Getting your advice on nutrition for optimum health from your doctor’s emergence rooms is not a good idea
I present this argument using an example of Vitamin B 12. Most cases of Vitamin B12 deficiency manifestations sneak in very slowly, characteristic of chronic illnesses and are also more prevalent in the much older adults. Some of the clinical manifestations include:
Interventions to prevent such chronic conditions is best approached through a regular and continuous intake of optimum levels of vitamin B12 from food or nutritional supplements.
Here is where the issues of unhelpful advice from your healthcare providers at the emergence rooms. The Food and Nutrition Board (FNB) of the US Institute of Medicine in 1998 revised the RDA of vitamin B12 in adults 51 years and above to 2.4 microgram/day. We also know that the current Dietary Reference Intake (DRI) is 6 microgram/day. However, because vitamin B12 malabsorption and vitamin B12 deficiency are more common in older adults, the Linus Pauling Institute recommends that adults older than 50 years take 100 to 400 μg/day of supplemental vitamin B12.
There is a huge difference between B12 intakes as recognized by the two institutions, and we have to ask: What clinical significance would emerge from this huge difference? It has to be effectiveness. Common sense tells us that if higher intake levels do not lead to toxicity, then we would expect much more effectiveness from the higher than the lower intake levels, especially were issues of availability, absorption, etc., of the nutrients in question are of concern. It is known that a Tolerable Upper Intake Level (UL) is the maximum daily dose unlikely to cause adverse side effects in the general population. Current knowledge indicates that there is no upper limit which has been set for vitamin B12, as there is no established toxic level.
In any case, the point to be clarified on the intake levels is whether the RDAs (2.4 microgram/day) would have an impact on prevention of health problems associated with vitamin B12 deficiency. From my independent research on vitamin B12 and prevention of associated health problems, the RDA levels of vitamin B12 which might be recommended by your health care provider at the emergency rooms, by far does not appear to have any impact on prevention of vitamin B12 deficiency associated diseases. The vitamin B12 RDAs need to be increased by 100x or more to have meaningful impact on prevention of the Vit. B12 associated health problems.
The problem with getting your nutritional advice for better health from from the emergency rooms is not really about knowledge deficiencies of the health professionals, but rather the deficiencies from the biomedical model (not ideal for handling complex nutrition-associated health problems), which guides their medical or other healthcare related practices.
Linus Pauling Institute, Micronutrient Information Centre (2019). Vitamin B12. Available at: https://lpi.oregonstate.edu/mic/vitamins/vitamin-B12