Vitamin D may play major role in disease risks

[Guest guest]

Vitamin D may play major role in disease risks

Dr. Harvey D. Cohen has been in private practice in Rancho Cucamonga since 1979. He is board certified in both internal medicine and geriatric medicine. He answers questions about Vitamin D in this week's Focus on 5.

Question: My doctor told me I have Vitamin D deficiency. How will that affect me? Answer: Vitamin D deficiency can cause Osteomalacia in adults and rickets in children. Osteomalacia is the softening of the bones due to defective bone mineralization. Osteomalacia in children is known as rickets. There may be signs of diffuse bone pain, muscle weakness and fragility of the bones. There may also be bowing of the legs, fractures and low-blood calcium. Muscle weakness can be so severe that going up a flight of stairs or getting up from a squatting position can be difficult. Osteomalacia is not the same as osteoporosis, another bone disorder that can also lead to bone fractures. Osteoporosis develops from weakness of previously constructed bone; whereas Osteomalacia results from a defect in bone building. In older patients, vitamin D deficiency can cause weakness of the muscle and increase the chances of falling. Vitamin D also plays a major role in the development of hypertension, some cancers, hyperparathyroid and autoimmune disorders. Q: Who is at risk for vitamin D deficiency? A: Older people, exclusively breast-fed infants, obese individuals, those with limited exposure to the sun or spend most time indoors (nursing home), people who use excessive sunscreen or keep the body covered with thick garments are at risk for vitamin D deficiency. Heavy consumption of alcohol, utilization of steroids or ulcer medications, and those who take nonstatin cholesterol lowering medications called bile acid sequestering agents, are also at risk. People with dark skin often develop Vitamin D deficiency as well.

Q: How do I get vitamin D or how much vitamin D supplement should I take? A: Our skin contains a precursor of active Vitamin D. The ultraviolet rays from the sun cause a chemical reaction, which converts the Vitamin D precursor in our skin to another precursor and from there it goes to the liver and kidney to become active Vitamin D. Natural sources of vitamin D are found in fish oils (cod liver oil); fatty fish species such as salmon, herring, catfish, and tuna; beef, liver and milk. The current recommended daily dose of Vitamin D supplement is 200 I.U. a day for adults 19-50 years old. For those 51-70 years old, 400 I.U. daily. And, for those over the age of 70, the dose is 600 I.U. daily. Experts now agree these doses are probably too low. Soon there will be updated recommendations, especially for those people who do not get sufficient exposure to the sun. Q: Does vitamin D deficiency play a role in heart disease, high blood pressure or diabetes? A: There is increased evidence suggesting that Vitamin D might have an important role in modifying risks for heart disease, diabetes and hypertension. A lower vitamin D concentration may be associated with a higher risk of high blood pressure and cardiovascular disease. Epidemiological studies have found an association between vitamin D deficiency and higher rates of cardiovascular disease and death. However, other studies are needed before we can draw this conclusion. The role of vitamin D remains very promising although still unproven. Therefore, while you want to make sure your current levels of vitamin D are adequate, the evidence for widespread use of higher than currently recommended dose supplements in the general population remains in question. Q: Is there a role of vitamin D in infection, multiple sclerosis? A: This is exactly what is being studied at this time. So far, it appears that vitamin D does play a role in the immune system and when vitamin D is decreased there may be an increased risk of influenza and tuberculosis. There is also a suggestion that vitamin D deficiency may be significant in the onset of multiple sclerosis. Some studies suggest pregnant women take vitamin D during pregnancy, especially during the winter months, because this may lessen the likelihood of your baby developing multiple sclerosis later in life. Vitamin D may induce the death of cancer cells. There are scientific studies suggesting an association between vitamin D intake and colon, breast and ovarian cancer. In a 2006 study that utilized data of 4 million cancer patients from 13 countries, a marked difference in cancer risk between countries that were classified as a sunny environment compared to a nonsunny environment was demonstrated, however, the jury is still out. Contact your own physician for updates regarding vitamin D deficiency.

http://www.sgvtribune.com/living/ci_14839460