Tuesday, July 14, 2009

Another look at Vitamin D

One thing I've been doing lately is checking Vitamin D levels. I am amazed at how Vitamin D deficiency is non-gender specific. I am seeing low Vitamin D levels in both men and women, with some men having lower Vitamin D levels than women.

What most of my patients will say when I check their labs and tell them their Vitamin D levels are low is that they really aren't in the sun that much. Well, think about it. We doctor's tell you to stay out of the sun or you'll get skin cancer; now we're turning around and telling everyone they have low Vitamin D levels and to get back in the sun! Arrghhh. Did we physicians mess up again?

All kidding aside, I had a Eureka! moment a few weeks ago where I leaped (or is it lept) up from my bed at about 2 am with some interesting thoughts. My first thought was why was I awake at this hour and my next thought was where was my 17 month old Lab named Princess. When I glanced to my right I saw her tail wagging and the remnants of my cell phone charger, luckily not plugged in as the phone was charged. She looked so proud of her accomplishment! "Hey, at least she didn't eat my phone this time," I thought.

My final thought was a look into why I may be seeing so many low Vitamin D levels. First off, Vitamin D is a hormone and it is made from cholesterol. That's right, cholesterol. Also, we need fat to absorb it properly as it is a fat-soluble vitamin. Could the reason why we are seeing so many people deficient in Vitamin D be because we have turned into a fat and cholesterol phobic nation. I think that is a good thought. I also think it is because we are not in the sun all that much anymore.

The current reccomendations (is it 1 c and 2 m's or the other way around) are if your Vitamin D level is below 32 is to take 2000 units a day and to re-check the level in 2-3 months. Some Endocrinologists are giving 50,000 units a week for those with very low levels and of course are rechecking levels in a few months.

Checking levels is important as Vitamin D,as a fat soluble vitamin, can increase to toxic levels if one takes too much. Same is true for Vitamin A. As an interesting side note, never,ever, eat polar bear liver. The amount of Vitamin A is so high it will probably kill you. Of course, if you got that close to a polar bear, it would probably be eating your liver. Polar bears are one of the few animals which actually hunt humans as prey. But then again, if you are about to eat its liver, it probably isn't much of a threat.

Back to Vitamin D. Remember it was a hormone and it is a hormone important in calcium regulation. In fact, calcium cannot be absorbed from the intestine or kidney without Vitamin D's presence. Since calcium is very important to bone health, and since our bones produce what are known as the formed elements of the blood (white and red blood cells and platelets); Vitamin D is a very important thing to have enough of.

One last note; why were so many people wearing orange shirts today?

Dr Jim

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