Introduction
The modern food system solved starvation. We're not dying of scurvy or rickets anymore. Grocery stores are full, and we fortify everything from bread to orange juice. But somewhere in that victory, we stopped asking a different question: what's the difference between enough nutrients to survive and those needed to thrive?
The research on that gap is sobering.
I spent years looking at my own bloodwork and seeing "normal" results. Like most physicians I was ordering standard lab tests that didn't paint the whole picture. I'd wake up tired, hit that afternoon wall around 2 or 3 PM, and need willpower just to push through basic tasks. In the emergency medicine world of high stress most would drink coffee throughout the day. I had learned that any coffee beyond my usual morning cup or two would effect my sleep so I passed on the caffeine stimulation to get through the afternoon blahs. I told myself it was age. Part of being in my sixties (yep,that was a while ago). Something to accept.
Looking back, I wasn't accepting age. I was accepting a deficiency state that had become so common it was statistically normal.
The data tells a story that most of us aren't hearing. Analysis of national health surveys shows that 31% of Americans are at risk for at least one vitamin deficiency based on blood markers. When researchers look at dietary intake rather than blood levels, the numbers get worse. Over 90% of us fail to eat enough of essential macronutrients like protein and even some micronutrients like Vitamin D and Vitamin E. We're not starving. But our cells are running on half power and it's considered normal because everyone else is in the same boat.
What changed my thinking was discovering why some nutrients matter more than others. There is a gap between "preventing disease" and "supporting optimal function" that may be the most important health distinction that very few talk about.
The Engine and the Thermostat
Let’s break down what's actually happening at the cellular level and why it matters for how you feel.
Think of your body as a house with two critical systems working together. Your mitochondria are like the furnace in the basement—they take the fuel you give them and turn it into the heat that keeps everything running. Your thyroid gland is the thermostat on the wall, telling the furnace how hard to run based on what your body needs.
These two systems speak to each other constantly through a chemical “wiring” language, and that wiring is made of specific micronutrients. When you're short on those nutrients, the conversation breaks down. The thermostat can’t send a clear signal, so it lowers its output. The furnace can’t burn fuel efficiently, so it produces less heat. You end up cold, tired, and foggy—even though nothing looks “broken” on standard lab tests.
Because we’ve built our definition of health on the absence of disease, the basic biochemistry of optimal function often gets overlooked.
The Triage Decision Your Body Makes Without Asking
In 2006, a researcher named Bruce Ames proposed something called the Triage Theory that explains what happens when nutrients run low. His insight was simple but profound: when micronutrients become scarce (not absent, just insufficient), your body makes choices about how to use what's available.
It prioritizes short-term survival over long-term health. The heart keeps pumping. Basic metabolism continues. But the maintenance work gets delayed. DNA repair slows down. Antioxidant defenses weaken. Mitochondrial function declines just enough that you can survive, but not enough that you thrive.
You're in triage mode, and you don't even know it.
The scary part is that triage looks normal on bloodwork. You're not deficient enough to trigger disease markers. You're just deficient enough to feel like garbage while your doctor tells you everything's fine. There are more specific lab tests but they aren’t routine and most health insurance policies aren’t designed to keep you healthy but to discover and treat overt disease.
I've been there. I spent years in that zone, assuming fatigue was inevitable at my age. It wasn't inevitable. It was reversible.
The Raw Materials Your Cellular Machinery Actually Needs
Most nutrition advice focuses on macronutrients: how much protein, fat, and carbohydrate you eat. That matters. But that’s only a part of the story. Your cellular engines don't only run on macros. They require on specific micronutrients that act as cofactors in the chemical reactions that produce energy and regulate metabolism.
When researchers looked at what nutrients are most commonly insufficient in the American diet, a pattern emerged. We're not missing everything. We're missing a specific subset of nutrients that happen to be critical for mitochondrial and thyroid function.
The Spark Plugs: CoQ10, Copper, and Heme Iron
Inside your mitochondria, energy production happens through something called the electron transport chain. Think of it like a bucket brigade passing electrons down a line. Each handoff requires a specific molecule to catch and pass the electron to the next station.
CoQ10 is one of those electron carriers. Some enzymes require specific cofactors to function.One of these is copper. So is heme iron (the form of iron found in animal tissue, not the non-heme iron in plants or some supplements).
Without these molecules in sufficient amounts, the electron transport chain backs up. Electrons leak out where they shouldn't, creating oxidative stress. Energy production drops. You feel tired not because you're lazy or old, but because your cells literally cannot make ATP efficiently.
Here's where food choices matter more than most people realize. When researchers measure the nutrient density of different foods, organ meats (particularly heart and liver) contain 10 to 100 times more of these specific cofactors compared to muscle meat. A serving of beef liver has more bioavailable CoQ10 than you'd get from 20 steaks. It's not even close.
I'm not suggesting organ meats taste good or that you need to eat them. I'm suggesting the biochemistry explains why populations that consumed whole animals (nose to tail) didn't have the "normal" fatigue epidemic we see today.
The Fuel: Tyrosine, Iodine, and Selenium
Thyroid hormone is built from two ingredients: the amino acid tyrosine and the mineral iodine. The active form of thyroid hormone (T3) is made by removing one iodine atom from the storage form (T4), and that conversion requires enzymes made from selenium.
This is where modern food systems have quietly created a problem. For most of the 20th century, iodized salt was the primary source of iodine in the American diet. It worked. Goiter and severe iodine deficiency essentially disappeared.
Then two things happened. Public health campaigns told us to reduce sodium intake. People switched from iodized table salt to sea salt or pink Himalayan salt, which typically contains no iodine. Iodine intake dropped, but not enough to cause the acute thyroid disease that would show up on screening. Just enough to put people into that triage zone where thyroid function is sluggish but technically normal.
At the same time, our environment filled with chemicals that look like iodine to your body. Fluoride in water. Bromine in flame retardants and food additives. These are called halides, and they can compete with iodine for absorption in the thyroid gland. If your iodine intake is marginal and you're exposed to fluoride and bromine regularly, your thyroid may uptake these imposters instead of the iodine it actually needs.
The result is exactly what you'd expect from triage: your body conserves iodine for the most critical functions and lets everything else run slower. You're cold. You're tired. Your hair thins. Your doctor checks your TSH and says you're fine.
What I'm Actually Doing Now
Once I understood how much of metabolism depends on nutrient availability, I realized my habits needed to shift in a few practical ways.
Rethinking protein sources. I used to think protein was protein. Get enough grams per day and you're covered. But the amino acid profile matters for thyroid function (you need tyrosine), and the cofactor density matters for mitochondrial function. I'm eating more seafood now. The problem with seafood is that the higher in the food chain the fish is the more toxins like the heavy metals accumulate. If you think you solve that with “farm raised Salmon” you miss the heavy metals and substitute toxins from the chemical treatment of crops. The best solution is to eat the small fish like sardines which haven’t eaten the other fish that have accumulated the heavy metals. Fish are dense in both selenium and iodine. Twice a week minimum. They are also high in the essential fatty acids, especially DHA.
Using desiccated organ supplements. I'll be honest: I don't love the taste of liver. But I respect the nutrient density data. I'm taking freeze-dried organ capsules (heart and liver) three times a week. Each serving provides the CoQ10, heme iron, and copper that I wasn't getting from muscle meat alone. My energy hasn't dramatically transformed overnight, but the trend is upward. I'm tracking it.
Switching back to iodized salt. This was humbling. I spent years using sea salt thinking it was healthier. It probably has trace minerals that table salt lacks, but it doesn't have iodine unless specifically fortified. I switched back to iodized sea salt and I'm measuring my intake to make sure I'm getting roughly half a teaspoon daily. That's about 150 micrograms of iodine, which is the amount research suggests supports thyroid function without overdoing it.
Adding Brazil nuts for selenium. Two to three Brazil nuts daily provides all the selenium I need for thyroid hormone conversion. It's cheaper than supplements and the absorption is better because it comes packaged with other nutrients that support selenium utilization.
Filtering drinking water. I installed a filter that reduces fluoride and chlorine. The research on fluoride's impact on thyroid function is strongest in populations with low iodine intake. I figure if I'm going to support my thyroid, I might as well reduce the competition for iodine uptake. Reverse osmosis is the type of filter to buy.
Still taking a multivitamin, but differently. I'm not abandoning supplements entirely. A high-quality multivitamin covers the gaps for nutrients I might not get consistently from food, particularly Vitamin D (which 93% of us are short on according to dietary intake surveys and lab tests) as well as magnesium. But I'm treating supplements as backup, not foundation.
The goal isn't perfection. It's getting my cellular machinery out of triage mode and into maintenance mode.
The Bottom Line
We solved the problem of acute starvation. That's worth celebrating. But we created a new problem in the process: we optimized our food system for calories and shelf life, not for the specific micronutrients that keep cellular machinery running efficiently.
The more you eliminate processed foods the less seed oil and chemical exposure you’ll have.
The research is clear. Roughly one-third of Americans are at risk for at least one vitamin deficiency based on blood tests, and over 90% fall short on dietary intake of essential nutrients. Those aren't fringe numbers. That's the statistical norm.
But "normal" just means common. It doesn't mean optimal. It doesn't even mean functional.
You can change this though. It takes time because you're rebuilding nutrient stores that may have been depleted for years. But the direction matters more than the speed.
I'm 75 years old and still learning. Still tracking my results. Still adjusting based on what the research suggests and what my body tells me. That's what this journey looks like: not perfection, but steady progress based on understanding what your cells actually need.
There are now many companies offering large lab profiles that will give you a better understanding of your baseline. Discuss those choices with us.
Your body is doing the best it can with what you give it. Maybe it's time to give it more.