Thursday, March 5, 2015

Got Vitamin D..?

As Dr Comfort chatted up with her comrades at work, a colleague came forward and stated he had a Vitamin D deficiency and had to take Vitamin D supplements for it.  There was a moment were others came forward with their own Vitamin D deficiency diagnoses and others wanting to know more about it through their questions:  What causes a Vitamin D Deficiency?  Is it life threatening?  What are the symptoms? Etc.
As the Comfort’s conversation flow changed into a clinical discussion on Vitamin D deficiency, it also made her pause and think of her father’s own ordeal with having the signs and symptoms for a long while without a diagnosis to treat. 
A while back, Comfort’s Dad started to feel regularly tired with unexplained muscle aches.  Multiple physicians were seen and tests were done with no definite cause discovered.  Comfort, the brilliant breast oncology surgeon in the US could not decipher what to make of the work up being done for her father in India.  
On her trip to visit her parents in India, Comfort could visibly see her father struggle to enjoy his day to day activities because of the pain and fatigue.  Randomly one day, Comfort thought to get her Dad’s Vitamin D level drawn….JACKPOT.   Dad had a CRITICALLY LOW LEVEL OF VITAMIN D (8.8 ng/ml, whereas most recommendations are to have it above 20 ng/ml at least).  
Diagnosis. Found. 
Treatment. Started.
However, the question had to be asked: How did Comfort’s Dad have a Vitamin D deficiency? Isn’t it associated with NOT being in a sunny area?
He lives in one of the sunniest parts of India where the summer temperatures reach a high of 41 degrees Celsius (106 F) and winters can be as cold as 11 degrees Celsius (52 F)!  Technically, he should be swimming in all that sunshine right?
You can have all the sunshine in the world around you, but it will not make a difference if you              don’t actually participate in it. 
Comfort’s Dad lived in a sunny area, but he spent most of his time OUT OF the sunlight, i.e. indoors, shaded areas, cars, office, etc. 
Ergo…the potential for a Vitamin D deficiency.
According to the National Institute of Health, the following group are at risk for a Vitamin D deficiency?
1. Groups who are given prolonged, exclusive nutrients via breast milk without recommended supplementation
2. Older adults
3. People with LIMITED sun exposure
4. People with dark skin 
5. People with Inflammatory Bowel Disease and other diseases causing fat malabsorption
As a follow up to Comfort’s workplace chat and reminiscing about her father’s condition, Dr Comfort and Dr Style both had their Vitamin D levels checked.  
Guess what?  Style’s level was LOW.  
Guess what else?  Style had been complaining about feeling tired all the time, dragging at work and having a low energy level.   
Turns out it was not just work stress- which we all have plenty of by the way.  
It was a true nutritional deficiency that improved symptoms upon restoration. 
Please note: we are not endorsing everyone needs to take Vitamin D supplements. 
The Federal Government’s 2010 Dietary Guidelines for Americans stated, “Nutrients should come from food.  Foods in nutrient-dense, mostly intact forms contain not only the essential vitamins and minerals that are often contained in nutrient supplements, but also dietary fiber and other naturally occurring substances that have positive health effects…Dietary supplements…may be advantageous in specific situations to increase intake of a specific vitamin or mineral.”
We ARE saying that you should have a Primary Care Provider who you trust and inform them of what is going on with you so they can help decide if a Vitamin D lab level is warranted and can recommend treatment if needed.  Chronic fatigue and muscle aches are serious concerns and we should not chalk them as consequences of our busy lives, limited sleep, work schedules, etc.   It’s worth a discussion with your doctor.  
Remember, everyone is prone to a Vitamin D deficiency: from the people of Midwest America and their brief glimpses of sunlight to the family members in West Central India where the sun does not miss a beat!
So pay attention to your bodies and get things checked out promptly!  
-Comfort and Style

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