanted to improve.

I incorporated citrus bergamot into what I was doing.

And on subsequent bloodwork:

My lipid markers improved.

That’s why citrus bergamot stayed on my radar.

Now, does that prove citrus bergamot will produce exactly the same response in everybody?

Of course not.

I wasn’t living inside a metabolic ward with every variable controlled.

My diet, training, body composition and other factors matter too.

But I have something better than:

“Some influencer said this works.”

I have before-and-after bloodwork on myself.

And interestingly, clinical research points in the same general direction. A systematic review and meta-analysis of 14 trials found bergamot supplementation was associated with reductions in total cholesterol, LDL-C and triglycerides, although the researchers also emphasized inconsistent findings and the need for better-quality studies.

So here’s how I phrase this:

Citrus bergamot helped improve my lipid markers.

That’s my experience.

There’s also clinical evidence suggesting it may improve lipid profiles in some people.

That’s considerably different from saying:

“Bergamot cures high cholesterol.”

It doesn’t replace appropriate medical treatment when medical treatment is indicated.

But for me?

I could measure the difference.

And that’s what I care about.

NAC: Helping Supply the Raw Material for Glutathione

NAC stands for N-acetylcysteine.

This one is particularly interesting.

Your body produces an antioxidant called glutathione.

Glutathione plays major roles in cellular redox balance and protecting cells against oxidative stress.

One of the things NAC does is provide cysteine—the amino-acid precursor your body can use to synthesize glutathione.

That’s why you’ll hear NAC referred to as an antioxidant.

Technically, the story is more interesting than:

“NAC runs around eating free radicals.”

A major part of its usefulness comes from helping replenish glutathione when the biological circumstances allow it.

In medicine, NAC is famously used for acetaminophen overdose because replenishing hepatic glutathione can literally be lifesaving.

I use NAC as part of my own health/supplementation strategy because I’m interested in supporting antioxidant defenses and liver health.

There’s also research examining NAC in kidney disease and oxidative-stress-related conditions, but the clinical evidence varies enormously depending on the disease, dose and situation.

So I’m not saying:

Take NAC and your kidneys and liver become indestructible.

I’m saying the mechanism is legitimate, glutathione is important, NAC has established medical uses, and it fits into my personal strategy.

TUDCA: Now We’re Deep Into the Supplement Nerd Shit

TUDCA stands for:

Tauroursodeoxycholic acid.

Congratulations.

You now understand why everybody calls it TUDCA.

😂

TUDCA is a hydrophilic bile acid related to ursodeoxycholic acid.

Bile acids aren’t merely digestive soap.

They’re involved in bile flow, cellular signaling and several metabolic processes.

TUDCA has been studied for hepatoprotective effects, including effects involving bile flow, cellular stress and apoptosis.

That’s why TUDCA became interesting to me as part of a liver-health strategy.

But this is another area where internet supplement lore gets ahead of itself.

You’ll hear claims about TUDCA for:

Liver health.

Gallbladder problems.

Digestion.

Kidney health.

Insulin sensitivity.

Brain health.

And apparently eventually it’ll rotate your tires.

Some of those areas have interesting mechanistic or early clinical research.

That doesn’t make TUDCA a universal treatment for all of them.

What About People Without a Gallbladder?

This deserves clarification because it’s commonly discussed.

Your liver makes bile.

Your gallbladder stores and concentrates it.

If your gallbladder is removed, your liver doesn’t suddenly forget how to make bile.

So I wouldn’t tell somebody:

“No gallbladder? You need TUDCA.”

That’s too simplistic.

Bile-acid therapies have legitimate medical uses in certain cholestatic liver diseases, and TUDCA has interesting hepatobiliary mechanisms.

But post-gallbladder-removal symptoms deserve an actual medical evaluation rather than automatic supplement treatment.

Berberine: One of the More Interesting Ones

Berberine is where things get particularly interesting for metabolic health.

It’s a plant-derived compound that has been studied extensively for effects on glucose and lipid metabolism.

I use berberine specifically because I’m interested in glucose management and insulin sensitivity.

People sometimes call it:

“Nature’s metformin.”

I don’t particularly love that description.

They’re different compounds.

They have overlapping metabolic effects and some overlapping pathways, but they aren’t interchangeable.

Berberine has been shown in randomized-trial meta-analyses to modestly reduce fasting glucose, HbA1c, fasting insulin and HOMA-IR.

It has also demonstrated modest improvements in LDL-C, triglycerides and ApoB in trials of people with dyslipidemia.

That’s real evidence.

What About Metformin and IGF-1?

Here’s where gym-world discussion gets messy.

You’ll sometimes hear:

“Berberine is better than metformin for lifters because metformin suppresses IGF-1 and therefore kills your gains.”

That’s considerably more confident than the evidence allows.

Metformin and berberine affect multiple cellular pathways.

And while there’s legitimate research examining metformin, AMPK, mitochondrial adaptations and responses to resistance training, I don’t think there’s good clinical evidence establishing:

Berberine = metformin’s glucose benefits without IGF-1 interference, therefore better muscle growth.

So I’m not going to tell you that.

I use berberine because I’m interested in its effects on glucose metabolism.

If someone has diabetes or is taking glucose-lowering medication, that’s a completely different conversation because combining agents can change glucose control and medication needs.

That’s doctor territory.

Zinc: More Important Than the Testosterone Marketing Suggests

Zinc gets marketed heavily toward men because of its relationship with testosterone.

And zinc is biologically important.

It participates in hundreds of enzymatic reactions and contributes to:

Immune function.

Protein synthesis.

DNA synthesis.

Wound healing.

Reproduction.

Normal endocrine function.

But here’s the distinction:

Correcting zinc deficiency isn’t the same thing as turning adequate zinc intake into a testosterone supercharger.

If you’re deficient, fixing that matters.

If you’re already getting enough?

More zinc isn’t automatically more testosterone.

And excessive zinc creates another problem.

Copper.

Zinc and Copper: The Relationship People Forget

High zinc intake can interfere with copper absorption.

That means somebody can spend months pounding high-dose zinc because they’re trying to “optimize testosterone” and accidentally create another nutritional problem.

Copper matters for:

Iron metabolism.

Connective tissue.

Energy production.

Nervous-system function.

Antioxidant enzymes.

And red-blood-cell physiology.

Which means zinc and copper are a perfect example of why randomly pushing one nutrient higher isn’t always intelligent.

Your body isn’t a collection of independent sliders.

These systems interact.

Selenium: Another Small Mineral With a Big Job

Selenium doesn’t get nearly as much gym-bro attention.

But it’s important.

Selenium is incorporated into proteins called selenoproteins, which participate in antioxidant defense and thyroid-hormone metabolism, among other functions.

That’s where selenium becomes particularly interesting alongside zinc when we’re talking broadly about endocrine and metabolic health.

But again:

More isn’t better.

Selenium toxicity is absolutely a thing.

This isn’t something I’d shovel into my mouth because someone said it’s “good for hormones.”

Iron: Extremely Important — and Not Something I’d Supplement Blindly

Iron deserves considerably more respect than it gets.

Your body needs iron to make hemoglobin.

Remember hemoglobin from Part I?

That’s the protein inside red blood cells responsible for carrying oxygen.

Iron also contributes to myoglobin and numerous enzymes involved in cellular metabolism.

So if you’re iron deficient?

Performance can suffer.

Energy can suffer.

Oxygen transport can suffer.

And eventually you can develop iron-deficiency anemia.

But here’s the important part:

Iron is not a supplement I’d take just because I feel tired.

Because too much iron can also cause harm.

And an iron deficiency can sometimes be a clue to something else.

Dietary deficiency?

Blood loss?

GI bleeding?

Malabsorption?

Menstruation?

Something else?

If iron is low, I want to know:

Why?

Ferritin Matters Too

Serum iron by itself doesn’t tell the whole story.

Ferritin reflects stored iron and is commonly used when evaluating iron status.

But even ferritin has context because it’s also an acute-phase reactant and can rise with inflammation.

Depending on the situation, clinicians may look at:

Serum iron.

Ferritin.

Transferrin.

TIBC.

Transferrin saturation.

Hemoglobin.

MCV.

And other markers.

Once again:

Pattern > single number.

Copper: The Mineral Hiding Behind Iron

Copper and iron metabolism are connected.

Your body needs copper-dependent proteins to properly mobilize and transport iron.

That means copper deficiency can actually contribute to hematological abnormalities—including anemia—even when simply throwing more iron at the situation doesn’t fix the underlying problem.

That’s fucking fascinating.

And it’s exactly why this series exists.

Someone sees anemia.

They think:

IRON.

But physiology says:

Maybe. Let’s figure out why first.

Magnesium: The One I Wouldn’t Leave Out

Magnesium participates in hundreds of enzymatic reactions.

It’s involved in:

Muscle contraction.

Nerve function.

Energy production.

Glucose metabolism.

Blood-pressure regulation.

Bone health.

And more.

It’s also another mineral where dietary intake can be inadequate in some people.

But again, supplementation depends on context.

Different magnesium forms have different absorption and GI effects.

And people with significant kidney impairment need to be particularly careful with supplemental magnesium because the kidneys are responsible for clearing excess magnesium.

Notice the pattern yet?

Know your body before throwing shit into it.

Calcium and Potassium: Food First Gets Really Important

Calcium isn’t just about bones.

It’s involved in muscle contraction, nerve signaling and numerous cellular processes.

Potassium is critical for membrane electrical activity, nerve transmission, muscle contraction and blood-pressure regulation.

But these are also perfect examples of nutrients where:

Food first makes a ton of sense.

Especially potassium.

Supplementing significant amounts of potassium isn’t something I’d casually recommend because abnormal potassium—high or low—can affect cardiac electrical activity.

If your potassium is abnormal on bloodwork?

That’s not:

“Order Potassium Xtreme from Amazon.”

That’s:

“Why is my potassium abnormal?”

Don’t Treat Bloodwork Like Whack-a-Mole

This is the lesson underneath all of this.

Imagine your labs show:

Low hemoglobin.

You take iron.

But the problem was B12.

Or copper.

Or blood loss.

Or kidney disease.

Or something else.

You didn’t fix anything.

You just hit one mole with a supplement hammer.

Same thing with cholesterol.

Same thing with glucose.

Same thing with liver markers.

Understand the problem before choosing the intervention.

This Is Why I Retest

This might be the most important part of my entire approach.

If I make a change because I’m trying to improve a measurable health marker:

I want to measure it again.

That’s exactly what happened with my lipids.

I wanted improvement.

Citrus bergamot became part of my approach.

Later bloodwork showed improvement.

Great.

That tells me considerably more than:

“Bergamot has 4.8 stars on Amazon.”

😂

If I’m trying to improve glucose control?

I want to see glucose and HbA1c.

If I’m correcting a vitamin D deficiency?

I want to see vitamin D.

If I’m addressing iron deficiency?

I want to see the appropriate iron markers and CBC.

The intervention isn’t the finish line.

The follow-up measurement is part of the intervention.

Don’t Supplement a Number Into the Ground

There’s another trap.

If some is good, more must be better.

No.

Your goal isn’t:

MAXIMUM ZINC.

Your goal is adequate zinc status.

Your goal isn’t:

IRON LEVEL: FUCKING MOON.

It’s normal iron physiology.

Same with vitamin D.

Same with selenium.

Same with copper.

Same with everything else.

Deficiency can cause problems.

Excess can cause problems too.

Health isn’t a competition to see who can generate the most expensive urine.

Food Still Comes First

I take supplements.

I like supplements.

Some have helped me.

But the foundation hasn’t changed from the nutrition article.

Protein.

Fish.

Meat.

Dairy.

Vegetables.

Fruit.

Potatoes.

Rice.

Whole foods.

A varied diet supplies a ridiculous number of nutrients simultaneously.

Then supplementation becomes more targeted.

Fill gaps. Address needs. Solve specific problems.

Not:

Replace vegetables with 27 capsules.

My Rule: Measure → Understand → Intervene → Measure Again

That’s really the entire article.

I don’t need everyone to use citrus bergamot because I use citrus bergamot.

I don’t need everyone taking NAC.

I don’t need everyone taking TUDCA.

I don’t need everyone swallowing berberine.

I don’t need everybody taking zinc, selenium, iron, copper, D3 and K2.

What I’m telling you is:

These things exist.

They have biological functions.

Some have useful clinical evidence.

I’ve personally used some of them as part of my own health strategy.

And in cases where I have objective markers available, I care about what happens to those markers.

Your physiology may respond differently.

Your genetics may be different.

Your diet may be different.

Your medications may be different.

Your health conditions may be different.

That’s why this isn’t:

THE EVIL DADDY UNIVERSAL SUPPLEMENT STACK™

It’s:

Here’s what I’ve learned managing my own health.

Don’t Become Your Own Doctor

Same rule as Part I.

Educating yourself is good.

Taking ownership is good.

Asking questions is good.

Understanding your bloodwork is good.

Ordering seventeen supplements because one laboratory result was two points outside the reference range?

Maybe slow the fuck down.

😂

Some abnormalities require medical investigation.

Some supplements interact with medications.

Some nutrients become toxic at excessive doses.

Some apparent deficiencies have underlying causes that matter considerably more than the deficiency itself.

So involve the appropriate professional when the situation calls for it.

The goal isn’t to replace medicine.

The goal is to stop being completely fucking clueless about your own body.

The Dashboard and the Toolbox

That’s how I think about these two articles together.

Part I was the dashboard.

What are RBCs?

What’s ApoB?

What’s A1c?

What’s cystatin C?

What are AST and ALT actually telling me?

Part II is the toolbox.

What does vitamin D do?

Why does iron matter?

Why can zinc affect copper?

What the fuck is NAC?

Why have I used bergamot?

Why is berberine interesting?

What’s TUDCA?

But owning a toolbox doesn’t mean you know what’s broken.

Diagnose the problem before grabbing the wrench.

And after you make the repair?

Turn the fucking car back on and check the dashboard.

Measure.

Understand.

Intervene.

Measure again.

That’s how I approach my health.

Not because I think I know more than every doctor.

Not because every supplement I use will work for everyone.

Because I have one body.

I plan on keeping the motherfucker for a while.

⭐⭐⭐⭐☆

Five stars require follow-up bloodwork.

Raw Sources:

https://ods.od.nih.gov/

https://pubmed.ncbi.nlm.nih.gov/36251526/

https://pubmed.ncbi.nlm.nih.gov/34956436/

https://pubmed.ncbi.nlm.nih.gov/37598753/

https://pubmed.ncbi.nlm.nih.gov/36941490/

https://pubmed.ncbi.nlm.nih.gov/24080471/

https://pubmed.ncbi.nlm.nih.gov/39430194/

https://pubmed.ncbi.nlm.nih.gov/31236688/

https://pubmed.ncbi.nlm.nih.gov/28249278/