Vitamin D deficiency is common

DEAR DR. DONOHUE: My doctor told me that my vitamin D level is low, and put me on high-dose replacement for eight weeks. The count was slightly lower after I took the treatment. She has me on the same high dose for another eight weeks. What causes vitamin D deficiency? Can a tumor drain you of this vitamin? My mother was losing her bone density, and one doctor found that she had a brain tumor. After it was removed, she recovered, but she had to take vitamin D for a long time. — J.S.

ANSWER: Sunlight produces a change in a skin precursor substance that transforms this substance into vitamin D. The liver and kidney both work on skin-made vitamin D to change it a bit more so that its activity reaches a peak. For most, a deficiency of this vitamin comes from getting too little sunshine. Furthermore, older people’s skin loses some of its power to produce the vitamin. Vitamin D is found in few foods, so that makes it difficult to get sufficient amounts of it from the diet. In winter, people living in the northern third of the U.S. and all of Canada produce close to zero vitamin D. These factors are responsible for most of its widespread deficiency. I know of no tumor that drains vitamin D. I believe your mother’s deficiency was simply a matter of two different conditions existing at the same time. If this second go-around with high vitamin D doses doesn’t restore your level, the doctor has to look for diseases of the digestive tract, kidney or liver that might be responsible for your deficiency. Not only does vitamin D enhance the absorption of calcium to keep bones strong, it is believed to lower the risk for many cancers and for heart attacks and diabetes. It also boosts the immune system — a busy vitamin, is D. The recommended daily intake of vitamin D is about to be increased to 1,000-1,200 IU. Vitamin D is a fat-soluble vitamin. That means it needs some fatty food for optimal absorption, so it’s quite acceptable to take the vitamin at mealtime. Foods with a supply of it include sardines (3 ounces, 650 IU), herring (3 ounces, 575 IU), mackerel (3 ounces, 300 IU) and fortified milk (1 cup, 100 IU), and a cup of fortified orange juice has the same as milk.

DEAR DR. DONOHUE: Some of my friends used Coumadin and some use aspirin for blood thinners. What is the difference between them? What are their side effects? — L.P.

ANSWER: Blood thinners don’t really thin blood; they make it less able to clot. Coumadin is a powerful anticoagulant, and it’s prescribed for those at high risk of forming clots. People with the heart-rhythm disturbance atrial fibrillation are usually put on Coumadin because their hearts are prone to developing clots. Blood tests have to be done regularly to make sure patients are getting enough but not too much. It works by stopping liver production of clotting factors, proteins necessary for clot formation. Bleeding is its most serious complication. Aspirin has a multitude of uses — pain relief, fever reduction and inflammation control. It also dampens clot formation by keeping blood platelets from sticking together. Platelets are the smallest blood cells, and are necessary for clot formation. Stomach irritation, ulcers and bleeding are among aspirin’s side effects. Aspirin is frequently used to prevent heart attacks and strokes.

DEAR DR. DONOHUE: I see black specks in my visual field. They move all around when I move my eyes. I was told they are floaters. What can I do about them? Will they go away? — J.Y.

ANSWER: Floaters are bits of debris, worn-out proteins or old red blood cells that are floating in the viscid fluid, the vitreous that fills the back two-thirds of the eye. They cast a shadow on the retina when the eyes move, and they look like black specks. They’re annoying. There is no treatment. People learn to ignore them. I have had them since the eighth grade. Sudden showers of floaters indicate the retina is detaching from its mooring, and it requires immediate attention from an eye doctor.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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