Wednesday, October 26, 2011

The "D" Dilemma

I received a call from the clinic yesterday afternoon.  My lab results say I am a little low in vitamin D.   They put in a pharmacy request for a supplement.   No worries.  I am to take the supplements and be tested again in a few weeks to see if it helps my "D" levels.  

Right now, I have several questions:
1)  Why am I low?
2)  How much do I really need? 
3)  Can’t I correct the problem by adapting my diet?

I think it’s time to research. 
According to a report in the Archives of Internal Medicine, experts believe that "up to 77 percent of Americans are vitamin D deficient (defined as having blood levels of less than 30 nanograms per milliliter).” 
Note:  -          In this past Saturday’s lab work, my blood levels were at 25 nanograms.  According to the nurse that called, its not critical, but reason to put me on the additional vitamin and retest me at a later date.  According to my research, 20 to 30 is fine, but 30 is desirable.  No worries.  Just how much am I getting?  Let’s see…every morning, I take a multivitamin which gives me 400 (iu) of vitamin D in addition to the 100 iu of vitamin D in my daily calcium chews.  Most references I have found say I should be getting around 600 iu a day.  That would make me just below what is needed.  But, do I need more with all the exercising I do?  Perhaps.  I am burning more calories, using more of what vitamins and nutrients I take in.  Come to think of it, it makes perfect sense that I would be somewhat low.  I do not drink milk and I only have soy milk in my occasional bowl of fiber cereal (which also has Vitamin D).  In case you are wondering, it turns out my soy milk has a higher percentage of vitamin D than the other lowfat or skim milk in our fridge. 
And wait, it’s October.  I’m not out in the sun much.  The sun provides us with vitamin D.  Mmmm...
“Sweetie, Mama needs a vacation.   I’ll pack my bikini.  No really…it’s medicinal.”  Yeah, I'm sure that'll work.  I do eat Salmon, but not every day.  Sometimes I have a veggie omelet (eggs) but, it is rare.  
I’ll pick up the supplement this morning, and we’ll see what happens. While I'm over there, I'll walk three laps at the mall (three laps equals six miles).  
But in addition, I’ll see if I can increase my vitamin D just by my adapting my eating habits.  Maybe its not a dilemma after all.  I can do both.  I can read the food labels, look for better ways to increase my Vitamin D and take the supplements.  

Food Source
Vitamin D (IU)
Cod liver oil+, 1 tablespoon
1,360
Salmon, 3.5 oz cooked
360
Mackerel, 3.5 oz cooked
345
Sardines, 1.75 oz canned in oil
250
Tuna fish, 3 oz canned in oil
200
Milk, 1 cup (fortified*)
100
Orange juice, 1 cup (fortified)
100
Soymilk, 1 cup (fortified)
100
Yogurt, 6 oz (fortified)
60-80
Pudding, 1/2 cup (made with fortified milk)
50
Egg, 1 whole (vitamin D found in yolk)
41
Ready-to-eat cereal, 3/4 cup to 1 cup (fortified)
40
Margarine, 1 teaspoon (fortified)
20
Beef liver, 3.5 oz cooked
15
Swiss cheese, 1 oz
12


http://www.webmd.com/diet/vitamin-d-deficiency
http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1357
http://www.powerbar.com/articles/169/vitamins-and-minerals-do-athletes-need-more.aspx

Update:  
We've just returned from walking the mall (6 miles).  I had the chance to check out the new Vitamin D I was prescribed.  I was given a prescription for 50,000 iu.  Yes, I question that amount.  It seems excessive.  I called and left a message for the Nurse Practitioner.  She was very nice when I first saw her, but I am not about to take anything I don't trust and that includes excessive vitamins.  At 50,000 iu, I could actually overdose on Vitamin D.  I plan to get my own supplement (a much smaller dose) and adapt my diet to include more vitamin D rich foods.  I will try to get out more, and get more natural sunshine.  She can still redo the blood test in four weeks, but on my terms.  Never blindly follow.  Mistakes are made everyday.

http://dramaticmedicine.com/2010/08/31/do-you-need-50000-iu-of-vitamin-d/



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